2018-11-05T16:14:11-06:00 2017-12-31 381357951 PLANTE & MORAN PLLC 8181 E TUFTS AVENUE SUITE 600 DENVER CO 802372579 990 2017-01-01 840765729 ROCKY MOUNTAIN HEALTH CARE SERVICES ROCK 7194668777 310 SOUTH 14TH STREET COLORADO SPRINGS CO 80904 NATHAN OLSON CEO 7194668777 2018-11-03 1 DORI J EGGETT P00645252 3037409400 2018-11-05 208.42.238.142 2018-11-05 16:11:21 MS P CD71869BFC494223FABD92E93AB0669CE7B22062 CD71869BFC494223FABD92E93AB0669CE7B22062 2017 2019-02-21 02:37:17Z NATHAN OLSON 310 SOUTH 14TH STREET COLORADO SPRINGS CO 80904 47879500 0 X WWW.RMHCARE.ORG X 1978 CO SEE SCHEDULE OIMPROVING LIVES, OPTIMIZING WELLNESS, AND PROMOTING INDEPENDENCE FOR ELDERLY AND ADULTS WITH BRAIN INJURIES. 13 13 416 14 165697 143247 153969 27576 38188871 47267551 -194333 22612 281597 330690 38430104 47648429 0 0 0 0 12368286 15985498 3000 0 49377 22107775 27476902 34479061 43462400 3951043 4186029 26126901 31791982 12885177 14364229 13241724 17427753 IMPROVING LIVES, OPTIMIZING WELLNESS, AND PROMOTING INDEPENDENCE FOR ELDERLY AND ADULTS WITH BRAIN INJURIES. 0 0 36158570 42817974 THE PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY (PACE) IS A MANAGED CARE PROGRAM THAT COMBINES REIMBURSMENT FROM MEDICARE AND MEDICAID ON A PER MEMBER PER MONTH BASIS. THE PACE PROGRAM IS RESPONSIBLE FOR EVERY LEVEL OF THE FRAIL ELDERLY PARTICIPANTS' CARE FROM IN-HOME CARE TO HOSPITALIZATION. PACE ELIMINATES FRAGMENTATION AND ACCESS CONFUSION AND GREATLY IMPROVES QUALITY OF CARE PROVIDED TO THIS POPULATION. ALL TREATMENT IS PROVIDED BY AN INTERDISCIPLINARY TEAM CONSISTING OF MEDICAL, SOCIAL, SPIRITUAL, AND TRANSPORTATION STAFF. IN 2017, THE PACE PROGRAM PROVIDED 5,940 MEMBER MONTHS OF SERVICE TO 546 INDIVIDUAL PARTICIPANTS. 5058585 3841226 THE ROCKY MOUNTAIN BRAINCARE PROGRAM OFFERS FOUR RESIDENTIAL FACILITIES, A STRUCTURED DAY TREATMENT PROGRAM, INDIVIDUAL AND GROUP COUNSELING, AND INDIVIDUAL LIVING SKILLS TRAINING AT HOME AND IN THE COMMUNITY FOR INDIVIDUALS WHO HAVE INCURRED A BRAIN INJURY. THESE PROGRAMS PROVIDE AN ADAPTIVE ENVIRONMENT IN WHICH CLIENTS RELEARN SKILLS OF DAILY LIVING, SOCIAL INTERACTION, AND COGNITIVE FUNCTIONING LOST DUE TO BRAIN INJURIES. RMHCS IS THE ONLY RESIDENTIAL TREATMENT FACILITY FOR BRAIN INJURED INDIVIDUALS IN EL PASO COUNTY AND THE ONLY POST-HOSPITALIZATION FACILITY FOR THE BRAIN INJURED IN COLORADO. TREATMENT PLANS ARE INDIVIDUALIZED TO SPECIFIC CLIENT CARE NEEDS. ONE HUNDRED TWELVE CLIENTS WERE SERVED BY THIS PROGRAM IN 2017. 608351 SUPPORTIVE SERVICES PROVIDED FOR RMOLTC AND VARIOUS OTHER PROGRAM SUPPORTIVE SERVICES. 41217155 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 234 0 1 416 1 1 1 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X MARCIA MITCHELL 7194668777 310 S 14TH STREET COLORADO SPRINGS CO 80904 BILL LEVIS BOARD CHAIR 2.00 X X 0 0 0 CAROLYN PACE BOARD MEMBER AT LARGE 1.00 X 0 0 0 DAN O'REAR BOARD TREASURER 2.00 X X 0 0 0 DANNIS SCHANEL BOARD MEMBER AT LARGE (PART YEAR) 1.00 X 0 0 0 DAVE KAST BOARD MEMBER AT LARGE (PART YEAR) 1.00 X 0 0 0 ED SMITH BOARD VICE-CHAIR 2.00 X X 0 0 0 JOHN BEAVERS BOARD MEMBER AT LARGE 1.00 X 0 0 0 MCDENNIS THOMAS BOARD MEMBER AT LARGE (PART YEAR) 1.00 X 0 0 0 MELISSA KERR BOARD MEMBER AT LARGE 2.00 1.00 X 0 0 0 RALPH ZIMMERMAN BOARD MEMBER AT LARGE (PART YEAR) 1.00 X 0 0 0 ROBIN THORNE BOARD SECRETARY 2.00 1.00 X X 0 0 0 SCOTT BOND BOARD MEMBER AT LARGE 1.00 X 0 0 0 SHAWN THOMPSON BOARD MEMBER AT LARGE (PART YEAR) 1.00 X 0 0 0 SHIRLEY STEWART BOARD MEMBER AT LARGE 1.00 X 0 0 0 THOMAS REITER PRESIDENT & CEO (PART YEAR) 38.00 2.00 X 138786 0 21273 LOUIE LARIMER PRESIDENT & CEO (PART YEAR) 38.00 2.00 X 85153 0 0 NATHAN OLSON PRESIDENT & CEO (PART YEAR) 40.00 X 18319 0 0 DAVID RICHMAN CHIEF MEDICAL OFFICER 40.00 X 212167 0 32191 TAMRIN APAYDIN CHIEF FINANCIAL OFFICER 38.00 2.00 X 138034 0 27546 WANDA JONES VP OPERATIONS 40.00 X 97076 0 21714 JUSTIN LEWIS VP ORGANIZATIONAL DEVELOPMENT 40.00 X 110890 0 25140 KIM GINTER VP HR 40.00 X 82627 0 3120 MARCIA MITCHELL VP ACCOUNTING 40.00 X 97112 0 14115 SCOT SICKBERT PACE PHYSICIAN 40.00 X 220561 0 29729 MARK WESSELMAN PACE PHYSICIAN 40.00 X 203966 0 22237 VALERIE ANDERS PACE EXECUTIVE DIRECTOR 40.00 X 116194 0 15417 REBECCA JOHNSON PACE PHYSICAL THERAPIST 40.00 X 103682 0 4732 ARLETTE KENNEDY PACE PHYSICAL THERAPIST 40.00 X 102860 0 1226 1727427 0 218440 9 0 1 0 KMTSJ INC (PHARMASTAR LLC) PO BOX 3217 EAU CLAIRE WI 54702 PHARMACY MGMT/PRESCRIPTIONS 5910845 PENROSE ST FRANCIS PO BOX 910506 DENVER CO 802910506 INPATIENT/OUTPATIENT/ER 2215446 MEMORIAL HEALTH SYSTEM 1400 E BOULDER STREET COLORADO SPRINGS CO 809095533 INPATIENT/OUTPATIENT/ER 2149187 SUNNY VISTA LIVING CENTER 2445 E CACHE LA POUDRE STREET COLORADO SPRINGS CO 80909 SKILLED NURSING FACILITY 1049086 PREMIER MEDICAL CORPORATION 5055 48TH AVENUE DENVER CO 80216 OXYGEN SERVICES 588720 46 576 16859 10141 27576 HEALTH CARE SERVICES 623990 46750291 46750291 RMOLTC 561110 517260 517260 47267551 22612 22612 376019 173807 202212 202212 149653 52559 55350 16859 36206 19144 19144 15190 21058 -5868 -5868 CATERING 722320 16044 16044 99158 99158 115202 47648429 47267551 165697 187605 1125264 766432 358832 12372144 11580958 760431 30755 274295 253859 19963 473 1211341 1129522 78890 2929 1002454 936013 64111 2330 45038 31296 13742 41702 41702 487255 383452 101444 2359 263394 258369 4822 203 101076 65501 35164 411 620881 528357 88771 3753 761074 682555 75553 2966 120701 109311 11390 61704 44022 17682 177552 112412 65140 725439 459615 265824 320364 263813 56551 CLIENT HEALTH CARE SERV 21938467 21938467 VEHICLE AND EQUIPMENT 628546 572718 55828 GROCERIES 332124 327309 4815 STAFF DEVELOPMENT 219570 182952 35135 1483 632015 590222 40078 1715 43462400 41217155 2195868 49377 7781636 10637202 40923 41230 2966219 5809923 389780 351106 19061286 4108765 14925677 14952521 22666 0 26126901 31791982 2669503 4209890 31473 46805 7069088 6755426 3115113 3352108 12885177 14364229 X 13241724 17427753 13241724 17427753 26126901 31791982 4186029 0 X 0 1 X 1 0 X 275315 75747 195825 153969 27576 728432 17181815 21331889 26951019 38188871 47267551 150921145 17457130 21407636 27146844 38342840 47295127 151649577 0 0 0 151649577 172578 320978 326897 341525 398631 1560609 28516 28516 172578 320978 326897 370041 398631 1589125 20777 57693 56089 19832 13276 167667 3753 2066 120081 99158 225058 17650485 21790060 27531896 38852794 47806192 153631427 0.98710 0.98560 0.01030 0.01200 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2013 AMOUNT: $ 0. 2014 AMOUNT: $ 3,753. 2015 AMOUNT: $ 2,066. 2016 AMOUNT: $ 120,081. 2017 AMOUNT: $ 99,158. 8989 8989 43400454 43409443 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 5000 5000 10244 8989 29233 250000 250000 250000 250000 1000000 1500000 616463 616463 16091933 2527291 13564642 1719788 1059829 659959 633102 521645 111457 14952521 PACE MEDICAL LIABILITIES 3352108 3352108 X 47893512 14012 231071 245083 47648429 0 47648429 43707483 14012 231071 245083 43462400 0 43462400 PART X, LINE 2: THE ORGANIZATION APPLIES A MORE-LIKELY-THAN-NOT MEASUREMENT METHODOLOGY TO REFLECT THE FINANCIAL STATEMENT IMPACT OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. AFTER EVALUATING THE TAX POSITIONS TAKEN, NONE ARE CONSIDERED TO BE UNCERTAIN; THEREFORE, NO AMOUNTS HAVE BEEN RECOGNIZED AS OF DECEMBER 31, 2017 AND 2016. IF INCURRED, INTEREST AND PENALTIES ASSOCIATED WITH TAX POSITIONS ARE RECORDED IN THE PERIOD ASSESSED AS GENERAL AND ADMINISTRATIVE EXPENSES. NO INTEREST OR PENALTIES HAVE BEEN ASSESSED AS OF DECEMBER 31, 2017 AND 2016. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 173,807. COST OF GOODS SOLD 21,058. FUNDRAISING EVENT EXPENSE 36,206. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 173,807. FUNDRAISING EVENT EXPENSE 36,206. CAFE CART EXPENSES 21,058. CHEF SHOWCASE 72209 16859 55350 3300 472 13186 7468 600 11180 72209 16859 55350 3300 472 13186 7468 600 11180 36206 19144 X X X X 1 0 0 0 0 0 0 0 0 THOMAS REITER PRESIDENT & CEO (PART YEAR) 133786 0 5000 0 0 0 5948 0 15325 0 160059 0 0 0 DAVID RICHMAN CHIEF MEDICAL OFFICER 211777 0 390 0 0 0 8367 0 23824 0 244358 0 0 0 TAMRIN APAYDIN CHIEF FINANCIAL OFFICER 137736 0 298 0 0 0 6007 0 21539 0 165580 0 0 0 SCOT SICKBERT PACE PHYSICIAN 217712 0 2849 0 0 0 9216 0 20513 0 250290 0 0 0 MARK WESSELMAN PACE PHYSICIAN 203966 0 0 0 0 0 6690 0 15547 0 226203 0 0 0 PART I, LINE 4A IN 2017 THOMAS REITER RECEIVED A SEVERANCE PAYMENT OF $41,250 AND JUSTIN LEWIS RECEIVED A SEVERANCE PAYMENT OF $11,628. FORM 990, PART VI, SECTION A, LINE 1 THERE IS AN EXECUTIVE COMMITTEE MADE UP OF THE BOARD CHAIR, VICE CHAIR, TREASURER, AND SECRETARY. EACH OF THESE MEMBERS SERVE ON THE GOVERNING BODY OF THE ORGANIZATION AS WELL. THE EXECUTIVE COMMITTEE HAS THE POWER TO ACT ON BEHALF OF THE BOARD OF DIRECTORS ON ROUTINE MATTERS THAT ARISE BETWEEN REGULAR BOARD MEETINGS AND IN URGENT SITUATIONS THAT CANNOT WAIT FOR THE NEXT FULL BOARD MEETINGS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT CPA FIRM, REVIEWED IN DETAIL BY THE BOARD AUDIT AND FINANCE COMMITTEE, AND THEN EMAILED TO THE FULL BOARD FOR REVIEW AND COMMENTS BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES COMPLETE A STATEMENT REGARDING CONFLICTS OF INTEREST ANNUALLY. THESE STATEMENTS ARE REVIEWED BY THE APPROPRIATE SUPERVISOR OR BOARD PRESIDENT. ANY POTENTIAL CONFLICTS OF INTEREST ARE RESOLVED USING PROCESSES DOCUMENTED IN THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS THE CEO ANNUALLY AND SETS COMPENSATION UTILIZING THE ORGANIZATION'S COMPENSATION PLAN ESTABLISHED USING CURRENT MARKET COMPENSATION SURVEY DATA. THE COMPENSATION AMOUNT AND APPROVAL ARE DOCUMENTED IN THE BOARD MINUTES. THE CEO SETS THE OTHER MANAGEMENT SALARIES ALSO UTILIZING THE ORGANIZATION'S COMPENSATION PLAN AND CURRENT COMPENSATION SURVEY DATA. AN OUTSIDE CONSULTANT WAS HIRED TO CREATE THE COMPENSATION PLAN BASED ON NATIONAL MARKET SURVEY DATA. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST PLICY, AND FINANCIAL STATEMENTS ARE ALL AVAILABLE UPON REQUEST. ROCKY MOUNTAIN BRAIN INJURY SERVICES LLC 310 S 14TH STREET COLORADO SPRINGS CO 80904 263739252 NONE CO 0 0 ROCKY MOUNTAIN HEALTH CARE SERVICES HEALTHRIDE LLC 310 S 14TH STREET COLORADO SPRINGS CO 80904 465153888 PROVIDES TRANSPORTATION SERVICES TO RMHCS CLIENTS & PATIENTS CO 0 112106 ROCKY MOUNTAIN HEALTH CARE SERVICES ROCKY MOUNTAIN OPTIONS FOR LONG TERM CARE 310 S 14TH STREET COLORADO SPRINGS CO 80904 743037370 MEDICAID SEP CASE MANAGEMENT CO 501(C)(3) LINE 12B, II N/A 0 ROCKY MOUNTAIN PACE LLC 310 S 14TH STREET COLORADO SPRINGS CO 80904 263526736 NONE CO 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 ROCKY MOUNTAIN OPTIONS FOR LONG TERM CARE Q 517260 CASH