2017-04-11T13:54:21-05:00 2016-11-30 410746749 CLIFTONLARSONALLEN LLP 20 E THOMAS RD STE 2300 PHOENIX AZ 85012 990 2015-12-01 860498020 MOUNTAIN PARK HEALTH CENTER MOUN 6023233344 2702 NORTH THIRD STREET SUITE 4020 PHOENIX AZ 850044608 CHRIS HEWETT CFO 6023233344 2017-03-30 1 CHRISTINE M ABELL P00279655 6022662248 2015 2021-01-29 14:40:06Z JOHN SWAGERT MD 2702 NORTH THIRD STREET SUITE 4020 PHOENIX AZ 850044608 81848969 0 X WWW.MOUNTAINPARKHEALTH.ORG X 1984 AZ PROVIDE AFFORDABLE PRIMARY CARE TO THE NEEDY AND UNINSURED IN THE GREATER PHOENIX AREA. 18 18 809 21 0 0 17033386 17577421 47977123 59887651 11284 67825 2198737 1764382 67220530 79297279 0 0 0 0 37588935 44764289 4200 0 2143 22761053 26737802 60354188 71502091 6866342 7795188 58504540 77773908 21536719 32960176 36967821 44813732 X MOUNTAIN PARK SUSTAINS AND IMPROVES HEALTH BY PROVIDING AFFORDABLE PRIMARY CARE TO THE NEEDY AND UNINSURED IN THE GREATER PHOENIX AREA. OUR COMMITMENT TO THE COMMUNITY IS TO KEEP HEALTHCARE AFFORDABLE AND ACCESSIBLE. 0 0 57169397 0 59887651 MOUNTAIN PARK HEALTH CENTER PROVIDES ENCOUNTERS TO THE UNINSURED PATIENTS IN CARRYING OUT ITS TAX-EXEMPT PURPOSE AS A PRIMARY CARE FACILITY. IN 1984, MOUNTAIN PARK HEALTH CENTER BEGAN SERVING THE COMMUNITY WITH ONE DOCTOR AND ONE CLINIC LOCATION. TODAY, OUR COMMUNITY HEALTH CENTER HAS EIGHT CLINICS IN DIVERSE NEIGHBORHOODS ACROSS THE VALLEY, INCLUDING PRIMARY MEDICAL, DENTAL, PHARMACEUTICAL, AND INTEGRATED HEALTH CARE. THE CENTER PROVIDED 334,160 MEDICAL, DENTAL, AND INTEGRATED HEALTH VISITS TO 80,400 PATIENTS DURING THE FISCAL YEAR.MOUNTAIN PARK HEALTH CENTER PROVIDES ENCOUNTERS TO THE UNINSURED PATIENTS IN CARRYING OUT ITS TAX-EXEMPT PURPOSE AS A PRIMARY CARE FACILITY. IN 1984, MOUNTAIN PARK HEALTH CENTER BEGAN SERVING THE COMMUNITY WITH ONE DOCTOR AND ONE CLINIC LOCATION. TODAY, OUR COMMUNITY HEALTH CENTER HAS EIGHT CLINICS IN DIVERSE NEIGHBORHOODS ACROSS THE VALLEY, INCLUDING PRIMARY MEDICAL, DENTAL, PHARMACEUTICAL, AND INTEGRATED HEALTH CARE. THE CENTER PROVIDED 334,160 MEDICAL, DENTAL, AND INTEGRATED HEALTH VISITS TO 80,400 PATIENTS DURING THE FISCAL YEAR. 57169397 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 67 0 809 1 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 AZ X ALDO APRILE 6023233477 2702 NORTH THIRD STREET SUITE 4020 PHOENIX AZ 85004 RICHARD SIEVER VICE CHAIR & CHAIR 2.00 0.00 X X 0 0 0 LINDA HUFF REDMAN CHAIR & IMMEDIATE PAST CHAIR 2.00 0.00 X X 0 0 0 KRISTIN GUBSER DIRECTOR & VICE CHAIR 2.00 0.00 X X 0 0 0 JARRET SHARP EDD TREASURER 2.00 0.00 X X 0 0 0 MOHAMED AHMAD DIRECTOR 2.00 0.00 X 0 0 0 KEVIN CAMBERG DIRECTOR 2.00 0.00 X 0 0 0 ANIELKA CONTRERAS DIRECTOR 2.00 0.00 X 0 0 0 SCOTT GORMAN MD IMMEDIATE PAST CHAIR & DIRECTOR 2.00 0.00 X 0 0 0 ROGER GRANCORVITZ DIRECTOR 2.00 0.00 X 0 0 0 ZEENAT HASAN DIRECTOR 2.00 0.00 X 0 0 0 REV ARNOLD JACKSON DIRECTOR 2.00 0.00 X 0 0 0 RITA KHALAF DIRECTOR 2.00 0.00 X 0 0 0 LINDA KNUTSON DIRECTOR 2.00 0.00 X 0 0 0 MARTIN PEREZ DIRECTOR 2.00 0.00 X 0 0 0 SIMAN QAASIM DIRECTOR 2.00 0.00 X 0 0 0 LORI ROBINSON DIRECTOR 2.00 0.00 X 0 0 0 KALEIGH SCHWALBE DIRECTOR 2.00 0.00 X 0 0 0 MARKI STEWART DIRECTOR 2.00 0.00 X 0 0 0 MANNY TARANGO DIRECTOR 2.00 0.00 X 0 0 0 DARREN VINER DIRECTOR 2.00 0.00 X 0 0 0 JORDAN YOUNG DIRECTOR 2.00 0.00 X 0 0 0 JOHN SWAGERT MD CEO 39.90 0.10 X 398471 0 23895 CHRIS HEWETT CFO 40.00 0.00 X 149704 0 11770 RACHEL LAMBERT COO 40.00 0.00 X 173790 0 20224 DAVINDER SINGH MEDICAL DIRECTOR 40.00 0.00 X 306082 0 25441 NEIL TRACHTENBERG PHYSICIAN 40.00 0.00 X 269431 0 371 MOHAMMAD AHMAD PHYSICIAN 40.00 0.00 X 262728 0 18652 GEORGE DAVIDSON PHYSICIAN 40.00 0.00 X 258171 0 24490 JOHN HARPENAU PHYSICIAN 40.00 0.00 X 222041 0 19385 DONALD CARTER PHYSICIAN 40.00 0.00 X 211077 0 12188 2251495 0 156416 65 0 1 0 CONCORD GENERAL CONTRACTORS 4215 E MCDOWELL RD STE 201 MESA AZ 85215 CONSTRUCTION SERVICES 3118971 COSMOPOLITAN MEDICAL COMMUNICATIONS 5665 W BEVERLY LN GLENDALE AZ 85306 ANSWERING SERVICE 2944882 SONORA QUEST LABS PO BOX 29661 DEPT 2059 PHOENIX AZ 85038 MEDICAL SERVICES 972578 ECLINICAL WORKS PO BOX 847950 BOSTON MA 022847950 PATIENT ACCOUNTING 821926 DOCTORS RESOURCE SPECIALIST LLC 2525 W BERYL AVE PHOENIX AZ 85021 PATIENT BILLING 735460 18 49150 16325552 1202719 3564312 17577421 NET PATIENT REVENUE 621400 57533330 57533330 PHARMACY REVENUE 621400 2354321 2354321 59887651 65565 65565 235219 0 235219 235219 235219 2515497 2512876 361 2621 -361 2260 2260 0 49150 38453 -38453 -38453 OTHER INCOME 621400 989616 989616 MEANINGFUL USE REVENUE 621400 578000 578000 1567616 79297279 59887651 0 1832207 X 1071618 857294 212181 2143 36539296 31226447 5312849 330210 277970 52240 4185259 3550753 634506 2637906 2252657 385249 93296 8006 85290 34600 34600 13538 13538 8591022 4786199 3804823 608689 308083 300606 1094844 454778 640066 635655 20146 615509 3719850 3197109 522741 172156 88990 83166 119775 54878 64897 747765 747765 1942112 1634919 307193 155926 2258 153668 MEDICAL SUPPLIES 7765699 7765699 MISCELLANEOUS EXPENSES 1042875 683211 359664 71502091 57169397 14330551 2143 13898210 17711274 398585 408722 4734956 6553860 6885706 12513024 14432 6240 39358 51086 336986 653079 47978196 11292595 29164261 36685601 3000000 3091053 32046 99969 58504540 77773908 4130720 6243770 548105 618095 11640131 11146151 15339 15339 5041600 14880750 160824 56071 21536719 32960176 X 36967821 44813732 36967821 44813732 58504540 77773908 7795188 50723 0 X 0 1 X 1 1 1 X 15498136 14346205 14166057 17033386 17577421 78621205 15498136 14346205 14166057 17033386 17577421 78621205 78621205 216 104 16998 223056 300784 541158 258928 523222 672783 1987388 1567616 5009937 84172300 210937212 0.93410 0.95350 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME DEBT FORGIVENESS MEANINGFUL USE REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 5904531 5904531 23951713 6393603 17558110 8554986 1984152 6570834 5669773 2914840 2754933 3897193 3897193 36685601 REFUNDABLE ADVANCES 56071 56071 X 79436218 113663 38814 152477 79283741 13538 13538 79297279 71640669 113663 38453 152116 71488553 13538 13538 71502091 PART IV, LINE 2B: THE ORGANIZATION HOLDS SECURITY DEPOSITS FOR TENANTS WHO LEASE SPACE IN A BUILDING. THE FUNDS ARE HELD IN A BANK ACCOUNT UNTIL RETURNED TO THE TENANT. FUNDS WILL BE REFUNDED TO TENANTS UPON TERMINATION OF THE LEASE. PART X, LINE 2: THE HEALTH CENTER FOLLOWS GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. THE HEALTH CENTER'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OF EQUIPMENT 361. SPECIAL FUNDRAISING EVENT EXPENSES 38,453. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL FUNDRAISING EVENT EXPENSES 38,453. 5K 40650 40650 1750 25717 40650 40650 1750 25717 27467 -27467 X X X 0 0 0 0 0 0 0 0 0 JOHN SWAGERT MD CEO 398471 0 0 0 0 0 6205 0 17690 0 422366 0 0 0 CHRIS HEWETT CFO 149704 0 0 0 0 0 0 0 11770 0 161474 0 0 0 RACHEL LAMBERT COO 173790 0 0 0 0 0 5281 0 14943 0 194014 0 0 0 DAVINDER SINGH MEDICAL DIRECTOR 306082 0 0 0 0 0 7751 0 17690 0 331523 0 0 0 NEIL TRACHTENBERG PHYSICIAN 269431 0 0 0 0 0 0 0 371 0 269802 0 0 0 MOHAMMAD AHMAD PHYSICIAN 262728 0 0 0 0 0 7210 0 11442 0 281380 0 0 0 GEORGE DAVIDSON PHYSICIAN 258171 0 0 0 0 0 7957 0 16533 0 282661 0 0 0 JOHN HARPENAU PHYSICIAN 222041 0 0 0 0 0 6929 0 12456 0 241426 0 0 0 DONALD CARTER PHYSICIAN 211077 0 0 0 0 0 6456 0 5732 0 223265 0 0 0 A ARIZONA HEALTH FACLITIES AUTHORITY 860453292 2014-02-27 12225000 SEE PART VI 0 0 0 A 12225000 235913 7000000 4989087 2015 0 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 PART I, COLUMN F DESCRIPTION OF PURPOSE: TO FINANCE THE CONSTRUCTION, IMPROVEMENT AND EQUIPPING OF HEALTH CARE FACILITIES FOR USE BY THE BORROWER; TO REFINANCE CERTAIN OF THE BORROWER'S OUTSTANDING OBLIGATIONS FOR THE ACQUISITION AND CONSTRUCTION OF PRIOR HEALTH CARE FACILITIES AND OPERATING EXPENSES; AND TO PAY THE COSTS OF ISSUANCE OF THE SERIES 2014 BONDS. X 173 3551793 FAIR VALUE X MISCELLANEOUS 5 12519 FAIR VALUE 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE CONSISTS OF THE BOARD OFFICERS AND THE IMMEDIATE PAST CHAIR IF STILL ON THE BOARD. THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE THE POWERS OF THE BOARD BETWEEN MEETINGS OF THE BOARD, BUT SHALL NOT POSSESS ANY AUTHORITY OF THE BOARD PROHIBITED BY LAW. IN ADDITION, THE EXECUTIVE COMMITTEE MAY NOT (A) FIX THE COMPENSATION OF, OR FILL ANY VACANCY ON, THE BOARD OF DIRECTORS OR ANY OF ITS COMMITTEES, (B) ADOPT AMENDMENTS TO THE ARTICLES OF INCORPORATION OR TO THE BYLAWS, (C) AUTHORIZE DISTRIBUTIONS, OR (D) APPROVE A MERGER OF THE ORGANIZATION OR SALE OF SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE AND AUDIT COMMITTEES REVIEWED AND APPROVED THE FORM 990, THEN THE BOARD OF DIRECTORS APPROVED THE FORM 990 BEFORE IT WAS SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ANNUALLY REVIEW AND SIGN A CONFLICT OF INTEREST STATEMENT. POTENTIAL CONFLICTS ARE BROUGHT TO THE FULL BOARD FOR A DETERMINATION OF WHETHER A CONFLICT EXISTS. EMPLOYEES ARE REQUIRED TO ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT TO DISCLOSE POTENTIAL CONFLICTS. IF THE SITUATION IS UNCLEAR, THE CEO DETERMINES WHETHER A CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15 SALARIES ARE DETERMINED BY A COMBINATION OF PERFORMANCE EFFECTIVENESS REVIEWS AND SALARY SURVEY DATA FOR COMPARABLE JOBS COMPILED BY AN INDEPENDENT FIRM. THE SALARIES OF THE CEO AND OTHER OFFICERS ARE SET AND REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS AND COMPARED TO SURVEY DATA FOR COMPARABLE JOBS. THE LAST COMPENSATION REVIEW OCCURRED IN 2016. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 4,786,199. MANAGEMENT AND GENERAL EXPENSES 3,804,823. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,591,022. MOUNTAIN PARK HEALTH CENTER TEMPE BUILDING LLC 2702 NORTH THIRD STREET 4020 PHOENIX AZ 85004 813099857 HOLD PROPERTY AZ 0 14099562 MOUNTAIN PARK HEALTH CENTER MOUNTAIN PARK HEALTH CENTER FOUNDATION 2702 NORTH 3RD STREET SUITE 4020 PHOENIX AZ 85004 205241918 SUPPORT MOUNTAIN PARK HEALTH CENTER AZ 501(C)(3) LINE 7 MOUNTAIN PARK HEALTH CENTER 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0