2016-02-08T16:09:42-06:00 2015-06-30 840571140 rfarmer llc p o box 1173 lamar CO 81052 990 2014-07-01 271388543 Southeast Health Group SOUT 7193835420 711 Barnes Avenue La Junta CO 81050 Teri Erickson President 7193835420 2016-01-15 1 P00436535 7193367428 2016-01-15 X 2014 2016-04-25 22:37:26Z Teri Erickson 711 Barnes Avenue La Junta CO 81050 8378848 0 X southeasthealthgroup.org X 2009 CO To provide administrative and supportive services to related organizations so the group may better service those in need. 5 5 109 0 0 0 0 0 5321512 6340224 1192 498 1448626 2038126 6771330 8378848 0 0 0 0 5258341 5854686 0 0 0 43855 84315 5302196 5939001 1469134 2439847 6654090 9002899 625203 534165 6028887 8468734 To provide administrative and supportive services to related organizations so the group may better service those in need. 0 0 5939001 8378848 Provided administrative and supportive services to Southeast Mental Health Services, Southeast Wellness Works LLC , Partnership for Progress, and Family Guidance Institute. 5939001 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 109 1 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Southeast Health Group 7193835420 711 Barnes Avenue La Junta CO 81050 Teri Erickson President 2.00 X 0 2100 0 Dennis Pearson Secretary 1.00 X 0 2095 0 Rob Keenan Treasurer 1.00 X 0 2100 0 Trevor La Cost Vice President 1.00 X 0 1350 0 Becky N Otteman CEO 50.00 X 149010 0 0 George Barry Shioshita CFO 45.00 X 132019 0 0 Joseph Carrica III COO/Program Manager 45.00 X 156905 0 0 Kali Mae Mendoza-Werner Health Care Provider 32.00 X 115774 0 0 Jacqueline M Brown Program Manager 40.00 X 101461 0 0 Dawn Romero Business Manager 40.00 X 62535 0 0 717704 7645 0 5 0 1 0 Anthem P O Box 541029 Los Angeles CA 900541029 Health Insurance Provider 630032 1 Employee leasing 561000 5100290 5100290 Administration fee 624100 1038840 1038840 Fee for services 621300 201094 201094 6340224 498 498 Gain from affiliates 900099 2038126 2038126 2038126 8378848 8378848 0 0 4786313 4786313 63287 63287 668233 668233 336853 336853 530 530 35098 35098 1255 1255 511 511 41172 41172 5428 5428 Other 321 321 5939001 5939001 0 0 757002 1062751 36291 40259 8048 9014 5852749 7890875 6654090 9002899 350203 284165 275000 250000 625203 534165 X 6028887 8468734 6028887 8468734 6654090 9002899 2439847 0 X 0 0 0 X 225000 27250 252250 5025330 4999572 5754232 5321513 6139130 27239777 5025330 5224572 5781482 5321513 6139130 27492027 0 0 0 27492027 38555 13367 4431 1192 337 57882 38555 13367 4431 1192 337 57882 300208 370236 4605 1448626 2038126 4161801 5364093 5608175 5790518 6771331 8177593 31711710 0.86690 0.91540 0.00180 0.00230 X 0 Investments in affiliates/subsidiaries 7890875 C 7890875 8378848 0 8378848 0 8378848 5939001 0 5939001 0 5939001 Form 990, Page 12, Part XII, line 2b There were not any FIN 48 disclosures. X X X X 0 0 0 0 0 0 0 0 0 Joseph Carrica III COO/Program Manager 156905 0 0 0 0 0 0 0 0 0 156905 0 0 0 Kali Mae Mendoza-Werner Health Care Provider 115774 0 0 0 0 0 0 0 0 0 115774 0 0 0 Dawn Romero Business Manager 62535 0 0 0 0 0 0 0 0 0 62535 0 0 0 Form 990, Part VI, Section B, line 11 A draft copy of form 990 was provided to the business manager for her review. Form 990, Part VI, Section B, line 12c Annually the board members are required to review the conflict of interest policy and all new board members are required to review and acknowledge the conflict of interest policy. Form 990, Part VI, Section B, line 15 The organization is active in the mental health associations within the state and does compare and/or discuss compensation of the CEO and other key employees with other like kind organizations. Form 990, Part VI, Section C, line 19 Requested documents are made available to the public upon request as long as HIPAA laws and regulations will not be violated. Southeast Mental Health Services 711 Barnes Avenue La Junta CO 81050 840519607 SEMHS pays for administrative and support services CO 501(c)(3) Line 7 0 Family Guidance Institute 711 Barnes Avenue La Junta CO 81050 741288315 Family Guidance leases real estate and personal property CO 501(c)(3) Line 9 0 Partnership for Progress 711 Barnes Avenue La Junta CO 81050 571238587 PFP pays for administrative and support services CO 501(c)(3) Line 9 0 Southeast Wellness Works LLC 711 Barnes Avenue La Junta CO 81050 271388813 the corporation provides administrative and supportive services CO Southeast Health Group health care 0 1 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 Southeast Mental Health Services O 4552855 Fair value of services Family Guidance Institute O 83958 Fair value of services Partnership for Progress O 402168 Fair value of services Southeast Wellness Works O 61309 Fair value of services