2015-01-13T16:00:55-06:00 2014-05-31 410746749 CLIFTONLARSONALLEN LLP 370 INTERLOCKEN BLVD SUITE 500 BROOMFIELD CO 80021 990 2013-06-01 840742145 MOUNTAIN FAMILY HEALTH CENTERS MOUN 9709452840 1905 BLAKE AVE NO 101 GLENWOOD SPRINGS CO 81601 ROSS BROOKS CHIEF EXECUTIVE OFFICER 9709452840 2015-01-13 1 V E SHOUP CPA P00220967 3034668822 2013 2016-02-25 16:41:14Z ROSS BROOKS 1905 BLAKE AVE NO 101 GLENWOOD SPRINGS CO 81601 9609692 0 X WWW.MOUNTAINFAMILY.ORG X 1977 CO TO PROVIDE HIGH QUALITY PRIMARY HEALTH, DENTAL, AND BEHAVIORAL HEALTH CARE IN THE COMMUNITIES WE SERVE, WITH SPECIAL CONSIDERATION FOR THE MEDICALLY UNDER-SERVED AND UNINSURED. 13 13 127 20 0 0 3344012 4227236 4495459 5347192 1136 -16302 66150 33860 7906757 9591986 0 0 0 0 5505768 6421297 0 0 0 2821833 2847824 8327601 9269121 -420844 322865 4804228 5281021 612466 766514 4191762 4514507 X TO PROVIDE HIGH QUALITY, INTEGRATED PRIMARY, BEHAVIORAL AND DENTAL HEALTH CARE IN THE COMMUNITIES WE SERVE, WITH SPECIAL CONSIDERATION FOR THE MEDICALLY UNDER-SERVED AND UNINSURED REGARDLESS OF ABILITY TO PAY. 1 0 7000948 5381052 PRIMARY CARE SERVICES - FIVE CLINICS PROVIDE OUTPATIENT MEDICAL TREATMENT FOR THE GENERAL PUBLIC, INCLUDING LOW-COST AND DONATED SERVICES FOR LOW INCOME AND INDIGENT PERSONS. THE CLINICS ARE PARTIALLY FUNDED BY AN OPERATING GRANT FROM THE US DEPT OF HEALTH AND HUMAN SERVICES. FOR THE FISCAL YEAR, 14,476 PATIENTS SERVED WITH 44,666 BILLABLE ENCOUNTERS. 7000948 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 47 0 1 127 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CO X X X ANNETTE FRANTA 9709452840 1905 BLAKE AVE NO 101 GLENWOOD SPRINGS CO 81601 JOANN SORENSEN CHAIR 2.00 X X 0 0 0 JEROME EVANS DIRECTOR 2.00 X 0 0 0 THOMAS BOAS TREASURER 2.00 X X 0 0 0 JOHN W BARBEE DIRECTOR 2.00 X 0 0 0 LIZ STARK SECRETARY 2.00 X X 0 0 0 KEN FRIEDMAN DIRECTOR 2.00 X 0 0 0 TOM LAMBRECHT DIRECTOR 2.00 X 0 0 0 SANDRO TORRES DIRECTOR 2.00 X 0 0 0 RACHEL OYS VICE CHAIR 2.00 X X 0 0 0 ROB STEIN DIRECTOR 2.00 X 0 0 0 MONICA PEREZ RHODES DIRECTOR 2.00 X 0 0 0 AMY E LEE DIRECTOR 2.00 X 0 0 0 KARYN RENAE ANDERSON DIRECTOR 2.00 X 0 0 0 ROSS BROOKS CEO 40.00 X 119846 0 14300 ANNETTE FRANTA CFO 40.00 X 90995 0 8126 CHRIS TONOZZI IT DIRECTOR 40.00 X 178305 0 10890 AMY BROWN PHYSICIAN 40.00 X 127195 0 9605 KEN DAVIS MEDICAL DIRECTOR OF INTEGRATED CARE 40.00 X 125294 0 9571 GARRY MILLARD DENTAL DIRECTOR 40.00 X 125812 0 13848 SANDRA PLYBON MD 40.00 X 137499 0 10502 904946 0 76842 6 0 1 0 HENRY SCHIEN DEPT CH 10241 PALATINE IL 60055 MEDICAL SUPPLIES 330080 ITENTIVE CORPORATION PO BOX 661391 CHICAGO IL 60666 SOFTWARE HOUSING 198487 QUALITY SYSTEMS INC 18111 VON KARMAN AVE SUITE 600 IRVINE CA 92612 HIT SOFTWARE AND SUPPORT 133409 ONYX HEALTHCARE INC DRAWER 1725 PO BOX 5935 TROY MI 48007 LOCUM PHYSICIANS 121878 4 2800622 1426614 293762 4227236 PATIENT FEES 621400 4792958 4792958 CONTRACT REVENUE 621400 542091 542091 PHARMACY REVENUE 621400 12143 12143 5347192 1404 1404 17706 -17706 -17706 -17706 MISCELLANEOUS INCOME 621400 33860 33860 33860 9591986 5381052 0 -16302 X 233267 233267 5030022 3975901 1054121 28274 22373 5901 760999 607506 153493 368735 288448 80287 1353 1353 22895 22895 339676 269182 70494 87470 82143 5327 205020 126171 78849 98025 26273 71752 268689 185044 83645 14607 14607 MEDICAL SUPPLIES 729380 719699 9681 PURCHASED SERVICES 548995 326958 222037 REPAIRS AND MAINTENANCE 240714 204377 36337 TELEPHONE 122199 71262 50937 168801 95611 73190 9269121 7000948 2268173 0 1050 1050 824061 827376 187603 733211 1011917 902462 20133 108839 3909773 1224421 2736899 2685352 22565 18470 4261 4804228 5281021 553200 729430 59249 28439 17 8645 612466 766514 X 4048055 3914313 143707 600194 4191762 4514507 4804228 5281021 322865 -120 0 X X 0 1 X 1 1 1 X 4108891 3966035 3259682 3344012 4227236 18905856 4108891 3966035 3259682 3344012 4227236 18905856 18905856 16426 47706 5057 1136 1404 71729 18977585 20508728 0.99620 0.98870 X SCHEDULE A, PART II, LINE 10 THE AMOUNTS REPORTED IN PRIOR YEARS AS OTHER INCOME ON LINE 10 WERE ACTUALLY GENERATED FROM EXEMPT ACTIVITIES AND HAVE BEEN MOVED TO LINE 12 IN ACCORDANCE WITH THE SCHEDULE A INSTRUCTIONS. THERE HAS BEEN NO SIGNIFICANT IMPACT ON THE SUPPORT PERCENTAGE AS A RESULT OF THIS RECLASSIFICATION. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2508861 309093 2199768 82815 61470 21345 1039146 706133 333013 278951 147725 131226 2685352 DEFERRED RENT 8645 8645 X 9898907 -120 307041 306921 9591986 0 9591986 9576162 307041 307041 9269121 0 9269121 PART X, LINE 2: THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX PROVISIONS. THE IMPLEMENTATION OF THE ACCOUNTING STANDARDS REGARDING UNCERTAIN TAX PROVISIONS HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS OR AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED FUSINESS INCOME OR EXCISE OR OTHER TAXES. X X X 0 0 0 1 0 0 0 0 0 CHRIS TONOZZI IT DIRECTOR 178305 0 0 0 0 0 640 0 10250 0 189195 0 0 0 PART I, LINE 5 THERE IS A PRODUCTIVITY INCENTIVE THAT IS OFFERED TO EMPLOYEES THAT MEET CERTAIN PRODUCTIVITY THRESHOLDS. X 2 293762 INVOICE VALUATION STMT 0 0 0 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTORS IS LISTED. FORM 990, PART III, LINE 2 ADDITION OF THE EDWARDS CLINIC SITE ON FEBRUARY 27, 2014. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS A SERVICE CONTRACT WITH THE VAIL VALLEY MEDICAL CENTER (VVMC) THAT, UNDER THEIR CONTRACT, IS GIVEN THE POWER TO APPOINT ONE MEMBER TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE BOD WILL BE GIVEN A COPY WITH A SUMMARY STATEMENT BY MANAGEMENT FOR REVIEW AND APPROVAL BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED MONTHLY WITH THE BOARD OF DIRECTORS AND INDIVIDUALLY WITH EACH NEW MEMBER AS THEY COME ON BOARD. ANNUALLY THE ORGANIZATION FORMALLY SURVEYS ALL BOD MEMBERS ON CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 SALARY SURVEY INFORMATION FROM MOUNTAIN STATES EMPLOYERS COUNCIL AND NACHC/CCHN IS USED TO DETERMINE COMPENSATION OF TOP MANAGEMENT OFFICIALS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 18 UPON REQUEST, VIA STATE OF COLORADO WEBSITE AS WELL AS ON THE MFHC WEBSITE. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 24E DUES AND SUBSCRIPTION: PROGRAM SERVICE EXPENSES 8,547. MANAGEMENT AND GENERAL EXPENSES 58,571. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 67,118. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 31,017. MANAGEMENT AND GENERAL EXPENSES 11,665. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,682. POSTAGE, SHIPPING & DELIVERY: PROGRAM SERVICE EXPENSES 29,200. MANAGEMENT AND GENERAL EXPENSES 2,954. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,154. TAXES AND LICENSES: PROGRAM SERVICE EXPENSES 26,847. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,847. FORM 990, PART XII, LINE 2C THE OVERSIGHT PROCESS OR SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.