2015-01-23T13:27:52-06:00 2014-04-30 430831507 ANDERS MINKLER HUBER & HELM LLP 800 MARKET STREET SUITE 500 ST LOUIS MO 631012501 990 2013-05-01 431752799 OZARK TRI-COUNTY HEALTH CARE CONSORTIUM DBA ACCESS FAMILY CARE OZAR 4174519450 PO BOX 758 NEOSHO MO 64850 SHEILA LONG CFO 4174519450 2015-01-21 1 BRIAN MCCOOK P00435856 3146555500 2013 2016-02-25 16:41:14Z ACCESS FAMILY CARE SHEILA LONG 475 NELSON AVENUE NEOSHO MO 64850 14120748 0 X WWW.ACCESSFAMILYCARE.ORG X 1996 MO WE ARE COMMITTED TO IMPROVING THE HEALTH OF THE MEDICALLY UNDERSERVED OF GREATER SOUTHWEST MISSOURI THROUGH DIRECT SERVICES AND COLLABORATIVE EFFORTS. 9 9 189 9 0 0 2797644 3190437 10241306 10917600 -75981 770 7326 11243 12970295 14120050 0 0 0 0 9410098 9237592 0 0 0 3910775 4235727 13320873 13473319 -350578 646731 9961665 10476375 1955388 1823367 8006277 8653008 WE ARE COMMITTED TO IMPROVING THE HEALTH OF THE MEDICALLY UNDERSERVED OF GREATER SOUTHWEST MISSOURI THROUGH DIRECT SERVICES AND COLLABORATIVE EFFORTS. 0 0 4956305 6505881 IN FY 2014, MEDICAL ENCOUNTERS TOTALED 33,525. 4956304 4422962 THE ORGANIZATION PROVIDES A WIDE VARIETY OF SERVICES TO THE PATIENT POPULATION IN ALL AREAS OF GENERAL DENTISTRY. IN FY 2014, DENTAL ENCOUNTERS TOTALED 21,908. 9912609 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 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 0 0 0 0 1 16 0 1 189 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X SHEILA LONG CFO 4174510619 475 NELSON AVENUE NEOSHO MO 64850 JERRIE WISE TREASURER 1.00 X X 0 0 0 MARY ANN BRADLEY VICE PRESIDENT 1.00 X X 0 0 0 ALICE SNOOK BOARD MEMBER 1.00 X 0 0 0 DR AL CHAPMAN PRESIDENT 1.00 X X 0 0 0 PEDRO PANTOJA BOARD MEMBER 1.00 X 0 0 0 PEGGY CARPENTER SECRETARY 1.00 X X 0 0 0 ELIZABETH PERSONS BOARD MEMBER 1.00 X 0 0 0 HEATHER MARTIN BOARD MEMBER 1.00 X 0 0 0 KELLY TICHENOR BROWN BOARD MEMBER 1.00 X 0 0 0 SHEILA LONG CHIEF FINANCIAL OFFICER 40.00 X 97585 0 13862 DEBRA DAVIDSON CHIEF OPERATING OFFICER 40.00 X 104104 0 5831 DON MCBRIDE CHIEF EXECUTIVE OFFICER 40.00 X 198027 0 17207 DR GERALD ENGLUND PHYSICIAN 40.00 X 219903 0 18302 DR LELAND MCCALL DENTIST 40.00 X 177678 0 16679 DR VICTOR MANGLER PHYSICIAN 40.00 X 148551 0 10962 DR CHARLES BENTLAGE MEDICAL/DENTAL DIRECTOR 40.00 X 178674 0 11906 DR JERRY JUMPER PHYSICIAN 40.00 X 162986 0 11636 1287508 0 106385 19 0 1 0 QUEST DIAGNOSTICS PO BOX 14730 SAINT LOUIS MO 631504730 LABORATORY SERVICES 150901 1 3049498 140939 1500 3190437 PATIENT SERVICE 624100 10734850 10734850 EHR INCENTIVE PROGRAMS 624100 182750 182750 10917600 1468 1468 698 -698 -698 -698 MISCELLANEOUS INCOME 900099 11243 11243 11243 14120050 10928843 0 770 436616 307372 129244 7216255 5112793 2103462 210069 150375 59694 815558 508856 306702 559094 391231 167863 2784 2784 52767 52767 527814 337082 190732 66071 23061 43010 214362 112155 102207 110203 61951 48252 410307 342328 67979 84161 33239 50922 79086 47299 31787 537839 454452 83387 136723 121083 15640 SUPPLIES 761504 761504 BAD DEBT EXPENSE 727746 727746 REPAIRS AND MAINTENANCE 437545 386425 51120 DUES AND SUBSCRIPTIONS 43731 13882 29849 43084 19775 23309 13473319 9912609 3560710 0 566113 1156968 1116315 1140788 174856 261276 845251 937833 84937 18401 300151 289903 9126832 3544190 5802142 5582642 49474 72524 1022426 1016040 9961665 10476375 1855081 1684015 100307 139352 1955388 1823367 X 7988137 8651904 18140 1104 8006277 8653008 9961665 10476375 646731 0 X X 0 1 X 1 1 1 X 3261104 2996732 4537689 2797644 3190437 16783606 5178463 6345300 7247560 10241306 10917600 39930229 8439567 9342032 11785249 13038950 14108037 56713835 0 0 0 56713835 4745 2644 2545 2327 1468 13729 4745 2644 2545 2327 1468 13729 7326 11243 18569 8444312 9344676 11787794 13048603 14120748 56746133 0.99940 0.99930 0.00020 0.00060 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 453935 453935 6086934 1762908 4324026 2585963 1781282 804681 5582642 DUE FROM MEDICARE/MEDICAID 727701 CONSTRUCTION IN PROGRESS 288339 1016040 X 13392304 0 13392304 727746 727746 14120050 12745573 0 12745573 727746 727746 13473319 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE"), EXCEPT ON NET INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES AS DEFINED IN THE CODE. ACCORDINGLY, THE ORGANIZATION FILES AS A TAX EXEMPT ORGANIZATION. THE ORGANIZATION FOLLOWS GUIDANCE ISSUED BY THE FASB ON ACCOUNTING FOR INCOME TAXES AND HAS EVALUATED ITS TAX POSITIONS, EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS, AND BELIEVES THAT NO PROVISION FOR INCOME TAXES IS NECESSARY TO COVER ANY UNCERTAIN TAX POSITIONS. THE ORGANIZATION'S RETURNS FOR TAX YEARS 2010 AND LATER REMAIN SUBJECT TO EXAMINATION BY TAXING AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 727,746. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 727,746. X X 0 0 0 0 0 1 0 0 0 DON MCBRIDE CHIEF EXECUTIVE OFFICER 194785 0 3242 0 0 0 6074 0 11133 0 215234 0 0 0 DR GERALD ENGLUND PHYSICIAN 187395 0 32508 0 0 0 5221 0 13081 0 238205 0 0 0 DR LELAND MCCALL DENTIST 177678 0 0 0 0 0 5468 0 11211 0 194357 0 0 0 DR VICTOR MANGLER PHYSICIAN 148551 0 0 0 0 0 4456 0 6506 0 159513 0 0 0 DR CHARLES BENTLAGE MEDICAL/DENTAL DIRECTOR 176081 0 2593 0 0 0 5368 0 6538 0 190580 0 0 0 DR JERRY JUMPER PHYSICIAN 154412 0 8574 0 0 0 4896 0 6740 0 174622 0 0 0 PART I, LINE 6 CONTINGENT COMPENSATION SCHEDULE D, PART 1, QUESTION 6A THE ORGANIZATION HAS AN INCENTIVE COMPENSATION PLAN. INCENTIVE COMPENSATION IS BASED ON THE PRODUCTIVITY OF THE MEDICAL AND DENTAL PROVIDERS EVERY 6 MONTHS. ALL EMPLOYEES RECEIVE A PORTION OF THE INCENTIVE COMPENSATION PAYMENT FROM THE DIVISION AND CLINIC THAT THEY WORK IN AND ADMINISTRATION SHARES IN ALL CLINICS INCENTIVE COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT VERSION OF THE 990 WILL BE REVIEWED BY INTERNAL MANAGEMENT AND THE BOARD CHAIR. ONCE RECOMMENDED CHANGES ARE MADE, A FINAL DRAFT WILL BE PROVIDED TO THE ENTIRE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C ANY DUALITY OF INTEREST, CONFLICTS OF INTEREST OR THE APPEARANCE OF CONFLICTS OF INTEREST ON THE PART OF ANY BOARD MEMBER, EMPLOYEE OR CONSULTANT IS PROHIBITED. SUCH DUALITY OF INTEREST, CONFLICTS OF INTEREST OR APPEARANCE OF CONFLICTS OF INTEREST SHALL BE DISCLOSED TO THE BOARD OF DIRECTORS FOR ADJUDICATION. FORM 990, PART VI, SECTION B, LINE 15 ALL COMPENSATION IS SUBJECT TO EVALUATION OF THE SALARY SURVEY COMPLETED BY MISSOURI PRIMARY CARE ASSOCIATION AND IS USED IN DETERMINING COMPENSATION FOR ALL EMPLOYEES. COMPARABILITY DATA AND A SALARY RANGE PREPARED BY THE MISSOURI PRIMARY CARE ASSOCIATION ARE USED FOR REVIEW. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST. COPIES OF THESE DOCUMENTS WILL BE MAILED TO THE PARTY REQUESTING THEM. FORM 990, PART XII, LINE 23 THERE WERE NO CHANGES FROM THE PRIOR YEAR.