2015-12-18T16:05:12-06:00 2015-05-31 410746749 CLIFTONLARSONALLEN LLP 370 INTERLOCKEN BLVD SUITE 500 BROOMFIELD CO 80021 990 2014-06-01 840613540 PLAN DE SALUD DEL VALLE INC PLAN 3032895147 203 SOUTH ROLLIE AVENUE FORT LUPTON CO 80621 DAVID MADSEN CHIEF FINANCIAL OFFICER 3032895147 2015-12-18 1 STEPHEN E LIVINGSTON CPA P00317845 3034668822 2014 2016-03-07 17:11:31Z JOHN SANTISTEVAN 203 SOUTH ROLLIE AVENUE FORT LUPTON CO 80621 64053521 0 X WWW.SALUDCLINIC.ORG X 1971 CO COMMUNITY HEALTH SERVICES 10 10 712 15 0 0 25979325 15886044 33404082 47880801 28359 33358 17856 18906 59429622 63819109 0 0 0 0 33517041 39773129 0 0 51653 19905843 22218144 53422884 61991273 6006738 1827836 68800850 70566763 20095652 20050010 48705198 50516753 SALUD IS A HEALTH CARE DELIVERY SYSTEM DEDICATED TO PROVIDING QUALITY, COMPREHENSIVE PRIMARY HEALTH CARE SERVICES TO MEDICAL AND DENTAL UNDERSERVED POPULATIONS AND THE COMMUNITY WITHIN THE SIX COUNTIES IN NORTH CENTRAL COLORADO. 0 0 52641487 0 47880801 PROVIDE HEALTH CARE SERVICES TO MEDICAID, MEDICARE, CHP+ AND OTHER PATIENTS IN RURAL COMMUNITIES. SALUD HAD 291,367 VISITS IN THE FISCAL YEAR ENDED 5/31/2015. 52641487 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 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 31 0 712 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 1 0 0 1 0 1 1 0 1 1 1 1 1 1 1 1 1 0 0 CO X DAVID MADSEN 3038926401 203 SOUTH ROLLIE AVENUE FORT LUPTON CO 80621 COLLEEN LAEGER CHAIRMAN 1.00 X X 0 0 0 RICHARD OLMEDO VICE CHAIRMAN 1.00 X X 0 0 0 JESUS TIJERINA SECRETARY 1.00 X X 0 0 0 MICHAEL MARTINEZ TREASURER 1.00 X X 0 0 0 CONSUELO CHAVEZ DIRECTOR 1.00 X 0 0 0 MANUAL GALLEGOS DIRECTOR 1.00 X 0 0 0 LINDA HUGHES DIRECTOR 1.00 X 0 0 0 CAROLINE SWIETER DIRECTOR 1.00 X 0 0 0 JODI TRAYLER DIRECTOR 1.00 X 0 0 0 VICTORIA VENGLEY DIRECTOR 1.00 X 0 0 0 JOHN D SANTISTEVAN PRESIDENT/CEO 40.00 X 231551 0 11767 DAVID MADSEN CHIEF FINANCIAL OFFICER 40.00 X 81414 0 1800 HANS ELZINGA PHYSICIAN 40.00 X 206891 0 13612 VIRGILIO LICONA ASSOCIATE MEDICAL DIRECTOR 40.00 X 208195 0 13681 ANDREW HUGHES PHYSICIAN 40.00 X 207919 0 4377 ELIAS HERNANDEZ PHYSICIAN 40.00 X 189000 0 12720 RUBEN ZORRILLA PHYSICIAN 40.00 X 179831 0 12262 1304801 0 70219 6 0 1 0 UNIVERSITY PHYSICIANS INC PO BOX 460578 GLENDALE CO 80246 CONTRACT DOCTORS 282625 1 15043186 842858 2205512 15886044 PATIENT FEES 621400 42259460 42259460 PHARMACY REVENUE 621400 5621341 5621341 47880801 31505 31505 18906 0 18906 18906 18906 236265 234412 1853 1853 1853 63819109 47880801 0 52264 392866 392866 29818363 26044417 3747161 26785 1147713 1049132 96893 1688 6218675 5598639 611029 9007 2195512 1975121 217213 3178 121249 121249 112787 112787 3676539 2909069 767470 197934 130179 67755 1103049 669078 423321 10650 609391 497748 111643 349960 212266 137694 495865 174036 321829 434606 94830 339776 2449314 1937242 512072 383862 375167 8695 MEDICAL SUPPLIES 8452387 8452387 EQUIPMENT 1690366 841466 848900 REPAIRS & MAINTENANCE 1614540 1336004 278536 DUES & SUBSCRIPTIONS 295143 113554 181244 345 231152 231152 61991273 52641487 9298133 51653 3914286 5335740 13871354 10308001 2703471 3442488 1082017 1681760 33938 38085 67522793 17950286 47064572 49572507 121212 114182 10000 74000 68800850 70566763 4783007 5265998 378844 345824 14585000 14060000 348801 378188 20095652 20050010 X 48705198 50516753 48705198 50516753 68800850 70566763 X 1827836 -16281 X 0 1 X 1 1 1 X 22833697 19886375 20470634 25979325 15886044 105056075 22833697 19886375 20470634 25979325 15886044 105056075 105056075 63234 63719 40570 46215 50411 264149 105320224 170946445 0.99750 0.99670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4429055 4429055 63093738 17950286 45143452 49572507 ACCRUED BOND DERIVATIVE 378188 378188 X 63849522 277846 277846 63571676 247433 247433 63819109 62037967 277846 277846 61760121 231152 231152 61991273 PART X, LINE 2: THE CORPORATION 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 CORPORATION'S FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN VALUE OF INTEREST RATE SWAP 16,281. BAD DEBT EXPENSE 231,152. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 231,152. X X 0 0 0 0 0 0 0 0 0 JOHN D SANTISTEVAN PRESIDENT/CEO 231551 0 0 0 0 0 11767 0 0 0 243318 0 0 0 HANS ELZINGA PHYSICIAN 206891 0 0 0 0 0 10492 0 3120 0 220503 0 0 0 VIRGILIO LICONA ASSOCIATE MEDICAL DIRECTOR 208195 0 0 0 0 0 10561 0 3120 0 221876 0 0 0 ANDREW HUGHES PHYSICIAN 207919 0 0 0 0 0 1257 0 3120 0 212296 0 0 0 ELIAS HERNANDEZ PHYSICIAN 189000 0 0 0 0 0 9600 0 3120 0 201720 0 0 0 RUBEN ZORRILLA PHYSICIAN 179831 0 0 0 0 0 9142 0 3120 0 192093 0 0 0 A COLORADO HEALTH FACILITIES AUTHORITY 840752932 2010-12-16 16110000 REFUND BONDS ISSUED 7/28/2005 & 12/4/2008 0 0 0 A 2050000 16110000 16110000 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 1 1 KEY BANK 5.000000000000 0 0 0 0 1 A 1 X 2 2205512 FAIR MARKET VALUE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE CONSISTS OF THE CURRENT OFFICERS OF THE BOARD. THE EXECUTIVE COMMITTEE IS AUTHORIZED TO FUNCTION ON BEHALF OF THE BOARD BETWEEN BOARD MEETINGS. ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE IN THE INTERIM ARE RATIFIED BY THE BOARD AT ITS SUBSEQUENT MEETING. THE EXECUTIVE COMMITTEE ALSO PERFORMS THE PLANNING AND EVALUATION FUNCTION FOR THE BOARD. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION'S BYLAWS WERE AMENDED IN DECEMBER 2014. AMONG THE AMENDMENTS WERE THE FOLLOWING SIGNIFICANT CHANGES: 1. THE NUMBER OF BOARD MEMBERS INCREASED FROM 11 TO 12-15 INDIVIDUALS. 2. THE REQUIREMENT FOR "CONSUMER MEMBERS", WHICH ARE DEFINED AS INDIVIDUALS WHO HAVE USED SALUD FOR HEALTHCARE SERVICES AT LEAST ONCE IN THE LAST 24 MONTHS, DECREASED FROM 100% OF BOARD MEMBERS TO AT LEAST 51%. 3. THE FORT LUPTON/WATTERNBERG AREA IS NOW REPRESENTED BY 1 DIRECTOR RATHER THAN 3 DIRECTORS. 4. THE APPOINTMENT OF BOARD MEMBERS FROM THE MIGRANT AND SEASONAL FARMWORKER COMMUNITY CHANGED FROM BEING OPTIONAL TO BEING REQUIRED, WITH 1-2 BOARD MEMBERS BEING FROM THAT COMMUNITY. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS DIVIDED ITS SERVICE AREA INTO NINE GEOGRAPHIC AREAS. EACH GEOGRAPHIC AREA ELECTS ONE INDIVIDUAL TO THE BOARD OF DIRECTORS BY A MAJORITY VOTE OF THE CONSUMERS RESIDING IN THAT GEOGRAPHIC AREA. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY SALUD'S CERTIFIED PUBLIC ACCOUNTING FIRM AND REVIEWED BY SALUD'S DIRECTOR OF ACCOUNTING AND FINANCE. THE FORM 990 IS THEN REVIEWED BY THE CHIEF EXECUTIVE OFFICER OF SALUD AND THEN PRESENTED TO THE BOARD OF DIRECTORS AT THEIR MONTHLY BOARD MEETING FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C SALUD DOES HAVE A FORMAL COMPLIANCE POLICY ADMINISTERED BY THE SALUD COMPLIANCE COMMITTEE. THE COMPLIANCE PROGRAM IS PRESENTED TO ALL NEW STAFF MEMBERS DURING NEW EMPLOYEE ORIENTATION. IN ADDITION, EMPLOYEES ARE REQUIRED TO COMPLETE ANNUAL MANDATORY COMPLIANCE TRAINING. SALUD COMPLIANCE PROGRAM DETAILS THE VARIOUS METHODS EMPLOYEES CAN REPORT AN ISSUE THEY CONSIDER TO BE NON-COMPLIANT. ANY REPORTED INSTANCES ARE REVIEWED AND APPROPRIATE ACTION TAKEN BY THE COMPLIANCE COMMITTEE. IN ADDITION, AN ANNUAL COMPLIANCE REPORT IS PREPARED AND PRESENTED TO SALUD'S BOARD OF DIRECTORS. SALUD BOARD MEMBERS ARE BOUND BY THE CODE OF ETHICS ADOPTED BY THE BOARD IN REGARD TO CONFLICT OF INTEREST OR THE APPEARANCE THEREOF. ON A YEARLY BASIS, EACH BOARD MEMBER SIGNS A NEW CONFLICT OF INTEREST STATEMENT. IF A BOARD MEMBER HAS A POTENTIAL CONFLICT, THEY INFORM THE CEO AND BOARD CHAIR. IF IT IS UNCLEAR WHETHER A CONFLICT EXISTS, THE BOARD CHAIR MAKES THE DETERMINATION. IF A BOARD MEMBER IS DEEMED TO HAVE A CONFLICT, THE SITUATION IS MONITORED BY THE BOARD CHAIR. FORM 990, PART VI, SECTION B, LINE 15A SALUD'S COMPENSATION FOR THE CEO AND OTHER KEY EMPLOYEES ARE DETERMINED AS FOLLOWS: ON AN ANNUAL BASIS THE DIRECTOR OF HUMAN RESOURCES WILL OBTAIN WAGE INFORMATION FROM SEVERAL RELEVANT SOURCES WITHIN THE HEALTH INDUSTRY. THE WAGE LEVELS ARE THEN COMPARED TO THE WAGES BEING PAID TO ASSURE THEY ARE WITHIN RELATIVE COMPARABLE RANGE. THE CEO'S WAGE INFORMATION IS PRESENTED TO SALUD'S COMPENSATION COMMITTEE THAT CONSISTS OF FOUR INDEPENDENT DIRECTORS WHO THEN DELIBERATE AND APPROVE THE CEO'S SALARY. THE CEO OF SALUD REVIEWS ALL OTHER TOP MANAGEMENT WAGE COMPARISONS. FORM 990, PART VI, SECTION C, LINE 19 SALUD'S WEBSITE PROVIDES THE CONTACT INFORMATION WHERE THE PUBLIC MAY REQUEST COPIES OF SALUD'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS WHICH ARE THEN PROVIDED UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP -16,281.