DIRECTOR OF ACCT & FINANCE

2012-03-02T10:36:53-06:00 2011-05-31 CLIFTONLARSONALLEN LLP 370 INTERLOCKEN BLVD SUITE 500 BROOMFIELD CO 80021 990 2010-06-01 840613540 PLAN DE SALUD DEL VALLE INC PLAN 3038990004 203 SOUTH ROLLIE AVENUE FORT LUPTON CO 80621 JOHN SANTISTEVAN DIRECTOR OF ACCT & FINANCE 3038990004 2012-02-21 1 V E SHOUP CPA 3034668822 2010 2016-02-24 21:20:13Z STANLEY J BRASHER 203 SOUTH ROLLIE AVENUE FORT LUPTON CO 80621 46927135 0 X WWW.SALUDCLINIC.ORG X 1971 CO COMMUNITY HEALTH SERVICES 9 9 462 8 0 0 22702971 19170489 25539720 27650529 55046 49826 44652 13408 48342389 46884252 0 0 0 0 26435983 30626008 0 0 58587 17403301 13118926 43839284 43744934 4503105 3139318 56384698 59823499 21207528 21507011 35177170 38316488 PRIMARY HEALTH CARE SERVICES TO MEDICAL AND DENTAL UNDERSERVED POPULATIONS AND THE COMMUNITY WITHIN THE SIX COUNTIES IN NORTH - CENTRAL COLORADO. ESTIMATE OVER 290,000 VISITS ANNUALLY. 0 0 37471353 27700355 PROVIDE HEALTH CARE SERVICES TO MEDICAID, MEDICARE, CHP+ AND OTHER PATIENTS IN RURAL COMMUNITIES. 37471353 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 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 0 1 36 0 1 462 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 CO X JOHN SANTISTEVAN 3038926401 203 SOUTH ROLLIE AVENUE FORT LUPTON CO 80621 CAROLINE SWIETER CHAIRMAN 1.00 X X 0 0 0 JESUS TIJERINA TREASURER 1.00 X X 0 0 0 CONSUELO CHAVEZ DIRECTOR 1.00 X 0 0 0 MANUEL GALLEGOS DIRECTOR 1.00 X 0 0 0 LINDA HUGHES DIRECTOR 1.00 X 0 0 0 COLLEEN LAEGER VICE CHAIRMAN 1.00 X X 0 0 0 RICHARD OLMEDO SECRETARY 1.00 X X 0 0 0 MICHAEL MARTINEZ DIRECTOR 1.00 X 0 0 0 VICTORIA MEDINA DIRECTOR 1.00 X 0 0 0 STANLEY J BRASHER EXECUTIVE DIRECTOR 40.00 X 161700 0 0 PRADEEP DHAR PHYSICIAN 40.00 X 178000 0 0 VIRGILIO LICONA ASSOCIATE MEDICAL DIRECTOR 40.00 X 183750 0 0 JACQUES LEBLANC PHYSICIAN 40.00 X 185000 0 0 ELIAS HERNANDEZ PHYSICIAN 40.00 X 192000 0 0 HANS ELZINGA PHYSICIAN 40.00 X 200000 0 0 1100450 0 0 56 0 1 0 UNIVERSITY PHYSICIANS INC PO BOX 460578 GLENDALE CO 80246 CONTRACT DOCTORS 231888 1 19170489 1897326 19170489 MEDICAID 621400 15880577 15880577 PATIENT PAY 621400 3641616 3641616 PHARMACY REVENUE - FL 621400 1990794 1990794 PRIVATE INSURANCE 621400 1697601 1697601 CHILD HEALTH PROGRAM 621400 1343080 1343080 3096861 3096861 27650529 30909 30909 13408 13408 13408 13408 61800 42883 18917 18917 18917 46884252 27700355 0 13408 161700 161700 22972001 20736503 2212187 23311 7492307 6754362 730345 7600 519604 519604 557667 470761 86906 247144 161416 84687 1041 331565 162672 168203 690 775612 448016 327596 1925462 1404801 520661 199503 179553 19950 SUPPLIES 3101923 2960736 116242 24945 CONSULTANTS & CONTRACT 3002200 2504641 497559 REPAIRS & MAINTENANCE 1274395 1162455 111940 EQUIPMENT 690073 303185 386888 TELEPHONE 489722 392196 97526 4056 -169944 173000 1000 43744934 37471353 6214994 58587 2185186 2263642 8840743 10853752 4330851 1505612 1114475 945599 5000 47088099 9703464 37560432 37384635 2348011 6870259 56384698 59823499 4347341 5115878 450187 396133 16410000 15995000 21207528 21507011 X 33177170 38316488 2000000 0 35177170 38316488 56384698 59823499 3139318 0 X X 0 1 1 X 0 X 19127717 22651535 22992127 22702971 22833697 110308047 19127717 22651535 22992127 22702971 22833697 110308047 110308047 364619 410493 175155 156014 63234 1169515 111477562 121881386 0.98950 0.98850 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4180070 4180070 36422100 5802077 30620023 331829 264393 67436 6104775 3599350 2505425 49325 37644 11681 37384635 LOAN FEES, NET OF AMORTIZATION 142302 CONSTRUCTION IN PROGRESS 6727957 6870259 46884252 43744934 3139318 0 3139318 50547460 3663208 3663208 46884252 0 46884252 47408142 3663208 3663208 43744934 0 43744934 PART XII, LINE 2D - OTHER: IN-KIND CONTRIBUTIONS: 3,663,208 PART XIII, LINE 2D - OTHER: IN-KIND: 3,663,208 X X X 0 0 0 0 0 0 0 0 0 STANLEY J BRASHER 161700 0 0 0 0 0 0 0 0 0 161700 0 0 0 PRADEEP DHAR 178000 0 0 0 0 0 0 0 0 0 178000 0 0 0 VIRGILIO LICONA 183750 0 0 0 0 0 0 0 0 0 183750 0 0 0 JACQUES LEBLANC 185000 0 0 0 0 0 0 0 0 0 185000 0 0 0 ELIAS HERNANDEZ 192000 0 0 0 0 0 0 0 0 0 192000 0 0 0 HANS ELZINGA 200000 0 0 0 0 0 0 0 0 0 200000 0 0 0 COLORADO HEALTH FACILITIES AUTHORITY 840752932 NC15163C1 2010-12-16 9770000 REFINANCE AND NEW FACILITIES 0 0 0 COLORADO HEALTH FACILITIES AUTHORITY 840752932 NC15163C2 2010-12-16 6340000 REFINANCE AND NEW FACILITIES 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 KEY BANK 5.000000000000 0 0 0 0 0 0 0 1 KEY BANK 5.000000000000 0 0 0 0 0 X 4 1897326 FAIR MARKET VALUE 0 0 0 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. 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, THE COMPLIANCE PROGRAM IS PRESENTED BY THE CHIEF EXECUTIVE OFFICER OF SALUD AT THEIR QUARTERLY STAFF MEETINGS TO ALL EMPLOYEES. 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. FORM 990, PART VI, SECTION B, LINE 15 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 BOARD OF DIRECTORS FOR REVIEW DURING THEIR ANNUAL EVALUATION. 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 THAT THE PUBLIC MAY REQUEST COPIES OF SALUD'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS. FORM 990, PART XII, LINE 2C THE AUDIT COMMITTEE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.