2021-01-21T11:52:29-06:00 2020-05-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2019-06-01 840742145 MOUNTAIN FAMILY HEALTH CENTERS MOUN 9709452840 2700 GILSTRAP COURT NO 100 GLENWOOD SPRINGS CO 81601 ROSS BROOKS CHIEF EXECUTIVE OFFICER 9709452840 2021-01-20 1 KURT BENNION CPA P01469618 4252506100 2021-01-20 2019 2022-09-23 18:48:47Z ROSS BROOKS 2700 GILSTRAP COURT NO 100 GLENWOOD SPRINGS CO 81601 19802801 0 X WWW.MOUNTAINFAMILY.ORG X 1977 CO TO PROVIDE HIGH QUALITY INTEGRATED PRIMARY, DENTAL AND BEHAVIORAL HEALTH CARE. 10 10 255 20 0 0 8411183 9665941 10473484 10126869 2935 -841 17439 8665 18905041 19800634 3650 7068 0 0 12468645 13560838 98546 143069 143069 5690426 5597879 18261267 19308854 643774 491780 9925307 12754527 2823632 5161107 7101675 7593420 TO PROVIDE HIGH QUALITY, INTEGRATED PRIMARY MEDICAL, BEHAVIORAL AND DENTAL HEALTH CARE IN THE COMMUNITIES WE SERVE, WITH SPECIAL CONSIDERATION FOR THE MEDICALLY UNDER-SERVED, REGARDLESS OF ABILITY TO PAY. 0 0 15469327 7068 10126869 MOUNTAIN FAMILY HEALTH CENTERS PROVIDES PRIMARY MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES AT EIGHT LOCATIONS. SERVICES ARE PROVIDED TO 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 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. FOR THE FISCAL YEAR ENDED MAY 31, 2020, 15,933 PATIENTS WERE SERVED THROUGH 62,246 BILLABLE ENCOUNTERS. DURING THE FISCAL YEAR, MOUNTAIN FAMILY HEALTH CENTERS ADDED A PEDIATRICIAN AND EXPANDED PSYCHIATRIC SERVICES. 15469327 1 1 0 1 0 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 110 0 255 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 1 0 1 1 0 1 1 1 1 1 1 1 1 1 0 0 CO X ANNETTE FRANTA 9709452840 2700 GILSTRAP COURT NO 100 GLENWOOD SPRINGS CO 81601 CASEY AGUIRRE DO PHYSICIAN 40.00 X 217928 0 9141 MATTHEW PERCY MD CHIEF MEDICAL TEAM 50.00 X 186505 0 28894 ANNELIESE HECKERT DO CHIEF MEDICAL TEAM 50.00 X 190705 0 22967 CHRIS TONOZZI MD PHYSICIAN, DIRECTOR OF DATA QUALITY 40.00 X 192795 0 14081 MARIA CHANSKY MD PHYSICIAN 40.00 X 176244 0 16273 ROSS BROOKS CEO 50.00 X 159164 0 17357 JENNIFER LANG FNP CHIEF MEDICAL TEAM 50.00 X 155005 0 21312 STEPHEN GLASS DDS DENTAL DIRECTOR 50.00 X 150615 0 12006 CONNOR RIVERS DMD DENTIST 40.00 X 138132 0 12008 ANNETTE FRANTA CFO 50.00 X 132509 0 12207 ARTURO FERNANDEZ COO 50.00 X 126359 0 17663 COURTNEY SCHWIND DENTIST 40.00 X 130536 0 12376 SCOTT OWENS SPHR CHIEF WORKFORCE OFFICER 50.00 X 106967 0 10485 MONICA PEREZ RHODES CHAIR 4.00 X X 0 0 0 RICHARD GONZALES VICE CHAIR 2.00 X X 0 0 0 ROB STEIN PHD SECRETARY 2.00 X X 0 0 0 JOHN FOX RUBIN TREASURER 4.00 X X 0 0 0 FAVIOLA ALDERETE BOARD MEMBER (THROUGH DEC 2019) 2.00 X 0 0 0 KARYN RENAE ANDERSON BOARD MEMBER 2.00 X 0 0 0 SAMUEL BERNAL BOARD MEMBER 2.00 X 0 0 0 MEGAN BURCH BOARD MEMBER 2.00 X 0 0 0 TRISH KRAMER BOARD MEMBER 2.00 X 0 0 0 BETTY LUCAS BOARD MEMBER 2.00 X 0 0 0 VICTOR MAMLIN BOARD MEMBER 2.00 X 0 0 0 HAIDITH RAMIREZ BOARD MEMBER (THROUGH DEC 2019) 2.00 X 0 0 0 2063464 0 206770 23 0 1 0 OSIS PO BOX 772852 CHICAGO IL 60677 SOFTWARE LICENSING/HOSTING 347937 LABORATORY CORPORATION OF AMERICA PO BO 12140 BURLINGTON NC 27216 LABORATORY SERVICES 138281 CAROLYN HARDIN PO BOX 1396 CARBONDALE CO 81623 GRANT WRITING 113500 3 5506565 4159376 292239 9665941 PATIENT FEES 621400 8476331 8476331 CONTRACT REVENUE 621400 1109369 1109369 PHARMACY REVENUE 621400 541169 541169 10126869 1326 1326 2167 -2167 -2167 -2167 MISCELLANEOUS INCOME 900099 8665 8665 8665 19800634 10126869 0 7824 995 995 6073 6073 1321731 447004 874727 9905790 8423318 1482472 102922 94940 7982 1387193 1190968 196225 843202 671997 171205 6725 6725 43661 43661 143069 143069 1457995 1149195 308800 80825 3844 76981 217690 164692 52998 683389 600542 82847 46637 19192 27445 71767 29533 42234 45090 25697 19393 453217 389765 63452 67776 59572 8204 MEDICAL SUPPLIES 1155058 1155058 BAD DEBT EXPENSE 761858 761858 REPAIRS & MAINTENANCE 289868 207981 81887 DUES & SUBSCRIPTIONS 130943 13243 117700 85380 53860 31520 19308854 15469327 3696458 143069 1246 1446 1233039 4211031 895567 1195377 1963032 1887666 106230 95475 8037573 2674365 5705661 5363208 20532 324 9925307 12754527 990643 1588841 29403 885595 1803586 1186671 1500000 2823632 5161107 X 6209363 6250789 892312 1342631 7101675 7593420 9925307 12754527 491780 -35 0 X 0 1 X 1 1 1 X 5637061 7048980 8408498 8411183 9665941 39171663 5637061 7048980 8408498 8411183 9665941 39171663 39171663 2687 2639 2875 1558 1326 11085 33232 14382 21465 17439 8665 95183 39277931 48332784 0.99730 0.99630 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7062 7062 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE COLORADO COMMUNITY HEALTH NETWORK, A PORTION OF WHICH ARE USED BY THE NETWORK TO LOBBY ON BEHALF OF ALL MEMBER ORGANIZATIONS. 1 0 77000 77000 0 0 2309160 531356 1777804 2928316 258005 2670311 2800097 1885004 915093 5363208 X 19167768 -35 711846 731198 1443009 17724759 2075875 2075875 19800634 19258842 711846 711846 18546996 761858 761858 19308854 PART IV, LINE 1B: MOUNTAIN FAMILY HEALTH CENTERS ACTS AS FISCAL AGENT FOR THE WEST MOUNTAIN REGIONAL HEALTH ALLIANCE. 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 BUSINESS INCOME OR EXCISE OR OTHER TAXES. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS 731,198. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 761,858. RESTRICTED CONTRIBUTIONS 1,314,017. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 761,858. X X X X X X 1 CAROLYN HARDIN PO BOX 1396 CARBONDALE CO 81623 GRANT WRITING 0 6214526 104325 6110201 ELISE THATCHER 175 METZ LANE 102 DURANGO CO 81301 SOCIAL MEDIA MANAGEMENT 0 0 25822 -25822 GREENVILLE FINANCIAL GROUP LLC PO BOX 1471 CARBONDALE CO 81623 DONOR DEVELOPMENT 0 0 8571 -8571 6214526 138718 6075808 CO 1 CARE ACCESS POOL MEDICAL ASSISTANCE 19 6073 PART I, LINE 2: THE ORGANIZATION ENSURES APPROPRIATE USE OF ASSISTANCE BY MAKING PAYMENTS DIRECTLY TO THE MEDICAL PROVIDER. X X X X X 0 1 0 0 0 0 0 0 0 CASEY AGUIRRE DO PHYSICIAN 216822 0 1106 0 0 0 0 0 9141 0 227069 0 0 0 MATTHEW PERCY MD CHIEF MEDICAL TEAM 183180 0 978 0 2347 0 6052 0 22842 0 215399 0 0 0 ANNELIESE HECKERT DO CHIEF MEDICAL TEAM 187163 0 1195 0 2347 0 5998 0 16969 0 213672 0 0 0 CHRIS TONOZZI MD PHYSICIAN, DIRECTOR OF DATA QUALITY 192018 0 777 0 0 0 5802 0 8279 0 206876 0 0 0 MARIA CHANSKY MD PHYSICIAN 175572 0 672 0 0 0 0 0 16273 0 192517 0 0 0 ROSS BROOKS CEO 155083 0 43 0 4038 0 4959 0 12398 0 176521 0 0 0 JENNIFER LANG FNP CHIEF MEDICAL TEAM 150987 0 3958 0 60 0 4920 0 16392 0 176317 0 0 0 STEPHEN GLASS DDS DENTAL DIRECTOR 150241 0 374 0 0 0 4532 0 7474 0 162621 0 0 0 CONNOR RIVERS DMD DENTIST 137874 0 258 0 0 0 4168 0 7840 0 150140 0 0 0 PART I, LINE 4B THE ORGANIZATION HAS A 457(F) PLAN THAT IS AVAILABLE TO THE EXECUTIVE TEAM MEMBERS. TO DATE, THE ORGANIZATION HAS NOT CONTRIBUTED TO THE PLAN, BUT EACH ELIGIBLE INDIVIDUAL MAY CHOOSE TO CONTRIBUTE. X 2 12884 DAILY TRADING PRICE X 60 279355 DONOR DETERMINED 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE OFFICERS OF THE BOARD. THE EXECUTIVE COMMITTEE HAS THE POWER TO ACT ON BEHALF OF THE BOARD BETWEEN ITS MEETINGS, ESPECIALLY WITH RESPECT TO EMERGENT OR TIME-SENSITIVE MATTERS. THE EXECUTIVE COMMITTEE DOES NOT HAVE AUTHORITY WITH RESPECT TO AMENDING, ALTERING OR REPEALING THE BYLAWS; ELECTING, APPOINTING, OR REMOVING ANY BOARD MEMBER OR EXECUTIVE COMMITTEE MEMBER; AMENDING OR RESTATING THE ARTICLES OF INCORPORATION; ADOPTING A PLAN OF MERGER OR CONSOLIDATION WITH ANOTHER COMPANY; AUTHORIZING THE SALE, LEASE, EXCHANGE OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS; AUTHORIZING THE ORGANIZATION'S VOLUNTARY DISSOLUTION OR REVOKING PROCEEDINGS THEREFORE; ADOPTING A PLAN FOR THE DISTRIBUTION OF THE ORGANIZATION'S ASSETS; OR AMENDING, ALTERING OR REPEALING ANY RESOLUTION OF THE BOARD. THE EXECUTIVE COMMITTEE MUST KEEP THE BOARD TIMELY AND REASONABLY INFORMED OF ITS DELIBERATIONS AND ACTIONS. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS A SERVICE CONTRACT WITH VAIL HEALTH THAT GIVES VAIL HEALTH THE POWER TO APPOINT ONE MEMBER TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED IN DETAIL BY THE FINANCE TEAM. IT WAS THEN REVIEWED BY THE CEO. THE BOARD OF DIRECTORS WAS THEN GIVEN A COPY OF THE FORM 990 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 BOARD OF DIRECTOR MEMBERS ON CONFLICTS OF INTEREST. WHEN A MATTER COMES BEFORE THE BOARD OF DIRECTORS THAT GIVES RISE TO A POTENTIAL CONFLICT OF INTEREST, THE AFFECTED DIRECTOR MAKES THE ISSUE KNOWN TO THE BOARD. AFTER DISCLOSING THE RELEVANT FACTS AND ANSWERING ANY QUESTIONS, THE AFFECTED DIRECTOR LEAVES THE MEETING FOR FURTHER DISCUSSION AND ANY VOTES. IF IT IS UNCLEAR WHETHER A CONFLICT EXISTS, THE REMAINING DIRECTORS MAKE THE DETERMINATION. IF THE BOARD OF DIRECTORS BELIEVES A DIRECTOR HAS FAILED TO DISCLOSE A CONFLICT, IT INFORMS THE DIRECTOR AND GIVES THEM A CHANCE TO RESPOND AND EXPLAIN. AFTER THIS, IF THE BOARD DETERMINES THAT THE DIRECTOR HAS FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE BOARD TAKES APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15A SALARY SURVEYS FROM THE EMPLOYERS COUNCIL AND NACHC/CCHN ARE USED TO DETERMINE COMPENSATION OF TOP MANAGEMENT OFFICIALS AND KEY EMPLOYEES. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS REVIEWED AND APPROVED BY THE CEO. THIS PROCESS LAST OCCURRED IN SEPTEMBER 2019. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST, ON MOUNTAIN FAMILY HEALTH CENTERS' WEBSITE, AND ON THE STATE OF COLORADO'S WEBSITE. OTHER DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. MOUNTAIN FAMILY HEALTH SOLUTIONS LLC 2700 GILSTRAP COURT SUITE 100 GLENWOOD SPRINGS CO 81601 840742145 TO HOLD MEDICAL SERVICE CONTRACTS WITH EMPLOYERS CO 6770 0 MOUNTAIN FAMILY HEALTH CENTERS