MOUNTAIN FAMILY HEALTH CENTERS: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- MOUNTAIN FAMILY HEALTH CENTERS (EIN 84-0742145)
- Tax period
- 2017-06-01 to 2018-05-31
- Filed
- 2019-04-08
- IRS object ID
- 201940989349301204
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule J
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-04-08T15:49:21-05:00 | ReturnTs |
| Tax Period End | 2018-05-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 370 INTERLOCKEN BLVD SUITE 500 | AddressLine1Txt |
| City | BROOMFIELD | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80021 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 840742145 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOUNTAIN FAMILY HEALTH CENTERS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MOUN | BusinessNameControlTxt |
| Phone | 9709452840 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2700 GILSTRAP COURT NO 100 | AddressLine1Txt |
| City | GLENWOOD SPRINGS | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81601 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROSS BROOKS | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 9709452840 | PhoneNum |
| Signature | 2019-03-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KURT BENNION | PreparerPersonNm |
| PTIN | P01469618 | PTIN |
| Phone | 3034668822 | PhoneNum |
| Preparation | 2019-03-26 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-03-26 | IPDt |
| IP Tm | 12:21:07 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B4AE3E2A15759F9337A2B81BCAF9FF6505250763 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A52F513B8D8172ADA5E5426B2D9DBB033DEB48E6 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROSS BROOKS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2700 GILSTRAP COURT NO 100 | AddressLine1Txt |
| City | GLENWOOD SPRINGS | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,340,215 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MOUNTAINFAMILY.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY INTEGRATED PRIMARY, DENTAL AND BEHAVIORAL HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 209 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $6,617 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,048,980 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,408,498 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,736,447 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,905,379 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,097 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,712 | CYInvestmentIncomeAmt |
| PY Other Revenue | $14,382 | PYOtherRevenueAmt |
| CY Other Revenue | $21,463 | CYOtherRevenueAmt |
| PY Total Revenue | $16,803,906 | PYTotalRevenueAmt |
| CY Total Revenue | $18,338,052 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $16,282 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,300 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,844,421 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,087,199 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $114,850 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $155,762 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $155,762 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,082,560 | PYOtherExpensesAmt |
| CY Other Expenses | $4,689,236 | CYOtherExpensesAmt |
| PY Total Expenses | $17,058,113 | PYTotalExpensesAmt |
| CY Total Expenses | $16,934,497 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$254,207 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,403,555 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,448,129 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,629,902 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,393,765 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,172,020 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,054,364 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,457,882 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE HIGH QUALITY, INTEGRATED MEDICAL, BEHAVIORAL AND DENTAL HEALTHCARE IN THE COMMUNITIES WE SERVE WITH SPECIAL CONSIDERATION FOR THE MEDICALLY UNDER-SERVED, REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,089,106 | ExpenseAmt |
| Grant | $2,300 | GrantAmt |
| Revenue | $9,905,379 | RevenueAmt |
| Desc | 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, 2018, 17,201 PATIENTS WERE SERVED THROUGH 64,158 BILLABLE ENCOUNTERS. | Desc |
| Total Program Service Expenses | $13,089,106 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 99 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 209 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CO | StatesWhereCopyOfReturnIsFldCd |
| Other | Yes (X) | OtherInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANNETTE FRANTA | PersonNm |
| Phone | 9709452840 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2700 GILSTRAP COURT NO 100 | AddressLine1Txt |
| City | GLENWOOD SPRINGS | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81601 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JON FOX RUBIN | ||||||||
| CHAIR | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROB STEIN PHD | ||||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MONICA PEREZ RHODES | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RICHARD GONZALES | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SARA AMBERG | ||||||||
| DIRECTOR (THROUGH APRIL 2018) | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KARYN RENAE ANDERSON | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SAMUEL BERNAL | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| TOM BOAS | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| TRISH KRAMER | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| HAIDITH RAMIREZ | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KELLEY STAIGHT | ||||||||
| DIRECTOR (THROUGH APRIL 2018) | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ROSS BROOKS | ||||||||
| CEO | 40.00 | Yes (X) | $154,682 | $0 | $30,646 | |||
| ANNETTE FRANTA | ||||||||
| CFO | 40.00 | Yes (X) | $118,918 | $0 | $10,888 | |||
| ARTURO FERNANDEZ | ||||||||
| COO | 40.00 | Yes (X) | $112,957 | $0 | $7,177 | |||
| AMY ARCHER DO | ||||||||
| CMO | 40.00 | $216,067 | $0 | $12,499 | Yes (X) | |||
| CHRIS TONOZZI MD | ||||||||
| IT DIRECTOR | 40.00 | $186,497 | $0 | $33,159 | Yes (X) | |||
| JOSHUA RUSK MD | ||||||||
| PHYSICIAN | 40.00 | $176,312 | $0 | $25,666 | Yes (X) | |||
| ANNELIESE BURCH MD | ||||||||
| SITE DIRECTOR | 40.00 | $176,032 | $0 | $9,925 | Yes (X) | |||
| MATTHEW PERCY MD | ||||||||
| SITE DIRECTOR | 40.00 | $157,933 | $0 | $19,335 | Yes (X) | |||
| CASEY AGUIRRE DO | ||||||||
| PHYSICIAN | 40.00 | $134,693 | $0 | $4,522 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,434,091 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $153,817 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ITENTIVE HELATHCARE SOLUTIONS | |||||
| 1 PIERCE PLACE SUITE 400E | ITASCA | IL | 60143 | SOFTWARE MAINTENANCE | $220,940 |
| VAIL HEALTH INC | |||||
| PO BOX 40000 | VAIL | CO | 81658 | LEASE & PATIENT SERVICES | $194,695 |
| LABORATORY CORPORATION OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LABORATORY SERVICES | $142,711 |
| CAROLYN HARDIN | |||||
| PO BOX 1396 | CARBONDALE | CO | 81623 | GRANT CONSULTING | $127,702 |
| QUALITY SYSTEMS INC | |||||
| PO BOX 511449 | LOS ANGELES | CA | 90051 | SOFTWARE MAINTENANCE | $107,976 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,979,814 | GovernmentGrantsAmt |
| All Other Contributions | $3,428,684 | AllOtherContributionsAmt |
| Noncash Contributions | $385,687 | NoncashContributionsAmt |
| Total Contributions | $8,408,498 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT FEES | 621400 | $8,317,353 | $8,317,353 |
| CONTRACT REVENUE | 621400 | $857,313 | $857,313 |
| PHARMACY REVENUE | 621400 | $730,713 | $730,713 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,905,379 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,875 | TotalRevenueColumnAmt |
| Exclusion | $2,875 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,163 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$163 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$163 | TotalRevenueColumnAmt |
| Exclusion | -$163 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $21,463 | TotalRevenueColumnAmt |
| Exclusion | $21,463 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $21,463 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,338,052 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,905,379 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $24,175 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,300 | TotalAmt |
| Program Services | $2,300 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $672,160 | TotalAmt |
| Management And General | $672,160 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,384,800 | TotalAmt |
| Program Services | $7,756,461 | ProgramServicesAmt |
| Management And General | $1,628,339 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,072 | TotalAmt |
| Program Services | $93,496 | ProgramServicesAmt |
| Management And General | $60,576 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,137,188 | TotalAmt |
| Program Services | $860,479 | ProgramServicesAmt |
| Management And General | $276,709 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $738,979 | TotalAmt |
| Program Services | $685,823 | ProgramServicesAmt |
| Management And General | $53,156 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,182 | TotalAmt |
| Management And General | $9,182 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,995 | TotalAmt |
| Management And General | $39,995 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,762 | TotalAmt |
| Fundraising | $155,762 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,197,821 | TotalAmt |
| Program Services | $815,425 | ProgramServicesAmt |
| Management And General | $382,396 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,157 | TotalAmt |
| Program Services | $24,248 | ProgramServicesAmt |
| Management And General | $62,909 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,041 | TotalAmt |
| Program Services | $136,583 | ProgramServicesAmt |
| Management And General | $59,458 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $391,341 | TotalAmt |
| Program Services | $271,577 | ProgramServicesAmt |
| Management And General | $119,764 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,981 | TotalAmt |
| Program Services | $45,657 | ProgramServicesAmt |
| Management And General | $34,324 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,604 | TotalAmt |
| Program Services | $16,718 | ProgramServicesAmt |
| Management And General | $83,886 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,492 | TotalAmt |
| Program Services | $188,909 | ProgramServicesAmt |
| Management And General | $41,583 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,676 | TotalAmt |
| Program Services | $30,858 | ProgramServicesAmt |
| Management And General | $16,818 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| UBI TAXES | $1,157 | $1,157 | |
| MEDICAL SUPPLIES | $1,243,656 | $8,801 | $1,234,855 |
| BAD DEBT EXPENSE | $733,989 | $733,989 | |
| REPAIRS AND MAINTENANCE | $186,019 | $16,574 | $169,445 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,125 | TotalAmt |
| Program Services | $22,283 | ProgramServicesAmt |
| Management And General | $121,842 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,934,497 | TotalAmt |
| Program Services | $13,089,106 | ProgramServicesAmt |
| Management And General | $3,689,629 | ManagementAndGeneralAmt |
| Fundraising | $155,762 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,246 | BOYAmt |
| EOY | $1,246 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $790,556 | BOYAmt |
| EOY | $3,041,950 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $550,420 | BOYAmt |
| EOY | $393,356 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,240,653 | BOYAmt |
| EOY | $1,465,552 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $169,359 | BOYAmt |
| EOY | $67,306 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,550,730 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,913,306 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,672,864 | BOYAmt |
| EOY | $2,637,424 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,030 | BOYAmt |
| EOY | $23,068 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,001 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,448,129 | BOYAmt |
| EOY | $7,629,902 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,299,864 | BOYAmt |
| EOY | $976,930 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,901 | BOYAmt |
| EOY | $195,090 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,393,765 | BOYAmt |
| EOY | $1,172,020 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,702,565 | BOYAmt |
| EOY | $4,861,883 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $351,799 | BOYAmt |
| EOY | $1,595,999 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,054,364 | BOYAmt |
| EOY | $6,457,882 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,448,129 | BOYAmt |
| EOY | $7,629,902 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,403,555 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$37 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,227,236 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,399,317 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,637,061 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,048,980 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,408,498 | CurrentTaxYearAmt |
| Total | $29,721,092 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,227,236 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,399,317 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,637,061 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,048,980 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,408,498 | CurrentTaxYearAmt |
| Total | $29,721,092 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $29,721,092 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,404 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,588 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,687 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,639 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,875 | CurrentTaxYearAmt |
| Total | $11,193 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $33,860 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $28,424 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $33,232 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,382 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,463 | CurrentTaxYearAmt |
| Total | $131,361 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $29,863,646 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $41,445,174 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99520 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99250 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS INCOME | ExplanationTxt |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,558 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,558 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $23,027 | BeginningBalanceAmt |
| Additions During Year | $0 | AdditionsDuringYearAmt |
| Distributions During Year | $23,027 | DistributionsDuringYearAmt |
| Ending Balance | $0 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,309,160 | OtherCostOrOtherBasisAmt |
| Depreciation | $412,786 | DepreciationAmt |
| Book Value | $1,896,374 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $124,085 | OtherCostOrOtherBasisAmt |
| Depreciation | $98,087 | DepreciationAmt |
| Book Value | $25,998 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,976,832 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,402,433 | DepreciationAmt |
| Book Value | $574,399 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $140,653 | OtherCostOrOtherBasisAmt |
| Book Value | $140,653 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,637,424 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $16,667,587 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$37 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $307,761 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $311,889 | OtherRevenueAmt |
| Revenue Not Reported | $619,613 | RevenueNotReportedAmt |
| Revenue Subtotal | $16,047,974 | RevenueSubtotalAmt |
| Other Revenues Not Included | $2,290,078 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,290,078 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $18,338,052 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $16,508,269 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $307,761 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $307,761 | ExpensesNotReportedAmt |
| Expenses Subtotal | $16,200,508 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $733,989 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $733,989 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $16,934,497 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1B: | MOUNTAIN FAMILY HEALTH CENTERS ACTED AS FISCAL AGENT FOR THE WEST MOUNTAIN REGIONAL HEALTH ALLIANCE FOR A PORTION OF THE YEAR. |
| 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 311,889. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 733,989. TEMPORARILY RESTRICTED CONTRIBUTIONS 1,556,089. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 733,989. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | ActivityActivityTxt | Fundraiser Control Of FundsFundraiserControlOfFundsInd | Gross ReceiptsGrossReceiptsAmt | Retained By ContractorRetainedByContractorAmt | Net To OrganizationNetToOrganizationAmt |
|---|---|---|---|---|---|---|---|---|
| CAROLYN HARDIN | ||||||||
| PO BOX 1396 | CARBONDALE | CO | 81623 | GRANT WRITING | 0 | $5,054,409 | $127,702 | $4,926,707 |
| ELISE THATCHER | ||||||||
| PO BOX 9505 | ASPEN | CO | 81612 | GRANT WRITING | 0 | $52,500 | $28,060 | $24,440 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $5,106,909 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $155,762 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $4,951,147 | TotalNetToOrganizationAmt |
| Licensed States | CO | LicensedStatesCd |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROSS BROOKS | ||||||||||||||
| CEO | $146,921 | $0 | $0 | $0 | $7,761 | $0 | $18,000 | $0 | $12,646 | $0 | $185,328 | $0 | $0 | $0 |
| AMY ARCHER DO | ||||||||||||||
| CMO | $197,764 | $0 | $15,000 | $0 | $3,303 | $0 | $1,427 | $0 | $11,072 | $0 | $228,566 | $0 | $0 | $0 |
| CHRIS TONOZZI MD | ||||||||||||||
| IT DIRECTOR | $182,491 | $0 | $0 | $0 | $4,006 | $0 | $17,934 | $0 | $15,225 | $0 | $219,656 | $0 | $0 | $0 |
| JOSHUA RUSK MD | ||||||||||||||
| PHYSICIAN | $174,484 | $0 | $0 | $0 | $1,828 | $0 | $18,000 | $0 | $7,666 | $0 | $201,978 | $0 | $0 | $0 |
| ANNELIESE BURCH MD | ||||||||||||||
| SITE DIRECTOR | $175,183 | $0 | $0 | $0 | $849 | $0 | $2,269 | $0 | $7,656 | $0 | $185,957 | $0 | $0 | $0 |
| MATTHEW PERCY MD | ||||||||||||||
| SITE DIRECTOR | $140,061 | $0 | $0 | $0 | $17,872 | $0 | $5,412 | $0 | $13,923 | $0 | $177,268 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | CHRISTOPHER TONOZZI, MD, PARTICIPATES IN A 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. DURING 2017, $16,509 WAS CONTRIBUTED TO THE PLAN, $564 ACCRUED WITHIN THE PLAN, AND THERE WERE NO DISTRIBUTIONS. | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $385,687 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | DONOR DETERMINED | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION HAS A SERVICE CONTRACT WITH THE 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 BOARD OF DIRECTORS WAS 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 SURVEY INFORMATION FROM MOUNTAIN STATES EMPLOYERS COUNCIL AND NACHC/CCHN IS 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 2018. |
| 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. |