PUEBLO COMMUNITY HEALTH CENTER INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- PUEBLO COMMUNITY HEALTH CENTER INC (EIN 84-0921521)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-05-14
- IRS object ID
- 201841349349305119
- Schema version
- 2017v2.2
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-14T13:04:14-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | 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 | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 840921521 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PUEBLO COMMUNITY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PUEB | BusinessNameControlTxt |
| Phone | 7195438711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 EAST ROUTT AVENUE | AddressLine1Txt |
| City | PUEBLO | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81004 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CINDY PRATT | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7195438711 | PhoneNum |
| Signature | 2018-05-14 | 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 | 2018-05-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DONALD MOORE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 EAST ROUTT AVENUE | AddressLine1Txt |
| City | PUEBLO | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $32,099,625 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PUEBLOCHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1983 | FormationYr |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE PRIMARY HEALTH CARE TO THOSE IN NEED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 371 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,560,591 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,380,878 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,159,482 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,348,087 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$9,036 | PYInvestmentIncomeAmt |
| CY Investment Income | $320,032 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,460,682 | PYOtherRevenueAmt |
| CY Other Revenue | $50,628 | CYOtherRevenueAmt |
| PY Total Revenue | $28,171,719 | PYTotalRevenueAmt |
| CY Total Revenue | $32,099,625 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $46,861 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $19,276,815 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $20,907,801 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,541,806 | PYOtherExpensesAmt |
| CY Other Expenses | $7,600,741 | CYOtherExpensesAmt |
| PY Total Expenses | $25,818,621 | PYTotalExpensesAmt |
| CY Total Expenses | $28,555,403 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,353,098 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,544,222 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,704,088 | TotalAssetsBOYAmt |
| Total Assets EOY | $34,609,605 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,929,887 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,379,615 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $27,774,201 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $32,229,990 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE PRIMARY HEALTH CARE TO THOSE IN NEED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $19,586,805 | ExpenseAmt |
| Grant | $46,861 | GrantAmt |
| Revenue | $19,284,981 | RevenueAmt |
| Desc | PRIMARY HEALTH CARE SERVICES, INCLUDING PREVENTATIVE CARE,URGENT AND MINOR EMERGENCY CARE, BEHAVIORAL HEALTH, PERINATAL, AND DIAGNOSTIC LABORATORY AND RADIOLOGY, FOR LOW-INCOME, MEDICALLY UNINSURED AND UNDERINSURED OF PUEBLO AND HUERFANO COUNTIES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,289,904 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,947,128 | RevenueAmt |
| Desc | PHARMACEUTICAL SERVICES FOR LOW-INCOME, MEDICALLY UNINSURED AND UNDERINSURED OF PUEBLO COUNTY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,640,791 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,115,978 | RevenueAmt |
| Desc | PREVENTATIVE, RESTORATIVE, AND EMERGENCY DENTAL HEALTH CARE SERVICES FOR LOW-INCOME, MEDICALLY UNINSURED AND UNDERINSURED OF PUEBLO COUNTY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $23,517,500 | 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 | 0 | 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 | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | 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 | 0 | 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 | 57 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 371 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CINDY PRATT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7195438718 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 EAST ROUTT AVENUE | AddressLine1Txt |
| City | PUEBLO | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81004 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 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 |
|---|---|---|---|---|---|---|---|---|
| MICHELLE HILL | ||||||||
| PRESIDENT & IMMEDIATE PAST PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| REBECCA GOODMAN | ||||||||
| PRESIDENT-ELECT & PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHRIS MARKUSON | ||||||||
| TREASURER & PRESIDENT-ELECT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN MARK HILD | ||||||||
| PAST PRESIDENT (THROUGH AUGUST 2017) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SHANTEL GALLEGOS | ||||||||
| SECRETARY (THROUGH AUGUST 2017) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ARTHUR YARBROUGH JR | ||||||||
| DIRECTOR & SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JAY RICHTER MD | ||||||||
| DIRECTOR & TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LOUIS BALIZET MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAE BRIMHALL DMD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SHIRLEY CORDOVA | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL GAGE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| VERONICA IBARRA | ||||||||
| DIRECTOR (THROUGH APRIL 2017) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| AMY JIMINEZ | ||||||||
| DIRECTOR (THROUGH JUNE 2017) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LINDA RIKHOFF RN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TERESA ROMERO | ||||||||
| DIRECTOR (THROUGH JULY 2017) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DONALD MOORE | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $151,519 | $0 | $29,913 | |||
| CINDY PRATT | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $123,832 | $0 | $14,087 | |||
| KAREN MILLER DDS | ||||||||
| CHIEF DENTAL OFFICER | 36.00 | Yes (X) | $157,948 | $0 | $17,073 | |||
| JUSTIN MCCARTHY | ||||||||
| CHIEF OPERATIONS OFFICER | 40.00 | Yes (X) | $126,966 | $0 | $24,845 | |||
| MICHAEL BARRIS MD | ||||||||
| CHIEF MEDICAL CO-OFFICER | 40.00 | Yes (X) | $252,623 | $0 | $32,395 | |||
| DAVID KRAUSE MD | ||||||||
| CHIEF MEDICAL CO-OFFICER | 34.00 | Yes (X) | $217,009 | $0 | $32,786 | |||
| CHAD HESS RN PA-C | ||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.00 | $171,155 | $0 | $26,535 | Yes (X) | |||
| BRETT HULET MD | ||||||||
| PHYSICIAN | 24.00 | $196,555 | $0 | $25,859 | Yes (X) | |||
| DANA RILEY MD | ||||||||
| PHYSICIAN | 36.00 | $231,703 | $0 | $33,813 | Yes (X) | |||
| STEPHANIE PARKER DO | ||||||||
| PHYSICIAN | 36.00 | $178,243 | $0 | $34,033 | Yes (X) | |||
| MARK SCHWARTZ MD | ||||||||
| PHYSICIAN | 28.00 | $159,225 | $0 | $9,573 | Yes (X) | |||
| RICHARD KING MD | ||||||||
| PHYSICIAN | 28.00 | $144,617 | $0 | $32,428 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,111,395 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $313,340 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 25 | 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 |
|---|---|---|---|---|---|
| CARDINAL HEALTH | |||||
| 7000 CARDINAL PL | DUBLIN | OH | 43017 | PHARMACY MANAGEMENT SERVICES | $1,061,469 |
| COLORDO COMMUNITY MANAGED CARE NETWORK | |||||
| 1212 S BROADWAY | DENVER | CO | 80210 | SOFTWARE SUPPORT SERVICES | $476,556 |
| COMPHEALTH | |||||
| 7259 S BINGHAM JCT BLVD | MIDVALE | UT | 84047 | LOCUMS | $270,390 |
| JD'S JANITORIAL SERVICE LLC | |||||
| 225 BROADWAY AVE | PUEBLO | CO | 81004 | JANITORIAL SERVICES | $231,369 |
| STAFF CARE INC | |||||
| 8840 CYPRESS WATERS BLVD 300 | COPPELL | TX | 75019 | LOCUMS | $187,915 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $7,340,713 | GovernmentGrantsAmt |
| All Other Contributions | $40,165 | AllOtherContributionsAmt |
| Noncash Contributions | $11,657 | NoncashContributionsAmt |
| Total Contributions | $7,380,878 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 621110 | $20,400,959 | $20,400,959 |
| PHARMACY REVENUE | 621110 | $3,947,128 | $3,947,128 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,348,087 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $320,032 | TotalRevenueColumnAmt |
| Exclusion | $320,032 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $50,628 | TotalRevenueColumnAmt |
| Exclusion | $50,628 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $50,628 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,099,625 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,348,087 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $370,660 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,861 | TotalAmt |
| Program Services | $46,861 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,378,686 | TotalAmt |
| Program Services | $726,019 | ProgramServicesAmt |
| Management And General | $652,667 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,220,358 | TotalAmt |
| Program Services | $14,347,292 | ProgramServicesAmt |
| Management And General | $1,873,066 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $581,181 | TotalAmt |
| Program Services | $476,206 | ProgramServicesAmt |
| Management And General | $104,975 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,536,259 | TotalAmt |
| Program Services | $1,230,715 | ProgramServicesAmt |
| Management And General | $305,544 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,191,317 | TotalAmt |
| Program Services | $1,004,024 | ProgramServicesAmt |
| Management And General | $187,293 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,547 | TotalAmt |
| Management And General | $58,547 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,311 | TotalAmt |
| Program Services | $550 | ProgramServicesAmt |
| Management And General | $46,761 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,700,529 | TotalAmt |
| Program Services | $1,341,243 | ProgramServicesAmt |
| Management And General | $359,286 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,692 | TotalAmt |
| Program Services | $63,237 | ProgramServicesAmt |
| Management And General | $117,455 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $580,881 | TotalAmt |
| Program Services | $406,031 | ProgramServicesAmt |
| Management And General | $174,850 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $661,458 | TotalAmt |
| Program Services | $406,119 | ProgramServicesAmt |
| Management And General | $255,339 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $775,866 | TotalAmt |
| Program Services | $606,365 | ProgramServicesAmt |
| Management And General | $169,501 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,896 | TotalAmt |
| Program Services | $48,295 | ProgramServicesAmt |
| Management And General | $5,601 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,822 | TotalAmt |
| Program Services | $52,124 | ProgramServicesAmt |
| Management And General | $63,698 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $955,458 | TotalAmt |
| Program Services | $491,262 | ProgramServicesAmt |
| Management And General | $464,196 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $2,030,922 | $2,030,922 | |
| DUES & LICENSES | $207,797 | $52,868 | $154,929 |
| BAD DEBT EXPENSE | $134,802 | $134,802 | |
| CONTINUING EDUCATION | $50,856 | $46,856 | $4,000 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,904 | TotalAmt |
| Program Services | $5,709 | ProgramServicesAmt |
| Management And General | $40,195 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,555,403 | TotalAmt |
| Program Services | $23,517,500 | ProgramServicesAmt |
| Management And General | $5,037,903 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,239,102 | BOYAmt |
| EOY | $1,252,135 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,116,786 | BOYAmt |
| EOY | $14,040,012 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $908,208 | BOYAmt |
| EOY | $795,958 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,085,375 | BOYAmt |
| EOY | $2,681,591 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,362 | BOYAmt |
| EOY | $65,702 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,427 | BOYAmt |
| EOY | $194,016 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $21,392,016 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,149,506 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,738,066 | BOYAmt |
| EOY | $13,242,510 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $411,561 | BOYAmt |
| EOY | $1,413,913 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $911,567 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,333 | BOYAmt |
| EOY | $1,333 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,868 | BOYAmt |
| EOY | $10,868 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,704,088 | BOYAmt |
| EOY | $34,609,605 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,929,887 | BOYAmt |
| EOY | $2,379,615 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,929,887 | BOYAmt |
| EOY | $2,379,615 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,774,201 | BOYAmt |
| EOY | $31,318,423 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $911,567 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,774,201 | BOYAmt |
| EOY | $32,229,990 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,704,088 | BOYAmt |
| EOY | $34,609,605 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,544,222 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $723,954 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $187,613 | 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 | $4,934,466 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,249,721 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,784,482 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,560,591 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,380,878 | CurrentTaxYearAmt |
| Total | $30,910,138 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,934,466 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,249,721 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,784,482 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,560,591 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,380,878 | CurrentTaxYearAmt |
| Total | $30,910,138 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $30,910,138 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,196 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,014 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,183 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,240 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $320,032 | CurrentTaxYearAmt |
| Total | $342,665 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $68,162 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $109,856 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $148,086 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $159,231 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $50,628 | CurrentTaxYearAmt |
| Total | $535,963 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $31,788,766 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $105,627,117 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97240 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99920 | 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
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
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 | $8,949 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $8,949 | 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 IS USED BY THE NETWORK TO LOBBY ON BEHALF OF ITS MEMBER ORGANIZATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,018,115 | OtherCostOrOtherBasisAmt |
| Book Value | $2,018,115 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,977,207 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,450,742 | DepreciationAmt |
| Book Value | $10,526,465 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,396,694 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,698,764 | DepreciationAmt |
| Book Value | $697,930 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,242,510 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $32,099,625 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $32,099,625 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $32,099,625 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $28,555,403 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $28,555,403 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $28,555,403 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS PREVIOUSLY RECEIVED NOTICE OF EXEMPTION OF INCOME TAX FROM THE INTERNAL REVENUE SERVICE UNDER SECTION 501(C)(3) OF THE FEDERAL INTERNAL REVENUE CODE. THE ORGANIZATION IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. 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. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PUEBLO COMMUNITY HEALTH CENTER FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 310 COLORADO AVENUE | AddressLine1Txt |
| City | PUEBLO | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 041404345 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $27,017 | CashGrantAmt |
| Purpose Of Grant | GENERAL OPERATING EXPENSES | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION MAKES CONTRIBUTIONS TO LOCAL CHARITIES AND GOVERNMENT AGENCIES. PUEBLO COMMUNITY HEALTH CENTER CONFIRMS THE CHARITABLE STATUS OF THE RECIPIENT ORGANIZATION, BUT DOES NOT MONITOR THE RECEIPTS FOR SPECIFIC USE OF THE FUNDS. FUNDS TRANSFERRED TO THE PUEBLO COMMUNITY HEALTH CENTER FOUNDATION ARE MONITORED BY COMMON MANAGEMENT WHO ENSURE THAT ALL TRANSFERRED FUNDS ARE USED FOR APPROPRIATE PURPOSES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | 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 (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DONALD MOORE | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $151,019 | $0 | $500 | $0 | $0 | $0 | $7,386 | $0 | $22,527 | $0 | $181,432 | $0 | $0 | $0 |
| KAREN MILLER DDS | ||||||||||||||
| CHIEF DENTAL OFFICER | $157,448 | $0 | $500 | $0 | $0 | $0 | $9,564 | $0 | $7,509 | $0 | $175,021 | $0 | $0 | $0 |
| JUSTIN MCCARTHY | ||||||||||||||
| CHIEF OPERATIONS OFFICER | $126,466 | $0 | $500 | $0 | $0 | $0 | $8,033 | $0 | $16,812 | $0 | $151,811 | $0 | $0 | $0 |
| MICHAEL BARRIS MD | ||||||||||||||
| CHIEF MEDICAL CO-OFFICER | $242,323 | $0 | $10,300 | $0 | $0 | $0 | $15,583 | $0 | $16,812 | $0 | $285,018 | $0 | $0 | $0 |
| DAVID KRAUSE MD | ||||||||||||||
| CHIEF MEDICAL CO-OFFICER | $206,709 | $0 | $10,300 | $0 | $0 | $0 | $13,572 | $0 | $19,214 | $0 | $249,795 | $0 | $0 | $0 |
| CHAD HESS RN PA-C | ||||||||||||||
| ASSOCIATE MEDICAL DIRECTOR | $170,655 | $0 | $500 | $0 | $0 | $0 | $10,767 | $0 | $15,768 | $0 | $197,690 | $0 | $0 | $0 |
| BRETT HULET MD | ||||||||||||||
| PHYSICIAN | $196,055 | $0 | $500 | $0 | $0 | $0 | $12,410 | $0 | $13,449 | $0 | $222,414 | $0 | $0 | $0 |
| DANA RILEY MD | ||||||||||||||
| PHYSICIAN | $218,603 | $0 | $13,100 | $0 | $0 | $0 | $11,286 | $0 | $22,527 | $0 | $265,516 | $0 | $0 | $0 |
| STEPHANIE PARKER DO | ||||||||||||||
| PHYSICIAN | $177,743 | $0 | $500 | $0 | $0 | $0 | $11,506 | $0 | $22,527 | $0 | $212,276 | $0 | $0 | $0 |
| MARK SCHWARTZ MD | ||||||||||||||
| PHYSICIAN | $154,525 | $0 | $4,700 | $0 | $0 | $0 | $9,573 | $0 | $0 | $0 | $168,798 | $0 | $0 | $0 |
| RICHARD KING MD | ||||||||||||||
| PHYSICIAN | $138,517 | $0 | $6,100 | $0 | $0 | $0 | $9,901 | $0 | $22,527 | $0 | $177,045 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 IN SITUATIONS THAT CANNOT WAIT FOR THE NEXT FULL BOARD MEETING. HOWEVER, THE EXECUTIVE COMMITTEE MAY NOT SUPERSEDE THE BOARD'S AUTHORITIES, FUNCTIONS AND RESPONSIBILITIES. THE EXECUTIVE COMMITTEE BRIEFS THE FULL BOARD ON ALL SUCH ACTIONS TAKEN. ON THOSE ACTIONS, THE BOARD SUBSEQUENTLY VOTES ON WHETHER TO RATIFY THE ACTIONS OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE ALSO HANDLES SPECIFIC QUESTIONS REFERRED BY THE FULL BOARD, ISSUES THAT NEED PRELIMINARY DISCUSSION BEFORE THE FULL BOARD CONSIDERS THEM, AND ROUTINE MATTERS NOT REQUIRING FULL BOARD ATTENTION. THE EXECUTIVE COMMITTEE ESTABLISHES AND IMPLEMENTS A PROCESS FOR ASSESSING THE PERFORMANCE OF THE CEO. |
| FORM 990, PART VI, SECTION A, LINE 3 | PHARMACY MANAGEMENT IS OUTSOURCED TO CARDINAL HEALTH. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS REVIEWED IN DETAIL BY THE CFO. IT WAS THEN REVIEWED BY THE FINANCE COMMITTEE, THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY PROHIBITS TRANSACTIONS THAT WOULD GIVE RISE TO A CONFLICT OF INTEREST. BOARD MEMBERS ARE PROVIDED WITH A CONFLICT OF INTEREST POLICY WHEN APPOINTED TO THE BOARD. ALL BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST AND COMPENSATION DISCLOSURE STATEMENT ANNUALLY. EMPLOYEES SIGN THAT THEY RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY WHEN HIRED AND ARE INFORMED THAT THEY NEED TO ADVISE THE ORGANIZATION IF A CONFLICT OF INTEREST ARISES. THE DISCLOSURE STATEMENTS ARE REVIEWED BY THE CEO AND PCHC'S LEGAL COUNSEL (IF NECESSARY). THE EXECUTIVE COMMITTEE DETERMINES THE APPROPRIATE PROCESS FOR RESOLVING AND/OR MANAGING THE CONFLICTS. AT EACH MONTHLY BOARD MEETING, BOARD MEMBERS ARE ASKED IF THEY HAVE ANY CONFLICTS TO DISCLOSE AND THIS IS NOTED IN THE BOARD MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD PERFORMS A THOROUGH REVIEW TO DETERMINE SUITABLE COMPENSATION FOR THE CEO. AFTER APPROVAL BY THE BOARD IN EXECUTIVE SESSION, A WRITTEN CONTRACT IS PREPARED AND SIGNED. COMPARABILITY DATA CAN INCLUDE COLORADO COMMUNITY HEALTH NETWORK OR MOUNTAIN STATES EMPLOYER'S COUNCIL COMPENSATION SURVEYS OR FORMS 990 OF SIMILAR ORGANIZATIONS. THE CEO AND HR DIRECTOR PERFORM A THOROUGH REVIEW TO DETERMINE SUITABLE COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES. COMPARABILITY DATA CAN INCLUDE COLORADO COMMUNITY HEALTH NETWORK OR MOUNTAIN STATES EMPLOYER'S COUNCIL COMPENSATION SURVEYS OR FORMS 990 OF SIMILAR ORGANIZATIONS. THESE PROCESSES LAST OCCURRED IN 2017. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. REQUESTS MAY BE SUBMITTED TO THE CEO AND ARE FORWARDED TO THE BOARD PRESIDENT. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN FOUNDATION 187,613. |