EXECUTIVE DIRECTOR

2014-04-02T17:20:58-05:00 2013-05-31 410746749 CLIFTONLARSONALLEN LLP 370 INTERLOCKEN BLVD SUITE 500 BROOMFIELD CO 80021 990 2012-06-01 840742145 MOUNTAIN FAMILY HEALTH CENTERS MOUN 9709452840 1905 BLAKE ST NO 101 GLENWOOD SPRINGS CO 81601 ROSS BROOKS EXECUTIVE DIRECTOR 9709452840 2014-03-28 1 V E SHOUP CPA P00220967 3034668822 2012 2015-11-30 17:44:51Z ROSS BROOKS 1905 BLAKE ST SUITE 101 GLENWOOD SPRINGS CO 81601 7906757 0 X WWW.MOUNTAINFAMILY.ORG X 1977 CO TO PROVIDE HIGH QUALITY PRIMARY HEALTH, DENTAL, AND BEHAVIORAL HEALTH CARE IN THE COMMUNITIES WE SERVE, WITH SPECIAL CONSIDERATION FOR THE MEDICALLY UNDER-SERVED AND UNINSURED. 9 9 112 20 0 0 3259682 3344012 4550535 4495459 2170 1136 15532 66150 7827919 7906757 0 0 0 0 5002414 5505768 0 0 0 2900988 2821833 7903402 8327601 -75483 -420844 5194228 4804228 581567 612466 4612661 4191762 TO PROVIDE HIGH QUALITY, INTEGRATED PRIMARY, BEHAVIORAL AND DENTAL HEALTH CARE IN THE COMMUNITIES WE SERVE, WITH SPECIAL CONSIDERATION FOR THE MEDICALLY UNDER-SERVED AND UNINSURED REGARDLESS OF ABILITY TO PAY. 0 0 6468440 0 4561609 PRIMARY CARE SERVICES - FOUR CLINICS PROVIDE OUTPATIENT MEDICAL TREATMENT FOR 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 US DEPT OF HEALTH AND HUMAN SERVICES. FOR THE FISCAL YEAR, 13,395 PATIENTS SERVED WITH 43,145 BILLABLE ENCOUNTERS. 6468440 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 33 0 1 112 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CO X X ANNETTE FRANTA 9709452840 1905 BLAKE ST NO 101 GLENWOOD SPRINGS CO 81601 JOANN SORENSEN PRESIDENT 2.00 X X 0 0 0 JEROME EVANS VICE-PRESIDENT 2.00 X X 0 0 0 THOMAS BOAS SECRETARY 2.00 X X 0 0 0 JOHN W BARBEE DIRECTOR 2.00 X 0 0 0 LIZ STARK DIRECTOR 2.00 X 0 0 0 KEN FRIEDMAN DIRECTOR 2.00 X 0 0 0 TOM LAMBRECHT DIRECTOR 2.00 X 0 0 0 SANDRO TORRES DIRECTOR 2.00 X 0 0 0 RACHEL OYS DIRECTOR 2.00 X 0 0 0 CHRIS TONOZZI PHYSICIAN, HIT DIRECTOR 40.00 X 176510 0 10432 AMY BROWN PHYSICIAN 40.00 X 162727 0 9957 KEN DAVIS MEDICAL DIRECTOR 40.00 X 104385 0 20488 GARRY MILLARD DENTAL DIRECTOR 40.00 X 127090 0 22940 570712 0 63817 4 0 1 0 HENRY SCHIEN DEPT CH 10241 PALATINE IL 60055 MEDICAL SUPPLIES 195474 CCMCN 600 GRANT STREET DENVER CO 80203 INFORMATION TECHNOLOGY SERVICES 170960 LABORATORY CORPORATION OF AMERICA PO BOX 2240 BURLINGTON NC 27216 LAB SERVICES 124679 QUALITY SYSTEMS INC 18111 VON KARMAN IRVINE CA 92612 HIT SOFTWARE AND SUPPORT 115305 ITENTIVE CORPORATION 1700 E HIGGINS RD 650 DES PLAINES IL 60018 INFORMATION TECHNOLOGY SERVICES 102500 5 2346200 997812 433635 3344012 PATIENT FEES 621400 4495459 4495459 4495459 1136 1136 MISCELLANEOUS INCOME 621400 66150 66150 66150 7906757 4561609 0 1136 794764 382801 411963 3738588 3270381 468207 972416 797843 174573 15415 11580 3835 20132 15124 5008 227922 171218 56704 75598 72458 3140 861236 849725 11511 170203 89867 80336 68140 16788 51352 246242 166310 79932 12500 12500 PURCHASED SERVICES 777415 403028 374387 REPAIRS AND MAINTENANCE 127117 111510 15607 TELEPHONE 112873 63490 49383 DUES AND SUBSCRIPTION 56497 4713 51784 50543 41604 8939 8327601 6468440 1859161 0 31953 764802 824416 60309 843489 660845 549744 538675 0 0 0 0 14861 20133 3707116 970217 2924087 2736899 5678 22565 0 0 0 0 5194228 4804228 537716 553200 0 43851 59249 0 0 0 0 0 0 17 581567 612466 X 3811765 4048055 800896 143707 0 4612661 4191762 5194228 4804228 -420844 -55 0 X 0 1 X 1 1 1 X 3361310 4108891 3966035 3259682 3211868 17907786 3361310 4108891 3966035 3259682 3211868 17907786 17907786 16160 16426 47706 5057 1136 86485 13196 8250 15001 15532 66150 118129 18112400 16456564 0.98870 0.98700 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 2508861 234539 2274322 82815 46484 36331 890396 572049 318347 225044 117145 107899 2736899 17 17 8213743 -55 307041 306986 7906757 0 7906757 8634642 307041 307041 8327601 0 8327601 LIABILITY UNDER FIN 48 FOOTNOTE: SCHEDULE D, PAGE 3, PART X, THE ORGANIZATION FOLLOWS THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ACCOUNTING STANDARD WHICH REQUIRES THE ORGANIZATION TO DETERMINE WHETHER A TAX POSITION (AND THE RELATED TAX BENEFIT) IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAXING AUTHORITY, BASED SOLELY ON THE TECHNICAL MERITS OF THE POSITION THE TAX BENEFIT TO BE RECOGNIZED IS MEASURED AS THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT, PRESUMING THAT THE TAX POSITION IS EXAMINED BY THE APPROPRIATE TAXING AUTHORITY THAT HAS FULL KNOWLEDGE OF ALL RELEVANT INFORMATION DURING THE YEAR ENDED MAY 31, 2013,THE ORGANIZATION'S MANAGEMENT EVALUATED ITS TAX POSITIONS TO DETERMINE THE EXISTENCE OF UNCERTAINTIES, AND DID NOT NOTE ANY MATTERS THAT WOULD REQUIRE RECOGNITION OR WHICH MAY HAVE AN EFFECT ON ITS TAX-EXEMPT STATUS. X X 0 0 0 0 0 0 0 0 0 CHRIS TONOZZI PHYSICIAN, HIT DIRECTOR 176510 0 0 0 0 0 0 0 10432 0 186942 0 0 0 AMY BROWN PHYSICIAN 162727 0 0 0 0 0 0 0 9957 0 172684 0 0 0 GARRY MILLARD DENTAL DIRECTOR 127090 0 0 0 0 0 0 0 22940 0 150030 0 0 0 X 6456 433635 FMV 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE BOD WILL BE GIVEN A COPY WITH A SUMMARY STATEMENT BY MANAGEMENT FOR REVIEW AND APPROVAL BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C POTENTIAL CONFLICTS ARE REVIEWED ANNUALLY WITH THE BOD VIA FORMAL SURVEY PROCESS, DISCLOSED MONTHLY AT EACH BOD MEETING, AND INDIVIDUALLY WITH EACH NEW MEMBER AS THEY COME ON BOARD. FORM 990, PART VI, SECTION B, LINE 15 EVERY TWO YEARS SALARY SURVEY INFORMATION FROM MOUNTAIN STATES EMPLOYERS COUNCIL AND NACHC/CCHN TO DETERMINE COMPENSATION OF TOP MANAGEMENT OFFICIALS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 18 UPON REQUEST AND VIA STATE OF COLORADO WEBSITE FORM 990, PART VI, SECTION C, LINE 19 MADE AVAILABLE UPON REQUEST.