2014-03-06T12:21:12-06:00 2013-04-30 430831507 ANDERS MINKLER HUBER & HELM LLP 800 MARKET STREET SUITE 500 ST LOUIS MO 631012501 990 2012-05-01 431752799 OZARK TRI-COUNTY HEALTH CARE CONSORTIUM DBA ACCESS FAMILY CARE OZAR 4174519450 PO BOX 758 NEOSHO MO 64850 SHEILA LONG 4174519450 2014-02-14 1 BRIAN MCCOOK P00435856 3146555500 2012 2015-11-30 17:44:51Z X ACCESS FAMILY CARE SHEILA LONG 4301 DONIPHAN DRIVE NEOSHO MO 64850 13048603 0 X WWW.ACCESSFAMILYCARE.ORG X 1996 MO WE ARE COMMITTED TO IMPROVING THE HEALTH OF THE MEDICALLY UNDERSERVED OF GREATER SOUTHWEST MISSOURI THROUGH DIRECT SERVICES AND COLLABORATIVE EFFORTS. 9 9 184 9 0 0 4537689 2797644 7247560 10241306 864 -75981 -40183 7326 11745930 12970295 0 0 0 0 7223523 9410098 0 0 0 3074412 3910775 10297935 13320873 1447995 -350578 10166805 9961665 1809950 1955388 8356855 8006277 WE ARE COMMITTED TO IMPROVING THE HEALTH OF THE MEDICALLY UNDERSERVED OF GREATER SOUTHWEST MISSOURI THROUGH DIRECT SERVICES AND COLLABORATIVE EFFORTS. 0 0 4992860 5753422 IN FY 2013, MEDICAL ENCOUNTERS TOTALED 35,003. 4992860 4495210 THE ORGANIZATION PROVIDES A WIDE VARIETY OF SERVICES TO THE PATIENT POPULATION IN ALL AREAS OF GENERAL DENTISTRY. IN FY 2013, DENTAL ENCOUNTERS TOTALED 22,060. 9985720 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 18 0 1 184 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 X X SHEILA LONG CFO 4174510619 475 NELSON AVENUE NEOSHO MO 64850 JERRIE WISE 1.00 X X 0 0 0 MARY ANN BRADLEY 1.00 X X 0 0 0 FRANCISCO BUSTILLO 1.00 X 0 0 0 DR AL CHAPMAN 1.00 X X 0 0 0 PEDRO PANTOJA 1.00 X 0 0 0 PEGGY CARPENTER 1.00 X X 0 0 0 ELIZABETH PERSONS 1.00 X 0 0 0 HEATHER MARTIN 1.00 X 0 0 0 KELLY TICHENOR BROWN 1.00 X 0 0 0 SHEILA LONG 40.00 X 86543 0 8409 DEBRA DAVIDSON 40.00 X 92579 0 3246 DON MCBRIDE 40.00 X 163317 0 10642 KAREN PORTE 40.00 X 135133 0 7935 DR LELAND MCCALL 40.00 X 145279 0 10501 ALLEN SMITH 40.00 X 145873 0 10163 CHARLES BENTLAGE 40.00 X 160388 0 5210 JERRY JUMPER MD 40.00 X 175042 0 11342 1104154 0 67448 18 0 1 0 QUEST DIAGNOSTICS PO BOX 14730 SAINT LOUIS MO 631504730 LABORATORY SERVICES 127554 1 2606459 191185 19474 2797644 PATIENT SERVICE 624100 9837556 9837556 EHR INCENTIVE PROGRAMS 624100 403750 403750 10241306 2327 2327 78308 -78308 -78308 -78308 MISCELLANEOUS INCOME 900099 7326 7326 7326 12970295 10248632 0 -75981 364736 259973 104763 7375146 5269549 2105597 213901 153073 60828 911190 600567 310623 545125 391680 153445 3480 3480 36945 36945 644056 578461 65595 41070 22501 18569 222054 125471 96583 414815 344647 70168 342776 288088 54688 55815 28246 27569 76542 46862 29680 569434 475949 93485 113864 94655 19209 SUPPLIES 601789 601789 BAD DEBT 544754 544754 REPAIRS AND MAINTENANCE 143433 106577 36856 RECRUITMENT & RETENTION 47619 26430 21189 52329 26448 25881 13320873 9985720 3335153 0 1206798 566113 513692 1116315 161289 174856 856973 845251 305450 84937 143114 300151 8810049 3007907 6389699 5802142 49474 589790 1022426 10166805 9961665 1513228 1855081 296722 100307 1809950 1955388 X 8350941 7988137 5914 18140 8356855 8006277 10166805 9961665 -350578 0 X X 0 1 X 1 1 1 X 5593794 3261104 2996732 4537689 2797644 19186963 3826640 5178463 6345300 7247560 10241306 32839269 9420434 8439567 9342032 11785249 13038950 52026232 0 0 0 52026232 16783 4745 2644 2545 2327 29044 16783 4745 2644 2545 2327 29044 7326 7326 9437217 8444312 9344676 11787794 13048603 52062602 0.99930 0.99670 0.00060 0.00180 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 428770 428770 5936515 1331423 4605092 2444764 1676484 768280 5802142 DUE FROM MEDICARE/MEDICAID 836323 CONSTRUCTION ON PROGRESS 186103 1022426 X 12425541 0 12425541 544754 544754 12970295 12776119 0 12776119 544754 544754 13320873 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE"), EXCEPT ON NET INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES AS DEFINED IN THE CODE. ACCORDINGLY, THE ORGANIZATION FILES AS A TAX EXEMPT ORGANIZATION. THE ORGANIZATION FOLLOWS GUIDANCE ISSUED BY THE FASB ON ACCOUNTING FOR INCOME TAXES AND HAS EVALUATED ITS TAX POSITIONS, EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS, AND BELIEVES THAT NO PROVISION FOR INCOME TAXES IS NECESSARY TO COVER ANY UNCERTAIN TAX POSITIONS. THE ORGANIZATION'S RETURNS FOR TAX YEARS 2010 AND LATER REMAIN SUBJECT TO EXAMINATION BY TAXING AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 544,754. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 544,754. X X 0 0 0 0 0 1 0 0 0 DON MCBRIDE 159158 0 4159 0 0 0 5116 0 5526 0 173959 0 0 0 DR LELAND MCCALL 145279 0 0 0 0 0 4473 0 6028 0 155780 0 0 0 ALLEN SMITH 145873 0 0 0 0 0 4154 0 6009 0 156036 0 0 0 CHARLES BENTLAGE 157061 0 3327 0 0 0 4823 0 387 0 165598 0 0 0 JERRY JUMPER MD 154268 0 20774 0 0 0 5338 0 6004 0 186384 0 0 0 SUPPLEMENTAL INFORMATION PART III CONTINGENT COMPENSATION SCHEDULE D, PART 1, QUESTION 6A THE ORGANIZATION HAS AN INCENTIVE COMPENSATION PLAN. INCENTIVE COMPENSATION IS BASED ON THE PRODUCTIVITY OF THE MEDICAL AND DENTAL PROVIDERS EVERY 6 MONTHS. ALL EMPLOYEES RECEIVE A PORTION OF THE INCENTIVE COMPENSATION PAYMENT FROM THE DIVISION AND CLINIC THAT THEY WORK IN AND ADMINISTRATION SHARES IN ALL CLINICS INCENTIVE COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT VERSION OF THE 990 WILL BE REVIEWED BY INTERNAL MANAGEMENT AND THE BOARD CHAIR. ONCE RECOMMENDED CHANGES ARE MADE, A FINAL DRAFT WILL BE PROVIDED TO THE ENTIRE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C ANY DUALITY OF INTEREST, CONFLICTS OF INTEREST OR THE APPEARANCE OF CONFLICTS OF INTEREST ON THE PART OF ANY BOARD MEMBER, EMPLOYEE OR CONSULTANT IS PROHIBITED. SUCH DUALITY OF INTEREST, CONFLICTS OF INTEREST OR APPEARANCE OF CONFLICTS OF INTEREST SHALL BE DISCLOSED TO THE BOARD OF DIRECTORS FOR ADJUDICATION. FORM 990, PART VI, SECTION B, LINE 15 ALL COMPENSATION IS SUBJECT TO EVALUATION OF THE SALARY SURVEY COMPLETED BY MISSOURI PRIMARY CARE ASSOCIATION AND IS USED IN DETERMINING COMPENSATION FOR ALL EMPLOYEES. COMPARABILITY DATA AND A SALARY RANGE PREPARED BY THE MISSOURI PRIMARY CARE ASSOCIATION ARE USED FOR REVIEW. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST. COPIES OF THESE DOCUMENTS WILL BE MAILED TO THE PARTY REQUESTING THEM. FORM 990, PART XII, LINE 23 THERE WERE NO CHANGES FROM THE PRIOR YEAR.