STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

PEAK VISTA COMMUNITY HEALTH CENTERS: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
PEAK VISTA COMMUNITY HEALTH CENTERS (EIN 84-0617567)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-08
IRS object ID
201343129349301404
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2013-11-08T09:58:51-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1STOCKMAN KAST RYAN & CO LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1102 N CASCADE AVENUE SUITE 400AddressLine1
CityCOLORADO SPRINGSCity
StateCOState
ZIP Code80903ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN840617567EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PEAK VISTA COMMUNITY HEALTH CENTERSBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% PEAK VISTA CHCInCareOfName
Name ControlPEAKNameControl
Phone7193446450Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1340 PRINTERS PARKWAYAddressLine1
Address Line2SuiteAddressLine2
CityCOLORADO SPRINGSCity
StateCOState
ZIP Code80910ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJEN KNELLINGERName
TitleCHAIRPERSONTitle
Phone7193446450Phone
Date Signed2013-11-04DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDOREEN B MERZName
Phone7196301186Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJEN KNELLINGERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1340 PRINTERS PARKWAYAddressLine1
CityCOLORADO SPRINGSCity
StateCOState
ZIP Code80910ZIPCode
FieldValueIRS element (for citing)
Gross Receipts50726648GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.peakvista.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1971YearFormation
State Legal DomicileCOStateLegalDomicile
Activity Or Mission DescriptionPeak Vista Community Health Centers' mission is to provide exceptional healthcare for people facing access barriers. See Schedule O for continuation.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees716TotalNbrEmployees
Total Nbr Volunteers258TotalNbrVolunteers
Total Gross UBI-28562TotalGrossUBI
Net Unrelated Business Txbl Income-28562NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year15126906ContributionsGrantsPriorYear
Contributions Grants Current Year15157938ContributionsGrantsCurrentYear
Program Service Revenue Prior Year32214814ProgramServiceRevenuePriorYear
Program Service Revenue CY34216332ProgramServiceRevenueCY
Investment Income Prior Year-43810InvestmentIncomePriorYear
Investment Income Current Year-34976InvestmentIncomeCurrentYear
Other Revenue Prior Year262093OtherRevenuePriorYear
Other Revenue Current Year1152563OtherRevenueCurrentYear
Total Revenue Prior Year47560003TotalRevenuePriorYear
Total Revenue Current Year50491857TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year30363421SalariesEtcPriorYear
Salaries Etc Current Year32811954SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY10376TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year376589TotalFundrsngExpCurrentYear
Other Expense Prior Year15319700OtherExpensePriorYear
Other Expenses Current Year16117896OtherExpensesCurrentYear
Total Expenses Prior Year45683121TotalExpensesPriorYear
Total Expenses Current Year48940226TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1876882RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1551631RevenuesLessExpensesCY
Total Assets BOY35314170TotalAssetsBOY
Total Assets EOY45267856TotalAssetsEOY
Total Liabilities BOY7397527TotalLiabilitiesBOY
Total Liabilities EOY15145317TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY27916643NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY30122539NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE EXCEPTIONAL HEALTHCARE FOR PEOPLE FACING ACCESS BARRIERS, SERVING MORE THAN 66,000 PEOPLE LIVING IN THE PIKES PEAK REGION (which is 1 out of every 10 people) through 21 centers. CONTINUED ON SCHEDULE O.MissionDescription
Significant New Program ServicestrueSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense34608124Expense
Revenue29527165Revenue
DescriptionPrimary Care: Peak Vista served 61,159 medical patients with 208,783 visits in 2012. Additionally, through our primary care program, Peak Vista provided care coordination for 36,497 visits, provided 11,944 visits for support services, 15,507 patient visits to our Convenient Care Center, 15,194 visits associated with our Behavioral Health Services, and 3,917 visits through our Volunteer Specialty Care Center. CONTINUED ON SCHEDULE O.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense3441462Expense
Revenue2938065Revenue
DescriptionDental: Peak Vista served 12,541 dental patients in 2012 with 26,321 visits. Dental visits have grown as our Family Health Centers and the Ronald McDonald Care Mobile have each experienced continued increase in demand for dental services.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense2964095Expense
Revenue127544Revenue
DescriptionThe homeless program provides primary care, dental care, and/or behavioral health care. However, to be served in this program, the patient MUST MEET the homeless criteria. Peak Vista served 1,393 patients though 7,152 visits in 2012. Our homeless services are located adjacent to community partners to better serve the homeless population.Description

Activity Other ActivityOther (4 entries)

RevenueRevenueDescriptionDescription
828750MEDICAID ELECTRONIC RECORD
67105MEDICAL RECORD COPIES
265830PRESCRIPTION AGREEMENT FEES
1642997OTHER
FieldValueIRS element (for citing)
Total Of Other Program Service Rev2804682TotalOfOtherProgramServiceRev
Total Program Service Expense41013681TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096132NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees716NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonPEAK VISTA CHCNamePerson
Telephone Number7196306450TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1340 PRINTERS PARKWAYAddressLine1
CityCOLORADO SPRINGSCity
StateCOState
ZIP Code80910ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (39 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Jen Knellinger
Chairperson1.01.0XX000
Vincent Yorke
Vice Chairperson1.0XX
Pam Taylor
Secretary1.0XX
Steve Scott
Treasurer1.0XX
Cindy Ellis
At-Large1.0X
Robert Wilson
Director1.01.0X
Diane Bignell
Director1.0X
Casey Corey
Director1.0X
Bob Duran
Director1.0X
George Guerrero
Director1.0X
Donna Johnson
Director1.0X
Victoria Stone
Director1.0X
Pam McManus
CEO / President40.01.0X18575422104
BJ Scott
Foundation Exec Director1.040.0X14782316271
Michael Welch
Vice President40.0X19425322284
Fitzwater Bradach
Vice President40.0X14768
Buckland Kandace
Vice President40.0X886144895
Tom Plamondon
Asst Vice President40.0X1365325461
Darvi Rahaman
Asst Vice President40.017967921861X
Scott Robinson
Asst Vice President40.019052014674X
Amir Salek
Asst Vice President40.017588021709X
Peter Liehr
Physician40.024955924656X
Jeff McCutcheon
OB Gyn Physician40.024099424314X
Dallas Thompson
OB Gyn Physician40.023088423909X
Svetlana Tsirkin
Physician40.021518023281X
Greg Unruh
Physician40.018004017400X
Barbara Divish
Physician40.016716316942X
Brenda Walker
Physician40.016619921322X
Michael Reisig
Physician40.016425621244X
Marsha Alger
Physician40.01354135416X
Paul Dube
Physician40.017960713847X
Amy Clauss
Physician40.017937920497X
Seufer Sonia
Physician40.017145917872X
Mihir Patel
Physician40.016920612434X
Thomas Henderson
Physician40.016656921337X
Sara Martin
Physician40.016496916854X
Debra Garcia
Physician40.016496916797X
Deepak Honaganahalli
Physician40.016496910236X
Luna Erin
Physician40.016219614075X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4586834TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation451692TotalOtherCompensation
Number Individuals GT100 K40NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MOUNTAIN VIEW MEDICAL GROUP
PO BOX 36140COLORADO SPRINGSCO80936HOSPITALIST SERVICES514955
MEDICAL CENTER OF COLORADO SPRINGS
11150 ACADEMY PARK LOOP STE 104COLORADO SPRINGSCO80910DENTISTRY SERVICES509536
LABORATORY CORPORATION OF AMERICA
PO BOX 12140BURLINGTONNC27216LABORATORY SERVICES458123
KENNEDY CONTRACTING
5275 BANCROFT HEIGHTSCOLORADO SPRINGSCO80906HOUSEKEEPING SERVICE293849
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Federated Campaigns112915FederatedCampaigns
Related Organizations3064699RelatedOrganizations
Government Grants5256451GovernmentGrants
All Other Contributions6723873AllOtherContributions
Noncash Contributions4296173NoncashContributions
Total Contributions15157938TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE/MEDICAID6214002298260422982604
PATIENT FEES62140054140345414034
TOBACCO REVENUE62140032212543221254
COLORADO INDIGENT CARE62140011330281133028
RCCO REVENUE621400736171736171

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column729241TotalRevenueColumn
Related Or Exempt Function Income729241RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue34216332TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5957TotalRevenueColumn
Exclusion$5,957ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real184736Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real193858Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-9122Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-9121TotalRevenueColumn
Related Or Exempt Function Income19441RelatedOrExemptFunctionIncome
Unrelated Business Revenue-28562UnrelatedBusinessRevenue

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other40933Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-40933Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-40933TotalRevenueColumn
Exclusion-$40,933ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICAID ELECTRONIC RECORD900099828750828750
MEDICAL RECORD COPIES9000996710467104
PRESCRIPTION AGREEMENT FEES900099265830265830
FieldValueIRS element (for citing)
Total Other Revenue1161684TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column50491857TotalRevenueColumn
Related Or Exempt Function Income35397457RelatedOrExemptFunctionIncome
Unrelated Business Revenue-28562UnrelatedBusinessRevenue
Exclusion-$34,976ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total4135559Total
Program Services3550021ProgramServices
Management And General551523ManagementAndGeneral
Fundraising34015Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total23280879Total
Program Services19956137ProgramServices
Management And General3133298ManagementAndGeneral
Fundraising191444Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total501992Total
Program Services431562ProgramServices
Management And General66300ManagementAndGeneral
Fundraising4130Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2871054Total
Program Services2404626ProgramServices
Management And General442898ManagementAndGeneral
Fundraising23530Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2022470Total
Program Services1738716ProgramServices
Management And General267116ManagementAndGeneral
Fundraising16638Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total55107Total
Program Services7215ProgramServices
Management And General47892ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total56100Total
Management And General56100ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total2820Total
Management And General2820ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total10376Total
Fundraising10376Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1709382Total
Program Services1466506ProgramServices
Management And General223511ManagementAndGeneral
Fundraising19365Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3935020Total
Program Services2808569ProgramServices
Management And General1065051ManagementAndGeneral
Fundraising61400Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1389883Total
Program Services876279ProgramServices
Management And General512604ManagementAndGeneral
Fundraising1000Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total87699Total
Program Services31513ProgramServices
Management And General54921ManagementAndGeneral
Fundraising1265Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total17902Total
Program Services14651ProgramServices
Management And General3214ManagementAndGeneral
Fundraising37Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total194723Total
Program Services159360ProgramServices
Management And General34955ManagementAndGeneral
Fundraising408Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1161284Total
Program Services786217ProgramServices
Management And General375067ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total81610Total
Program Services66789ProgramServices
Management And General14650ManagementAndGeneral
Fundraising171Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PHARMACEUTICALS116771211600357677
MAINTENANCE & REPAIRS928980645610283220150
OTHER PERSONNEL4818951731593017876949
CONTRIBUTED SUPPLIES48392484736716102532

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total8531Total
Management And General2820ManagementAndGeneral
Fundraising5711Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total48940226Total
Program Services41013681ProgramServices
Management And General7549956ManagementAndGeneral
Fundraising376589Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY10570BOY
EOY9870EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8207719BOY
EOY11543460EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY479336BOY
EOY599780EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1285614BOY
EOY2623068EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY320967BOY
EOY331159EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY444404BOY
EOY421349EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis36612714LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8921207LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY23355018BOY
EOY27691507EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1210542BOY
EOY2047663EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY35314170BOY
EOY45267856EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2844976BOY
EOY6410449EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY109453BOY
EOY7962EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY4443098BOY
EOY8726906EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7397527BOY
EOY15145317EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY26324472BOY
EOY29751124EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1592171BOY
EOY371415EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27916643BOY
EOY30122539EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY35314170BOY
EOY45267856EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1551631ReconcilationRevenueExpenses
Reconcilation Other Changes654265ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals2820FilingOrganizationsTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals2820FilingOrganizationsTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals49943806FilingOrganizationsTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals49946626FilingOrganizationsTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals
FieldValueIRS element (for citing)
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus31000000CurrentYearMinus3
Current Year Minus21000000CurrentYearMinus2
Current Year Minus11000000CurrentYearMinus1
Current Year1000000CurrentYear
Total4000000Total
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmount

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

FieldValueIRS element (for citing)
Current Year Minus33290CurrentYearMinus3
Current Year Minus215594CurrentYearMinus2
Current Year Minus13737CurrentYearMinus1
Current Year2820CurrentYear
Total25441Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus3250000CurrentYearMinus3
Current Year Minus2250000CurrentYearMinus2
Current Year Minus1250000CurrentYearMinus1
Current Year250000CurrentYear
Total1000000Total
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmount

Grassroots Lobbying Expenditures GrassrootsLobbyingExpenditures

FieldValueIRS element (for citing)
Current Year Minus33290CurrentYearMinus3
Total3290Total

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Contributions20000Contributions
End Of Year Balance20000EndOfYearBalance
FieldValueIRS element (for citing)
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis2124443OtherCostOrOtherBasis
Book Value2124443BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis24647556OtherCostOrOtherBasis
Depreciation4059625Depreciation
Book Value20587931BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis7383199OtherCostOrOtherBasis
Depreciation4861582Depreciation
Book Value2521617BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2457516OtherCostOrOtherBasis
Book Value2457516BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings27691507TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt52100034TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities719121DonatedSrvcAndUseOfFacilities
Other Revenues889056OtherRevenues
Revenue Not Rptd F9901608177RevenueNotRptdF990
Revenue Subtotal50491857RevenueSubtotal
Total Revenue Per Form99050491857TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt49894138TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities719121DonatedServicesUseOfFacilities
Other Expenses Included234791OtherExpensesIncluded
Expenses Not Rptd F990953912ExpensesNotRptdF990
Expenses Subtotal48940226ExpensesSubtotal
Total Expenses Per Form99048940226TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierExplanationExplanation
SCHEDULE D, PART V, LINE 4Endowment funds are used to support the operations of Peak Vista Community Health Center. SCHEDULE D, PART X, LINE 2 THE ORGANIZATION BELIEVES THAT IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2DRENTAL EXPENSES - NETTED FOR 990 PRESENTATION: $193,858 LOSS ON DISPOSAL - REPORTED AS EXPENSE IN AUDIT: $ 40,933 CHANGE IN NET ASSETS OF FOUNDATION: $654,266
SCHEDULE D, PART XII, LINE 2DRENTAL EXPENSES - NETTED FOR 990 PRESENTATION: $193,858 LOSS ON DISPOSAL - REPORTED AS CONTRA-REVENUE ON 990: $ 40,933

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (23 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrg
Pam McManus
CEO / President185754743014674207858
BJ Scott
Foundation Exec Director147823607310198164094
Michael Welch
Vice President18875376101467421653715004000
Darvi Rahaman
Asst Vice President179679718714674201540
Scott Robinson
Asst Vice President19052014674205194
Amir Salek
Asst Vice President175880703514674197589
Peter Liehr
Physician249559998214674274215
Jeff McCutcheon
OB Gyn Physician240994964014674265308
Dallas Thompson
OB Gyn Physician230884923514674254793
Svetlana Tsirkin
Physician215180860714674238461
Greg Unruh
Physician180040720210198197440
Barbara Divish
Physician167163668710255184105
Brenda Walker
Physician166199664814674187521
Michael Reisig
Physician164256657014674185500
Paul Dube
Physician179607359210255193454
Amy Clauss
Physician179379582314674199876
Seufer Sonia
Physician171459554612326189331
Mihir Patel
Physician16920667685666181640
Thomas Henderson
Physician166569666314674187906
Sara Martin
Physician164969659910255181823
Debra Garcia
Physician164969659910198181766
Deepak Honaganahalli
Physician16496945705666175205
Luna Erin
Physician16219657513500176271

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSCHEDULE J, PART I, LINE 3Identifier
ExplanationDetermination of the CEO's salary at Peak Vista Community Health Centers is determined by making salary comparisons of similar positions at community health centers and other similar agencies in the state, Federal Region VIII, nation, and a survey of Mountain States salaries. From this analysis, a proposal is made to the Board of Directors and the proposal is accepted by them or adjustments are made as appropriate based on merit and budget constraints.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1COLORADO HEALTH FACILITIES AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN840752932IssuerEIN
Date Issued2012-11-20DateIssued
Issue Price9100000IssuePrice
Description Of PurposeSee Part VIDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds8379000TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds91993IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures4360436CapitalExpenditures
Other Spent Proceeds3926571OtherSpentProceeds
Amount Unspent0AmountUnspent
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers
Change In Use Bond Financed PropfalseChangeInUseBondFinancedProp
Remedial Action TakenfalseRemedialActionTaken
Non Qualified Bond Remed ProcdrsfalseNonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiled
Rebate Not Due YettrueRebateNotDueYet
Exception To RebatefalseExceptionToRebate
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Superintegrated HedgefalseSuperintegratedHedge
Hedge TerminatedfalseHedgeTerminated
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierPart I line A column FIdentifier
Return Reference0ReturnReference
ExplanationDescription of purpose: The bonds were used to buy medical equipment, remodel and refinance buildings. The medical equipment purchased from these bonds was used for patient care. The remodeling was done at a building at 3207 and 3205 North Academy for clinical space, enrollment services, pharmacy and well child waiting, and the refinancing was done for a building and equipment loan at Printers Parkway, South Union, Wasatch, and International Circle which includes clinical and administrative services.Explanation

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications

Clothing And Household Goods ClothingAndHouseholdGoods

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F99038073NoncashContribsRptdF990
Method Of Determining RevenuesCOSTMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty
Securities Publicly TradedSecuritiesPubliclyTraded
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions5NumberOfContributions
Noncash Contribs Rptd F9904127124NoncashContribsRptdF990
Method Of Determining RevenuesSEE PART IIMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts

Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)

Non Cash CheckboxNonCashCheckboxDescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
XBUILDING1127736FMV
Xother13240FMV
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII (2 entries)

IdentifierIdentifierExplanationExplanation
SCHEDULE M, PART I, LINE 20DISCOUNT REPLACEMENT COST
SCHEDULE M, PART I, COLUMN BTHESE AMOUNTS REPRESENT NUMBER OF CONTRIBUTORS.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierExplanationExplanation
FORM 990, PART I, LINE 1Our niche in the Pikes Peak region's healthcare marketplace is as a non-profit multi-specialty provider of integrated medical, dental, and behavioral health primary care services, mostly for working families. In this role, Peak Vista has endeavored to serve populations that are under or uninsured as well as those on public programs. Partnerships are a significant component of Peak Vista's ability to successfully meet its mission. We frequently collaborate with organizations of similar mission to better serve our mutual populations.
FORM 990, PART III, LINE 1Peak Vista offers numerous ancillary services and programs to benefit our patients to include: First Visitor which provides information to parents before and after the baby is born with trained volunteers making home visits designed to connect parents with community resources and early childhood materials. Health education supports patients with management of chronic diseases such as diabetes, high blood pressure, obesity, and asthma. A full service on-site laboratory and pharmacy provide easy access to testing and medications. Second Sight Vision Services help patients with vision impairment, giving them the tools they need to better accomplish daily activities. Well Child Waiting Areas (3) welcome little ones into a secure and child-friendly environment so that patients can attend appointments worry free.
FORM 990, PART III, LINE 22012 Peak Vista Community Health Centers accomplishments include: Patient Growth - Peak Vista served the largest number of patients in our history in 2012 serving over 66,000 patients, serving 1 in 10 people in the Pikes Peak Region. In 2012 Peak Vista averaged 1,050 patient visits per day (in 2006, the daily average was 600). Opening of the Falcon Peak School Based Health Center - Peak Vista's innovative partnerships with local school districts allowed us to open a new school based health center in Falcon, located at Falcon elementary school in District 49, which serves all children attending District 49 and their siblings. Opening / Expansion of the Mountain Family School Based Health Center in Cripple Creek - Together with our partners Cripple Creek-Victor School District RE-1, the Teller County Health Department, the Aspen Mine Center and community funders, we opened an expanded School Based Health Center - The Mountain Health Center - at Cresson Elementary School in Cripple Creek which serves all children attending RE-1 and their siblings. Lane Family Senior Health Center Capital Campaign - Together with our partner, UCCS, and community benefactors, Peak Vista completed the Lane Family Senior Center fundraising campaign and began construction during 2012. Academy - Together, with our major partners Penrose-St.Francis Health Services and the Colorado Health Foundation, we completed our major purchase of the former Penrose Community Hospital that will house our Convenient Care Center (which provided evening hour and weekend appointments), Developmental Disabilities Health Center, and two expanded Family Health Centers.
FORM 990, PART III, LINE 4ACONTINUED: A full line of ancillary services, all of which patients access in high volumes, compliment Peak Vista's primary care offerings. Health Education and care coordination supports patients with management of chronic diseases such as Diabetes, high blood pressure, obesity, and asthma. A full service laboratory, x-ray and pharmacy on site provide easy access to testing and medications. Second Sight Vision Services help patients with vision impairment, giving them the tools they need to better accomplish daily activities. Well Child Waiting Areas (3 locations) welcome young children into a secure and child friendly environment so that parents and other siblings can attend appointments without concern or distraction. First Visitor provides information to parents before and after a baby is born with trained volunteers making home visits designed to connect parents with community resources and early childhood materials.
FORM 990, PART III, LINE 4DPeak Vista Community Health Center's other services include: A school based health center in the Cripple Creek and Victor Mountain Health Center. Operation of the ""Green"" Ronald McDonald Care Mobile, providing pediatric patients with medical and dental services. Assumption of A grant-funded audiology program that provides free hearing aides to hearing-impaired seniors living in El Paso, Teller and Park Counties. The Reach Out and Read Program; a nationally acclaimed program that encourages reading by providing every Peak Vista patient from the age of six months to five years with a new, age-appropriate book to take home and keep when they visit our Pediatric Health Center and all our Family Health Centers for well-child check-ups.
FORM 990, PART VI, SECTION A, LINE 4The Bylaws for the organization were amended and restated January 2012. Key changes included adding specific responsibilities for the Board of Directors, clarifing terms, revising definitions of Compensation of Board and Operations Officers, adding a section on removal of operations officers, deleting sections on surety bonds, adding information on the authority of the executive committee and revising the indemnification article. FORM 990, PART VI, SECTION B, LINE 11 The entire Form 990 is brought to the Finance Committee of the Board of Directors. It is reviewed in detail and any changes can be made. The Finance Committee then takes a summary to the full board along with a recommendation to accept. The full board accepts the updated Form 990 through a motion.
FORM 990, PART VI, SECTION B, LINE 12CPeak Vista Community Health Centers' compliance plan and bylaws contain policies on conflict of interest. In order to ensure that conflicts of interest are disclosed, board members and leadership sign a disclosure statement when first appointed or employed and annually thereafter. Human Resources distribute the disclosure statements to leadership and the CEO's staff ensures that the statement is given to the Board of Directors. Any new board member or leadership staff is given education on the conflict of interest policy. If at any time during the year a potential conflict of interest arises, board members are required to inform those charged with approving the transaction of the conflict, disclose any material facts, and excuse themselves from voting.
FORM 990, PART VI, SECTION B, LINE 15Determination of salaries of highly compensated employees at Peak Vista Community Health Centers are determined by making salary comparisons of similar positions at community health centers and other similar agencies in the state, Federal Region VIII, national, and a survey of Mountain States salaries. From this analysis, a proposal is made to the VP of Finance, VP of Operations, VP of Medical and Dental, CEO and the Assistant VP of Workforce Development, and the proposal is accepted by them or adjustments are made as appropriate based on budget constraints. The CEOs salary comparison is completed by external independent experts and reviewed and approved by the Board of Directors.
FORM 990, PART VI, SECTION C, LINE 19As a private not-for-profit, the documents are not open to the public. Peak Vista Community Health Centers does however produce an annual report for the public, showing key events and a financial summary.
FORM 990, PART XI, Line 9Other Changes in Net assets: Change in beneficial interest in Foundation Net Assets FORM 990, PART XII, LINE 2B PRIOR TO 2012, PEAK VISTA DID NOT CONSOLIDATE THE FOUNDATION'S FINANCIAL STATEMENTS, BUT DID RECOGNIZE ITS BENEFICIAL INTEREST IN THE NET ASSETS OF THE FOUNDATION THAT WERE RESTRICTED BY DONORS FOR PEAK VISTA.
FORM 990, PART XII, LINE 2CTHIS PROCESS DID NOT CHANGE IN 2012.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1PEAK VISTA COMMUNTIY HEALTH CENTERS FDNBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1340 PRINTERS PARKWAYAddressLine1
CityCOLORADO SPRINGSCity
StateCOState
ZIP Code80910ZIPCode
FieldValueIRS element (for citing)
EIN203640104EIN
Primary ActivitiesFUNDRAISINGPrimaryActivities
Legal Domicile StateCOLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status11CPublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1See Part VIBusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgtrueControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1PEAK VISTA COMMUNITY HEALTH CENTERS FDNBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeCTransactionType
Amount Involved3064699AmountInvolved
Method Of Amt Determinationcash transferMethodOfAmtDetermination

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierPart II line 1 column FIdentifier
ExplanationDirect controlling entity of Peak Vista Community Health Centers Foundation is the reporting entity, Peak Vista Community Health Center.Explanation