2012-11-09T15:05:42-06:00 2011-12-31 STOCKMAN KAST RYAN & CO LLP 102 N CASCADE AVENUE SUITE 400 COLORADO SPRINGS CO 80903 990 2011-01-01 840617567 PEAK VISTA COMMUNITY HEALTH CENTERS % PEAK VISTA CHC PEAK 7193446450 340 PRINTERS PARKWAY COLORADO SPRINGS CO 80910 Jen Knellinger 2012-11-06 true DOREEN B MERZ 7196301186 2011 2016-02-24 21:20:13Z JEN KNELLINGER 340 PRINTERS PARKWAY COLORADO SPRINGS CO 80910 47736275 false X www.peakvista.org X 1971 CO To provide exceptional healthcare for people facing access barriers. See Schedule O for continuation. 15 15 662 74 -130 -130 20518132 15126906 31686829 32214814 -238026 -43810 370753 262093 52337688 47560003 0 0 0 0 27273076 30363421 0 0 448190 16135592 15319700 43408668 45683121 8929020 1876882 36453062 35314170 10413301 7397527 26039761 27916643 X To provide exceptional healthcare for people facing access barriers, serving more than 65,000 people living in the Pikes Peak Region through 18 centers. CONTINUED ON SCHEDULE O. true false 33666964 28931626 Of the total Peak Vista patients, the largest portion are seen for primary care: Peak Vista served 56,080 medical patients with 190,480 visits in 2011. CONTINUED ON SCHEDULE O. 3190825 3066616 In addition to primary care, Peak Vista has a dental program. Some of the patients may also be included in the primary care numbers if they receive services in both programs. Peak Vista served 12,027 dental patients in 2011 with 25,245 visits. Dental visits have grown as our Family Health Centers and the Ronald McDonald Care Mobile have each experienced a significant increase in demand for dental services. 1059875 142677 The homeless program provides primary care, dental care, and/or behavioral health care. However, to be served in this program, the patient meets the homeless criteria. Peak Vista served 1,369 patients though 5,808 visits in 2011. Our homeless services are located adjacent to community partners to better serve the homeless population. 195088 336118 38112752 true true false true false false false false false false true false false false false true true false false false false false false false false false false false false true true false false false false false false false false false false true false false false false false false false false false true X 185 0 662 true true true false false false false false false false false false X 15 15 false false false false false false false true true false false true true true true true true true true false X PEAK VISTA CHC 7196306450 340 PRINTERS PARKWAY COLORADO SPRINGS CO 80910 George Guerrero 1.0 X X Jen Knellinger 1.0 X X Donna Johnson 1.0 X X Robin McGrath 1.0 X X Santiago Duran 1.0 X Marilyn Diane Bignell 1.0 X Ted Borden 1.0 X Cerela Corey 1.0 X Jeff Dunn 1.0 X Cindy Ellis 1.0 X Johnnie Fant 1.0 X Steve Scott 1.0 X Pam Taylor 1.0 X Robert Willson 1.0 X Vince Yorke 1.0 X Pam McManus 40.0 X 156039 0 16741 BJ Scott 1.0 X 165849 0 21843 Michael Welch 40.0 X 182560 0 17787 Katie Lutze 40.0 X 51807 0 56 Len Graybeal 40.0 X 61907 0 1963 Darvi Rahaman 40.0 X 170420 0 16661 Amir Salek 40.0 X 165885 0 15685 Scott Robinson 40.0 X 196420 0 8234 Peter Liehr 40.0 X 236365 0 18320 Jeff McCutcheon 40.0 X 230229 0 18578 Dallas Thompson 40.0 X 217620 0 17499 Svetlana Tsirkin 40.0 X 222011 0 17526 Greg Unruh 40.0 X 176710 0 15923 Marsha Alger 40.0 X 163441 0 8316 Jonathon Weston 40.0 X 162182 0 15309 Brenda Walker 40.0 X 157670 0 14965 Barbara Divish 40.0 X 160644 0 14902 Mary Lou Kalmar 40.0 X 158103 0 8351 Paul Dube 40.0 X 166080 0 10040 Debra Garcia 40.0 X 170783 0 16278 Thomas Henderson 40.0 X 156589 0 14835 Mihir Patel 40.0 X 165731 0 9889 3695045 0 299701 40 false true false MOUNTAIN VIEW MEDICAL GROUP PO BOX 36140 COLORADO SPRINGS CO 80936 HOSPITALIST 513789 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LABORATORY 489673 KENNEDY CONTRACTING 5275 BANCROFT HEIGHTS COLORADO SPRINGS CO 80906 HOUSEKEEPING 280059 NORMAN FARRAR DDS 4935 BREABURN WAY COLORADO SPRINGS CO 80919 DENTISTRY 203841 4 147951 8265700 6713255 4947482 15126906 MEDICARE/MEDICAID 621400 21302322 21302322 PATIENT FEES 621400 5214706 5214706 TOBACCO REVENUE 621400 4260513 4260513 COLORADO INDIGENT CARE 621400 1244109 1244109 RCCO REVENUE 621400 193164 193164 32214814 12316 12316 0 0 123249 120146 3103 3103 3233 -130 56126 -56126 -56126 -56126 0 0 0 MISCELLANEOUS 621400 210937 210937 RCCO COMMITTEE REVENUE 621400 48053 48053 258990 47560003 32477037 -130 -43810 0 0 0 0 3118070 2653333 428392 36345 0 22068544 18758567 3054985 254992 450415 383578 61555 5282 2810949 2351184 431411 28354 1915443 1631211 261769 22463 0 57979 49356 8231 392 63630 54166 9033 431 3737 3737 0 0 2308654 1965288 327756 15610 0 2761873 1632392 1070857 58624 0 0 1229443 955170 274273 77718 28999 47417 1302 0 24236 14325 9397 514 213203 140014 68161 5028 0 1353521 909508 444013 71383 42191 27677 1515 PHARMACEUTICALS 1250510 1246718 3792 MAINTENANCE & REPAIRS 852160 642821 205339 4000 OTHER PERSONNEL 508198 189623 310059 8516 CONTRIBUTED SUPPLIES 4538633 4464308 74325 4822 4822 45683121 38112752 7122179 448190 10245 10570 7849353 8207719 612940 479336 1912303 1285614 0 0 0 0 0 0 861097 320967 628908 444404 30834796 7479778 23325481 23355018 0 0 0 0 0 0 0 0 1252735 1210542 36453062 35314170 5430186 2844976 0 0 0 109453 4983115 4443098 0 0 0 0 0 0 0 0 0 0 10413301 7397527 X 24185513 26324472 1854248 1592171 0 0 26039761 27916643 36453062 35314170 1876882 X X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3737 3737 38160529 38164266 1000000 250000 1000000 1000000 1000000 1000000 4000000 6000000 600 3290 15594 3737 23221 250000 250000 250000 250000 1000000 1500000 3290 3290 1562736 1562736 22387377 3314509 19072868 6829383 4165269 2664114 55300 55300 23355018 0 0 47560003 45683121 1876882 1876882 48639266 902990 176273 1079263 47560003 47560003 46762384 902990 176273 1079263 45683121 45683121 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 XII, LINE 2D RENTAL EXPENSES - NETTED FOR 990 PRESENTATION: 120,147 LOSS ON DISPOSAL - REPORTED AS EXPENSE IN AUDIT: 56,126 SCHEDULE D, PART XIII, LINE 2D RENTAL EXPENSES - NETTED FOR 990 PRESENTATION: 120,147 LOSS ON DISPOSAL - REPORTED AS CONTRA-REVENUE ON 990: 56,126 X X X false false false false false false false false false Pam McManus 156039 0 0 0 0 0 6677 0 10064 0 172780 0 0 0 BJ Scott 160107 0 0 0 5742 0 6490 0 15353 0 187692 0 0 0 Michael Welch 181060 0 1500 0 0 0 7687 0 10100 0 200347 0 0 0 Darvi Rahaman 169520 0 900 0 0 0 7041 0 9620 0 187081 0 0 0 Amir Salek 164635 0 1250 0 0 0 6915 0 8770 0 181570 0 0 0 Scott Robinson 195670 0 750 0 0 0 0 0 8234 0 204654 0 0 0 Peter Liehr 236365 0 0 0 0 0 9969 0 8351 0 254685 0 0 0 Jeff McCutcheon 230229 0 0 0 0 0 9387 0 9191 0 248807 0 0 0 Dallas Thompson 217088 0 532 0 0 0 9139 0 8360 0 235119 0 0 0 Svetlana Tsirkin 221479 0 532 0 0 0 8740 0 8786 0 239537 0 0 0 Greg Unruh 176710 0 0 0 0 0 7152 0 8771 0 192633 0 0 0 Marsha Alger 163441 0 0 0 0 0 6245 0 2071 0 171757 0 0 0 Jonathon Weston 162182 0 0 0 0 0 6669 0 8640 0 177491 0 0 0 Brenda Walker 157670 0 0 0 0 0 6614 0 8351 0 172635 0 0 0 Barbara Divish 160044 0 600 0 0 0 6551 0 8351 0 175546 0 0 0 Mary Lou Kalmar 158103 0 0 0 0 0 0 0 8351 0 166454 0 0 0 Paul Dube 165880 0 200 0 0 0 1885 0 8155 0 176120 0 0 0 Debra Garcia 170783 0 0 0 0 0 6468 0 9810 0 187061 0 0 0 Thomas Henderson 156589 0 0 0 0 0 6475 0 8360 0 171424 0 0 0 Mihir Patel 165731 0 0 0 0 0 3910 0 5979 0 175620 0 0 0 SCHEDULE J, PART I, LINE 3 Determination of the CEO's salary at Peak Vista Community Health Centers is made by the board of directors. The salary is determined after the independent salary comparisons of similar positions at community health centers and other similar not-for-profits in the state, Federal Region VIII, and nation are received by the executive committee of the board. A salary range is determined Based on the CEO's experience, education, and other factors and a salary recommendation is made from the Board of Director's executive committee to the full board of directors. The recommendation is accepted by them or adjustments are made as appropriate. CITY OF COLORADO SPRINGS 846000573 2006-09-01 7000000 SEE SCHEDULE O false false false 0 0 7000000 0 0 0 50000 0 0 6950000 0 0 2007 false false true true false false false false 0.00000 0.00000 0.00000 true false false false 0 false 0 false false X X 31871 COST X 8243 COST X 1 3475 FMV X 8 4936433 SEE PART II X OFFICE FURNITURE 2 4440 FMV X MISCELLANEOUS 2 1390 FMV false true false SCHEDULE M, PART I, LINE 20 DISCOUNT REPLACEMENT COST SCHEDULE M, PART I, COLUMN B THESE AMOUNTS REPRESENT NUMBER OF CONTRIBUTORS. FORM 990, PART I, LINE 1 Our 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. Our intention is not to compete with private practices in the community, many of whom are our strategic partners in providing more specialized care and/or offering volunteer services. 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 1 Peak 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 2 2011 Peak Vista Community Health Centers accomplishments include: PATIENT GROWTH: IN AUGUST, PEAK VISTA SERVED THE LARGEST NUMBER OF patients in our history: 22,357 patients were treated in one month, breaking the previous record of 21,200 set in March of 2010. In 2011 Peak Vista averaged 1,000 patient visits per day (in 2006, the daily average was 600). OPENING OF THE DEVELOPMENTAL DISABILITIES HEALTH CENTER (DDHC): AT DDHC we focus on providing exceptional healthcare for adult patients (18 and older) that have a developmental disability. Adults with intellectual and developmental disabilities (I/DD) can receive primary healthcare, comprehensive behavioral health services, and referrals to specialty care providers - all with care coordination and all customized to the needs of people with I/DD. OPENING OF THE MORENO HEALTH CENTER: THE MORENO HEALTH CENTER MARKS A new partnership, integrating medical and behavioral healthcare in one setting. Patients are enabled to see both categories of providers at one location, giving them the opportunity to establish one comprehensive medical home. PATIENT CENTERED MEDICAL HOME ACCREDITATION: PEAK VISTA RECEIVED AAAHC accreditation as a primary medical home. This accreditation emphasizes a healthcare setting that facilitates partnerships between individual patients and their personal providers, and when appropriate, the patient's family. This ensures that patients get the indicated care when and where they need it. ADDITION OF X-RAY SERVICES: THROUGH LOCAL PARTNERSHIPS, SERVICES WERE expanded to provide this basic need for patients for the first time in Peak Vista history. X-Ray services are now available throughout the day, five times a week at our International Circle location. School Based Health Expansion: Peak Vista's innovative partnerships with local school districts resulted in being awarded the Health Resources and Services Administration's Capital Grant for Peak Vista's School Based Health Centers. The award is being utilized to construct a new School Based Center in Falcon, expand the Cripple Creek - Victor Mountain Health Center and purchase equipment for Harrison District 2's Entrada Center. FORM 990, PART III, LINE 4A Additionally, through our primary care program, Peak Vista provided 4,325 visits for support services. 14,569 patient visits to our Convenient Care Center, 13,073 visits associated with our Behavioral Health Services, and 5,440 visits through our Volunteer Specialty Care Center. A full line of ancillary services, all of which patients access in high volumes, compliment Peak Vista's primary care offerings. Health Education 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 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 4D PEAK VISTA COMMUNITY HEALTH CENTER'S OTHER SERVICES: Expenses related to federal ARRA funding that provided for increased services and access as well as capital improvements. 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 12C Peak 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 15 Determination 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 not-for-profits in the state, Federal Region VIII, nation, and a survey of Mountain States salaries. From this analysis, a proposal is made to the VP of Finance and the VP of Human Resources, and the proposal is accepted by them or adjustments are made as appropriate. The CEOs salary comparison is reviewed and approved by the Board of Directors. These reviews are included in employee personnel folders. FORM 990, PART VI, SECTION C, LINE 19 As 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. The bonds were used to buy medical equipment, purchase, remodel and refinance buildings. The medical equipment purchased from these bonds was used for patient care. The remodeling was done at a building at 225 South Union for clinical space, and the refinancing was done for a building loan at 340 Printers Parkway, which includes clinical and administrative services. FORM 990, PART XII, LINE 2C THIS PROCESS DID NOT CHANGE IN 2011. SCHEDULE K, PART I, LINE A, COLUMN F The bonds were used to buy medical equipment, purchase, remodel and refinance buildings. The medical equipment purchased from these bonds was used for patient care. The remodeling was done at a building at 225 South Union for clinical space, and the refinancing was done for a building loan at 340 Printers Parkway, which includes clinical and administrative services.