2023-09-28T15:19:09-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 8390 EAST CRESCENT PARKWAY SUITE 300 GREENWOOD VILLAGE CO 80111 990 2022-01-01 201139635 SUMMIT COMMUNITY CARE CLINIC INC SUMM 9706684040 PO BOX 4337 FRISCO CO 80443 DAN BECKER INTERIM CEO & CFO 9706684040 2023-09-28 1 DAN BECKER XXX-XX-XXXX 1 SARAH HINTZ P00492291 3037795710 2023-09-28 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DAN BECKER PO BOX 4337 FRISCO CO 80443 17076104 0 X WWW.SUMMITCLINIC.ORG X 2004 CO PROVIDE EXCEPTIONAL, INTEGRATED, PATIENT-CENTERED HEALTH CARE SERVICES REGARDLESS OF ABILITY TO PAY. 17 17 160 33 0 0 8857642 8038062 7284494 8985828 -5106 10920 7999 -10540 16145029 17024270 2097090 2874000 0 0 8527894 9301953 0 0 233841 3070858 4396950 13695842 16572903 2449187 451367 6246036 7031139 1040674 1375286 5205362 5655853 X PROVIDE EXCEPTIONAL, INTEGRATED, PATIENT-CENTERED HEALTH CARE SERVICES DESIGNED TO MEET THE NEEDS OF ALL PATIENTS, PARTICULARLY THOSE WHO EXPERIENCE BARRIERS TO ACCESSING CARE, REGARDLESS OF THEIR ABILITY TO PAY. 0 0 14229998 2874000 8985828 SINCE ITS HUMBLE BEGINNINGS IN 1993, THE CARE CLINIC HAS GROWN INTO ONE OF THE MOST WELL-RESPECTED SAFETY NET CLINICS IN THE STATE OF COLORADO.THE CARE CLINIC PROVIDES THE FOLLOWING SERVICES TO THE MEDICALLY UNDERSERVED INDIVIDUALS AND FAMILIES IN SUMMIT AND SURROUNDING COUNTIES: PRIMARY AND PREVENTIVE HEALTH CARE IN THE FORM OF SAME DAY OR SCHEDULED APPOINTMENTS; ORAL HEALTH MAINTENANCE AND TREATMENT; BEHAVIORAL HEALTH SERVICES; REPRODUCTIVE HEALTH AND FAMILY PLANNING SERVICES; UNIVERSAL DRUG AND ALCOHOL SCREENING AND SUBSTANCE ABUSE TREATMENT; SCHOOL-BASED HEALTH SERVICES INCLUDING PRIMARY; ORAL AND BEHAVIORAL HEALTH; PATIENT NAVIGATION SERVICES; CHRONIC DISEASE (CONTINUED ON SCHEDULE O)MANAGEMENT; AND COMMUNITY AND SCHOOL-WIDE SCREENING EVENTS. THE CARE CLINIC USES AN INTEGRATED MODEL OF CARE DELIVERY.IN 2022, THE CARE CLINIC SERVED 8,815 UNDUPLICATED PATIENTS WITH 30,719 VISITS IN PRIMARY CARE, ORAL HEALTH, AND BEHAVIORAL HEALTH AT THE MAIN CARE CLINIC OFFICE AND 15 ADDITIONAL SITES IN SUMMIT, PARK, AND LAKE COUNTIES. PRIMARY CARE VISITS REPRESENT OVER 44% OF TOTAL VISITS WHILE 34% ARE FOR ORAL HEALTH SERVICES AND 22% ARE FOR BEHAVIORAL HEALTH. APPROXIMATELY 55% OF PATIENTS WHO REPORT THEIR INCOME EARN LESS THAN 200% OF THE FEDERAL POVERTY LEVEL.2022 PRESENTED THE OPPORTUNITY FOR THE CARE CLINIC TO SUPPORT NEEDS RELATED TO THE COVID-19 PANDEMIC. THIS INCLUDED PROVISION OF TREATMENT AND VACCINATION SERVICES WITHIN THE CLINIC, AS WELL AS DRIVE-UP AND SITE BASED COMMUNITY VACCINATION EVENTS FOR PATIENTS AND NON-PATIENTS. MANY OF THE VACCINATION EVENTS WERE PROVIDED IN COLLABORATION WITH LOCAL NONPROFIT ORGANIZATIONS AND PUBLIC HEALTH. THE CARE CLINIC CONTINUED TO UTILIZE TELEHEALTH OPTIONS TO SCREEN PATIENTS AND PROVIDE CARE REMOTELY. WITH SUCCESS AT IMPLEMENTING NEW WORKFLOWS, THECARE CLINIC WAS ABLE TO MAINTAIN DELIVERY OF TYPICAL SERVICES IN ADDITION TO COVID-19 RELATED SERVICES.THE CARE CLINIC EMPBARKED ON PLANNING EFFORTS WITH A COMPREHENSIVE NEEDS ASSESSMENT IN SPRING 2022, AN EFFFICIENCY ANALYSIS, AND DEVELOPMENT OF A NEW COMPRHENSIVE STRATEGIC PLAN. 14229998 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 25 0 1 160 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 17 17 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 0 0 X DANIEL BECKER MBA 9704248833 323 W MAIN ST SUITE 201 FRISCO CO 80443 KATHLEEN COWIE CHIEF MEDICAL OFFICER 30.00 X 187831 0 24646 CHARLES LACKEY PHYSICIAN 32.00 X 177933 0 7401 HELEN ROYAL CEO 35.00 X 161775 0 22287 JOANNA KOPYTEK DENTIST 33.00 X 156752 0 17120 JOSHUA RUSK PHYSICIAN 35.00 X 138060 0 14966 MISTY SHELL COO 35.00 X 120160 0 17305 ELEANOR BRUIN CHIEF BEHAVIORAL HEALTH OFFICER 34.00 X 114260 0 22628 ANDREW NG DENTIST 38.00 X 121069 0 9480 MALLORY MAYEDA DENTIST (THROUGH 10/2022) 27.00 X 117357 0 6255 ERIN MAJOR CHIEF DENTAL OFFICER 35.00 X 101182 0 21350 SUSAN ROBERTSON CHIEF STRATEGY OFFICER 32.00 X 113715 0 6006 CASSANDRA ANTON CHIEF QUALITY AND RISK OFFICER 35.00 X 103860 0 12324 CHERYL CARLSON INTERIM CFO (THROUGH 11/2022) 31.00 X 99845 0 11482 DAVE BYRD CFO (THROUGH 4/2022) 35.00 X 40074 0 4133 PATRICIA PRICE THRU 22022 CHIEF WORKFORCE OFFICER 6.00 X 24037 0 5574 WILSON BLAKE PRESIDENT 1.50 X X 0 0 0 DANA COTTRELL VICE PRESIDENT 1.50 X X 0 0 0 JIM BECKMANN TREASURER 1.50 X X 0 0 0 DON PARSONS MD SECRETARY 1.50 X X 0 0 0 JUDY LAPOINT SECRETARY (THROUGH 10/2022) 1.50 X X 0 0 0 JOSH COGDILL BOARD MEMBER 1.50 X 0 0 0 GASTON FEUEREISEN BOARD MEMBER 1.50 X 0 0 0 MEG MASTEN BOARD MEMBER 1.50 X 0 0 0 BRADEN MCMILLAN BOARD MEMBER 1.50 X 0 0 0 DAVID NICOLI ESQ BOARD MEMBER 1.50 X 0 0 0 RICK O'BRIEN MD BOARD MEMBER 1.50 X 0 0 0 TONY PESTELLO BOARD MEMBER 1.50 X 0 0 0 JASMIN PIMENTEL BOARD MEMBER 1.50 X 0 0 0 GLORIA QUINTERO BOARD MEMBER (THROUGH 1/2022) 1.50 X 0 0 0 DUSTIN STOKES BOARD MEMBER 1.50 X 0 0 0 NORM STOLLER DMD BOARD MEMBER 1.50 X 0 0 0 JULIE THEBEAU LCSW BOARD MEMBER (THROUGH 8/2022) 1.50 X 0 0 0 DEBBIE WELLE-POWELL BOARD MEMBER 1.50 X 0 0 0 AMY WINELAND BOARD MEMBER 1.50 X 0 0 0 NIC ZADOR BOARD MEMBER 1.50 X 0 0 0 MARYJO ZWEIG BOARD MEMBER (THROUGH 6/2022) 1.50 X 0 0 0 1777910 0 202957 16 0 1 0 RECEPT PHARMACY 1620 W NORTHWEST HWY SUITE 100 GRAPEVINE TX 76501 PHARMACY MANAGEMENT 226760 SCOTT OWENS SOLUTIONS LLC 329 FAAS RANCH RD NEW CASTLE CO 81647 HR CONSULTING 107448 2 216572 6061178 1760312 157163 8038062 PATIENT FEES 624100 8985828 8985828 8985828 11158 11158 238 -238 -238 -238 34885 216572 51596 -16711 -16711 MISCELLANEOUS INCOME 900099 6171 6171 6171 17024270 8985828 0 380 2874000 2874000 1309730 106563 1186581 16586 6449450 6302721 146729 127161 124217 2944 835321 816429 18892 580291 512415 55557 12319 17267 17267 62415 62415 1183552 1004212 169303 10037 93203 12621 80582 420376 248441 171935 350891 103729 243805 3357 325880 304758 3247 17875 27931 23941 3913 77 25200 12351 12833 16 673 673 193426 170286 23140 53920 15481 38439 MEDICAL SUPPLIES 777757 777757 BAD DEBT EXPENSE 601436 601436 EDUCATION & TRAINING 149527 139105 10422 DUES & LICENSES 82394 65953 16441 31102 13582 12511 5009 16572903 14229998 2109064 233841 1218588 743867 2058408 3069563 1154706 809425 803442 708022 57585 82337 103393 82545 2337756 1166091 823466 1171665 5624 4676 20824 359039 6246036 7031139 805086 891202 74198 6579 3501 154811 480583 1040674 1375286 X 4967180 5110407 238182 545446 5205362 5655853 6246036 7031139 451367 -876 0 X X 0 1 X 1 1 1 X 5283868 4920332 6837043 8857642 8038062 33936947 4450177 4789999 6228543 7284494 8985828 31739041 367050 433588 355996 440761 385311 1982706 10101095 10143919 13421582 16582897 17409201 67658694 378563 422695 327038 146794 32655 1307745 0 378563 422695 327038 146794 32655 1307745 66350949 129 953 387 523 11158 13150 129 953 387 523 11158 13150 4542 5119 9661 11406 28052 26628 20645 6171 92902 10117172 10178043 13448597 16604065 17426530 67774407 0.97900 0.96970 0.00020 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2018 AMOUNT: $ 11,406. 2019 AMOUNT: $ 28,052. 2020 AMOUNT: $ 26,628. 2021 AMOUNT: $ 20,645. 2022 AMOUNT: $ 6,171. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 0 0 0 1 1744 1744 0 PART II-B, LINE 1: SUMMIT COMMUNITY CARE CLINIC PAYS ANNUAL DUES TO THE COLORADO COMMUNITY HEALTH NETWORK (CCHN). CCHN USES A PORTION OF THOSE DUES TO CONDUCT LOBBYING ON BEHALF OF SUMMIT COMMUNITY CARE CLINIC AND OTHER MEMBER ORGANIZATIONS. 56919 107 57026 56911 8 56919 56858 53 56911 56531 327 56858 55423 900 208 56531 1.00000 0.00000 0.00000 0 0 1302843 497365 805478 1034913 668726 366187 1171665 RIGHT OF USE - RENT 344515 RENT DEPOSIT 14524 359039 DEFERRED RENT 480583 480583 X 13984865 -876 385311 51596 436031 13548834 3475436 3475436 17024270 13534374 385311 51596 436907 13097467 3475436 3475436 16572903 PART V, LINE 4: ENDOWMENTS ARE BOARD DESIGNATED TO SUBSIDIZE THE ORGANIZATION'S OPERATIONS. PART X, LINE 2: 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 51,596. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 601,436. CHARITY CARE 2,874,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 51,596. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 601,436. CHARITY CARE 2,874,000. SOUP FOR THE SOUL 216572 216572 2689 36810 RALLY FOR THE CURE 34885 0 34885 150 11947 251457 216572 34885 2839 48757 51596 -16711 1 SLIDING SCALE FEE ADJUSTMENT 1972 2874000 0 N/A N/A PART I, LINE 2: SLIDING SCALE FEE ADJUSMENT ARE DETERMINED BASED ON PATIENT FINANCIAL NEED. X X X X 0 0 0 0 0 0 0 0 0 KATHLEEN COWIE CHIEF MEDICAL OFFICER 187711 0 0 0 120 0 8350 0 16296 0 212477 0 0 0 CHARLES LACKEY PHYSICIAN 177315 0 0 0 618 0 3165 0 4236 0 185334 0 0 0 HELEN ROYAL CEO 153759 0 7500 0 516 0 7288 0 14999 0 184062 0 0 0 JOANNA KOPYTEK DENTIST 156656 0 0 0 96 0 6473 0 10647 0 173872 0 0 0 JOSHUA RUSK PHYSICIAN 137952 0 0 0 108 0 6094 0 8872 0 153026 0 0 0 X 1 157163 FAIR MARKET VALUE 0 0 0 0 PART I, COLUMN (B): COLUMN B LISTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE IS EMPOWERED TO MAKE DECISIONS ON BEHALF OF THE BOARD REGARDING MATTERS THAT REQUIRE IMMEDIATE ACTION. SUCH DECISIONS ARE FORMALLY ENDORSED, AMENDED, OR REJECTED BY THE BOARD OF DIRECTORS AT ITS NEXT REGULAR MEETING. EXECUTIVE COMMITTEE MEMBERS MAY CO-SIGN WITH THE CEO OR ATTEST TO THE CEO'S SIGNATURE WHEN REQUIRED ON CONTRACTS, GRANT AGREEMENTS, AND OTHER OFFICIAL DOCUMENTS. IN THE EVENT OF A CEO VACANCY, THE EXECUTIVE COMMITTEE MAY BE EMPOWERED BY THE BOARD OF DIRECTORS TO ACT IN THE ROLE OF CEO, INCLUDING AUTHORITY TO SIGN CONTRACTS, GRANT AGREEMENTS, AND OTHER OFFICIAL DOCUMENTS. FORM 990, PART VI, SECTION A, LINE 2 DON PARSONS, MD, AND AMY WINELAND HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED IN DETAIL BY MANAGEMENT. A PUBLIC INSPECTION COPY OF THE FORM 990 WAS PRESENTED TO THE FINANCE COMMITTEE FOR A DETAILED REVIEW AND APPROVAL. THE FINANCE COMMITTEE THEN PRESENTED A PUBLIC INSPECTION COPY OF THE FORM 990 TO THE FULL BOARD FOR APPROVAL BEFORE THE RETURN WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY AND AT ANY BOARD MEETING ANY BOARD MEMBER OR ADVISORY MEMBER WITH A POTENTIAL CONFLICT OF INTEREST MUST NOTIFY THE EXECUTIVE COMMITTEE, WHO WILL REVIEW THE INFORMATION WITH THE BOARD AS APPROPRIATE. IN ALL CASES OF CONFLICT OR POTENTIAL CONFLICT, THE BOARD MEMBER IN QUESTION MUST REFRAIN FROM VOTING AND RECUSE HIM OR HERSELF FROM PARTICIPATING IN THE DISCUSSION, SELECTION, AWARD OR ADMINISTRATION OF ANY CONTRACT OR OTHER AFFILIATION INVOLVING SUCH CONFLICT. DISCUSSION RELATED TO ANY POTENTIAL CONFLICTS OF INTEREST IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION B, LINE 15A IN ACCORDANCE WITH THE BYLAWS, THE EXECUTIVE COMMITTEE OF THE BOARD PERFORMS AN ANNUAL REVIEW OF THE CEO'S PERFORMANCE, INCLUDING COMPENSATION. HUMAN RESOURCES PROVIDES THE EXECUTIVE COMMITTEE WITH SALARY SURVEYS WITH OTHER COLORADO FQHC'S AND OTHER COMPENSATION SURVEYS AS REQUIRED. THE DISCUSSION RELATED TO THE CEO'S COMPENSATION IS DOCUMENTED IN THE BOARD MINUTES. THE EXECUTIVE COMMITTEE MAKES THE FINAL DECISION ON THE CEO'S COMPENSATION. THE MOST RECENT SALARY REVIEW FOR THE CEO WAS CONDUCTED IN 2023. KEY EMPLOYEES COMPENSATION REVIEWS ARE CONDUCTED BY THE CEO AND HUMAN RESOURCES, THE EXCECUTIVE COMMITTEE IS NOT INVOLVED IN THIS PROCESS. THE MOST RECENT SALARY REVIEW FOR KEY EMPLOYEES WAS CONDUCTED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.