Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
ROCKY MOUNTAIN MULTIPLE SCLEROSIS CENTER
Employer identification number
84-0795455
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
991,034
1,491,935
1,252,521
794,718
2,523,912
7,054,120
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3
991,034
1,491,935
1,252,521
794,718
2,523,912
7,054,120
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
2,076,688
6
Public support. Subtract line 5 from line 4.
4,977,432
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
991,034
1,491,935
1,252,521
794,718
2,523,912
7,054,120
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
16,056
11,355
18,391
13,306
14,055
73,163
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
8,609
12,600
21,209
11
Total support (Add lines 7 through 10).
7,148,492
12
Gross receipts from related activities, etc. (see instructions)
..................
12
5,925,534
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
69.630 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
91.320 %
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
13
Total support. (Add lines 9, 10c, 11, and 12.)..
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2013
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
ROCKY MOUNTAIN MULTIPLE SCLEROSIS CENTER
Employer identification number
84-0795455
Return Reference
Explanation
FORM 990, PART III, LINE 4A:
SPECIALTY CARE SERVICES: KADEP: THE KING ADULT DAY ENRICHMENT PROGRAM (KADEP) SERVES YOUNGER ADULTS WHO HAVE MODERATE TO SEVERE DISABILITY CAUSED BY NEUROLOGICAL ILLNESSES OR TRAUMA. KADEP IS DESIGNED TO ENHANCE WELLNESS, MAINTAIN OR IMPROVE FUNCTIONAL STATUS, AND PROVIDE OPPORTUNITIES FOR SOCIALIZATION, PERSONAL DEVELOPMENT AND ENJOYMENT. MS SPECIALTY CARE: THROUGH ITS AFFILIATION WITH THE MS CENTER AT THE ANSCHUTZ MEDICAL CAMPUS (MS CENTER AT AMC), THE UNIVERSITY OF COLORADO AT DENVER AND THE UNIVERSITY OF COLORADO HOSPITAL HAVE JOINED TOGETHER TO FORM AN "MS CENTER OF EXCELLENCE," WHICH SERVES THE ROCKY MOUNTAIN REGION THROUGH PATIENT CARE, EDUCATION, SUPPORT AND CUTTING-EDGE RESEARCH. STATE-OF-THE-ART MEDICAL CARE IS PROVIDED BY MS FELLOWSHIP TRAINED NEUROLOGISTS, AND INCLUDES A PEDIATRIC PROGRAM THAT SPECIALIZES IN TREATING CHILDREN AND TEENS WITH MS. THROUGH AN AFFILIATION WITH METRO COMMUNITY PROVIDER NETWORK (MCPN), UNINSURED OR UNDERINSURED PATIENTS HAVE ACCESS TO SPECIALTY CARE TWO DAYS PER WEEK AT THE MS CENTER AT POTOMAC STREET CLINIC. THE MS CENTER ALSO HAS AFFILIATED MS-SPECIALTY CLINICS AT THE DENVER VETERAN'S ADMINISTRATION HOSPITAL AND DENVER HEALTH MEDICAL CENTER. SPECIALTY-CARE CLINICS: THE MS CENTER IS AFFILIATED WITH SPECIALTY-CARE CLINICS THAT ARE DESIGNED TO HELP MS PATIENTS MANAGE SPECIFIC ISSUES RELATED TO MULTIPLE SCLEROSIS. THE MS DISABILITY ASSESSMENT CLINIC HELPS INDIVIDUALS NAVIGATE THE CHALLENGING PROCESS OF APPLYING FOR SOCIAL SECURITY DISABILITY INSURANCE. THE MS CENTER ALSO OFFERS MS HYDROTHERAPY PROGRAMS, WHICH PROVIDE MAINTENANCE REHABILITATION TO INDIVIDUALS LIVING WITH MS. THE MS CENTER PROVIDES COUNSELING AND SUPPORT SERVICES FOR PEOPLE WITH MS AND THEIR FAMILIES. THROUGH INDIVIDUAL AND FAMILY COUNSELING SESSIONS, AS WELL AS SEMINARS, THE CENTER OFFERS A RANGE OF RESOURCES TO ADDRESS INDIVIDUAL NEEDS. EVERY MONTH MS 101 CLASSES ARE OFFERED TO THE NEWLY DIAGNOSED PATIENTS AND THEIR FAMILIES.
FORM 990, PART III, LINE 4B:
EDUCATION: THE MS CENTER CONDUCTS A VARIETY OF PROGRAMS TO EDUCATE THOSE WITH MULTIPLE SCLEROSIS, THEIR FAMILIES, THE GENERAL PUBLIC, AND PROFESSIONALS PROVIDING SERVICES AND CARE FOR INDIVIDUALS WITH MS. THE MS CENTER CONDUCTS A VARIETY OF PUBLIC SEMINARS AND MAINTAINS AN INTERACTIVE WEBSITE AT WWW.MSCENTER.ORG, WHICH FEATURES A "LIVING WELL" LANDING PAGE WITH RELEVANT PATIENT EDUCATIONAL INFORMATION. ADDITIONAL EDUCATIONAL RESOURCES INCLUDE PAMPHLETS, WRITTEN MATERIALS AND VIDEOS. THE MS CENTER PUBLISHES A QUARTERLY MAGAZINE, "INFORMS," WHICH IS AVAILABLE IN BOTH PRINT AND ELECTRONIC VERSIONS, AND DISTRIBUTES AN ELECTRONIC NEWSLETTER, "EMS NEWS," WHICH FEATURES RESEARCH INFORMATION, OPPORTUNITIES TO PARTICIPATE IN MS CLINICAL RESEARCH, AND INFORMATION ON UPCOMING EVENTS.
FORM 990, PART III, LINE 4C:
RESEARCH: CLINICAL TRIALS: THE MS CENTER ENGAGES IN A VARIETY OF RESEARCH PROJECTS DESIGNED TO IMPROVE THE LIVES OF INDIVIDUALS LIVING WITH MULTIPLE SCLEROSIS. FACULTY INITIATED CLINICAL RESEARCH FUELS THE SEARCH FOR SAFER AND MORE EFFECTIVE TREATMENTS AND COMBINATION THERAPIES TO TREAT MS. BRAIN AND TISSUE BANK: THE MS CENTER HOUSES ONE OF THE WORLD'S LARGEST FRESH BRAIN TISSUE BANKS. THE TISSUE IS RETRIEVED, STORED AND PROVIDED TO MS RESEARCHERS FROM AROUND THE WORLD, AND IS ESSENTIAL TO THE GLOBAL EFFORT TO FIND THE CAUSE OF, AND CURE FOR, MS. TRANSLATIONAL RESEARCH: IN 2012, THE MS CENTER BEGAN RAISING FUNDS FOR THE BENEFIT OF THE TRANSLATIONAL RESEARCH PROGRAM AT THE UNIVERSITY OF COLORADO AT DENVER. THIS NEW RESEARCH INITIATIVE APPLIES THE CLINICAL RESEARCH KNOWLEDGE GAINED OVER THE LAST 20 YEARS AND ACTIVELY MOVES US TOWARD IMPROVED THERAPIES AND A CURE.
FORM 990, PART VI, SECTION A, LINE 8B
THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11
THE FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR, THE FINANCE COMMITTEE AND EXECUTIVE COMMITTEE. THE FILING IS THEN PRESENTED TO THE GOVERNING BODY FOR RATIFICATION/APPROVAL BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12C
DURING ORIENTATION, ALL BOARD MEMBERS AND KEY EMPLOYEES REVIEW THE CONFLICT OF INTEREST POLICY. ALL ARE REQUIRED TO SIGN A DOCUMENT INDICATING THAT THEY HAVE READ AND UNDERSTAND THE POLICY, AND THAT THEY MUST DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS IN WRITING. THE DOCUMENT IS UPDATED ANNUALLY. DIRECTORS AND OFFICERS ARE REQUIRED TO PROTECT THE INTERESTS OF THE MS CENTER AND TO INFORM THE BOARD OF ANY MATTERS OR AFFILIATIONS THAT MAY CREATE ACTUAL OR APPARENT CONFLICTS. FURTHER, THEY ARE REQUIRED TO REFRAIN FROM USING THEIR POSITION OR INFORMATION THEY RECEIVE BY REASON OF SERVING THE MS CENTER FOR PRIVATE GAIN OR FOR THE BENEFIT OF A THIRD PARTY - EVEN IF THE THIRD PARTY IS ANOTHER NONPROFIT ORGANIZATION. DIRECTORS AND OFFICERS ARE REQUIRED TO COMPLETE A FORM TO IDENTIFY THEIR AFFILIATIONS, SO THAT THE BOARD IS INFORMED AND CAN DISCUSS AND HANDLE POTENTIAL CONFLICTS BEFORE THEY ARISE. DIRECTORS MUST ALSO REVIEW AND UNDERSTAND THE FIDUCIARY RESPONSIBILITY STATEMENT. ALONG WITH THE AFFILIATIONS FORM, THIS SHOULD HELP TO IDENTIFY POTENTIAL CONFLICTS THAT MIGHT OTHERWISE INCREASE PERSONAL LIABILITY FOR THE DIRECTORS AND OFFICERS, AND POSSIBLY OVERALL LIABILITY OF THE MS CENTER. IDENTIFYING CONFLICTS MAY ALSO HELP ENSURE COMPLIANCE WITH ANTITRUST LAWS. UPON DISCLOSURE OF A POSSIBLE CONFLICT OF INTEREST, A DETERMINATION SHALL BE MADE BY THE BOARD AS TO THE PARTICIPATION OF THE INDIVIDUAL IN THE MATTER AND, IN THE CASE OF A DIRECTOR, AS TO PARTICIPATION IN THE VOTING MATTER. A DIRECTOR MAY DISQUALIFY HIMSELF OR HERSELF FROM VOTING ON ANY ISSUE THAT MAY BE PERCEIVED AS AN APPARENT OR ACTUAL CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15A
A PERFORMANCE REVIEW IS CONDUCTED ANNUALLY BY THE BOARD OF DIRECTORS REGARDING PERFORMANCE AND COMPENSATION OF THE EXECUTIVE DIRECTOR. A MINIMUM OF THREE INDEPENDENT DATA SOURCES RELATED TO NONPROFIT EMPLOYEE COMPENSATION ARE USED. TYPICALLY, THE EXECUTIVE DIRECTOR'S PERFORMANCE REVIEW IS DONE IN AN EXECUTIVE SESSION. THE RESULTS OF THE PERFORMANCE REVIEW ARE WRITTEN BY THE CHAIRMAN OF THE BOARD. A PERFORMANCE REVIEW OF THE EXECUTIVE DIRECTOR WAS LAST CONDUCTED IN MAY OF 2013.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION'S FORM 990, AUDITED FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS ALSO AVAILABLE BY REQUEST TO ANY INTERESTED PARTY VIA THE ORGANIZATION'S WEBSITE. THE FORM 990 IS ALSO POSTED ON THE GIVING FIRST WEBSITE AND THE COLORADO SECRETARY OF STATE WEBSITE.
FORM 990, PART IX, LINE 11G
MEDICAL DIRECTOR: PROGRAM SERVICE EXPENSES 273,978. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 273,978. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 107,456. MANAGEMENT AND GENERAL EXPENSES 19,203. FUNDRAISING EXPENSES 45,270. TOTAL EXPENSES 171,929.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.