Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | AXIS HEALTH SYSTEM IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE CEO AND VP OF FINANCE FOR AXIS HEALTH SYSTEM, THE SOLE MEMBER, AND A COMPLETED DRAFT IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS AND OFFICERS ARE COVERED BY THE POLICY. DETERMINATIONS ARE MADE AT THE BOARD LEVEL WITH THE ASSISTANCE OF GENERAL COUNSEL. ACTUAL CONFLICTS ARE REVIEWED BY THE BOARD. IF A CONFLICT IS FOUND IT WILL BE CURED BY RECUSAL. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S OFFICERS ARE COMPENSATED BY AXIS HEALTH SYSTEM, THE SOLE MEMBER OF UNCOMPAHGRE MENTAL HEALTH SERVICES, INC. AXIS HEALTH SYSTEM'S COMPENSATION POLICY IS AS FOLLOWS: COMPENSATION FOR ALL JOB CLASSIFICATIONS, INCLUDING EXECUTIVE MANAGEMENT, IS REVIEWED PERIODICALLY USING INDEPENDENT RESOURCES. COMPENSATION INFORMATION IS ALSO OBTAINED FROM ALL COMMUNITY MENTAL HEALTH CENTERS AND FQHCS IN THE STATE TO ENSURE A VALID ASSESSMENT IS MADE. IN ADDITION, THE CEO COMPENSATION IS SUBJECT TO ADDITIONAL ANNUAL REVIEW BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | FMV ADJUSTMENT DUE TO MERGER -367,222. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTORS OF THE SOLE MEMBER OF THE ORGANIZATION ASSUMES THE RESPONSIBILTY FOR SELECTING THE INDEPENDENT AUDITORS. THEY ARE ALSO RESPONSIBLE FOR ENSURING THE AUDIT IS COMPLETE. THE SOLE MEMBER'S BOARD DIRECTS THE CEO TO ENSURE TIMELY COMPLETION OF THE FINANCIAL STATEMENTS FOR REGULAR BOARD REVIEW AND THE PERFORMANCE OF THE ANNUAL AUDIT OF ITS FINANCIAL STATEMENTS. THE SOLE MEMBER'S CEO DIRECTS/DELEGATES THIS FUNCTION TO THE CFO. |
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