2023-11-14T13:56:36-06:00 2022-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2022-01-01 840447998 LOWER VALLEY HOSPITAL ASSOCIATION LOWE 9708582228 228 N CHERRY STREET PO BOX 130 FRUITA CO 81521 KORREY KLEIN MD PRESIDENT/CEO 9708582228 2023-11-13 1 KORREY KLEIN MD 999009999 1 MICHAEL J PETERSON CPA P01833529 2187224705 2023-11-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z FAMILY HEALTH WEST KORREY KLEIN MD 228 N CHERRY STREET PO BOX 130 FRUITA CO 81521 81417960 0 X FHW.ORG X 1946 CO ADDRESS THE HEALTHCARE NEEDS OF THE GREATER FRUITA COMMUNITY AND PROVIDE HEALTHCARE SERVICES WITHOUT REGARD TO RACE, AGE, HANDICAP, CREED, OR NATIONAL ORIGIN. PROVIDE THOSE SERVICES TO INDIVIDUALS OF ALL INCOME LEVELS CONSISTENT WITH OUR FINANCIAL ABILITY TO DO SO. 9 8 756 13 0 0 1089490 721466 76953674 78902508 130904 -137388 0 404356 78174068 79890942 0 0 0 0 43189507 45989743 0 0 0 30826904 34270750 74016411 80260493 4157657 -369551 64162006 62606343 52459037 51272925 11702969 11333418 ADDRESS THE HEALTHCARE NEEDS OF THE GREATER FRUITA COMMUNITY AND PROVIDE HEALTHCARE SERVICES WITHOUT REGARD TO RACE, AGE, HANDICAP, CREED, OR NATIONAL ORIGIN. PROVIDE THOSE SERVICES TO INDIVIDUALS OF ALL INCOME LEVELS CONSISTENT WITH OUR FINANCIAL ABILITY TO DO SO. 0 0 46932532 0 65353505 LOWER VALLEY HOSPITAL ASSOCIATION OPERATES A 25-BED SWING AND ACUTE CARE CRITICAL ACCESS HOSPITAL. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS, PROVIDES CHARITY CARE AND OTHER ASSISTANCE TO ENSURE ACCESS TO THESE SERVICES IN OUR COMMUNITY. OUR HOSPITAL SERVICES ARE 53% MEDICARE. WE OFFER LABS FOR THE GOOD SAMARITAN PROGRAM, ROCK STEADY BOXING AND THE SENIOR STEP ON PROGRAM FOR OUR COMMUNITY. IN 2022, WE ADMINISTERED COVID VACCINE TO OUR COMMUNITY PARTNERS AT NO COST. 17847335 0 12245565 THE ORGANIZATION SPONSORS CLINICS TO ENSURE ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES IN THE COMMUNITY. THESE OPERATIONS ARE NOT LIMITED TO ANESTHESIA, EMERGENCY PROVIDERS, HOSPITALIST, RADIOLOGIST, ORTHOPEDIC SPECIALISTS, PODIATRY, RHEUMATOLOGY, NEUROSURGERY AND PHYSIATRY. AN ATHLETIC TRAINER IS DONATED TO THE LOCAL SCHOOLS DURING SPORTS TRAINING AND GAMES. 1604656 0 1303438 THE ORGANIZATION OPERATES A MEMORY CARE FACILITY THAT PROVIDE RESIDENTIAL ACCOMMODATIONS AND LIMITED HEALTHCARE SERVICES TO THE ELDERLY AND DISABLED FOR A TOTAL BED COUNT OF 26. THE WILLOWS IS DEDICATED TO RESIDENTS WITH DEMENTIA AND IS A SECURED FACILITY. 66384523 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 119 0 756 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CO X THERESA TABOR 9708582228 228 N CHERRY STREET PO BOX 130 FRUITA CO 81521 CHRIS COPELAND PHYSICIAN 40.00 X 583658 0 38168 PETER SCHEFFEL PHYSICIAN 40.00 X 573983 0 38180 RICHARD ACKERSON PHYSICIAN 40.00 X 562411 0 34630 KORREY KLEIN CEO/SECRETARY 40.00 4.00 X 357374 0 43172 BRIAN BELNAP PHYSICIAN 40.00 X 350779 0 34841 MITCHELL BURNBAUM PHYSICIAN 40.00 X 308080 0 12251 TROY GRIFFITHS TRUSTEE/DIRECTOR OF WOUND CENTER 40.00 X 239703 0 32982 CHRISTOPER TAGGART MD CHIEF MEDICAL OFFICER 40.00 X 221539 0 41945 VANESSA MCCLELLAN DO CHIEF OF MEDICAL STAFF 40.00 X 225265 0 23857 LORI RANDALL EXECUTIVE VP 40.00 X 207211 0 24581 DIANE MILLER CHIEF FINANCIAL OFFICER (THRU 04/22) 40.00 X 127977 0 5551 ERROL SNIDER EMERITUS TRUSTEE 32.00 X 65210 0 15567 THERESA TABOR CHIEF FINANCIAL OFFICER 40.00 X 66846 0 1775 DUSTIN WELLS CHAIR 1.00 X X 0 0 0 JENNIFER LANDINI VICE CHAIR 1.00 X X 0 0 0 PAUL BURDETT TREASURER 1.00 X X 0 0 0 CHRISTI FLYNN TRUSTEE 1.00 X 0 0 0 JEANNE HABERER DO TRUSTEE 1.00 X 0 0 0 JERRY HAMILTON TRUSTEE 1.00 1.00 X 0 0 0 KEN PALMER TRUSTEE 1.00 X 0 0 0 LARRY TICE MD TRUSTEE 1.00 X 0 0 0 3890036 0 347500 45 0 1 0 PSYCHIATRIC MEDICAL CARE 215 N PLUM STRET FRUITA CO 81521 PROFESSIONAL GROUP THERAPY SERVICES 403524 COLORADO WEST EMERGENCY PHYSICIANS LLC 2635 N 7TH STREET GRAND JUNCTION CO 81501 PROFESSIONAL ED SERVICES 248476 ANESTHESIA CONSULTANTS OF WESTERN COLORA 1120 WELLINGTON AVENUE SUITE 206 GRAND JUNCTION CO 81501 PROFESSIONAL ANESTHESIA SERVICES 211514 SCOTT E VINCENT MD PC 601 CENTER AVE GRAND JUNCTION CO 81501 PROFESSIONAL ED SERVICES 175990 COLORADO SURGICAL AFFILIATES LLC 2440 NORTH 11TH STREET GRAND JUNCTION CO 81501 PROFESSIONAL SURGICAL SERVICES 147070 10 261916 459550 721466 HOSPITAL REVENUE 621110 65233313 65233313 PHYSICIAN CLINICS 621110 12245565 12245565 ASSISTED LIVING 623990 1303438 1303438 120192 120192 78902508 49103 49103 1340527 1527018 -186491 -186491 -186491 404356 404356 404356 79890942 78902508 0 266968 1700556 785290 915266 36263985 31576884 4687101 949995 750178 199817 4514561 3534286 980275 2560646 1985138 575508 143193 81729 61464 1386 1386 6643541 3957184 2686357 105 105 517389 339998 177391 1550652 795595 755057 965125 878653 86472 40499 15444 25055 2354678 1607386 747292 2650628 1809412 841216 542309 253011 289298 MEDICAL SUPPLIES 13703519 13691966 11553 BAD DEBT EXPENSE 2222485 2222485 PUBLIC RELATIONS 787918 122809 665109 RENTAL EXPENSES 776005 751744 24261 1371318 1225226 146092 80260493 66384523 13875970 0 17209345 13479611 9191749 9016626 8678549 9508415 1861151 1952822 598500 1226771 66286227 42209233 24408145 24076994 205749 1127247 72758 22481 1936060 2195376 64162006 62606343 5928761 6498911 473592 0 38075994 37387998 2788 1000 4410891 4900828 3567011 2484188 52459037 51272925 X 11702969 11333418 11702969 11333418 64162006 62606343 -369551 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1386 1386 0 PART II-B, LINE 1: LOWER VALLEY HOSPITAL ASSOCIATION PAYS MEMBERSHIP DUES TO THE COLORADO HOSPITAL ASSOCIATION (CHA). A PORTION OF THESE DUES ARE USED BY CHA FOR POLITICAL EXPENDITURES DURING THE YEAR AND ARE NOT DEDUCTIBLE. IN 2022, THE ORGANIZATION PAID $34,318 IN MEMBERSHIP DUES TO CHA. CHA ESTIMATED THAT 4.04% OF THE DUES WERE SPENT ON LOBBYING ACTIVITIES. 0 1 694803 694803 46728019 26030489 20697530 1118880 892359 226521 17739525 15286385 2453140 5000 5000 24076994 DEFERRED COMPENSATION PLAN LIABILITY 697811 AMOUNTS PAYABLE TO THIRD-PARTY REIMBURSEMENT PROGRAMS 1786377 2484188 1 1 X 1 X 125.000000000000 1 X 450.000000000000 1 1 0 1 1 54935 54935 0.00070 10988173 9933698 1054475 0.01350 26954 26954 0.00030 11070062 9933698 1136364 0.01450 572851 572851 0.00730 15965766 12245566 3720200 0.04770 16538617 12245566 4293051 0.05500 27608679 22179264 5429415 0.06950 1 1054867 527434 18449439 18426278 23161 X 1 1 1 1 LOWER VALLEY HOSPITAL ASSOCIATION 300 W OTTLEY AVENUE FRUITA CO 81521 FHW.ORG 2511OC X X X X LOWER VALLEY HOSPITAL ASSOCIATION 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X HTTPS://FHW.ORG/PATIENT-RESOURCES/COMMUNITY-HEALTH-NEEDS/ X HTTPS://HEALTH.MESACOUNTY.US/2021CHNA/ X 1 21 1 HTTPS://FHW.ORG/PATIENT-RESOURCES/COMMUNITY-HEALTH-NEEDS/ 0 1 X 125.000000000000 450.000000000000 X X X X X X 1 1 X X X X 1 X HTTPS://FHW.ORG/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE/ X HTTPS://FHW.ORG/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE/ X HTTPS://FHW.ORG/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 LOWER VALLEY HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: CURRENT COUNTY OFFICIALS LOWER VALLEY HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6A: - ST. MARY'S MEDICAL CENTER- WEST SPRINGS HOSPITAL- VA WESTERN COLORADO HEALTH CARE SYSTEM LOWER VALLEY HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: MESA COUNTY PUBLIC HEALTH LOWER VALLEY HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: CURRENTLY PARTICIPATING IN THE ALTO PROJECT TO PROVIDE NON OPIOID ALTERNATIVES IN OUR EMERGENCY DEPARTMENT. OFFERING REDUCED FEES FOR HEALTH SCREENING AND SPORTS PHYSICALS. PROVIDING QUICK ACCESS TO HEALTH CARE FOR THE UNDER AND UNINSURED. PROVIDING A LOCAL COAGULATION CLINIC FOR THE ELDERLY. SUPPORTING SMOKE FREE CAMPUS. PROVIDING FREE SPACE FOR IMMUNIZATION CLINICS FOR CHILDREN. PROVIDING NUTRITIONAL SUPPORT AT THE LOCAL FARMER'S MARKET. PROVIDING SPORTS CLINICS AND FREE ATHLETIC TRAINERS AT TWO OF THE LOCAL HIGH SCHOOLS. PROVIDING FREE TRANSPORTATION FOR PATIENTS TO HOSPITAL AND PHYSICIAN APPOINTS. PROVIDING TRAVELING THERAPISTS TO THE ELDERCARE FACILITIES. PROVIDING DIABETIC FOOT CARE CLINICS TO THE COMMUNITY. PROVIDING FREE OF CHARGE COVID VACCINATIONS TO OUR LOCAL COMMUNITY HEALTH CARE PROVIDERS. PROVIDED COVID VACCINE CLINICS TO THE GENERAL COMMUNITY. 2 1 - PHYSICIAN SERVICES 551 KOKOPELLI BLVD FRUITA CO 81521 PHYSICIAN CLINICS AND SUPPORTING SERVICES 2 - WILLOWS ASSISTED LIVING 243 NORTH CHERRY STREET FRUITA CO 81521 STATE LICENSED ASSISTED LIVING FACILITY PART I, LINE 6A: COMMUNITY REPORT PREPARED IN CONJUNCTION WITH MESA COUNTY COLORADO HOSPITALS AND HEALTHCARE FACILITIES. PART I, LINE 7: THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. PART I, LINE 7G: THE ORGANIZATION HAS LISTED CERTAIN PHYSICIAN SERVICES AS SUBSIDIZED SERVICES IN 2022. PART I, LN 7 COL(F): THE ORGANIZATION HAS REPORTED BAD DEBT EXPENSE IN THE AMOUNT OF $2,222,485 ON FORM 990, PART IX, LINE 24. PART III, LINE 2: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE YEAR TO ESTIMATE THE COST OF CARE OF PATIENTS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSS PATIENT SERVICE REVENUE ON THE CONSOLIDATED FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL. PART III, LINE 3: MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES PATIENTS DO NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS AND ASSISTANCE WITH THE APPLICATIONS. DUE TO NO RESPONSES FROM SOME PATIENTS, A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH FAMILY HEALTH WEST EXPECTS TO BE ENTITLED, IN EXCHANGE FOR PROVIDING PATIENT CARE SERVICES. PATIENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND IMPLICIT PRICE CONCESSIONS WHICH REFLECTS MANAGEMENT'S ESTIMATE OF THE TRANSACTION PRICE. FAMILY HEALTH WEST ESTIMATES THE TRANSACTION PRICE BASED ON NEGOTIATED CONTRACTUAL AGREEMENTS, HISTORICAL EXPERIENCE, AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS AND IS RECORDED THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE.FAMILY HEALTH WEST DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: LOWER VALLEY HOSPITAL ASSOCIATION IS DESIGNATED A CRITICAL ACCESS HOSPITAL AND, AS SUCH, A PORTION OF ITS MEDICARE REVENUES ARE PAID UNDER A COST REIMBURSEMENT SYSTEM. THE TOTAL MEDICARE REVENUE SHOWN INCLUDES ONLY A PORTION OF THE TOTAL GROSS MEDICARE REVENUE THE HOSPITAL RECEIVES AND DOES NOT CONSIDER ALL OF THE CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE REVENUE DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS RADIOLOGIST OR URGENT CARE PROFESSIONAL SERVICES. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT METHOD AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT THE HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREA. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES, WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN SERVICES, WHICH THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTH CARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. PART III, LINE 9B: PATIENTS ARE PROVIDED ALL PAPERWORK AND ACCESS TO WEB INFORMATION TO APPLY FOR FINANCIAL ASSISTANCE. OUR PAYMENT RESOLUTION CENTER ATTEMPTS TWO PHONE CALLS FOR ANY UNPAID BALANCE. PART VI, LINE 2: SURVEY INFORMATION IS SENT TO THE COMMUNITY. ATTENDANCE AT THE LOCAL FARMER'S MARKETS PROVIDES FEEDBACK FROM THE LOCAL COMMUNITY. PART VI, LINE 3: PATIENT FINANCIAL ASSISTANCE POLICIES ARE AVAILABLE ON OUR WEBSITE IN PLAIN LANGUAGE SUMMARY FORM AND IN PAPER TO ALL PATIENTS. PATIENT FINANCIAL REPRESENTATIVES ARE AVAILABLE IN THE HOSPITAL AT THE TIME OF REGISTRATION AND DISCHARGE TO WORK WITH PATIENTS TO ENSURE THEY ARE AWARE OF FINANCIAL ASSISTANCE. ALL PATIENT STATEMENTS HAVE INFORMATION ABOUT FINANCIAL ASSISTANCE WRITTEN AT THE BOTTOM. WE HAVE CREATED A PATIENT RESOLUTION CENTER TO REACH OUT TO PATIENTS WITH OVERDUE BALANCES FOR ASSISTANCE IN APPLICATION FOR CHARITABLE SERVICES OR HARDSHIP DEFERMENT OF PAYMENT PLANS. PART VI, LINE 4: WE SERVE THE LOWER VALLEY COMMUNITY WITH FRUITA COLORADO AS OUR HOME BASE. THIS IS A RURAL COMMUNITY LOCATED NEXT TO THE URBAN POPULATION OF GRAND JUNCTION COLORADO. THE COMMUNITY IS MADE UP OF FARMERS, RANCHERS, RETIRED FAMILIES, AND A BEDROOM COMMUNITY TO THE MANY RESIDENTS WHO WORK IN GRAND JUNCTION. OUR HOSPITAL IS THE FARTHEST WEST HOSPITAL IN THE AREA. WE ARE 19 MILES FROM THE UTAH BORDER RIGHT OFF INTERSTATE 70 WHICH RUNS FROM SALT LAKE CITY UTAH TO DENVER COLORADO. PART VI, LINE 6: N/A X X X X 0 0 0 0 0 0 0 0 0 CHRIS COPELAND PHYSICIAN 537708 0 45950 0 0 0 12200 0 25968 0 621826 0 0 0 PETER SCHEFFEL PHYSICIAN 533708 0 40275 0 0 0 12200 0 25980 0 612163 0 0 0 RICHARD ACKERSON PHYSICIAN 514261 0 48150 0 0 0 12200 0 22430 0 597041 0 0 0 KORREY KLEIN CEO/SECRETARY 311476 0 45898 0 0 0 12200 0 30972 0 400546 0 0 0 BRIAN BELNAP PHYSICIAN 340524 0 10255 0 0 0 12200 0 22641 0 385620 0 0 0 MITCHELL BURNBAUM PHYSICIAN 246120 0 61960 0 0 0 11750 0 501 0 320331 0 0 0 TROY GRIFFITHS TRUSTEE/DIRECTOR OF WOUND CENTER 213747 0 25956 0 0 0 10038 0 22944 0 272685 0 0 0 CHRISTOPER TAGGART MD CHIEF MEDICAL OFFICER 221339 0 200 0 0 0 9608 0 32337 0 263484 0 0 0 VANESSA MCCLELLAN DO CHIEF OF MEDICAL STAFF 194027 0 31238 0 0 0 9226 0 14631 0 249122 0 0 0 LORI RANDALL EXECUTIVE VP 207211 0 0 0 0 0 8564 0 16017 0 231792 0 0 0 A CITY OF FRUITA 846000669 00359427A 2017-12-19 33600000 HEALTHCARE HOSPITAL EXPANSION 0 0 0 A 675000 33600000 2813875 680000 6278059 2009 0 1 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 1 CITIGROUP FINANCIAL 0.215000000000 1 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF FRUITA DATE THE REBATE COMPUTATION WAS PERFORMED: 03/13/2023 FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS ANNOUNCED AND POSTED TO BOARD PORTAL FOR THEIR REVIEW, PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS, OFFICERS, AND DIRECTORS OF THE FOUNDATION AND PERSONS IN POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER DECISIONS OF FHW (KEY EMPLOYEES) ARE REQUIRED TO ANNUALLY DISCLOSE ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THE GOVERNING BOARD AND COMPLIANCE OFFICER THEN REVIEW THE DISCLOSURES TO DETERMINE WHETHER A CONFLICT EXISTS. IF A CONFLICT IS DETERMINED TO EXIST, THE INTERESTED PERSON WILL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE PROPOSED TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S CEO COMPENSATION IS REVIEWED AND DETERMINED BY THE LOWER VALLEY HOSPITAL GOVERNING BOARD. A FULL WAGE EVALUATION IS PERFORMED BY OUR HR DEPARTMENT BASED ON THE AMERICAN HOSPITAL ASSOCIATION WAGE DATA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANNIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FAMILY HEALTH WEST FOUNDATION 228 N CHERRY STREET FRUITA CO 81521 825487165 PROVIDING SUPPORT FOR THE LOWER VALLEY HOSPITAL ASSOCIATION. CO 501(C)(3) LINE 10 LOWER VALLEY HOSPITAL ASSOCIATION 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 FAMILY HEALTH WEST FOUNDATION C 261916 CASH