REGIONAL WEST HEALTH SERVICES: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- REGIONAL WEST HEALTH SERVICES (EIN 36-3314157)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202213189349306046
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T12:03:29-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT ST STE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363314157 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL WEST HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | REGI | BusinessNameControlTxt |
| Phone | 3086353711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1Txt |
| City | SCOTTSBLUFF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69361 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL ICKOWSKI | PersonNm |
| Person Title | CFO/TREASURER | PersonTitleTxt |
| Phone | 3086353711 | PhoneNum |
| Signature | 2022-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MICHAEL | PersonFirstNm |
| Person Last | ICKOWSKI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WENDY R COOLEY CPA | PreparerPersonNm |
| PTIN | P01523804 | PTIN |
| Phone | 4023302660 | PhoneNum |
| Preparation | 2022-11-11 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN MENTGEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1Txt |
| City | SCOTTSBLUFF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69361 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $27,300,935 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RWHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | HEALTH CARE SERVICES FOR THE PEOPLE OF WESTERN NEBRASKA AND EASTERN WYOMING. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 143 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,618,052 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,076,346 | CYProgramServiceRevenueAmt |
| PY Investment Income | $87,849 | PYInvestmentIncomeAmt |
| CY Investment Income | $56,070 | CYInvestmentIncomeAmt |
| PY Other Revenue | $14,614,588 | PYOtherRevenueAmt |
| CY Other Revenue | $14,168,519 | CYOtherRevenueAmt |
| PY Total Revenue | $28,320,489 | PYTotalRevenueAmt |
| CY Total Revenue | $27,300,935 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $6,729,481 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $5,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,866,580 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,465,449 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,161,160 | PYOtherExpensesAmt |
| CY Other Expenses | $3,122,319 | CYOtherExpensesAmt |
| PY Total Expenses | $24,757,221 | PYTotalExpensesAmt |
| CY Total Expenses | $20,592,768 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,563,268 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,708,167 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $60,804,964 | TotalAssetsBOYAmt |
| Total Assets EOY | $68,282,327 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,650,752 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,864,945 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $48,154,212 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $55,417,382 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HEALTH CARE SERVICES FOR THE PEOPLE OF WESTERN NEBRASKA AND EASTERN WYOMING. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $20,592,768 | ExpenseAmt |
| Grant | $5,000 | GrantAmt |
| Revenue | $27,244,865 | RevenueAmt |
| Desc | REGIONAL WEST HEALTH SERVICES, (RWHS), PROVIDES A CONTINUUM OF CARE THROUGH PROGRAMS DEVELOPED IN ACUTE, SKILLED, INTERMEDIATE, RESIDENTIAL, HOME AND AMBULATORY CARE FOR THE PEOPLE IN THE REGION OF WESTERN NEBRASKA AND EASTERN WYOMING. RWHS IS A SUPPORTING ORGANIZATION TO REGIONAL WEST MEDICAL CENTER, REGIONAL WEST GARDEN COUNTY, REGIONAL WEST PHYSICIANS CLINIC, REGIONAL WEST FOUNDATION, AND REGIONAL WEST VILLAGE. REGIONAL WEST MEDICAL CENTER PROVIDES COMPREHENSIVE AND ADVANCED MEDICAL CARE TO THE PEOPLE OF WESTERN NEBRASKA AND EASTERN WYOMING THROUGH A LICENSED 182-BED HOSPITAL WHICH IS A REGIONAL REFERRAL CENTER AND LEVEL II TRAUMA CENTER. REGIONAL WEST MEDICAL CENTER ALSO PROVIDES ANCILLARY SERVICES TO SUPPORT ITS PRIMARY MISSION OF COMPREHENSIVE AND ADVANCED MEDICAL CARE. REGIONAL WEST GARDEN COUNTY IS A CRITICAL ACCESS HOSPITAL THAT PROVIDES HIGH QUALITY HEALTH CARE TO THE REGION THROUGH A 10-BED ACUTE CARE UNIT, A 40-BED NURSING HOME FACILITY, AND A RURAL HEALTH CLINIC. REGIONAL WEST PHYSICIANS CLINIC IS A MULTI-SPECIALTY MEDICAL GROUP OF MORE THAN 70 PHYSICIANS AND ASSOCIATED HEALTH CARE PROVIDERS. REGIONAL WEST VILLAGE OPERATES A RETIREMENT AND ASSISTED LIVING FACILITY ADJACENT TO THE REGIONAL WEST MEDICAL CENTER CAMPUS. REGIONAL WEST VILLAGE PROVIDES TWENTY FOUR HOUR COVERAGE OF ITS FACILITY AND ASSISTS RESIDENTS WITH MEALS, TRANSPORTATION, AND MEDICATIONS IN AN EFFORT TO PROVIDE A CONTINUUM OF CARE TO THE ELDERLY IN THE NEBRASKA PANHANDLE. | Desc |
| Total Program Service Expenses | $20,592,768 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 143 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL ICKOWSKI | PersonNm |
| Phone | 3086301111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1Txt |
| City | SCOTTSBLUFF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69361 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JEFFREY HOLLOWAY MD | ||||||||
| DIRECTOR | 1.00 | 41.00 | Yes (X) | $0 | $693,501 | $61,805 | ||
| JOHN MENTGEN | ||||||||
| CEO/PRESIDENT | 40.00 | 6.00 | Yes (X) | $568,880 | $0 | $107,104 | Yes (X) | |
| DAVID CORNUTT | ||||||||
| DIRECTOR OF OUTREACH | 40.00 | 0.00 | $440,564 | $0 | $39,222 | Yes (X) | ||
| TIMOTHY OSTERHOLM | ||||||||
| EVP & COO | 40.00 | 0.00 | $370,503 | $0 | $89,587 | Yes (X) | ||
| PAUL HOFMEISTER | ||||||||
| GENERAL COUNSEL | 40.00 | 3.00 | $371,715 | $0 | $40,874 | Yes (X) | ||
| MICHAEL ICKOWSKI | ||||||||
| CFO/TREASURER | 40.00 | 6.00 | Yes (X) | $334,705 | $0 | $45,745 | Yes (X) | |
| MARGO FERGUSON | ||||||||
| CHIEF QUALITY OFFICER | 40.00 | 0.00 | $227,618 | $0 | $72,773 | Yes (X) | ||
| AMANDA VICK | ||||||||
| VP OF PATIENT CARE SERVICES | 40.00 | 0.00 | $225,760 | $0 | $36,189 | Yes (X) | ||
| MELODY BIBB | ||||||||
| SECRETARY | 40.00 | 2.00 | $72,289 | $0 | $48,750 | Yes (X) | ||
| HOD KOSMAN | ||||||||
| CHAIR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| REV LAUREN EKDAHL | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CAROLYN ESCAMILLA | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK GILLAM | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEE GLENN | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DENNIS HADDEN | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN MASSEY | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS HOLYOKE | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DENNIS MILLER | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM TRUMBULL | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,612,034 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $693,501 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $542,049 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 21 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SULLIVAN COTTER HOLDINGS INC | |||||
| 62272 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | CONSULTING | $684,514 |
| HEALTH ALL CONSULTING LLC | |||||
| PO BOX 104 | NORTH ANDOVER | MA | 01845 | CONSULTING | $399,150 |
| TRUST HEALTHCARE CONSULTING SERVICES LLC | |||||
| 2042 SOUTH BRENTWOOD | SPRINGFIELD | MO | 65804 | CONSULTING | $166,168 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MANAGEMENT SERVICES REVENUE | Desc |
| Business | 561000 | BusinessCd |
| Total Revenue Column | $13,076,346 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,076,346 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,076,346 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $56,070 | TotalRevenueColumnAmt |
| Exclusion | $56,070 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAL CENTER OF THE ROCKIES | 523000 | $13,733,253 | $13,733,253 |
| RCI INCOME | 523000 | $429,626 | $429,626 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,640 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,640 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $14,168,519 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,300,935 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,244,865 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $56,070 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,000 | TotalAmt |
| Program Services | $5,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,177,473 | TotalAmt |
| Program Services | $1,177,473 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,483,174 | TotalAmt |
| Program Services | $8,483,174 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $209,425 | TotalAmt |
| Program Services | $209,425 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,982,283 | TotalAmt |
| Program Services | $6,982,283 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $613,094 | TotalAmt |
| Program Services | $613,094 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,091 | TotalAmt |
| Program Services | $23,091 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,584,085 | TotalAmt |
| Program Services | $1,584,085 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,236 | TotalAmt |
| Program Services | $2,236 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,157 | TotalAmt |
| Program Services | $6,157 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18 | TotalAmt |
| Program Services | $18 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $564 | TotalAmt |
| Program Services | $564 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257 | TotalAmt |
| Program Services | $257 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PHYSICIAN RECRUITMENT | $967,588 | $967,588 |
| LICENSES AND ASSOCIATIO | $521,264 | $521,264 |
| TAXES | $8,704 | $8,704 |
| TELEPHONE | $8,355 | $8,355 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,592,768 | TotalAmt |
| Program Services | $20,592,768 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,836,089 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,099 | BOYAmt |
| EOY | $306,204 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,008,662 | BOYAmt |
| EOY | $4,079,399 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $133,333 | BOYAmt |
| EOY | $161,475 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,318,737 | BOYAmt |
| EOY | $4,884,275 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,270,594 | BOYAmt |
| EOY | $51,962,199 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,973,539 | BOYAmt |
| EOY | $5,052,686 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,804,964 | BOYAmt |
| EOY | $68,282,327 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,352,427 | BOYAmt |
| EOY | $2,919,252 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,298,325 | BOYAmt |
| EOY | $9,945,693 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,650,752 | BOYAmt |
| EOY | $12,864,945 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,154,212 | BOYAmt |
| EOY | $55,417,382 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,154,212 | BOYAmt |
| EOY | $55,417,382 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,804,964 | BOYAmt |
| EOY | $68,282,327 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,708,167 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $555,003 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 5 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (5 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| REGIONAL WEST MEDICAL CENTER | ||||
| 470385129 | 3 | Yes (1) | $5,000 | $0 |
| REGIONAL WEST GARDEN COUNTY | ||||
| 391904975 | 3 | 0 | $0 | $0 |
| REGIONAL WEST FOUNDATION | ||||
| 237171022 | 10 | 0 | $0 | $0 |
| REGIONAL WEST PHYSICIANS CLINIC | ||||
| 363314159 | 10 | 0 | $0 | $0 |
| REGIONAL WEST VILLAGE | ||||
| 363314162 | 10 | 0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 5 | SupportedOrganizationsTotalCnt |
| Support Sum | $5,000 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | 0 | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (1) | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, SECTION A, LINE 1: | FormAndLineReferenceDesc |
| Explanation | REGIONAL WEST HEALTH SERVICES' (RWHS') ARTICLES OF ORGANIZATION PROVIDE THAT IT WILL SUPPORT REGIONAL WEST MEDICAL CENTER AND RWHS' "OTHER TAX EXEMPT SUBSIDIARIES IN THEIR COLLECTIVE MISSION OF THE OPERATION, MANAGEMENT AND CONTROL OF A REGIONAL MEDICAL FACILITY PROVIDING HEALTH CARE AND RELATED SERVICES". ALL OF THE SUPPORTED ORGANIZATIONS ARE CONTROLLED BY RWHS. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,307,997 | BeginningYearBalanceAmt |
| Contributions | $190,018 | ContributionsAmt |
| Investment Earnings Or Losses | $1,350,185 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $40,956 | GrantsOrScholarshipsAmt |
| End Year Balance | $8,807,244 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,188,204 | BeginningYearBalanceAmt |
| Contributions | $324,798 | ContributionsAmt |
| Investment Earnings Or Losses | $824,828 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $29,833 | GrantsOrScholarshipsAmt |
| End Year Balance | $7,307,997 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,837,335 | BeginningYearBalanceAmt |
| Contributions | $719,879 | ContributionsAmt |
| Investment Earnings Or Losses | $1,352,989 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $98,684 | GrantsOrScholarshipsAmt |
| Other Expenditures | $623,315 | OtherExpendituresAmt |
| End Year Balance | $6,188,204 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,551,048 | BeginningYearBalanceAmt |
| Contributions | $538,883 | ContributionsAmt |
| Investment Earnings Or Losses | -$191,365 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $61,231 | GrantsOrScholarshipsAmt |
| End Year Balance | $4,837,335 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,507,319 | BeginningYearBalanceAmt |
| Contributions | $106,517 | ContributionsAmt |
| Investment Earnings Or Losses | $296,128 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $358,916 | GrantsOrScholarshipsAmt |
| End Year Balance | $4,551,048 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.15219 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.84781 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| INVESTMENT IN MED CTR OF THE | $38,081,248 | C |
| EXECUTIVE BENEFIT PLANS | $9,945,693 | F |
| INVESTMENT IN REGIONAL CARE INC | $3,935,258 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $51,962,199 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATES | $5,022,007 |
| ACCRUED INTEREST | $30,679 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,052,686 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED COMPENSATION | Desc |
| Amt | $9,945,693 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $9,945,693 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENT FUNDS ARE RESTRICTED FOR HEALTHCARE RESEARCH, HEALTHCARE EDUCATIONAL SCHOLARSHIPS, AND CAPITAL PROJECTS. |
| PART X, LINE 2: | RWHS, THE MEDICAL CENTER, THE FOUNDATION, THE VILLAGE, RWPC AND RWGC ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND HAVE RECEIVED DETERMINATION LETTERS THAT THEY ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE MEDICAL CENTER HAS REALIZED CERTAIN INCOME WHICH THE INTERNAL REVENUE SERVICE CONSIDERS TO BE UNRELATED BUSINESS INCOME SUBJECT TO INCOME TAX. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX EXEMPT STATUS. RCI IS A FOR-PROFIT CORPORATION AND FILES A SEPARATE FEDERAL INCOME TAX RETURN. A PROVISION FOR INCOME TAXES IS PROVIDED FOR THOSE ACTIVITIES THAT CREATE TAXABLE INCOME. RCI RECOGNIZED INCOME TAX EXPENSE OF $8,912 IN 2021 AND AN INCOME TAX REFUND OF $180,654 IN 2020. THE INCOME TAX REFUND AND EXPENSE IS INCLUDED IN SUPPLIES AND OTHER EXPENSES IN THE CONSOLIDATED STATEMENTS OF OPERATIONS. RWHS ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740 INCOME TAXES. RWHS RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2021 AND 2020, RWHS HAD NO UNCERTAIN TAX POSITIONS ACCRUED. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFREY HOLLOWAY MD | ||||||||||||||
| DIRECTOR | $0 | $687,261 | $0 | $3,918 | $0 | $2,322 | $0 | $11,600 | $0 | $50,205 | $0 | $755,306 | $0 | $0 |
| JOHN MENTGEN | ||||||||||||||
| CEO/PRESIDENT | $559,601 | $0 | $0 | $0 | $9,279 | $0 | $59,646 | $0 | $47,458 | $0 | $675,984 | $0 | $0 | $0 |
| DAVID CORNUTT | ||||||||||||||
| DIRECTOR OF OUTREACH | $438,901 | $0 | $0 | $0 | $1,663 | $0 | $0 | $0 | $39,222 | $0 | $479,786 | $0 | $0 | $0 |
| TIMOTHY OSTERHOLM | ||||||||||||||
| EVP & COO | $331,694 | $0 | $29,311 | $0 | $9,498 | $0 | $43,601 | $0 | $45,986 | $0 | $460,090 | $0 | $0 | $0 |
| PAUL HOFMEISTER | ||||||||||||||
| GENERAL COUNSEL | $332,687 | $0 | $0 | $0 | $39,028 | $0 | $11,587 | $0 | $29,287 | $0 | $412,589 | $0 | $0 | $0 |
| MICHAEL ICKOWSKI | ||||||||||||||
| CFO/TREASURER | $324,658 | $0 | $0 | $0 | $10,047 | $0 | $41,125 | $0 | $4,620 | $0 | $380,450 | $0 | $0 | $0 |
| MARGO FERGUSON | ||||||||||||||
| CHIEF QUALITY OFFICER | $199,110 | $0 | $20,069 | $0 | $8,439 | $0 | $26,508 | $0 | $46,265 | $0 | $300,391 | $0 | $0 | $0 |
| AMANDA VICK | ||||||||||||||
| VP OF PATIENT CARE SERVICES | $217,464 | $0 | $0 | $0 | $8,296 | $0 | $34,648 | $0 | $1,541 | $0 | $261,949 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | REGIONAL WEST HEALTH SERVICES PAID FOR ONE MONTH OF A MEMBERSHIP TO THE YMCA FOR ANY EMPLOYEE WHO CHOSE TO ENROLL. THIS AMOUNT WAS TREATED AS TAXABLE COMPENSATION TO THE EMPLOYEE. THE ONLY DIRECTOR, OFFICER, OR HIGHEST COMPENSATED EMPLOYEE WHO RECEIVED THIS BENEFIT IN THE CURRENT YEAR WAS MELODY BIBB. |
| PART I, LINE 4B | THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: JOHN MENTGEN 48,891 MICHAEL ICKOWSKI 29,525 TIMOTHY OSTERHOLM 32,001 MARGO FERGUSON 17,300 AMANDA VICK 25,725 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD WILL HAVE AN OPPORTUNITY TO REVIEW DRAFTS OF THE FORM 990 ELECTRONICALLY PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL DISCLOSURE BY BOARD MEMBERS OF ANY CONFLICT OF INTEREST, AS SET FORTH IN THE POLICIES, IS REQUIRED. FOR ANY POSSIBLE CONFLICT OF INTEREST IDENTIFIED, THE REMAINING BOARD DETERMINES IF IT ACTUALLY CONSTITUTES A CONFLICT OF INTEREST WITHOUT THE CONFLICTED BOARD MEMBER PRESENT. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE BOARD, LESS THE CONFLICTED MEMBER, WILL THEN DECIDE THE LEVEL OF INVOLVEMENT OF THE MEMBER IN DECISION MAKING FOR THE ENTITY, IF THERE IS AN ALTERNATIVE ARRANGEMENT THAT WILL ELIMINATE THE CONFLICT OF INTEREST, AND THE APPROPRIATENESS OF THE CONFLICTED MEMBER CONTINUING AS A BOARD MEMBER. FAILURE TO DISCLOSE A CONFLICT OF INTEREST CAN RESULT IN DISCIPLINARY AND CORRECTIVE ACTION FOR THE CONFLICTED MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION PROCESS FOR TOP OFFICIAL: COMPENSATION FOR THE CEO IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE RWHS BOARD. THE DETERMINATION IS BASED ON MARKET DATA AND RECOMMENDATIONS FROM AN INDEPENDENT CONSULTING FIRM WHO COLLECTS THAT INFORMATION FOR COMPARISON PURPOSES. MINUTES ARE KEPT OF THESE MEETINGS. COMPENSATION PROCESS FOR OFFICERS: COMPENSATION FOR OTHER OFFICERS IS REVIEWED BY AN INDEPENDENT CONSULTANT ON AN ANNUAL BASIS TO ENSURE THE COMPENSATION PLAN MEETS REASONABLENESS TESTING COMPARED TO MGMA COMPENSATION SURVEY. THE COMPENSATION MODEL IS ALSO REVIEWED BY LEGAL COUNSEL FOR REASONABLENESS AND COMPLIANCE WITH IRS REQUIREMENTS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| PART XII, LINE 2C: | THE CFO IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT PUBLIC ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| REGIONAL WEST HEALTH SERVICES & AFFILIATES | ||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 470658690 | HEALTH PLAN | NE | 501(C)(9) | REGIONAL WEST HEALTH SERVICES | Yes (1) | |
| REGIONAL WEST GARDEN COUNTY | ||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 391904975 | CRITICAL ACCESS HOSPITAL | NE | 501(C)(3) | REGIONAL WEST HEALTH SERVICES | Yes (1) | LINE 3 |
| REGIONAL WEST FOUNDATION | ||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 237171022 | FUNDRAISING | NE | 501(C)(3) | REGIONAL WEST HEALTH SERVICES | Yes (1) | LINE 12A, I |
| REGIONAL WEST PHYSICIANS CLINIC | ||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 363314159 | DR. CLINICS | NE | 501(C)(3) | REGIONAL WEST HEALTH SERVICES | Yes (1) | LINE 10 |
| REIONAL WEST VILLAGE | ||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 363314162 | RETIREMENT FACILITY | NE | 501(C)(3) | REGIONAL WEST HEALTH SERVICES | Yes (1) | LINE 10 |
| REGIONAL WEST MEDICAL CENTER | ||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 470385129 | HOSPITAL | NE | 501(C)(3) | REGIONAL WEST HEALTH SERVICES | Yes (1) | LINE 3 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL CARE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1Txt |
| City | SCOTTSBLUFF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69361 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470760050 | EIN |
| Primary Activities | TPA | PrimaryActivitiesTxt |
| Legal Domicile State | NE | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL WEST HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $4,824,733 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $4,338,463 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| REGIONAL WEST MEDICAL CENTER | ||
| L | $8,269,926 | FMV |
| REGIONAL WEST HEALTH SERVICES & AFFILIATE | ||
| R | $10,465,582 | CASH |
| REGIONAL WEST PHYSICIANS CLINIC | ||
| L | $60,885 | FMV |
Comments