2016-08-15T10:43:05-07:00 2015-12-31 990 2015-01-01 840447998 LOWER VALLEY HOSPITAL ASSOCIATION LOWE 9708589871 228 North Cherry Fruita CO 81521 Mark Francis CEO 9708582105 2016-08-15 2015 2016-09-27 15:27:22Z FAMILY HEALTH WEST Mark Francis 228 N Cherry St Fruita CO 81521 49031985 0 X www.familyhealthwest.org X 1946 CO Address the health care 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. 13 0 638 200 151267 0 321724 129797 45897891 48178701 104999 116076 -203678 607411 46120936 49031985 0 0 0 0 23785908 22558460 0 0 0 20050299 20830072 43836207 43388532 2284729 5643453 77137371 49193720 72836413 39249308 4300958 9944412 X Address the health care needs of the greater Fruita community and provide health care services without regard to race, color, age, handicap, creed or national origin. Provide those services to individuals of all income levels consistent with our ability to do so. 1 0 25874595 20944 37249971 Family Health West operates a 16 bed acute care 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. 6356471 47367 5596668 The organization operates a Nursing Home providing unskilled nursing care and services. The facility does not limit the percentage of medicaid residents that are admitted to the facility. The total number of licensed beds is 90. 2693925 0 2872943 The Organization operates two assisted living facilities that provide residential accommodations and limited healthcare services to the elderly and disabled for a total bed count of 96. One of the facilities is dedicated to residents with dementia. The other provides cared with no cap on the percentage of medicaid residents. 4252954 0 3157572 The organization sponsors clinics to ensure access to primary and specialty care services in the community. These operations include are not limited to Anesthesia, Emergency providers, Hospitalist and Radiologist. 17100 0 58718 The mission of the Family Health West Foundation is to provide sustainable funding to ensure the organization's ability to continuously provide comprehensive healthcare services to our community 4270054 0 3216290 39195045 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 79 0 1 638 1 0 0 0 0 0 1 1 0 0 0 0 X 13 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CO X Diane Miller 9708582228 228 North Cherry Fruita CO 81521 Christopher Wibblesman Director/Chief of Staff 5 0 X 0 0 0 William F Byers Trustee 2 0 X 0 0 0 Jeffrey D Freeland Trustee 2 0 X 0 0 0 Tom Oliver Trustee 2 0 X 0 0 0 Tim Sarmo Trustee 2 0 X 0 0 0 Kenneth Lewis Trustee/Director 2 0 X 97200 0 0 Thomas Motz Trustee/Physician 2 0 X 0 0 0 Michael Hughes MD Trustee/ER Physician 2 0 X 0 0 0 Randy Brown Trustee 1 0 X 0 0 0 Michael Neste MD Designee for Chief of Staff 40 0 X X X 313367 0 0 Blaine Buck Chair 4 0 X 0 0 0 Kenneth Palmer Vice Chair 2 0 X 0 0 0 Mark Francis Secretary 40 0 X X X 222800 0 0 Lori Randall Assistant Secretary 40 0 X X 177488 0 0 Kurtis M Holmes Treasurer 2 0 X 0 0 0 Kevin Howell Physician 40 0 X X 289134 0 0 Larry Tice Physician 40 0 X X 307585 0 0 Scott Vincent Physician 40 0 X 253551 0 0 Troy Griffiths Physician 40 0 X 267132 0 0 Joseph Kupets Physician 40 0 X 216268 0 0 Brian Belnap MD Anesthesiologist 35 0 X X 304752 0 0 David Kirch MD Anesthesiologist 35 0 X X 307153 0 0 Dennis E Ficklin Former Officer 0 0 X 113070 0 0 Errol Snider Former Officer 0 0 X 99671 0 0 2969171 0 0 18 1 1 0 Western Valley Family Practice 281 N Plum Fruita CO 81521 Physician Coverage for Hospitalist 451418 Elizabeth Mensing 2279 Homestead Dr Grand Junction CO 81505 Contracted Doctor 208128 Jaws LLC PO Box 1401 Grand Junction CO 81502 Office Space 180984 GCC MFE West LLC C/O Wells Fargo 359 Main Street Grand Junction CO 81501 Rent 136337 Grand Junction Medical Center c/o Developmental Solutions Group 1623 Blake Street Suite 300 Denver CO 80202 Office Space Rent 128839 6 0 0 0 0 68311 61486 0 129797 Hospital Acute Care 622000 36996120 36996120 0 0 Nursing Home, Unskilled 623110 5379403 5379403 0 0 Assisted Living, Secured and Unsecured 623312 2868449 2868449 0 0 Physician Clinics and Offices 621110 2934729 2934729 0 0 0 0 0 0 48178701 889 889 0 0 95207 95207 0 0 0 0 0 0 176511 0 0 0 176511 0 176511 176511 0 0 19980 0 0 0 19980 0 19980 19980 0 0 151267 0 0 151267 151267 0 0 0 0 0 0 0 15926 0 15926 15926 0 0 263707 263707 0 0 263707 49031985 48750921 151267 0 2871971 2258942 613029 0 0 0 0 0 15574566 13395131 2179435 0 559997 459592 100405 0 2266336 1859990 406346 0 1285590 1055088 230502 0 0 0 0 62775 0 62775 600995 0 600995 0 0 0 0 0 0 2570129 2570129 0 436363 436363 0 144934 144934 0 73581 73581 0 0 0 0 1554249 1554249 0 5653 5653 0 0 0 0 0 0 0 2450095 2450095 0 152303 152303 0 3482068 3482068 0 479758 479758 0 Supplies 7329829 7329829 0 0 Medical contracted services 1104281 1104281 0 0 Equipment Rental 220357 220357 0 0 Repairs and Maintenance 52728 52728 0 0 109974 109974 0 0 43388532 39195045 4193487 0 6230021 9514419 4551299 4037293 0 0 37874083 9735146 0 0 0 0 0 0 959464 1346741 762934 705678 45430994 21649286 26684835 23781708 74735 72735 77137371 49193720 38293507 7278333 0 0 0 0 27265000 27010000 0 0 0 0 6233994 4960975 0 1043912 72836413 39249308 X 4300958 9944412 0 0 0 0 4300958 9944412 77137371 49193720 5643453 1 0 0 0 0 X 1 X 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 546432 546432 0 23184872 21494840 1690032 0 7736599 0 7736599 0 13265591 0 13265591 0 697500 154446 543054 23781708 49031985 0 0 0 0 0 49031985 0 0 0 49031985 40954290 0 0 0 0 0 40954290 0 2434242 2434242 43388532 Schedule D, Part XII, Line 4b Interest Expense Red Barron Ball 151267 0 151267 0 0 19333 0 35170 21791 0 0 151267 0 151267 0 0 19333 0 35170 21791 76294 74973 1 1 1 X 1 X 1 1 0 1 1 1168135 0 0 0.03 0 0 0 0 0 0 0 0 0 0 1168135 0 0 0.03 0 0 0 0 0 0 0 0 9022722 7483851 1538871 0.04 0 0 0 0 0 0 0 0 0 0 9022722 7483851 1538871 0.04 0 0 10190857 7483851 1538871 0.07 1 844156 336129 6293025 4996686 1296339 X 1 1 1 1 Colorado Canyons Hospital and Medical Center 300 West Ottley Fruita CO 81521 FHW.org 2511OC X X X X Colorado Canyons Hospital and Medical Center 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X FHW.org X http://health.mesacounty.us/images/DataReports/CHNA2015.pdf 1 15 1 fhw.org 0 0 1 X 200 399 X X X X X X 1 1 X X X X 1 X FHW.org X FHW.org X FHW.org X X X 1 X 0 X 1 X 0 0 Schedule H, Part V, Section B, Line 5-Colorado Canyons Hospital and Medical Center Mesa County Health Department Schedule H, Part V, Section B, Line 6a-Colorado Canyons Hospital and Medical Center Mesa County created a community needs assessment for St. Mary's Hospital, Community Hospital and Colorado Canyons Hospital. Schedule H, Part V, Section B, Line 6b-Colorado Canyons Hospital and Medical Center Mesa County Health Department created a Community Health Needs Assessment for 2015 - 2017 Schedule H, Part V, Section B, Line 11-Colorado Canyons Hospital and Medical Center We have instituted a campus wide no smoking policy and offered help to current smokers to stop this focuses on lung disease prevention. We have given space in our buildings to the Mesa County Department of Health to help with unindended pregnancies and vaccinations, Mind Springs to address suicide prevention, Hope West for end of life support and Mesa County Services. We provide an Access Clinic on our campus for easy access to care. We do not exclude or limit Medicare or Medicaid patients. We provide quality, home-town health care for residents of rural Mesa County to include a broad spectrum of services caring for people through every stage of life. We offer the only Medicare swing bed hospital in the Grand Valley. We provide a nursing home that does not limit the number of Medicaid beds. We provide education to the community by hosting free of charge educational seminars on health care led by physicians in the community. We assist patients in filling our applications for Medicaid and CHP+. Schedule H, Part V, Section B, Line 22d-Colorado Canyons Hospital and Medical Center The Hospital used the charge master and discounted according to income level eligible discount. 4 Physician Services 551 Kokopelli Blvd Fruita CO 81521 Physician Clinics and Supported Services. Courtyard Care Center 228 North Cherry Street Fruita CO 81521 Long Term Care Nursing Facility. No Medicare Part A beds. Oaks Assisted Living Facility 805 West Ottley Fruita CO 81521 State Licensed Assisted Living Facility that accepts unlimited number of Medicaid clients. 70 Beds. Willows Assisted Living 243 North Cherry Street Fruita CO 81521 State Licensed Secure Assisted Living facility with 26 beds memory care. Schedule H, Part I, Line 6a Mesa County Health Department created a Community Health Needs Assessment for St. Mary, Community and Colorado Canyons Hospital. Schedule H, Part I, Line 7 Financial statements and cost report Schedule H, Part III, Section A, Line 4 Bad Debt is not reported separate in the audited financials. Schedule H, Part III, Section B, Line 8 We do not limit the amount of patients we provide services for based on their insurance affiliation. Schedule H, Part III, Section C, Line 9b Patients are offered assistance in applying for Charitable services before collections steps are taken Schedule H, Part VI, Line 2 Community needs assessment was gathered through the Mesa County Health Department Schedule H, Part VI, Line 3 Patient financial assistance is part of our discharge process and given to patients at time of discharge. Payment arrangements and assistance are offered to all patients. All forms and policies are available on our website and in the hospital at time of service. Schedule H, Part VI, Line 4 Quality home-town health care is provided in our rural community covering people through every stage of life. Schedule H, Part VI, Line 5 Educational forums are presented at the community recreation center free of charge to the community covering varying healthcare topics concerning the community. Schedule H, Part VI, Line 6 The facility provides space free of charge to our community health partners Mesa County Health Department assistance, Mind Springs mental health care, Hilltop home health care and Hope West end of life care. X X 0 0 0 0 0 0 0 0 0 Dennis E Ficklin Former Officer 113070 0 0 0 0 0 0 0 0 0 113070 0 0 Errol Snider Former Officer 99671 0 0 0 0 0 0 0 0 0 99671 0 0 0 Schedule J, Part I, Line 3 Compensation is researched and approved by the Board of Directors A City of Fruita 846000669 359428AC3 2008-04-10 28000000 Replacement Hospital and Debt Consolidation 0 0 0 A 0 0 28000 0 0 0 697500 0 0 1961459 0 0 2009 0 0 0 1 A 0 0 0 0 0 0 0 1 0 1 A 0 0 0 0 0 0 1 Citigroup Financial Partners .215 1 0 1 Form 990, Part III, Line 2 Extablished the Family Health West Foundation to provide sustainable funding to ensure the organization's ability to continuously provide comprehensive healthcare services to our community Form 990, Part VI, Section B, Line 11b The form is made available to all board members at the board meeting Form 990, Part VI, Section B, Line 12c Disclosure forms are reviewed by the compliance committee Form 990, Part VI, Section B, Line 15 CEO is selected and reviewed annually by the board Form 990, Part VI, Section C, Line 19 Annual financial statements are available to the public in our annual report. The board has the 990 all financial statements and conflict of interest available upon request. Obtained an extension due to audited financials not being completed by due date