2015-08-14T18:09:42-07:00 2014-12-31 990 2014-01-01 840447998 LOWER VALLEY HOSPITAL ASSOCIATION LOWE 9708589871 228 North Cherry Fruita CO 81521 Mark Francis CEO 9708582105 2015-08-14 2014 2016-03-07 17:11:31Z FAMILY HEALTH WEST Mark Francis PO Box 130 Fruita CO 81521 46517605 0 X www.familyhealthwest.org X 1949 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 0 694 142 6259137 0 325004 321724 38944874 45897891 96337 104999 218101 -203678 39584316 46120936 0 0 0 0 20568749 23785908 0 0 0 16832634 20050299 37401383 43836207 2182933 2284729 40587802 77137371 38570670 72836413 2017132 4300958 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. 0 0 26864669 0 33546093 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. 6315568 80000 6259137 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 120. 2442309 25908 3214252 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 116. One of the facilities is dedicated to residents with dimensia. The other provides cared with no cap on the percentage of medicaid residents. 4436264 0 3101455 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, and Wound Care Clinic. 4436264 0 3101455 40058810 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 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 1 0 0 0 0 0 0 0 0 1 98 0 1 694 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 2 0 X 0 0 0 William F Byers Trustee 2 0 X 0 0 0 Michael Hughes MD Trustee/ER Physician 2 0 X 0 0 0 Jeffrey D Freeland Trustee 2 0 X 0 0 0 Kenneth Lewis Trustee/Physician 2 0 X 0 0 0 Jerry Hamilton 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 Stacey Mascarenas Chair 4 0 X 0 0 0 Thomas Motz Trustee/Physician 2 0 X 0 0 0 Korrey Klein Director/Chief of Staff Designee 10 0 X 52360 52360 0 Kurtis M Holmes Treasurer 10 0 X 0 0 0 Lori Henderson Assistant Secretary 40 0 X X 177349 0 0 Jason McCormick Assistant Secretary 40 0 X X 177546 0 0 Mark Francis Secretary 40 0 X X 235079 0 0 Kenneth Palmer Vice Chair 1 0 X 0 0 0 Melody White Employee 40 0 X 120808 0 0 Joseph Kupets Doctor 40 0 X 228791 0 0 Rebecca Glasser Employee 35 0 X 250186 0 0 Brian Belnap MD Anesthesiologist 40 0 X 303112 0 0 David Kirch MD Anesthesiologist 40 0 X 301923 0 0 Dennis E Ficklin Former Officer 0 0 X 109776 0 0 Errol Snider Former Officer 0 0 X 96768 0 0 2053698 52360 0 3 1 1 0 Western Valley Family Practice 281 N Plum Fruita CO 81521 Physician Coverage for Hospitalist 497336 Grand Junction Medical Center c/o Developmental Solutions Group 1623 Blake Street Suite 300 Denver CO 80202 Office Space Rent 303039 Dr Fred Barbero MD 2205 Desert Varnish Court Grand Junction CO 81504 Emergency Room Physician 187644 Elizabeth Mensing 2279 Homestead Dr Grand Junction CO 81505 Contracted Doctor 182623 Jaws LLC PO Box 1401 Grand Junction CO 81502 Office Space 179719 9 0 0 122514 0 185588 13622 0 321724 Hospital Acute Care 622000 33423651 33423651 0 0 Nursing Home, Unskilled 623110 6259137 0 6259137 0 Assisted Living, Secured and Unsecured 623312 2892528 2892528 0 0 Physician Clinics and Offices 621110 3322575 3322575 0 0 0 0 0 0 45897891 1676 1676 0 0 94940 94940 0 0 0 0 0 0 175548 0 396669 0 -221121 0 -221121 -221121 0 0 8383 0 0 0 8383 0 8383 8383 0 0 122514 Rebates 622000 17443 17443 0 0 0 0 0 0 17443 46120936 39540075 6259137 0 589992 0 589992 0 19206754 17048171 2158583 0 646868 646868 0 0 1935403 1935403 0 0 1406891 1406891 0 0 76341 76341 60581 60581 564172 564172 0 0 0 0 2929802 2929802 0 456005 456005 0 323303 323303 586295 586295 0 0 0 0 1402977 1402977 0 0 11142 6717 4425 0 0 0 0 0 0 0 2366495 2366495 0 0 77974 77974 0 0 3217277 3217277 0 0 516939 516939 0 0 Supplies 5579215 5579215 0 Repairs and Maintenance 251357 251357 0 0 Medical Contracted Services 216753 216753 0 0 Food 899312 899312 0 0 514359 514359 43836207 40058810 3777397 0 3961951 6230021 9963776 4551299 0 0 4738024 37874083 0 0 0 0 0 0 1037871 959464 726797 762934 47554148 20869313 19573291 26684835 586092 74735 40587802 77137371 6885216 38293507 0 0 27500000 27265000 0 0 1335125 6233994 2850329 1043912 38570670 72836413 X 2017132 4300958 0 0 0 0 2017132 4300958 40587802 77137371 2284729 -903 0 0 0 0 X 1 X 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 646432 646432 0 23343636 9718967 13624669 0 11561075 4033895 7527180 0 11305505 6985670 4319835 0 697500 130781 566719 26684835 0 Interest Payable 1043912 1043912 46120936 0 0 0 0 0 46120936 0 0 0 46120936 43836207 0 0 0 0 0 43836207 0 0 0 43836207 Red Barron Ball 122514 0 122514 0 0 18872 0 0 32158 0 0 122514 0 122514 0 0 18872 0 0 32158 51030 71484 1 1 X 1 X 1 X 1 1 0 1 1 471277 0.01 1582493 141499 0.04 0 0 2195269 0 0 0.05 489345 0.01 0 2885736 0.07 0 0 0 0 3375081 0 0 0.08 0 0 5570350 0 0 0.13 0 1 884778 265200 2805936 6113995 -3308059 X 1 1 1 1 Family Health West Hospital 300 West Ottley Fruita CO 81521 X X X Swing bed Services Family Health West Hospital 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X familyhealthwest.org 0 0 1 X 200 200 X X X X X X 1 1 X X X X 1 X X X X X X X 0 0 1 0 0 Schedule H, Part V, Section B, Line 5-Family Health West Hospital An independent firm participated in a survey of our community. Schedule H, Part V, Section B, Line 11-Family Health West Hospital The organization is providing services for uninsured and under insured patients through the Access Clinic. Schedule H, Part V, Section B, Line 16a-Family Health West Hospital Available on our web page FHW.org Schedule H, Part V, Section B, Line 16b-Family Health West Hospital Application available on our website FHW.org Schedule H, Part V, Section B, Line 16c-Family Health West Hospital Available of our website FHW.org 4 Family Health West Nursing Home 228 North Cherry Street Fruita CO 81521 Long Term Care 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. 90 beds Willows Assisted Living 243 North Cherry Fruita CO 81521 State Licensed Secure Assisted Living facility with 25 beds. Practice Management 551 Kokopelli Blvd Fruita CO 81521 Physician Clinics and Support Services Schedule H, Part I, Line 7 Cost Report data and billing reports were used to calculate data. Schedule H, Part I, Line 7, Column f N/A Schedule H, Part I, Line 7g Community Benefit by providing physician clinics was $2090288. Schedule H, Part III, Section A, Line 4 Family Health West Hospital provides medically necessary health care services regardless of the ability to pay and extends credit to patients, substantially all of whom are local residents. Schedule H, Part III, Section B, Line 8 This should be included in community benefit. Cost information obtained from cost report and revenue attained from billing. Schedule H, Part III, Section C, Line 9b Patients are verified to have no insurance and already denied for Government help. Schedule H, Part VI, Line 2 Health Needs Survey. Provides in house charity care, Urgent care, payment plans, reduced sports physicals and reduced rates for children in school with no insurance. Schedule H, Part VI, Line 3 Patients are informed of assistance when checking our of the Hospital on their discharge instructions and through patient financial services. Patients with concerns are referred to our financial services department. Schedule H, Part VI, Line 4 Rural community consisting of a mix of new young families and elderly individuals. Active community with access to many outdoor activities throughout the year. Schedule H, Part VI, Line 5 Participates weekly at the Farmers Market during the summer handing out water and educating the community on services available to them. Monthly educational talks at the community recreation center by physicians. Bike fitting seminars by therapists. Schedule H, Part VI, Line 6 N/A Schedule H, Part VI, Line 7 N/A X X X X 0 0 0 0 0 0 0 0 0 Brian Belnap MD Anesthesiologist 303112 0 0 0 0 0 0 0 0 0 303112 0 0 0 David Kirch MD Anesthesiologist 301923 0 0 0 0 0 0 0 0 0 301923 0 0 0 Rebecca Glasser Employee 250186 0 0 0 0 0 0 0 0 0 250186 0 0 0 Mark Francis Secretary 235079 0 0 0 0 0 0 0 0 0 235079 0 0 0 Joseph Kupets Doctor 228791 0 0 0 0 0 0 0 0 0 228791 0 0 0 Jason McCormick Assistant Secretary 177546 0 0 0 0 0 0 0 0 0 177546 0 0 0 Lori Henderson Assistant Secretary 177349 0 0 0 0 0 0 0 0 0 177349 0 0 Dennis E Ficklin Former Officer 109776 0 0 0 0 0 0 0 0 0 109776 0 0 Errol Snider Former Officer 96768 0 0 0 0 0 0 0 0 0 96768 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 28000000 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 0 0 1 0 Form 990, Part VI, Section B, Line 11b The form is made available to all board members at the monthly meeting. Form 990, Part VI, Section B, Line 12c The compliance committee reviewed the activity and each member completed disclosure form. Form 990, Part VI, Section B, Line 15 CEO is selected by the board. CEO is annually reviewed 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 conflicts of interest available upon request.