2014-06-24T11:10:43-05:00 2013-12-31 410746749 CLIFTONLARSONALLEN LLP 1 BRONZE POINTE BELLEVILLE IL 62226 990 2013-01-01 261243347 GUNNISON VALLEY HEALTH FOUNDATION GUNN 9706428406 711 N TAYLOR STREET GUNNISON CO 81230 JAMES BARBUAT CFO 9706428406 2014-06-05 1 KURT BENNION P01469618 6182331200 2013 2015-11-30 17:44:51Z NANCY OSMUNDSON 711 N TAYLOR STREET GUNNISON CO 81230 223727 0 X WWW.GUNNISONVALLEYHEALTH.ORG X 2007 CO TO DEVELOP, PRESERVE, AND PROVIDE FINANCIAL RESOURCES TO THE GUNNISON HEALTHCARE FACILITIES. 10 6 0 20 0 0 447214 84004 0 0 58657 99777 24127 29427 529998 213208 169459 12250 0 0 130429 0 42000 0 1371 40862 21070 382750 33320 147248 179888 1652586 1832474 0 0 1652586 1832474 X THE GUNNISON VALLEY HEALTH FOUNDATION EXISTS TO DEVELOP, PRESERVE & PROVIDE FINANCIAL RESOURCES TO THE GUNNISON HEALTHCARE FACILITIES TO IMPROVE THE QUALITY AND BREADTH OF HEALTH CARE IN GUNNISON COUNTY. 0 0 12250 12250 0 THE GUNNISON VALLEY HEALTH FOUNDATION PROVIDES FINANCIAL SUPPORT TO GUNNISON VALLEY HOSPITAL.THE FOUNDATION HAS PARTNERED WITH GUNNISON VALLEY HOSPITAL TO FACILITATE THE MEDICAL STUDENT LOAN PROGRAM. THE GOAL OF THIS PROGRAM IS TO RECRUIT AND RETAIN FAMILY PRACTICE AND OTHER NEEDED PHYSICIANS TO OUR RURAL AREA. THE FOUNDATION AND HOSPITAL RECENTLY COMPLETED ITS FIRST 3-YEAR STUDENT LOAN AGREEMENT PROVIDING $10,000 EACH YEAR TO A MEDICAL STUDENT WHO WILL RETURN TO THE AREA TO PRACTICE MEDICINE IN RETURN FOR FORGIVENESS OF THE LOAN. THE FOUNDATION RAISES THE MONEY AND GIVES IT TO THE HOSPITAL; THE HOSPITAL THEN PAYS AND HAS THE AGREEMENT WITH THE MEDICAL STUDENT.IN ADDITION, THE DR. TARR NURSING AWARD PROGRAM WAS STARTED A NUMBER OF YEARS AGO BY A GENEROUS DONOR. THE GUNNISON VALLEY HEALTH FOUNDATION PARTNERS WITH GUNNISON VALLEY HOSPITAL TO HELP OVERSEE THIS ANNUAL AWARD FOR NURSING EXCELLENCE. THE FOUNDATION RECEIVES THE DONATION AND GIVES THE MONEY TO THE HOSPITAL; THE HOSPITAL THEN PAYS THE RECIPIENT. MEDICAL STAFF AND PEERS VOTE FOR A DESERVING NURSE EACH YEAR. 12250 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 10 6 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X LAUREN HOLBROOK 9706428406 711 N TAYLOR STREET GUNNISON CO 81320 MARLA COVEY CHAIR 5.00 X X 0 0 0 VIRGINIA JONES SECRETARY 1.00 X X 0 0 0 ROBERT SANTILLI CEO HOSPITAL 2.00 38.00 X X 0 189003 0 JOHN TARR CMO HOSPITAL 1.00 39.00 X X 0 58156 0 JAMES BARBUAT CFO/TREASURER 2.00 38.00 X X 0 49406 0 NICHOLE BAKER DIRECTOR 2.00 38.00 X 0 67917 3654 CHUCK CLIGGETT DIRECTOR 1.00 X 0 0 0 FRED HAVERLY TRUSTEE LIASION 1.00 1.00 X 0 0 0 TAMMY SCOTT DIRECTOR 1.00 X 0 0 0 CATHY STEINBERGER DIRECTOR 1.00 X 0 0 0 LUCY ZAVALA DIRECTOR 1.00 X 0 0 0 NANCY OSMUNDSON EXECUTIVE DIRECTOR 40.00 0.00 X 0 14417 0 LAUREN HOLBROOK FORMER EXECUTIVE DIRECTOR 40.00 0.00 X 0 24428 0 0 403327 3654 0 0 1 0 0 10000 11158 62846 84004 99777 99777 39946 10000 10519 29427 29427 213208 0 0 129204 12250 12250 524 524 18958 18958 32 32 MISCELLANEOUS EXPENSE 1556 185 1371 33320 12250 19699 1371 174953 267200 50092 26587 200 1040 116654 16654 100000 100000 1324341 1434647 3000 3000 1652586 1832474 0 0 X 1652586 1832474 1652586 1832474 1652586 1832474 179888 0 X X 0 1 X 1 0 X 41627 1053353 189330 447214 84004 1815528 89783 126156 123053 194078 533070 131410 1179509 312383 641292 84004 2348598 2348598 71 8451 39273 47954 99777 195526 4285 4285 2548409 116418 0.92160 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 100000 100000 16654 16654 0 100000 GOLF CLASSIC 38646 10000 28646 1572 7836 1111 WOLKOV GALA 11300 11300 49946 10000 39946 1572 7836 1111 10519 29427 1 GUNNISON VALLEY HOSPITAL 711 N TAYLOR ST GUNNISON CO 81230 846008116 GOVERNMENT 10125 FMV SUPPORT HOSPITAL 1 0 PART I, LINE 2: GRANT FUNDS ARE MADE TO RELATED ORGANIZATIONS. THE ORGANIZATIONS ARE IN CONSTANT CONTACT RELATED TO PROGRAMS AND ACTIVITY EXPENDITURES. 0 0 0 0 0 0 0 0 0 ROBERT SANTILLI CEO HOSPITAL 0 189003 0 0 0 0 0 0 0 0 0 189003 0 0 PART I, LINE 3 COMPENSATION OF THE GUNNISON VALLEY HEALTH FOUNDATION EXECUTVE DIRECTOR IS DETERMINED BY THE HOSPITAL CEO AND THE HOSPITAL HUMAN RESOURCES DEPARTMENT AS THE EXECUTIVE DIRECTOR IS A HOSPITAL EMPLOYEE. FORM 990, PART VI, SECTION A, LINE 7A ALL BOARD MEMBERS ARE ELECETED BY THE BOARD OF TRUSTEES OF GUNNISON VALLEY HEALTH SYSTEM. FIVE OF THE BOARD MEMBERS ARE THE HEALTH SYSTEM'S CEO AND CFO, A MEMBER OF THE HEALTH SYSTEM'S BOARD OF TRUSTEES WHO IS APPOINTED BY THE CHAIR OF THE HEALTH SYSTEM'S BOARD OF TRUSTEES, A PHYSICAN REPRESENTATIVE WHO IS APPOINTED BY THE HEALTH SYSTEM'S CHIEF OF STAFF, AND A HEALTH SYSTEM NON-PHYSICIAN STAFF MEMBER WHO IS APPOINTED BY THE HEALTH SYSTEM'S CEO. FORM 990, PART VI, SECTION B, LINE 11 A REVIEW OF THE 990 IS CONDUCTED BY THE GUNNISON VALLEY HEALTH CEO AND HEALTH FOUNDATION DIRECTOR AND A COPY IS PROVIDED TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION'S CONFLICT OF INTEREST QUESTIONNAIRE IS DISTRIBUTED TO, COMPLETED BY, AND COLLECTED FROM EACH DIRECTOR ON THE BOARD ON AN ANNUAL BASIS. 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 XII, LINE 2C THERE WAS NO CHANGE FROM THE PRIOR YEAR. GUNNISON VALLEY HOSPITAL 711 N TAYLOR ST GUNNISON CO 81230 846008116 HOSPITAL CO GOVERNMENT N/A 0 GUNNISON VALLEY HEALTH SENIOR CARE CENTER 1500 W TOMICHI AVENUE GUNNISON CO 81230 841288611 HEALTH CARE CENTER CO GOVERNMENT N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0