COLORADO WEST PSYCHIATRIC HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COLORADO WEST PSYCHIATRIC HOSPITAL INC (EIN 26-4166675)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-16
- IRS object ID
- 201441369349301019
- Schema version
- 2012v2.3
- 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) |
|---|---|---|
| Timestamp | 2014-05-16T14:11:35-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 South Tejon Suite 800 | AddressLine1 |
| City | Colorado Springs | City |
| State | CO | State |
| ZIP Code | 809039848 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264166675 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Colorado West Psychiatric Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % THE ORGANIZATION | InCareOfName |
| Name Control | COLO | NameControl |
| Phone | 9703843032 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 Horizon Drive | AddressLine1 |
| Address Line2 | Suite 225 | AddressLine2 |
| City | Grand Junction | City |
| State | CO | State |
| ZIP Code | 81506 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Matthew Tulin | Name |
| Title | CFO | Title |
| Phone | 9703843032 | Phone |
| Date Signed | 2014-05-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Rita F Worster CPA | Name |
| Phone | 7194714290 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | West Springs Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Sharon Raggio | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 28 3/4 Road Bldg A | AddressLine1 |
| City | Grand Junction | City |
| State | CO | State |
| ZIP Code | 81501 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 10478633 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 5688 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.westspringshospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2009 | YearFormation |
| State Legal Domicile | CO | StateLegalDomicile |
| Activity Or Mission Description | West Springs Hospital is a leading psychiatric hospital in Colorado, recognized for skill in treatment and compassionate, professional staff. We treat patients of all ages from across our state and region. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 7 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 566638 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 472623 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 8226280 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 10006010 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -11246 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 8781672 | TotalRevenuePriorYear |
| Total Revenue Current Year | 10478633 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 110 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4753973 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5259671 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5068300 | OtherExpensePriorYear |
| Other Expenses Current Year | 5754253 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 9822273 | TotalExpensesPriorYear |
| Total Expenses Current Year | 11014034 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1040601 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -535401 | RevenuesLessExpensesCY |
| Total Assets BOY | 1344559 | TotalAssetsBOY |
| Total Assets EOY | 1227096 | TotalAssetsEOY |
| Total Liabilities BOY | 996441 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 162617 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 348118 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1064479 | NetAssetsOrFundBalancesEOY |
| Mission Description | Our mission is to create access to quality mental health and substance abuse services, enhancing recovery and resilience in our communities. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 9636626 | Expense |
| Grants | 110 | Grants |
| Revenue | 10006010 | Revenue |
| Description | Psychiatric Hospital Services | Description |
| Total Program Service Expense | 9636626 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | THE ORGANIZATION | NamePerson |
| Telephone Number | 9706837149 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 HORIZON DRIVE STE 225 | AddressLine1 |
| City | Grand Junction | City |
| State | CO | State |
| ZIP Code | 81506 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Sharon Raggio | ||||||||
| President & CEO | 1.0 | 39.0 | X | X | 0 | 216330 | 9716 | |
| Mike Stahl | ||||||||
| Secretary/Treasurer | 1.0 | X | X | 0 | 0 | |||
| Buzz Binder | ||||||||
| Chair | 1.0 | X | X | 0 | 0 | |||
| Sarah Place | ||||||||
| Director | 1.0 | X | 0 | 0 | ||||
| Timothy Grimsby | ||||||||
| Director | 1.0 | X | 0 | 0 | ||||
| Jon Gordon | ||||||||
| Director | 1.0 | X | 0 | 0 | ||||
| Tom Fisher | ||||||||
| Director | 1.0 | X | 0 | 0 | ||||
| Carol Skubic | ||||||||
| Director | 1.0 | X | 0 | 0 | ||||
| Mary DesOrmeau | ||||||||
| Director thru 03/2013 | 1.0 | X | 0 | 0 | ||||
| Chantal Unfug | ||||||||
| Director thru 05/2013 | 1.0 | X | 0 | 0 | ||||
| Jon Peacock | ||||||||
| Chair thru 09/2012 | 1.0 | X | 0 | 0 | ||||
| Sandy Randall | ||||||||
| Board member thru 09/2012 | 1.0 | X | 0 | 0 | ||||
| Bonita Wasli | ||||||||
| CFO | 1.0 | 39.0 | X | 150977 | 12667 | |||
| Holly Covington | ||||||||
| ANP | 39.0 | 1.0 | 120583 | 6243 | X | |||
| Kimberly J Boe | ||||||||
| Vice President | 40.0 | 113572 | 5223 | X | ||||
| Neil A Venard | ||||||||
| Medical Director CWPH | 7.0 | 33.0 | 253388 | 15584 | X | |||
| Regina Y LeVerrier | ||||||||
| Psychiatrist | 40.0 | 236041 | 15386 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1090891 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 64819 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Colorado West Inc | |||||
| 515 28 3/4 Road | GRAND JUNCTION | CO | 81501 | Management Services | 1298344 |
| Locumtenenscom LLC | |||||
| 2655 Northwinds Pkwy | ALPHARETTA | GA | 30009 | Physician Staffing | 100824 |
| BERNA B'S CLASSIC CUISINE CATERIN | |||||
| 2913 PATTERSON ROAD UNIT 101 | GRAND JUNCTION | CO | 81504 | CATERING SERVICES | 220449 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Government Grants | 18240 | GovernmentGrants |
| All Other Contributions | 454383 | AllOtherContributions |
| Total Contributions | 472623 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICARE/MEDICAID PAYMENTS | 900099 | 2038660 | 2038660 |
| CLIENT SERVICE REVENUE | 900099 | 6626439 | 6626439 |
| FEES & CONTRACTS FROM GOVT AGENCIES | 900099 | 1340911 | 1340911 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 10006010 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10478633 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10006010 | RelatedOrExemptFunctionIncome |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110 | Total |
| Program Services | 110 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4126031 | Total |
| Program Services | 3409941 | ProgramServices |
| Management And General | 716090 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28645 | Total |
| Program Services | 17734 | ProgramServices |
| Management And General | 10911 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 766749 | Total |
| Program Services | 637919 | ProgramServices |
| Management And General | 128830 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 338246 | Total |
| Program Services | 278163 | ProgramServices |
| Management And General | 60083 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 710794 | Total |
| Program Services | 497556 | ProgramServices |
| Management And General | 213238 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 300983 | Total |
| Program Services | 267983 | ProgramServices |
| Management And General | 33000 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 294862 | Total |
| Program Services | 294651 | ProgramServices |
| Management And General | 211 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8929 | Total |
| Program Services | 8929 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64520 | Total |
| Program Services | 40607 | ProgramServices |
| Management And General | 23913 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 385245 | Total |
| Program Services | 385195 | ProgramServices |
| Management And General | 50 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 420113 | Total |
| Program Services | 323892 | ProgramServices |
| Management And General | 96221 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37847 | Total |
| Program Services | 31146 | ProgramServices |
| Management And General | 6701 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1516 | Total |
| Management And General | 1516 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11918 | Total |
| Program Services | 9188 | ProgramServices |
| Management And General | 2730 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39601 | Total |
| Program Services | 21292 | ProgramServices |
| Management And General | 18309 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 2626063 | 2626063 | |
| MEDICATIONS & SUPPLIES | 455083 | 455083 | |
| CLIENT FOOD | 259946 | 259366 | 580 |
| DUES/FEES/SUBSCRIPTIONS | 59573 | 1341 | 58232 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77260 | Total |
| Program Services | 70467 | ProgramServices |
| Management And General | 6793 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11014034 | Total |
| Program Services | 9636626 | ProgramServices |
| Management And General | 1377408 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20931 | BOY |
| EOY | 25521 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 692592 | BOY |
| EOY | 1027944 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 5681 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 219335 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 115378 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69518 | BOY |
| EOY | 103957 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 561518 | BOY |
| EOY | 63993 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1344559 | BOY |
| EOY | 1227096 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83286 | BOY |
| EOY | 137617 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23248 | BOY |
| EOY | 25000 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 889907 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 996441 | BOY |
| EOY | 162617 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 346085 | BOY |
| EOY | 1057396 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2033 | BOY |
| EOY | 7083 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 348118 | BOY |
| EOY | 1064479 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1344559 | BOY |
| EOY | 1227096 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -535401 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 1251762 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2033 | BeginningOfYearBalance |
| Contributions | 5050 | Contributions |
| End Of Year Balance | 7083 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 0 | BeginningOfYearBalance |
| Contributions | 2033 | Contributions |
| End Of Year Balance | 2033 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus2 Years | CurrentYearMinus2Years | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years | |
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Land | Land | |
| Buildings | Buildings | |
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 215870 | OtherCostOrOtherBasis |
| Depreciation | 111913 | Depreciation |
| Book Value | 103957 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3465 | OtherCostOrOtherBasis |
| Depreciation | 3465 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 103957 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE FROM RELATED ORGANIZATION | Description |
| Book Value | 63993 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 63993 | TotalBookValueOtherAssets |
| Tot Revenue Etc Audited Fincl Stmt | 11730395 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 1251762 | OtherRevenues |
| Revenue Not Rptd F990 | 1251762 | RevenueNotRptdF990 |
| Revenue Subtotal | 10478633 | RevenueSubtotal |
| Total Revenue Per Form990 | 10478633 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11014034 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 11014034 | ExpensesSubtotal |
| Total Expenses Per Form990 | 11014034 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Use of organization's endowment funds | Part V, Line 4 | Temporarily restricted net assets are those whose use by the Hospital has been limited by donors to a specific time period or purpose. |
| Uncertain Tax Positions | Part X, Line 2 | Management has evaluated their income tax positions under the guidance included in asc 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. |
| Revenue on books, not on return | part XI, Line 2d | transfer of equity from affiliate 1,251,762 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 50. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1338440 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1171811 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 166629 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01990 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3156424 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2708787 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 447637 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05340 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4494864 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3880598 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 614266 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07330 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4494864 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3880598 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 614266 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07330 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $2,626,063 | BadDebtExpenseAmount |
| Amount Attributable To | 1304366 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 1547834 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 1520695 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 27139 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Colorado West Psychiatric Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 28 3/4 Rd | AddressLine1 |
| City | Grand Junction | City |
| State | CO | State |
| ZIP Code | 81501 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Colorado West Psychiatric Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | true | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Other Method | X | OtherMethod |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 50. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 400. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Part I, line 3c | Homeless and the indigent are provided free care which is determined on a case-by-case basis. | |
| Part I, Line 7, column f | Total bad debt expense removed from the denominator prior to the percentage calculation = $2,626,063. | |
| Part I, Line 7 | The organization used a cost-to charge ratio for lines 7a and 7b. The cost-to-charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. | |
| Part III, Line 2 | The amount reported in the Organization's bad debt expense is the total amount of bad debt expense for the year. | |
| Part III, Line 3 | Patient Accounts are written off to bad debt expense when the patient declines to pay the amount that has been determined to be affordable and the patient has the ability to pay. In addition, amounts are written off to bad debt when the patient declines to submit financial assistance paperwork and then additionally declines to pay their bill. The amount on line 3 is determined by taking total bad debt expense multiplied by the cost to charge ratio of 49.67% as an estimate of bad debt expense related to patients that decline to submit financial assistance paperwork. | |
| Part III, line 4 | Please see pages 7-8 of the attached audited financial statements for the footnote decribing bad debt expense. | |
| Part III, Line 8 | All Medicare reimbursement shortfall should be treated as community benefit, as there are no alternative inpatient psychiatric facilities available. The nearest facilities for inpatient psychiatric care are in Salt Lake City, Utah and Denver, Colorado. Allowable Medicare costs were determined by taking Medicare A&B patient revenue (not net of contractual adjustments and transfers) and multiplying it by the Cost to Charge Ratio. | |
| Part V, line 3, Describe how the hospital took into account input from | The Healthy Mesa County 2012-2017 report/CHNA is a collaborative, comprehensive report with input from various community stakeholders. consulted. | persons who represent the community |
| Part V, Line 4 | Community Hospital, Family Health West Hospital, St. Mary's Hospital & Regional Medical Center in addition to non hospital organizations of City of Grand Junction, Colorado Mesa University, Colorado West Regional Mental Health, Inc., Hilltop Community Resources, Marillac Clinic, Mesa County 211, Mesa County Department of Human Services, Strive, Primary Care Partners, P.C., Rocky Mountain Health Plans, United Way of Mesa County, Ute Water Conservancy District | List of hospitals included in the CHNA |
| Part V, line 5a & 5c | Although not available on the hospital facility's website, it is widely available on the Mesa County Health Department's website and other community partners' websites. http://health.mesacounty.us/data/template.aspx?id=3245 Part V, Line 6a & 6b Implementation Plan Colorado West Psychiatric Hospital (CWPH) conducted its Community Health Needs Assessment (CHNA) with other hospitals and health related entities. The implementation plan was created, however, the plan covered the broad interests of all the hospitals and health related entities included, and the governing board of CWPH did not specifically adopt an implementation plan specific to CWPH. Realization that CWPH was not in compliance with adopting the implementation plan occurred on May 12, 2014. Immediately upon discovery of the failure, the organizations Director of Quality & Compliance began working on the implementation plan which will be adopted by the governing body at the next board meeting. The failure to adopt the implementation plan was neither wilful or egregious, as the organization began taking the necessary steps to remedy the act immediately after the discovery. Part V, line 7 Needs addressed in the most recently conducted CHNA Not all identified needs in the CHNA were addressed by Colorado West Psychiatric Hospital because the CHNA was conducted with other hospitals and health related entities that were better suited to address those specific needs. | How the CHNA was made widely available to the public |
| Part V, Line 20d- Indicate how the hospital determined the maximum amounts | The hospital determines a self-funded client's responsibility based on The standard fees less the charitable care discount. The standard fee is derived from cost analysis. The hospital applies a means test for each self-funded client and discounts are in proportion to the federal poverty guidelines. Charitable discounts are considered for clients whose number in household and income is less than 400% of the federal poverty guidelines. | that can be charged to FAP-eligible individuals for care |
| Needs Assessment | Program development and design is taken into account as a result of community meetings and interaction with community leaders. | |
| Patient Education of Eligibility for Assistance | Patients are informed of the organization's charity care policy at their first visit when payment terms are discussed. | |
| Community Information | Colorado West Psychiatric Hospital, Inc., serves the entire Western Slope of Colorado and further as the nearest inpatient psychiatric facilities are located in Salt Lake City, Utah and Denver, Colorado. | |
| Other Information | Our mission is to create access to quality mental health and substance abuse services, enhancing recovery and resilience in our communities. When our patients become and maintain wellness, they are able to stay in their communities and live productive lives. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sharon Raggio | ||||||||||||||
| President & CEO | 0 | 165394 | 0 | 17500 | 0 | 33436 | 0 | 5384 | 0 | 4332 | 0 | 226046 | 0 | 0 |
| Bonita Wasli | ||||||||||||||
| CFO | 98999 | 24500 | 27478 | 3790 | 8877 | 163644 | 0 | |||||||
| Neil A Venard | ||||||||||||||
| Medical Director CWPH | 252708 | 0 | 680 | 0 | 15584 | 268972 | 0 | |||||||
| Regina Y LeVerrier | ||||||||||||||
| Psychiatrist | 222939 | 0 | 13102 | 5619 | 9767 | 251427 | 0 | |||||||
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| MEMBERS | PART VI, LINE 6, 7A, & 7B | Colorado West, Inc. dba Mind Springs, Inc. is the sole member of Colorado West Psychiatric Hospital, Inc. (CWPH). The sole member of the Corporation has the exclusive power and authority to appoint all of the Directors to serve on the Board of Directors of the Corporation and to remove the Directors it appoints. The sole member may delegate this function to the board of directors of the Corporation, reserving for itself the right of final approve of such actions. Approval of the sole member is required to: (a) Amend or restate the Articles of Incorporation or Bylaws of the Corporation; (b) Elect or remove Directors of the Corporation; (c) Create Corporation budgets, amend the budgets, sell or purchase goods or services or property outside or inconsistent with the budgets, or establish spending authority of the CEO; (d) Create Corporation strategic plans; (e) Appoint and/or Remove chairperson or President of the Board of Directors; (f) Change the name of the Corporation, sell the Corporation, enter into a joint venture or discontinue any Corporation operation for more than three consecutive days; (g) Establish a Corporate Compliance Plan; (h) Appoint an independent auditor for the Corporation. |
| DESCRIBE PROCESS TO REVIEW THE FORM 990 | PART VI, LINE 11B | The Form 990 is prepared by an outside third party and is reviewed by the Controller and CFO. |
| DESCRIBE HOW CONFLICT OF INTEREST POLICY IS MONITORED & ENFORCED | PART VI, LINE 12C | In connection with any actual or possible conflict of interest that an interested person may have with a proposed transaction, the interested person must disclose the existence of all financial interests that could be construed to be a conflict of interest and be given the opportunity to disclose all material facts to the directors and members of committees with governing board delegated powers considering the proposed transaction or arrangement. Each director, principal officer and member of a committee with governing board-delegated powers shall annually sign a statement, which affirms such person has received a copy of the conflicts of interest policy; has read and understands the policy; has agreed to comply with the policy; and understands the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. Periodic reviews are conducted to determine if officers and directors are in compliance with the policy. If the Governing board or committee has reasonable cause to believe a member has failed to disclose actual or possible conflicts of interest, it shall inform the member of the basis for such belief and afford the member an opportunity to explain the alleged failure to disclose. If, after hearing the member's response and after making further investigation as warranted by the circumstances, the governing board or committee determines the member has failed to disclose an actual or possible conflict of interest, it shall take appropriate disciplinary and corrective action. |
| DESCRIBE PROCESS FOR DETERMINING CEO COMPENSATION | PART VI, LINE 15A | Compensation is paid by a related party, Colorado West, Inc. Compensation is reviewed minimally semi-annually by Colorado West's Human Resources as directed by the board of directors. CEO compensation was determined by performing a market analysis of CEO compensation in Colorado for a variety of Community Mental Health Organizations. This information was shared with the executive recruiter for the CEO position who then compared this information with national market analysis' for CEO compensation, taking into account the size and volume of the organization. Most recent market analysis was performed in 2010. The Board does not approve executive compensation and the decision is not formally documented. CEO compensation is, however, disclosed in a written employment contract. |
| DESCRIBE PROCESS FOR DETERMINING OTHER OFFICERS COMPENSATION | PART VI, LINE 15B | Compensation is paid by a related party, Colorado West, Inc. Compensation is reviewed minimally on a semi-annual basis by Colorado West's Human Resources as directed by the CEO and CFO of the organization. Other officer compensation is determined by using Mountain States Employers Council compensation survey for Colorado. Most recent market analysis was performed in 2010. The Board does not approve other officer's compensation and the decision is not formally documented. |
| DESCRIBE HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC | PART VI, LINE 19 | The governing documents, financial statements, and conflict of interest policy are available upon request. |
| OTHER CHANGES IN NET ASSETS | PART XI, LINE 9 | transfer of equity from affiliate 1,251,762 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Colorado West Inc | ||||||||||
| 515 28 3/4 Road Bldg A | Grand Junction | CO | 81501 | 264166271 | Admin Svcs | CO | 501(c)(3) | ln11 type I | na | false |
| Health Service Programs Inc | ||||||||||
| 515 28 3/4 Road Bldg A | Grand Junction | CO | 81501 | 742232434 | HUD Housing | CO | 501(c)(3) | line 9 | co west inc | false |
| Colorado West Regional Mental Health Inc | ||||||||||
| 515 28 3/4 Road Bldg A | Grand Junction | CO | 81501 | 840625890 | Mental Health | CO | 501(c)(3) | line 9 | co west inc | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | true | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Colorado West Regional Mental Health Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | L | TransactionType |
| Amount Involved | 1171808 | AmountInvolved |
| Method Of Amt Determination | interco amount | MethodOfAmtDetermination |
Comments