2014-05-16T14:11:35-05:00 2013-06-30 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2012-07-01 264166675 Colorado West Psychiatric Hospital Inc % THE ORGANIZATION COLO 9703843032 715 Horizon Drive Suite 225 Grand Junction CO 81506 Matthew Tulin 9703843032 2014-05-15 true Rita F Worster CPA 7194714290 2012 2015-11-30 17:44:51Z West Springs Hospital Inc Sharon Raggio 515 28 3/4 Road Bldg A Grand Junction CO 81501 10478633 false 5688 X www.westspringshospital.org X 2009 CO 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. 8 7 0 7 0 566638 472623 8226280 10006010 -11246 0 0 0 8781672 10478633 0 110 0 0 4753973 5259671 0 0 0 5068300 5754253 9822273 11014034 -1040601 -535401 1344559 1227096 996441 162617 348118 1064479 Our mission is to create access to quality mental health and substance abuse services, enhancing recovery and resilience in our communities. false false 9636626 110 10006010 Psychiatric Hospital Services 9636626 true true false false false false false false false true true false false true false false true true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false true 0 0 0 false false false false false false false false false false X 8 7 false false false false true true true true true false false false true true true false true false false false X THE ORGANIZATION 9706837149 715 HORIZON DRIVE STE 225 Grand Junction CO 81506 X Sharon Raggio 1.0 39.0 X X 0 216330 9716 Mike Stahl 1.0 X X 0 0 Buzz Binder 1.0 X X 0 0 Sarah Place 1.0 X 0 0 Timothy Grimsby 1.0 X 0 0 Jon Gordon 1.0 X 0 0 Tom Fisher 1.0 X 0 0 Carol Skubic 1.0 X 0 0 Mary DesOrmeau 1.0 X 0 0 Chantal Unfug 1.0 X 0 0 Jon Peacock 1.0 X 0 0 Sandy Randall 1.0 X 0 0 Bonita Wasli 1.0 39.0 X 150977 12667 Holly Covington 39.0 1.0 X 120583 6243 Kimberly J Boe 40.0 X 113572 5223 Neil A Venard 7.0 33.0 X 253388 15584 Regina Y LeVerrier 40.0 X 236041 15386 0 1090891 64819 0 false true false 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 3 18240 454383 472623 MEDICARE/MEDICAID PAYMENTS 900099 2038660 2038660 CLIENT SERVICE REVENUE 900099 6626439 6626439 FEES & CONTRACTS FROM GOVT AGENCIES 900099 1340911 1340911 10006010 0 0 0 0 0 0 0 0 0 0 0 10478633 10006010 110 110 0 0 0 0 0 4126031 3409941 716090 0 28645 17734 10911 766749 637919 128830 338246 278163 60083 710794 497556 213238 0 300983 267983 33000 0 0 0 294862 294651 211 8929 8929 64520 40607 23913 385245 385195 50 0 420113 323892 96221 37847 31146 6701 0 1516 1516 0 0 11918 9188 2730 39601 21292 18309 BAD DEBT EXPENSE 2626063 2626063 MEDICATIONS & SUPPLIES 455083 455083 CLIENT FOOD 259946 259366 580 DUES/FEES/SUBSCRIPTIONS 59573 1341 58232 77260 70467 6793 11014034 9636626 1377408 0 20931 25521 0 0 0 0 692592 1027944 0 0 0 0 0 0 0 0 0 5681 219335 115378 69518 103957 0 0 0 0 0 0 0 0 561518 63993 1344559 1227096 83286 137617 0 0 23248 25000 0 0 0 0 0 0 0 0 0 0 889907 0 996441 162617 X 346085 1057396 2033 7083 0 0 348118 1064479 1344559 1227096 X -535401 1251762 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2033 5050 7083 0 2033 2033 0.00000 0.00000 1.00000 false false 215870 111913 103957 3465 3465 0 103957 DUE FROM RELATED ORGANIZATION 63993 63993 11730395 1251762 1251762 10478633 10478633 11014034 11014034 11014034 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 true true X true X 50. true X true true true false false 1338440 1171811 166629 0.01990 3156424 2708787 447637 0.05340 4494864 3880598 614266 0.07330 4494864 3880598 614266 0.07330 false 2626063 1304366 1547834 1520695 27139 X true false 1 1 Colorado West Psychiatric Hospital

515 28 3/4 Rd Grand Junction CO 81501

X Colorado West Psychiatric Hospital 1 true X X X X X X X X X 12 true true true X X X X X X false false true true 50. true 400. true X X X true true X X true false X X X X true X false false 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 persons who represent the community The Healthy Mesa County 2012-2017 report/CHNA is a collaborative, comprehensive report with input from various community stakeholders. consulted. Part V, Line 4 List of hospitals included in the CHNA 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 Part V, line 5a & 5c How the CHNA was made widely available to the public 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. Part V, Line 20d- Indicate how the hospital determined the maximum amounts that can be charged to FAP-eligible individuals for care 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. 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. false false false false false false false Sharon Raggio 0 165394 0 17500 0 33436 0 5384 0 4332 0 226046 0 0 Bonita Wasli 98999 24500 27478 3790 8877 163644 0 Neil A Venard 252708 0 680 0 15584 268972 0 Regina Y LeVerrier 222939 0 13102 5619 9767 251427 0 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 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 false false false true true false false false false false true true true true true true true false true Colorado West Regional Mental Health Inc L 1171808 interco amount