LOWER VALLEY HOSPITAL ASSOCIATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- LOWER VALLEY HOSPITAL ASSOCIATION (EIN 84-0447998)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-08-15
- IRS object ID
- 201242289349304089
- Schema version
- 2011v1.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-15T17:03:44-07:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 840447998 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOWER VALLEY HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LOWE | NameControl |
| Phone | 9708589871 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 228 North Cherry | AddressLine1 |
| City | Fruita | City |
| State | CO | State |
| ZIP Code | 81521 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dennis Ficklin | Name |
| Title | CEO/CFO | Title |
| Phone | 9708582105 | Phone |
| Date Signed | 2012-08-14 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILY HEALTH WEST | BusinessNameLine1 |
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lower Valley Hospital Association | BusinessNameLine1 |
| Business Name Line2 | dba Family Health West | BusinessNameLine2 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 130 228 North Cherry Street | AddressLine1 |
| City | Fruita | City |
| State | CO | State |
| ZIP Code | 81521 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 31542949 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.familyhealthwest.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1949 | YearFormation |
| State Legal Domicile | CO | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 608 | TotalNbrEmployees |
| Total Nbr Volunteers | 250 | TotalNbrVolunteers |
| Total Gross UBI | -2473 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 183814 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 141678 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 25296741 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 30988157 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 8479 | InvestmentIncomePriorYear |
| Investment Income Current Year | 466 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 110512 | OtherRevenuePriorYear |
| Other Revenue Current Year | 377881 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 25599546 | TotalRevenuePriorYear |
| Total Revenue Current Year | 31508182 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13886005 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 16321205 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 36823 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 13090866 | OtherExpensePriorYear |
| Other Expenses Current Year | 14962100 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 26976871 | TotalExpensesPriorYear |
| Total Expenses Current Year | 31283305 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1377325 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 224877 | RevenuesLessExpensesCY |
| Total Assets BOY | 31948330 | TotalAssetsBOY |
| Total Assets EOY | 32477852 | TotalAssetsEOY |
| Total Liabilities BOY | 33300561 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 33605206 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -1352231 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -1127354 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 18646432 | Expense |
| Grants | 0 | Grants |
| Revenue | 21104925 | Revenue |
| Description | The Hospital provided 663 days of acute care. Of those days, 408 days were to Medicare patients, 53 days were to private pay patients, and the remaining 202 days were to insured patients. The hospital provided 3,220 days of swing bed or hospital based skilled nursing care. Of those days, 2,664 or 83% were to Medicare patients and 13 days were to Medicaid patients. The remaining 543 days were provided to self pay and insured patients. Ancillary Gross Revenue was 48% Medicare and Medicaid. The provision of 24 hour emergency medical care to residents regardless of ability to pay is a primary responsibility of the organization. In 2011 emergency and urgent care visits increased by 831 visits to 5,613 visits. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 7606326 | Expense |
| Grants | 0 | Grants |
| Revenue | 7052889 | Revenue |
| Description | The Nursing Home provided 38,478 days of care in 2011. Of those days, 29,550 or 77% were provided to Medicaid clients, 1,147 days or 3% were for VA clients, and the remaining 7,781 days or 20% were for private pay clients. By virtue of the community we serve, we provide care for a large number of Medicaid recipients. In colorado Medicaid for Long Term Care is cost based reimbursed with certain caps. We make no distinction or separation of nursing home residents or any other patient with respect to their ability to pay. The same services are provided across the spectrum, and acre giving staff are unaware of the pay source of our residents and patients. Half of the 120 nursing home beds are dedicated to Alzheimer's care, provided in a setting geared toward a social model of care which has been acclaimed locally and state-wide. This approach requires additional services and higher staffing levels. The nursing home's performance continues to reflect the Lower Valley Hospital Association's mission. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2504863 | Expense |
| Grants | 0 | Grants |
| Revenue | 2830343 | Revenue |
| Description | The two assisted living facilities owned and operated by the Lower Valley Hospital Associatio provided 37,230 days of care to the low to moderate income frail elderly in 2011. Of the total revenue for assisted living services, 56% was from Medicaid clients under the Colorado Home and Community Based Services program. The Lower Valley Hospital Association owns two assisted living facilities. The Willows is a secure, wander-free, 26 bed facility for early Alheimer's clients. It was funded under a pilot initiative from the Colorado Housing and Finance Authority to make assisted living affordable for low to moderate income clientele. The facility address a continuing need for Alzheimer's care in Mesa County. The Oaks is a 90 bed assisted living facility primarily for the low-income frail elderly. Over 70% of its clientele are Medicaid recipients, many of whom come from HUD 202 or similar environments. Assisted living continues to reflect the mission of the Lower Valley Hospital Association. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 28757621 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 608 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 0 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CO | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Jason McCormick | NamePerson |
| Telephone Number | 9708582166 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 228 North Cherry | AddressLine1 |
| City | Fruita | City |
| State | CO | State |
| ZIP Code | 81521 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Thomas Motz | ||||||||
| Chair/ER Physician | 8.00 | X | X | 32045 | 0 | 0 | ||
| Stacey Mascarenas | ||||||||
| Vice Chair | 1 | X | X | 0 | 0 | 0 | ||
| Michael Hughes MD | ||||||||
| Trustee/ER Physician | 18 | X | 83705 | 0 | 0 | |||
| Jeffrey D Freeland | ||||||||
| Treasurer | 1 | X | 0 | 0 | 0 | |||
| Michael Dohm MD | ||||||||
| Trustee | 1 | X | 0 | 0 | 0 | |||
| Dennis E Ficklin | ||||||||
| President, Secretary/CEO | 40 | X | X | 182270 | 0 | 0 | X | X |
| Kurtis M Holmes | ||||||||
| Trustee/ER Physician | 18 | X | 83994 | 0 | 0 | |||
| Sue Brown | ||||||||
| Trustee | 1 | X | 0 | 0 | 0 | |||
| Kenneth Lewis | ||||||||
| Trustee/Anesthesiologist | 6.5 | X | 27510 | 0 | 0 | |||
| Kristi Pollard | ||||||||
| Trustee | 1 | X | 0 | 0 | 0 | |||
| Jill Rimmey | ||||||||
| Trustee | 1 | X | 0 | 0 | 0 | |||
| Tim Sarmo | ||||||||
| Trustee | 1 | X | 0 | 0 | 0 | |||
| Errol Snider | ||||||||
| Assistant Secretary/Hosp Administrator | 40 | 149942 | 0 | 0 | X | X | ||
| Mark Francis | ||||||||
| COO | 40 | 139989 | 0 | 0 | X | X | ||
| Lori Henderson | ||||||||
| Chief Nursing Officer | 40 | 121615 | 0 | 0 | X | X | ||
| David Kirch MD | ||||||||
| Anesthesiologist | 40 | 278106 | 0 | 0 | X | X | ||
| Brian Nelnap MD | ||||||||
| Anesthesiologist | 40 | 278782 | 0 | 0 | X | X | ||
| Jason McCormick | ||||||||
| CFO | 40 | 141255 | 0 | 0 | X | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1519213 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Dr Fred Barbero MD | NamePerson |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 West Ottley | AddressLine1 |
| City | Fruita | City |
| State | CO | State |
| ZIP Code | 81521 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Director of Emergency Dpt | DescriptionOfServices |
| Compensation | 134501 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 95535 | FundraisingEvents |
| Related Organizations | 0 | RelatedOrganizations |
| Government Grants | 0 | GovernmentGrants |
| All Other Contributions | 46143 | AllOtherContributions |
| Noncash Contributions | 0 | NoncashContributions |
| Total Contributions | 141678 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Hosp Medicare, Medicaid and VA | 622000 | 11225024 | 11225024 | 0 | $0 |
| Hospital Commercial Insurance | 622210 | 8970154 | 8970154 | 0 | $0 |
| Hospital Private Pay | 622000 | 896129 | 896129 | 0 | $0 |
| Long Term Care Medicaid and VA | 623000 | 6370058 | 6370058 | 0 | $0 |
| Long Term Care Private Pay | 623000 | 3526792 | 3526792 | 0 | $0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 30988157 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 466 | TotalRevenueColumn |
| Related Or Exempt Function Income | 466 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 300618 | Real |
| Personal | 0 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 300618 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 300618 | TotalRevenueColumn |
| Related Or Exempt Function Income | 300618 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 32294 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 95535 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 34767 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -2473 | TotalRevenueColumn |
| Unrelated Business Revenue | -2473 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 79736 | TotalRevenueColumn |
| Related Or Exempt Function Income | 79736 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 79736 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31508182 | TotalRevenueColumn |
| Related Or Exempt Function Income | 31368977 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -2473 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1288719 | Total |
| Program Services | 698143 | ProgramServices |
| Management And General | 590576 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12617540 | Total |
| Program Services | 11324932 | ProgramServices |
| Management And General | 1260120 | ManagementAndGeneral |
| Fundraising | 32488 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1417302 | Total |
| Program Services | 1227579 | ProgramServices |
| Management And General | 188620 | ManagementAndGeneral |
| Fundraising | 1103 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 997644 | Total |
| Program Services | 861642 | ProgramServices |
| Management And General | 132770 | ManagementAndGeneral |
| Fundraising | 3232 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6750 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 6750 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51687 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 51687 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 82464 | Total |
| Program Services | 82464 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53825 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 53825 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 191271 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 191271 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 279883 | Total |
| Program Services | 279883 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1149619 | Total |
| Program Services | 1149619 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2751 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 2751 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37742 | Total |
| Program Services | 27251 | ProgramServices |
| Management And General | 10491 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2232676 | Total |
| Program Services | 2232676 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2044219 | Total |
| Program Services | 2044219 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 211270 | Total |
| Program Services | 211270 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Supplies | 4276664 | 4276664 | 0 | 0 |
| Medical Contracted Services | 1540129 | 1540129 | 0 | 0 |
| Repairs/Maintenance | 520014 | 520014 | 0 | 0 |
| Food | 1032493 | 1032493 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1248643 | Total |
| Program Services | 1248643 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31283305 | Total |
| Program Services | 28757621 | ProgramServices |
| Management And General | 2488861 | ManagementAndGeneral |
| Fundraising | 36823 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1083754 | BOY |
| EOY | 1024755 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3734083 | BOY |
| EOY | 3764081 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41950 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3237267 | BOY |
| EOY | 5543416 | 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 | 611978 | BOY |
| EOY | 678151 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 689802 | BOY |
| EOY | 598600 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 33777661 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 12908812 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22549496 | BOY |
| EOY | 20868849 | 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 | 0 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31948330 | BOY |
| EOY | 32477852 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4501343 | BOY |
| EOY | 5215151 | 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 | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28000000 | BOY |
| EOY | 27875000 | 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 | 799218 | BOY |
| EOY | 515055 | 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 | 0 | BOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33300561 | BOY |
| EOY | 33605206 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -1352231 | BOY |
| EOY | -1127354 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | 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 | -1352231 | BOY |
| EOY | -1127354 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31948330 | BOY |
| EOY | 32477852 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 224877 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | 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
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 106997 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Book Value | 106997 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 23023240 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 8564157 | Depreciation |
| Book Value | 14459083 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 617505 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 246190 | Depreciation |
| Book Value | 371315 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 6279620 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 3816849 | Depreciation |
| Book Value | 2462771 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 3750299 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 281616 | Depreciation |
| Book Value | 3468683 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 20868849 | TotalOfBookValueLandBuildings |
| Total Revenue | 31508182 | TotalRevenue |
| Total Expenses | 31283305 | TotalExpenses |
| Excess Or Deficit For Year | 224877 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 0 | NetUnrealizedGLOnInvestments |
| Donated Services And Facilities | 0 | DonatedServicesAndFacilities |
| Investment Expenses | 0 | InvestmentExpenses |
| Prior Period Adjustments | 0 | PriorPeriodAdjustments |
| Other | $0 | OtherAmount |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 224877 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 31508182 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 0 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 0 | DonatedSrvcAndUseOfFacilities |
| Recoveries Of Prior Year Grants | 0 | RecoveriesOfPriorYearGrants |
| Other Revenues | 0 | OtherRevenues |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 31508182 | RevenueSubtotal |
| Investment Expenses Not Included | 0 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 0 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 31508182 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 31283305 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 0 | DonatedServicesUseOfFacilities |
| Prior Year Adjustments | 0 | PriorYearAdjustments |
| Losses Reported | 0 | LossesReported |
| Other Expenses Included | 0 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 31283305 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 0 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 31283305 | TotalExpensesPerForm990 |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Red Baron Ball | NameOfEvent1 |
| Gross Receipts Event1 | 127829 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 95535 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 32294 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 0 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 8021 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 4895 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 15122 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 1518 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 5211 | OtherDirectExpensesEvent1 |
| Food And Beverage Other Events | 0 | FoodAndBeverageOtherEvents |
| Entertainment Other Events | 0 | EntertainmentOtherEvents |
| Gross Receipts Total | 127829 | GrossReceiptsTotal |
| Charitable Contributions Total | 95535 | CharitableContributionsTotal |
| Gross Revenue Total Events | 32294 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 0 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 8021 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 4895 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 15122 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 1518 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 5211 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 34767 | DirectExpenseSummaryEvents |
| Net Income Summary | -2473 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 95030 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 95030 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.003 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 389536 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 389536 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0125 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 484566 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 484566 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0155 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2834675 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 47783 | TotalCommunityBenefitExpense |
| Percent Of Total Expense | 0.0015 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 2882458 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0915 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 3367024 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 484566 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.1070 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $463,532 | BadDebtExpenseAmount |
| Amount Attributable To | 115883 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 4256263 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4256263 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 0 | 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 | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | 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 | Family Health West Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 West Ottley | AddressLine1 |
| City | Fruita | City |
| State | CO | State |
| ZIP Code | 81521 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Other | Swing bed Services | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Family Health West Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| 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. |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchH_P01_S00_L07 | Schedule H, Part I, Line 7 | The expense relates to a subsidy for longterm care services calculated from the Medicare Cost Report. This subsidy is $1,359,844. The next subsidy is for the operation of the Emergency Department. The calculation is based on the Medicare Cost Report plus the cost for Professional Providers. The amount is $1,474,831. The organization also condtibuted to several communty benefit organizations such as the Boy Scouts of America, other non-for-profit healthcare organization and so for. The actual amount of contribution is listed. |
| SchH_P01_S00_L072f | Schedule H, Part I, Line 7, Column f | Effective in 2011 Bad Debt expense is reported as an offset to revenue and not as an expense. |
| SchH_P01_S00_L07g | Schedule H, Part I, Line 7g | For 2011 there were no subsdies of physician clinics reported in the 990 schedule H. |
| SchH_P03_S0A_L04 | Schedule H, Part III, Section A, Line 4 | No note is stated by the auditors in the audit report. |
| SchH_P03_S0B_L08 | Schedule H, Part III, Section B, Line 8 | The Hospital is recognized by medicare as a Critical Access Hospital. Cost based reimbursment is recieved. |
| SchH_P03_S0C_L09b | Schedule H, Part III, Section C, Line 9b | Attempts are made to inform patient of programs that provide charitable assistance. Without income information it is not possible to determine potential eligibility. |
| SchH_P06_S00_L02 | Schedule H, Part VI, Line 2 | To be completed in 2013 |
| SchH_P06_S00_L03 | Schedule H, Part VI, Line 3 | Notices of programs and contact information is posted at points of registration. Information is posted on internet and periodicaly in local news papers. Employees screen individuals at time of scheduling, registration, and billing for potential eligiblility for programs. |
| SchH_P06_S00_L04 | Schedule H, Part VI, Line 4 | The hospital serves the residents of the Lower Grand Valley on the Western Slope of the Colorado Rockies. This includes the communities of Fruita, Loma, Mack, North west Grand Junction, North half of the Redlands and travels along I-80. We estimate the population to be 15,000. Ages range from child to elder. |
| SchH_P06_S00_L05 | Schedule H, Part VI, Line 5 | The organization has an open medical staff with DO, MD and Peditrist practicing at the facility. The Board is a community board that is self appointing. About 4 tenths of the board members are physicians. All funds are reinvested into the organization with focus on services not otherwise proveded in the community. There is no limit or restriction on patients with government payer sources. All patients are treated regarless of pay source or no pay source. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dennis E Ficklin | |||||||||||||
| 181430 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1440 | 0 | 182870 | 0 | 0 | 0 |
| Errol Snider | |||||||||||||
| 149942 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 149942 | 0 | 0 | 0 |
| Mark Francis | |||||||||||||
| 139989 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 139989 | 0 | 0 | 0 |
| Lori Henderson | |||||||||||||
| 119215 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2400 | 0 | 121615 | 0 | 0 | 0 |
| David Kirch MD | |||||||||||||
| 238106 | 0 | 40000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 278106 | 0 | 0 | 0 |
| Brian Nelnap MD | |||||||||||||
| 238782 | 0 | 40000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 278782 | 0 | 0 | 0 |
| Jason McCormick | |||||||||||||
| 141255 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 141255 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchJ_P01_S00_L05 | Identifier |
| Return Reference | Schedule J, Part I, Line 5 | ReturnReference |
| Explanation | The Anesthesiologists, Dr. Kirsch and Dr. Belnap were paid an incentive bonus based on the numer of surgical cases. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | City of Fruita | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 846000669 | IssuerEIN |
| CUSIP Number | 359428AC3 | CUSIPNumber |
| Date Issued | 2008-04-10 | DateIssued |
| Issue Price | 28000000 | IssuePrice |
| Description Of Purpose | Replacement Hospital and Debt Consolidation | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 0 | AmountRetired |
| Amount Bond Defeased | 0 | AmountBondDefeased |
| Total Proceeds | 28000000 | TotalProceeds |
| Amount In Reserve Fund | 3709014 | AmountInReserveFund |
| Capitalized Interest | 0 | CapitalizedInterest |
| Refunding Escrow | 0 | RefundingEscrow |
| Issuance Costs From Proceeds | 697500 | IssuanceCostsFromProceeds |
| Credit Enhancement | 0 | CreditEnhancement |
| Working Capital Expenditures | 0 | WorkingCapitalExpenditures |
| Capital Expenditures | 19431806 | CapitalExpenditures |
| Other Spent Proceeds | 0 | OtherSpentProceeds |
| Amount Unspent | 0 | AmountUnspent |
| Year Of Subst Completion | 2009 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 1 | GrossProceedsInvestedInGIC |
Name Of GIC Provider NameOfGICProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Citigroup Financial Partners | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of GIC | .215 | TermOfGIC |
| Regulatory Safe Harbor Satisfied | 1 | RegulatorySafeHarborSatisfied |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | The 990 is reviewed with the Governing Board. Answers and explanations are provided. Direction and feed back is acted upon. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | The compensation committee establishes goals and reviews performance to the goals. The Board acts on the recommendation of the committee. Salaries are determined in comparison with stae wide surveys of like facilities. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | The referenced documents are available upon request and are available in the administrative offices. |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Extension was filed and accepted. | Explanation |
Comments