COLORADO WEST HEALTHCARE SYSTEM: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- COLORADO WEST HEALTHCARE SYSTEM (EIN 84-0469270)
- Tax period
- 2009-05-01 to 2010-04-30
- Filed
- 2011-03-15
- IRS object ID
- 201140749349300919
- Schema version
- 2009v1.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-03-15T13:18:29-07:00 | Timestamp |
| Tax Period End Date | 2010-04-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHADWICKSTEINKIRCHNERDAVIS & CO PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 NORTH 5TH STREET SUITE 401 | AddressLine1 |
| City | GRAND JUNCTION | City |
| State | CO | State |
| ZIP Code | 815012645 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-05-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 840469270 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLORADO WEST HEALTHCARE SYSTEM DBA COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COLO | NameControl |
| Phone | 9702566321 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2021 N 12TH STREET | AddressLine1 |
| City | GRAND JUNCTION | City |
| State | CO | State |
| ZIP Code | 815012980 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WES WHITE | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 9702566321 | Phone |
| Date Signed | 2011-03-15 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ORVILLE F PETERSEN CPA | Name |
| Phone | 9702453000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CHRIS THOMAS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2021 N 12TH STREET | AddressLine1 |
| City | GRAND JUNCTION | City |
| State | CO | State |
| ZIP Code | 81501 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 68627956 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.YOURCOMMUNITYHOSPITAL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1956 | YearFormation |
| State Legal Domicile | CO | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF COLORADO WEST HEALTHCARE SYSTEM AND COMMUNITY HOSPITAL IS TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE INDIVIDUALS AND COMMUNITIES WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 700 | TotalNbrEmployees |
| Total Nbr Volunteers | 103 | TotalNbrVolunteers |
| Total Gross UBI | 102737 | TotalGrossUBI |
| Contributions Grants Prior Year | 206021 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 89096 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 65664279 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 67698495 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 38182 | InvestmentIncomePriorYear |
| Investment Income Current Year | -6460 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 679383 | OtherRevenuePriorYear |
| Other Revenue Current Year | 812335 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 66587865 | TotalRevenuePriorYear |
| Total Revenue Current Year | 68593466 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 30427776 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 31125971 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 35322653 | OtherExpensePriorYear |
| Other Expenses Current Year | 38977107 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 65750429 | TotalExpensesPriorYear |
| Total Expenses Current Year | 70103078 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 837436 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1509612 | RevenuesLessExpensesCY |
| Total Assets BOY | 33237626 | TotalAssetsBOY |
| Total Assets EOY | 31936782 | TotalAssetsEOY |
| Total Liabilities BOY | 18060026 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 18185564 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 15177600 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 13751218 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF COLORADO WEST HEALTHCARE SYSTEM AND COMMUNITY HOSPITAL IS TO IMPROVE THE | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 54481161 | Expense |
| Revenue | 68408093 | Revenue |
| Description | COMMUNITY HOSPITAL PROVIDES INPATIENT, OUTPATIENT, EMERGENCY, URGENT, PRIMARY AND HOME HEALTH CARE SERVICES TO COMMUNITIES IN WESTERN COLORADO. DURING FISCAL YEAR 2010, COMMUNITY HOSPITAL HAD 6,895 PATIENT DAYS, 14,608 EMERGENCY ROOM VISITS, 6,739 URGENT CARE VISITS, 3,749 PRIMARY CARE VISITS, AND PERFORMED 4,632 SURGERIES. | Description |
| Total Program Service Expense | 54481161 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| 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 |
| 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 | true | 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 | true | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 128 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 700 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| 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 | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | 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 | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CO | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9702566321 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2021 N 12TH STREET GRAND | AddressLine1 |
| City | JUNCTION | City |
| State | CO | State |
| ZIP Code | 81501 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| DAVID PRICE | |||||||
| CHAIRPERSON | 2.00 | X | 0 | 0 | 0 | ||
| R CURT HATCH | |||||||
| 2010 VICE CHAIRPERSON/2009 TREASURER | 2.00 | X | 0 | 0 | 0 | ||
| DAN THOMAS | |||||||
| 2009 VICE-CHAIRPERSON | 2.00 | X | 0 | 0 | 0 | ||
| MICHAEL DANIELS | |||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | ||
| MITCHELL COPELAND DO | |||||||
| CHIEF OF STAFF | 2.00 | X | 0 | 0 | 9208 | ||
| STEVEN O'DELL DO | |||||||
| BOARD MEMBER | 1.50 | X | 0 | 0 | 17102 | ||
| KEVIN HOWELL DO | |||||||
| BOARD MEMBER | 1.50 | X | 0 | 0 | 31800 | ||
| AMIR BESHAI MD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| KELLY KING DO | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 68360 | ||
| J DALE UTT DO | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 1833 | ||
| WILLIAM WATERHOUSE MD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| MONTY LANGSTON MD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 110987 | ||
| LARRY KENT | |||||||
| BOARD MEMBER | 1.50 | X | 0 | 0 | 0 | ||
| DAVID VARGO | |||||||
| BOARD MEMBER | 1.50 | X | 0 | 0 | 0 | ||
| SCOTT MERCIER | |||||||
| BOARD MEMBER | 1.50 | X | 0 | 0 | 0 | ||
| SAM STARRITT | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| CHRISTIAN THOMAS | |||||||
| CEO | 40.00 | 324619 | 0 | 0 | X | ||
| ELIZABETH BRICKER | |||||||
| CHIEF NURSING OFFICER | 40 | 142563 | 4407 | X | |||
| WESLEY WHITE | |||||||
| CHIEF FINANCIAL OFFICER | 40 | 171772 | 4969 | X | |||
| DAVID MURRAY | |||||||
| CHIEF COMPLIANCE OFFICER | 40 | 135629 | 4953 | X | |||
| DONALD NICOLAY | |||||||
| CHIEF MEDICAL OFFICER | 40 | 171800 | 3732 | X | |||
| DEBORA RIGGLE | |||||||
| VP OF ANCILLARY SERVICES | 40 | 119450 | 4599 | X | |||
| PAUL NUMSEN | |||||||
| ER PHYSICIAN | 36 | 247552 | 8040 | X | |||
| JOSEPH KUPETS | |||||||
| ER PHYSICIAN | 36 | 245327 | 6861 | X | |||
| JULIE MILLS | |||||||
| ER PHYSICIAN | 36 | 249951 | 5306 | X | |||
| DEBRA SMITH | |||||||
| ER PHYSICIAN | 36 | 246841 | 6864 | X | |||
| SCOTT VINCENT | |||||||
| ER PHYSICIAN | 36 | 242375 | 8096 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2297879 | TotalReportableCompFromOrg |
| Total Other Compensation | 297117 | TotalOtherCompensation |
| Number Individuals GT100 K | 11 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| COMMUNITY ANESTHESIA CONSULTANTS | |||||
| 2754 COMPASS DR STE 300 | GRAND JUNCTION | CO | 81506 | PHYSICIAN SERVICES | 887896 |
| QUORUM HEALTH RESOURCES | |||||
| 105 CONTINENTAL PL | BRENTWOOD | TN | 37027 | MANAGEMENT | 695378 |
| JOHNSON & JOHNSON HCS | |||||
| 425 HOES LN | PISCATAWAY | NJ | 08854 | BUSINESS SERVICES | 791338 |
| CARDINAL HEALTH PHARMACEUTICAL DIST | |||||
| 7000 CARDINAL PL | DUBLIN | OH | 43017 | PHARMACEUTICAL SUPPLY | 1221641 |
| CARDINAL HEALTH MEDICAL PRODUCTS | |||||
| 7000 CARDINAL PL | DUBLIN | OH | 43017 | HEALTH-CARE PRODUCTS | 1785624 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 67 | NumberOfContractorsGT100K |
| All Other Contributions | 89096 | AllOtherContributions |
| Total Contributions | 89096 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT REVENUE | Description |
| Business Code | 622000 | BusinessCode |
| Total Revenue Column | 67698495 | TotalRevenueColumn |
| Related Or Exempt Function Income | 67698495 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 67698495 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 28030 | TotalRevenueColumn |
| Exclusion | $28,030 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 34490 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -34490 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -34490 | TotalRevenueColumn |
| Exclusion | -$34,490 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| OTHER REVENUE | 622000 | 709598 | 709598 | |
| INVESTMENT IN LLC | 561490 | 102737 | 102737 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 812335 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 68593466 | TotalRevenueColumn |
| Related Or Exempt Function Income | 68408093 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 102737 | UnrelatedBusinessRevenue |
| Exclusion | -$6,460 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 401782 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 401782 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25147083 | Total |
| Program Services | 18042928 | ProgramServices |
| Management And General | 7104155 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 349334 | Total |
| Program Services | 349334 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3379510 | Total |
| Program Services | 3353058 | ProgramServices |
| Management And General | 26452 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1848262 | Total |
| Program Services | 1583187 | ProgramServices |
| Management And General | 265075 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 887896 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 887896 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 291629 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 291629 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69600 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 69600 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3130704 | Total |
| Program Services | 2488869 | ProgramServices |
| Management And General | 641835 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 408461 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 408461 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15147350 | Total |
| Program Services | 13973404 | ProgramServices |
| Management And General | 1173946 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 492439 | Total |
| Program Services | 487734 | ProgramServices |
| Management And General | 4705 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 191413 | Total |
| Program Services | 144729 | ProgramServices |
| Management And General | 46684 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 663202 | Total |
| Program Services | 418866 | ProgramServices |
| Management And General | 244336 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2940408 | Total |
| Program Services | 2940408 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 660856 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 660856 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| COLLECTION FEES | 411873 | 0 | 411873 | 0 |
| LICENSES & TAXES | 273526 | 44750 | 228776 | 0 |
| RECRUITMENT COSTS | 425661 | 425661 | 0 | 0 |
| PHYSICIAN FEES | 2255060 | 2255060 | 0 | 0 |
| BAD DEBTS | 7859625 | 7859625 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2867404 | Total |
| Program Services | 113548 | ProgramServices |
| Management And General | 2753856 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70103078 | Total |
| Program Services | 54481161 | ProgramServices |
| Management And General | 15621917 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2582161 | BOY |
| EOY | 2140165 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1346206 | BOY |
| EOY | 697758 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6475469 | BOY |
| EOY | 8058807 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32293 | BOY |
| EOY | 1176 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2996703 | BOY |
| EOY | 2952013 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 200231 | BOY |
| EOY | 284288 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 41695792 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 26624998 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16832381 | BOY |
| EOY | 15070794 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2487367 | BOY |
| EOY | 2613350 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 284815 | BOY |
| EOY | 118431 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33237626 | BOY |
| EOY | 31936782 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5239739 | BOY |
| EOY | 6389735 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3495627 | BOY |
| EOY | 2101764 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 102811 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8888642 | BOY |
| EOY | 8408530 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 436018 | BOY |
| EOY | 1182724 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18060026 | BOY |
| EOY | 18185564 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15177600 | BOY |
| EOY | 13751218 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15177600 | BOY |
| EOY | 13751218 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33237626 | BOY |
| EOY | 31936782 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| Public Support Total170 | 0 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Pertcentage170 | 0 | PublicSupportPertcentage170 |
| Public Support Total509 | 0 | PublicSupportTotal509 |
| Public Support Percentage509 | 0 | PublicSupportPercentage509 |
| Investment Income Percentage | 0 | InvestmentIncomePercentage |
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) |
|---|---|---|
| Other Cost Or Other Basis | 6795630 | OtherCostOrOtherBasis |
| Book Value | 6795630 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10543216 | OtherCostOrOtherBasis |
| Depreciation | 7627418 | Depreciation |
| Book Value | 2915798 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11184 | OtherCostOrOtherBasis |
| Depreciation | 1118 | Depreciation |
| Book Value | 10066 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 23982895 | OtherCostOrOtherBasis |
| Depreciation | 18660151 | Depreciation |
| Book Value | 5322744 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 362867 | OtherCostOrOtherBasis |
| Depreciation | 336311 | Depreciation |
| Book Value | 26556 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 15070794 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (5 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVESTMENT IN DOCTOR'S CLINIC BUILDING | 1955994 | C |
| INVESTMENT IN COMMUNITY HEALTH PROVIDERS ORG | 18065 | C |
| INVESTMENT IN FCSDCS LLC | 805920 | C |
| INVESTMENT IN PHYSICIAN'S CHOICE REAL ESTATE | -175727 | C |
| OTHER INVESTMENTS | 9098 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 2613350 | TotalOfBookValueProgramRelated |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| BOND ISSUANCE COSTS | 22264 |
| DUE FROM SUBSIDIARIES | 60550 |
| LOAN ORIGINATION COSTS | 35617 |
| ESTIMATED THIRD PARTY SETTLMENT RECEIVABLE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 118431 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CURRENT RELATED COMPANY PAYABLE | |
| ESTIMATED THIRD PARTY SETTLEMENT PAYABLE | $1,182,724 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1182724 | TotalOfAmounts |
| Total Revenue | 68593466 | TotalRevenue |
| Total Expenses | 70103078 | TotalExpenses |
| Excess Or Deficit For Year | -1509612 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | -1509612 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 68951169 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -4797 | NetUnrealizedGainsInvestments |
| Other Revenues | 362500 | OtherRevenues |
| Revenue Not Rptd F990 | 357703 | RevenueNotRptdF990 |
| Revenue Subtotal | 68593466 | RevenueSubtotal |
| Total Revenue Per Form990 | 68593466 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 70103078 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 70103078 | ExpensesSubtotal |
| Total Expenses Per Form990 | 70103078 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| 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 | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1886403 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1886403 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02690 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7237057 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4809050 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2428007 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03460 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1703667 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 328860 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1374807 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01960 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10827127 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5137910 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5689217 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08110 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 31037 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 31037 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 34813 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 34813 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 204607 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 204607 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 270457 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 270457 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00380 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11097584 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5137910 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5959674 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08490 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $3,379,639 | BadDebtExpenseAmount |
| Amount Attributable To | 844910 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 11738636 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 16346868 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4608232 | 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 | true | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical |
|---|---|---|---|---|---|
| COMMUNITY HOSPITAL | |||||
| 2021 N 12TH STREET | GRAND JUNCTION | CO | 815012980 | X | |
| FIRST CHOICE SAME DAY SURGICAL CENTER | |||||
| 2596 F ROAD | GRAND JUNCTION | CO | 81505 | X | |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Footnote | THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON FACTORS | BadDebtFootnote |
| Shortfall As Community Benefit | APPROXIMATELY 75% OR $3,456,174 OF THE MEDICARE SHORTAGE SHOULD BE TREATED | ShortfallAsCommunityBenefit |
| Debt Collection Policy | PART OF THE HOSPITAL'S FINANCIAL ASSISTANCE AND CHARITY CARE WRITTEN | DebtCollectionPolicy |
| Needs Assessment | COMMUNITY HOSPITAL USES THE STRATEGIC PLAN PROVIDED BY QUORUM HEALTH | NeedsAssessment |
| Patient Education Assistance | PART OF THE HOSPITAL'S WRITTEN FINANCIAL ASSISTANCE AND CHARITY CARE POLICY | PatientEducationAssistance |
| Community Information | THE HOSPITAL'S PRIMARY SERVICE AREA IS WESTERN COLORADO AND THE | CommunityInformation |
| Other Information | COMMUNITY HOSPITAL EXPANDED ITS SERVICES TO MEET COMMUNITY | OtherInformation |
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 | 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 |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg |
|---|---|---|---|---|
| CHRISTIAN THOMAS | ||||
| 318263 | 6356 | 832 | 325451 | |
| WESLEY WHITE | ||||
| 171772 | 1836 | 176741 | 3133 | |
| DONALD NICOLAY | ||||
| 171800 | 1632 | 175532 | 2100 | |
| PAUL NUMSEN | ||||
| 247552 | 3600 | 255592 | 4440 | |
| JOSEPH KUPETS | ||||
| 245327 | 2448 | 252188 | 4413 | |
| JULIE MILLS | ||||
| 249951 | 804 | 255257 | 4502 | |
| DEBRA SMITH | ||||
| 246841 | 2448 | 253705 | 4416 | |
| SCOTT VINCENT | ||||
| 242375 | 3696 | 250471 | 4400 | |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DR LOU BAIR | NamePerson |
| Purpose Of Loan | LEGAL SETTLEMENT | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $164,110 | OriginalPrincipalAmount |
| Balance Due | 102811 | BalanceDue |
| Default | true | Default |
| Approved By Board | true | ApprovedByBoard |
| Written Agreement | true | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 102811 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (32 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Pt VI-A, Line 2 | DIRECTORS MITCHELL COPELAND, STEVEN O'DELL, KEVIN HOWELL, AND DALE UTT |
| ARE PARTNERS IN A RELATED ENTITY, PHYSICIANS CHOICE REAL | |
| ESTATE. | |
| Pt VI-A, Line 3 | THE HOSPITAL HAS A MANAGEMENT AGREEMENT WITH QUORUM HEALTH |
| RESOURCES. | |
| Pt VI-B, Line 11A | THE 990 IS PREPARED BY THE HOSPITAL'S INDEPENDENT CPA FIRM AND REVIEWED |
| BY THE HOSPITAL'S ACCOUNTING STAFF AND ADMINISTRATION, INCLUDING THE CEO, CFO, | |
| AND COMPLIANCE OFFICER. A PRELIMINARY DRAFT IS PRESENTED TO THE EXECUTIVE | |
| FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR DETAILED REVIEW AND APPROVAL. | |
| A FINAL COPY OF THE 990 IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO THE FINAL | |
| FILING WITH THE | |
| IRS. | |
| Pt VI-B, Line 12c | THE HOSPITAL'S CONFLICT OF INTEREST POLICY IS MAINTAINED AND MANAGED |
| BY THE CHIEF COMPLIANCE OFFICER. ON AN ANNUAL BASIS, ALL BOARD MEMBERS, | |
| OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST | |
| DISCLOSURE FORM AND SUBMIT IT TO THE COMPLIANCE DEPARTMENT. THAT | |
| DOCUMENTATION IS REVIEWED BY AND RETAINED BY THE COMPLIANCE OFFICER. | |
| ANY CONFLICTS OF INTEREST THAT ARISE ARE ADDRESSED BY THE COMPLIANCE | |
| DEPARTMENT AND THE BOARD OF | |
| TRUSTEES. | |
| Pt VI-B, Line 15 | COMMUNITY HOSPITAL IS A QUORUM HEALTH RESOURCES MANAGED HOSPITAL |
| WHEREBY THE CEO IS AN EMPLOYEE OF THE MANAGMENT COMPANY. SALARY AND BENEFITS | |
| FOR THE CEO ARE BASED ON THE MANAGEMENT COMPANY'S SALARY SURVEY DATA | |
| FOR HOSPITALS OF COMPARABLE SIZE AND IS APPROVED BY THE EXECUTIVE | |
| COMMITTEE OF THE BOARD OF TRUSTEES. SALARIES AND BENEFITS FOR OTHER | |
| MEMBERS OF SENIOR MANAGEMENT ARE BASED ON SALARY SURVEY DATA COMPILED | |
| BY THE HOSPITAL'S HR DEPARTMENT AND ARE APPROVED BY THE BOARD OF | |
| DIRECTORS THROUGH THE ANNUAL BUDGET | |
| PROCESS. | |
| Pt VI-C, Line 19 | GOVERNING DOCUMENTS, POLICIES AND PROCEDURES, AND AUDITED FINANCIAL |
| STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST ON A CASE | |
| BY CASE BASIS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2021 N 12TH STREET | AddressLine1 |
| City | GRAND JUNCTION | City |
| State | CO | State |
| ZIP Code | 815012980 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 742576856 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivities |
| Legal Domicile State | CO | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | I | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLORADO WEST HEALTHCARE SYSTEM | BusinessNameLine1 |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHYSICIANS CHOICE REAL ESTATE LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2012 N 12TH STREET | AddressLine1 |
| City | GRAND JUNCTION | City |
| State | CO | State |
| ZIP Code | 815012980 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 841601063 | EIN |
| Primary Activity | REAL ESTATE | PrimaryActivity |
| Legal Domicile State | CO | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | INVESTMENT | PredominantIncomeType |
| Share Of Total Income | 109113 | ShareOfTotalIncome |
| Share Of EOY Assets | 1469040 | ShareOfEOYAssets |
| Disproportionate Allocations | false | DisproportionateAllocations |
| General Or Managing Partner | true | GeneralOrManagingPartner |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| DOCTOR'S CLINIC BUILDING INC | |||||||||||
| 1060 ORCHARD AVE | GRAND JUNCTION | CO | 81501 | 840507943 | REAL ESTATE | CO | NA | C | 1124268 | 2103280 | 1.00000 |
| COMMUNITY HEALTH PROVIDERS ORGANIZATION INC | |||||||||||
| 2021 N 12TH ST | GRAND JUNCTION | CO | 81501 | 841081855 | INSURANCE | CO | NA | C | 21300 | 26053 | 0.50000 |
| 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 |
| 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 | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| DOCTOR'S CLINIC BUILDING | |
| d | 39744 |
| COMMUNITY HEALTH PROVIDERS' ORGANIZATION INC | |
| d | 21267 |
| COMMUNITY HOSPITAL FOUNDATION | |
| e | 451 |
| DOCTOR'S CLINIC BUILDING | |
| j | 554027 |
| PHYSICIAN'S CHOICE REAL ESTATE | |
| j | 634057 |
Comments