2019-11-08T15:33:09-06:00 2018-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-01-01 840469270 Colorado West Healthcare System COLO 9702566321 2351 G Road Grand Junction CO 81505 Christian Thomas CEO 9702566321 2019-11-01 1 Kim C Hunwardsen CPA P00484560 6122536500 2019-11-01 216.147.181.45 2019-11-01 11:25:59 CD P 66CC91E6B7F11C4783FFFA5645E675327CB67316 66CC91E6B7F11C4783FFFA5645E675327CB67316 2018 2020-01-14 16:20:31Z Community Hospital Grand Junction Christian Thomas 2351 G Road Grand Junction CO 81505 150965554 0 X www.yourcommunityhospital.com X 1956 CO Improve the health and quality of life of the individuals and communities we serve. 11 9 1157 61 429607 408799 120033 19500 127113964 148907044 428575 1222050 1507695 636277 129170267 150784871 0 68735 0 0 61608655 68264529 0 0 0 68280631 82106554 129889286 150439818 -719019 345053 110194423 113098279 85947893 88506696 24246530 24591583 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. 0 0 113865326 68735 149113714 Community Hospital provides inpatient, outpatient, emergency, urgent, and primary health care services to communities in western Colorado which has been identified as a physician shortage area. During the tax year ended December 2018, Community Hospital had 7,723 patient days, 16,676 emergency room visits, 13,755 urgent care visits, 53,142 primary care visits, 3,878 oncology infusions and performed 3,473 surgeries.During the tax year, the Hospital was able to provide charity care services to those who could not otherwise afford necessary medical care. The Hospital provides care to persons covered by governmental programs at/or below cost and to individuals who are unable to pay. 113865326 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 162 0 1 1157 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 CO X Jon Hooker 9702576295 2351 G Road Grand Junction CO 81505 Sam Starritt Chairman 1.50 0.00 X X 0 0 0 Janet Brink Vice Chairman 1.50 0.00 X X 0 0 0 Tarek Arja DO Secretary 1.50 0.00 X X 0 0 0 Todd Young Treasurer 1.50 0.00 X X 0 0 0 JJ Stroh DO Board Member 1.50 0.00 X 0 0 0 Dale Rooks Board Member 1.50 0.80 X 0 0 0 Dean Havlik MD Board Member 1.50 0.00 X 0 0 0 Deedra Shear Board Member 1.50 0.00 X 0 0 0 Mark Harrington Board Member 1.50 0.00 X 0 0 0 Todd Hegstrom Board Member 1.50 0.00 X 0 0 0 David Kast MD Board Member 1.50 0.00 X 0 0 0 Christian Thomas CEO 40.00 0.80 X 0 0 0 Ed Johlman CFO 40.00 0.00 X 207178 0 24048 Scot Houska CCO 40.00 0.00 X 201012 0 30230 Carolle Anne Banville CNO 40.00 0.00 X 219513 0 15171 John Skillicorn Executive Director of Physicians 40.00 0.00 X 181367 0 27049 Brent Woodson Physician 40.00 0.00 X 506749 0 36815 Jo Anne Virgilio Physician 40.00 0.00 X 500911 0 39301 Jack Bagley Physician 40.00 0.00 X 454046 0 36062 Jonathan Frandsen Physician 40.00 0.00 X 457507 0 35331 Sudy Jahangiri Physician 40.00 0.00 X 418372 0 26402 3146655 0 270409 89 0 1 0 Community Anesthesia Consultants 2754 Compass Drive Suite 300 Grand Junction CO 81506 Anesthesia services 1746455 Medical Solutions Inc 1010 N 102nd St Suite 300 Omaha NE 68114 Contract work 1247360 University of Utah 201 Presidents Cir Salt Lake City UT 84112 Management assistance 1161164 Quorum Health Resources LLC 105 Continental Place Brentwood TN 37027 Management assistance 1067503 Mayo Collaborative Services Inc 200 1st St SW Rochester MN 55905 Reference lab 549894 37 19500 19500 Patient Service Revenue 621110 144509289 144509289 Pharmancy Revenue 621110 3613772 3613772 Cafeteria Revenue 621110 523767 523767 Other Revenue 621110 394881 394881 Equity in Subsidiary Income 900099 -134665 -134665 148907044 191337 191337 1144439 113726 1030713 1030713 1030713 84641 66957 17684 17684 Investment in LLC's 900099 618593 188986 429607 618593 150784871 149113714 429607 1222050 68735 68735 908393 908393 58083585 47595867 10487718 986214 630297 355917 4566024 3036592 1529432 3720313 2964018 756295 983731 983731 307127 307127 117335 117335 2307 2307 14585914 9387372 5198542 374501 374501 4440507 2796010 1644497 2450871 1539122 911749 64558 606 63952 296245 153253 142992 6249844 5307111 942733 5044048 4283198 760850 1362329 62765 1299564 Medical Supplies 27127823 27127823 Bad Debt 4985636 4985636 Provider Fees 4805819 4805819 UBI Tax 170246 170246 8737713 3924614 4813099 150439818 113865326 36574492 0 1377337 4613640 5190239 19491844 22163550 281519 2737393 2994206 1075988 1000506 111276786 33831109 77715572 77445677 619164 -471937 -709828 3373067 4394765 110194423 113098279 14280665 16470281 116399 111771 62255407 69000436 9295422 2924208 85947893 88506696 X 24246530 24591583 24246530 24591583 110194423 113098279 345053 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 2307 2307 0 Part II-B, Line 1: The Organization pays dues to the Colorado Hospital Association and a portion of the money is used for lobbying activities. 4041532 4041532 61048899 7531703 53517196 4978947 483034 4495913 41027259 25816372 15210887 180149 180149 77445677 Estimated Third-Party Payor Settlement 1383450 Deferred Compensation 1540758 2924208 X Part X, Line 2: The Hospital is organized as a Colorado nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Interal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Hospital files an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS to report its unrelated business taxable income. Income tax expense, if any, is included in other expenses in the consolidated statements of operations. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 150.000000000000 1 1 0 1 1 807534 807534 0.00560 30315718 21998216 8317502 0.05720 774114 566739 207375 0.00140 31897366 22564955 9332411 0.06420 315640 315640 0.00220 315640 315640 0.00220 32213006 22564955 9648051 0.06640 1 4985636 0 28785041 36066773 -7281732 X 1 1 1 Grand Junction Medical Center Property Rental 0.10000 0.00000 0.40000 2 Canyon View ASC LLC Ambulatory Surgery Center 0.51000 0.00000 0.49000 3 Physicians Choice Real Estate LLC Property Rental 0.63000 0.00000 0.37000 1 1 Community Hospital 2351 G Road Grand Junction CO 81505 http://www.yourcommunityhospital.com/ 011119 X X X Community Hospital 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X See Line 7d X See Line 7d X X 1 18 1 See Line 7d 0 1 X 100.000000000000 150.000000000000 X X X X X 1 1 X X X X 1 X https://yourcommunityhospital.com/Billing.cfm X https://yourcommunityhospital.com/Billing.cfm X https://yourcommunityhospital.com/Billing.cfm X X X X X X 1 X 0 X X X X 1 X 0 0 Community Hospital Part V, Section B, Line 5: Community Hospital was an active participant in the CHNA collaboration with the Mesa County Health Department and a number of other local hospitals and organizations in Mesa County. A Community Hospital representative worked with the CHNA planning committee and the Mesa County Community Transformation Group to determine what data needed to be gathered. Community Hospital provided aggregate health screening reports for its contracted employer groups to Mesa County Health Department. The healthcare partners of our community met regularly to put together a timeline and action plan to implement the Strategy Report and ensure no duplication of efforts. Community Hospital utilized previous assessments to guide interventions and collaborations. Primary data was collected from subject matter experts and community members through focus groups, informal interviews, and electronic surveys. Community Hospital Part V, Section B, Line 6a: The CHNA was conducted with the following other hospital facilities: Family Health West Hospital, St. Mary's Hospital & Regional Medical Center, Mind Springs Hospital, Inc. Community Hospital Part V, Section B, Line 6b: Mesa County Public Health, Hilltop, Marillac Clinic Community Hospital Part V, Section B, Line 7d: Hospital Website:https://yourcommunityhospital.com/Community_Health_Needs_Assessment.cfmOther Website:http://health.mesacounty.us/services/community/data-reports/Implementation Strategy:https://yourcommunityhospital.com/Community_Health_Needs_Assessment.cfm Community Hospital Part V, Section B, Line 11: Community Hospital was an active participant in the CHNA in collaboration with the Mesa County Public Health and a number of other local hospitals and organizations in Mesa County. This collaborative approach enabled the group to identify areas where the various organizations might work together to achieve needed improvements. Community Hospital has been utilizing this assessment as a guide for providing programs to address identified community health needs in support of the collaborators and with the mission of our organization "to improve the health and quality of life of the individuals and communities we serve."We do not have adequate resources to solve all problems identified. Some issues identified are beyond the mission of the health system and action is best suited for a response by others. Some improvements will require personal actions by individuals rather than the response of an organization. We view this plan as providing guidance around how we, along with other area organizations and agencies, can collaborate to make the best medical care available to the citizens of our community.Community Hospital's Implementation StrategiesCommunity Hospital is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs. Community Hospital also recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, Community Hospital will continue to work in partnership with other local entities to refine its goals and strategies over time. With this approach, Community Hospital will most effectively address the needs identified.Community Hospital's implementation strategies address five of the six areas identified in the CHNA. For each area, the plan outlines the following: the goals and objectives designed to guide improvement efforts, Community Hospital's role or action in addressing the areas of concern, expected outcomes, and measures which may be used to determine the action(s)' effectiveness.1. Institutional InequitiesObjectives: continue to recruit additional primary care providers to the service area; continue to grow Community Hospital's service line offerings; maintain a generous payer mix to allow for improved access to healthcare services for publicly insured or underinsured patients.Community Hospital continues to add more employed providers in the form of primary care, obstetrics and gynecology, oncology, and other ancillary services. In 2018 alone, Community Hospital has recruited 43 additional providers, across all service lines. Community Hospital also owns and operates six primary and pediatric care clinics in the Grand Valley. We recognize there is still a shortage of primary care providers in the area despite improved statistics, and we opened an additional practice in August 2018 as a result. Furthermore, we will continue to recruit additional providers until Mesa County's needs are met. For improved customer service, we continue to operate a primary care call center to assist patients with healthcare needs and continue to streamline the communication process between patient and provider.We also continue to expand and improve our Community Health Partnership (CHP) employer initiative. Our robust medical clinic contracts allow local employer groups to improve their covered lives' access to all healthcare services, specifically primary care, through narrow network facility agreements; this approach has also proven to substantially lower healthcare costs for our partners. One of the foundational goals of the CHP program is to foster the primary care provider-patient relationship as an appropriate entry point to the healthcare system. Our CHP agreements also include comprehensive disease management and wellness services. Currently, members are free to utilize nearly every primary care practice in the Grand Valley, including private practices. Since the last CHNA in 2015, we have again extended our current employer group partnerships for additional plan years and added a new employer partner who has also agreed to a multi-year agreement. We continue to offer the CHP Hotline, which is a resource designed to assist employer health plan members with questions and helps them navigate the healthcare system in an efficient and cost-effective way. The volume of calls to the CHP Hotline continues to grow year over year. Community Hospital has discovered from our own data that there is a high percentage of newborns with mothers insured by Medicaid in Mesa County. Through our participation in the 340B program, we are able to provide these Medicaid mothers with a safe, patient-centered environment to receive pre-natal, delivery, and post-natal care.2. Living ConditionsObjective: through facilitating improved provider-patient relationships, Mesa County residents will become better educated as to when and how to utilize appropriate healthcare services.The CHNA presented staggering statistics about the lack of preventive care utilization in Mesa County. At Community Hospital, we recognize that preventive care is designed to help decrease the severity of chronic health conditions through early detection and treatment. Thus, the more Mesa County residents utilize preventive care measures, the healthier the community will be.Community Hospital has continued to work with our CHP employer group partners to remove the financial barriers for preventive care. Many preventive resources - such as annual physical examinations, labs, and cancer screenings -are covered either through our direct contracts or through the member's health plan at a low or no cost copay. By eliminating the stressor of how care is afforded, this has a direct impact on the utilization of preventive care. Additionally, the CHP program offers onsite health screenings for our employer groups on an annual basis. These screenings provide a convenient opportunity for employees and spouses to find out their current health status through both biometric measurements and lab tests at no cost to them. A health screening such as this may help community members to identify health conditions they were previously unaware of. At the CHP health screenings in fall 2018, Community Hospital promoted an initiative to get all participants connected with a primary care provider. Not only did this initiative allow those with potentially abnormal results to follow up with a provider in a timely manner, but it also aided participants in establishing a regular source of health care moving forward. Additionally, as all of the CHP employer groups are privately insured, this initiative helped to increase the number of privately insured patients who have a regular primary care provider in Mesa County. By continuing to add additional employer groups to this partnership in the coming years, Community Hospital will help facilitate growth of private health insurance coverage in Mesa County.In 2018, Community Hospital also partnered with Anthem Blue Cross Blue Shield and Heritage Group to create a clinically integrated network for Anthem patients in Mesa County - The Mountain West Integrated Health Network. Mountain West is a closed network healthcare delivery system working to improve the quality of care and lower the costs of Mesa County-area patients. The clinically integrated network is an attempt to get providers and insurers to work together in a collaborative partnership that better allows them to more efficiently provide care for patients. This improved efficiency in turn lowers the costs and improves the quality of the care. Heritage Group uses population health strategies, utilization review, and case management tools to support its patients and providers. Heritage is able to early identify patients most at risk of a medical event and is able to provide support services that prevent expensive disease events. Maintenance of health in turn lowers the cost of care by reducing unnecessary and expensive ER visits and hospitalizations. The clinically integrated network also leads to a more informed and supportive and patient-centered care experience. Besides improved access to primary care services, home care services are an integral part of the successful management of patients in the network. Identification of patients most at risk and bolstering home care support and services to high-risk patients helps avoid expensive acute care events. In the end, using the collaboration, integration, and coordination of care the clinically integrated network brings enables Community Hospital to support, maintain and even improve the health of our patients while lowering the costs of the care delivered. continued... Community Hospital Part V, Section B, Line 13h: Community Hospital may make a presumption of eligibility on the basis of individual life circumstances that may include homelessness, patient deceased with no known estate, and other circumstances. The facility may use outside agencies in determining estimated income amounts for presumptive charity care eligibility. Community Hospital Part V, Section B, Line 16j: Summary on website, posted in ER and waiting rooms, posted in admissions offices, and provided on admission. Community Hospital Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy. Part V, Section B, Line 11 Continued: 3. Risk BehaviorsObjectives: support initiatives to improve the health of teens and young adults in Mesa County; continue to encourage usage of effective tobacco cessation programs; continue to integrate and promote lifestyle-modification initiatives through the CHP program, continue to provide no cost flu vaccinations at the CHP annual health screenings, in our primary care clinics, and through Canyon View Pharmacy.Community Hospital participates in a committee, along with other local health-related organizations and the school system, to develop and implement a school-based health center. A facility such as this would allow teenagers to receive access to essential healthcare services, such as primary care and behavioral health services, in a location that is most convenient for them. By providing onsite services, students can receive care that helps to reduce risk behaviors like physical inactivity, smoking, and early drug and alcohol use. It is our hope that, by supporting this initiative through both participatory efforts and financial investment, Community Hospital can help contribute to a much-needed opportunity that will improve the health of students in Mesa County.Community Hospital also offers a weight management program for children, teens, and their families, called Project U. Project U is designed to involve the participant and their whole family. This 10-week program includes: pre assessment, post assessment, nutrition, physical activity, and mental health education, along with exercise classes. Additionally, Community Hospital providers and health coaches promote tobacco cessation during their visits. Health coaches help facilitate healthy behaviors and act as a resource to help their patients in evaluating their progress in reaching their goals. In addition to tobacco cessation, health coaches also help patients mitigate risk behaviors such as poor nutrition and limited physical activity; the CHP employer groups receive 12 health coaching visits per year at no cost to the employee. Grand Valley Oncology is also currently working towards creating a tobacco cessation program to benefit their patients.Community Hospital also offers a comprehensive behavior modification program to all CHP employer groups and Hospital employees. The Lifestyle Medicine Program is an 18-week program, designed to educate and incorporate lifestyle modifications. This class takes participants with chronic conditions, and offers them pre and post assessments, weekly nutrition education, mental health education, and exercise classes. We have partnered with Western Colorado Community College to offer hands-on cooking classes during this program. Community Hospital also acts as an advocate for flu prevention through offering no cost flu vaccines to all clinic patients, at annual CHP health screenings, and through our outpatient pharmacy.Through the Community Hospital and School District 51 health screenings, we are able to identify health risk areas for employees in the respective employer groups. Once these health risk areas have been identified, we are able to implement wellness initiatives, such as specific wellness classes, programs, and challenges. These types of programs help to better the overall health of the employee and ultimately help to decrease the identified health risk area.4. Disease & InjuryObjectives: Focus on initiatives to decrease rates and severity of lung cancer and suicide.Lung Cancer:In 2018, Community Hospital created a comprehensive lung cancer care team, which is made up of pulmonologists, radiation oncologists, a thoracic and vascular surgeon, medical oncologists, and a diagnostic radiologist. In addition to state-of-the-art technology, this care team serves to treat the whole patient through comprehensive and coordinated efforts; Community Hospital believes that this approach is likely to lead to both better outcomes and improved care quality for lung cancer patients in Mesa County.Suicide:Community Hospital is committed to providing mental health stability for all patients. Any patient that goes to the Community Hospital Emergency Department is screened for suicide risk. If a patient is a suicide risk, they are placed in a safe environment and consulted by a Community Hospital Behavioral Health Specialist. This specialist does an assessment on the patient and determines if the patient is safe to go home or needs placement within the hospital. The specialist works with West Springs Hospital, as well as other facilities in Colorado, to find placement so the patient can receive treatment. Community Hospital keeps the patient in a safe environment until their treatment placement can be found. Community Hospital also provides aggregate suicide data to Mesa County Public Health and is part of a local suicide prevention coalition. Grand Valley Primary Care is also working towards integrating behavioral health to offer coordinated outpatient counseling and medication management. In 2018, we brought on Community Hospital's first psychiatric nurse practitioner. Through promoting improved behavioral health care in the outpatient setting, Community Hospital's counselors help patients establish coping mechanisms and support systems that may decrease suicidal tendencies. In combination, our inpatient and outpatient efforts support our ultimate goal to decrease the suicide rate in Mesa County.5. Obesity:Objective: Focus on initiatives to reduce obesity in Mesa County.Severe obesity increases the risk of death because of a comorbidity, such as diabetes, high blood pressure, and cardiovascular disease. According to the National Institutes of Health, 15.5 million people in the United States suffer from severe obesity, and the numbers continue to increase. In addition to the aforementioned lifestyle improvement programs, Community Hospital believes that bariatric surgery can be an effective means of weight loss for the appropriate patie Schedule H, Part V, Section B, Line 16a-c: FAP:https://yourcommunityhospital.com/PDFs/Financial%20Assistance%20Policy.pdfFAP Application:https://yourcommunityhospital.com/PDFs/Financial%20Application%20Website.pdfPlain Language Summary:https://yourcommunityhospital.com/PDFs/Financial%20Assistance%20in%20Plain20%Language.pdf 15 1 - Grand Valley Medical Oncology 2596 F Road Grand Junction CO 81505 Outpatient medical infusion 2 - Grand Valley Primary Care 603 28 1/4 Road Grand Junction CO 81506 Primary Physician Care 3 - Therapy Works at Community Hospital 2004 N 12th St Grand Junction CO 81501 Rehabilitation Programs 4 - Occupational Health 2004 N 12th St Grand Junction CO 81501 Employment-related Exam Services 5 - Grand Valley Urgent Care 1060 Orchard Ave Suite N Grand Junction CO 81501 Urgent Medical Services 6 - EAP Behavioral Health Services 605 A B 28 1/4 Road Grand Junction CO 81501 Counseling Services 8 - Colorado Mesa University Student Health 1060 Orchard Ave Suite N Grand Junction CO 81501 Student Medical Services 9 - Colorado West Woman Care of the Grand Va 603 28 1/4 Road Grand Junction CO 81501 Obstetrics and Gynecology 10 - Internal Medicine Assoc of the Grand Va 607 28 1/4 Road Grand Junction CO 81506 Internal Medicine 11 - Fruita Family Medicine - Grand Valley 551 Kokopelli Dr Suite F Grand Junction CO 81501 Outpatient Physician Practice 12 - Grand Valley ENT & Facial 2373 G Road Suite 270 Grand Junction CO 81505 ENT & Facial 13 - Grand Valley Pediatrics 601 B 28 1/4 Road Grand Junction CO 81506 Pediatrics 14 - Western Orthopedics & Sports Medicine 2373 G Road Suite 100 Grand Junction CO 81505 Sports Medicine & General Orthopedics 15 - Western Colorado Spine 2373 G Road Suite 100 Grand Junction CO 81505 Sports Medicine & General Orthopedics 16 - Advanced Pulmonary and Critical Care of 2373 G Road Suite 160 Grand Junction CO 81505 Pulmonary Part I, Line 3c: In addition to FPL, the organization used an asset test in determining eligibility for financial assistance. The organization also took insurance status and medical indigency into consideration. Part I, Line 6a: The community benefit report is available upon request. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments.Line 7b and 7c were determined using the overall cost to charge ratio. Line 7i is actual expenses from the general ledger. Part I, Ln 7 Col(f): The Bad Debt expense included in Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $4,985,636. Part III, Line 2: Community Hospital follows Healthcare Financial Management Association Statement No. 15, and therefore bad debt does not include amounts that would be attributable to charity care. Bad debt on line 2 is reported at charges. Part III, Line 3: Charity care is calculated as a percentage of total revenues. Part III, Line 4: The footnote that describes bad debt expense is found on pages 9-10 of the attached audit report. Part III, Line 8: The Medicare cost report was used to determine the amount of the Medicare shortfall.The organization estimates 100% should be considered a community benefit. If these individuals did not qualify for Medicare, they would qualify for financial assistance, based on the demographics of the community in which we operate. Part III, Line 9b: Part of the Hospital's financial assistance and charity care policy provides for a financial counselor to meet with all uninsured patients prior to discharge from the Hospital. Every effort is made to work with self-pay patients to determine financial assistance eligibility. Collections actions are not taken until eligibility is determined. Part V, Line 16i Financial Assistance Policy Description of failureType of failure: 501(r)(4) - The hospital is required to translate the financial assistance policy, plain language summary and financial assistance policy application into Spanish as more than the lesser of 1,000 individuals or 5% of the community served by the hospital speaks Spanish as a primary language. The hospital did not translate the financial assistance policy or plain language summary into Spanish. Cause of the failure: The hospital facility did not realize the FAP and plain language summary were required to be translated in addition to the application. The facility does have staff that are able to provide translation services in Spanish. The hospital did translate the financial assistance application into Spanish and made that available upon request.Facility or facilities where the failure occurred: The failure occurred in all facilities operated under Colorado West Healthcare System. The date(s) of the failure: UnknownThe date of the discovery of the failure: October 28, 2019The number of occurrences: UnknownDescription of the correction of the failureMethod of correction: The financial assistance policy and plain language summary are being translated into Spanish. The documents will be made available at each facility and on the website.Date of correction: Prior to November 30, 2019Description of the practices or procedures put into placeThe financial assistance policy and plain language summary will be translated into Spanish and posted on the website at https://yourcommunityhospital.com/. The translated documents will also be available at each facility. In addition, Colorado West Healthcare System continues to provide translation services to assist LEP patients with questions they may have regarding financial assistance. Part VI, Line 2: Community Hospital develops its strategic plan both internally and supported by Quorum Health Resources to assess the healthcare needs of the community it serves. This plan includes market assessment of the service area and local demographic characteristics, clinical service line utilization and projections for inpatient, ambulatory, and provider practices. Clinical foci resulting from the same are diabetes, obesity, and primary care access. Part VI, Line 3: Part of the Hospital's written financial assistance and charity care policy provides for financial counselors to meet with all uninsured patients prior to discharge. The Hospital's billing team may also inform patients of the Hospital's financial assistance and charity care program. Part VI, Line 4: The Hospital's primary service area is western Colorado and the residents of Mesa County. Mesa County's population is approximately 150,000 with 15% of the population being over the age of 65. Community Hospital captures 15.9% of the area's healthcare market for those patients requiring inpatient stays. Part VI, Line 5: The Hospital is governed by a 12-member Board of Trustees composed of seven Mesa County, Colorado, community members and five community medical staff members who are all committed to fulfilling the following mission statement: Community Hospital will improve the health and quality of life of the individuals and communities we serve. The community members use their unique experience and abilities to lead the Hospital in directions that support the needs of the community. 1 Grand Junction Soccer Club 552 25 Road Suite B Grand Junction CO 81505 840743815 501(c)(3) 10000 General Support St Baldrick's Foundation 1333 South Mayflower Suite 400 Monrovia CA 91016 201173824 501(c)(3) 5000 General Support Colorado Mesa University Foundation 1041 Mesa Avenue Grand Junction CO 81502 846037667 501(c)(3) 5000 General Support Grand Junction Economic Partnership 122 North 6th Street Grand Junction CO 81501 840972492 501(c)(3) 10000 General Support John McConnell Math & Science 2660 Unaweep Avenue Grand Junction CO 81503 201641549 501(c)(3) 10000 General Support B4 BabiesHilltop 1129 Colorado Avenue Suite 117 Grand Junction CO 81504 742321009 501(c)(3) 5000 General Support District 51 Foundation 2115 Grand Avenue Grand Junction CO 81501 273662704 501(c)(3) 5000 General Support Western Slope Center for Children PO Box 3978 Grand Junction CO 81502 841128554 501(c)(3) 7500 General Support Community Hospital Foundation 2351 G Road Grand Junction CO 81505 742576856 501(c)(3) 10000 Gala Support 9 0 Part I, Line 2: The Organization provides assistance to nonprofit organizations for general support. As such, the hospital does not feel there is a need to monitor how the assistance is used. 0 0 0 0 0 0 0 1 0 Ed Johlman CFO 201477 0 0 0 5701 0 6271 0 18491 0 231940 0 0 0 Scot Houska CCO 195003 0 0 0 6009 0 6206 0 24732 0 231950 0 0 0 Carolle Anne Banville CNO 215854 0 0 0 3659 0 1707 0 14229 0 235449 0 0 0 John Skillicorn Executive Director of Physicians 178281 0 0 0 3086 0 5674 0 22011 0 209052 0 0 0 Brent Woodson Physician 478259 0 0 0 28490 0 15441 0 22194 0 544384 0 0 0 Jo Anne Virgilio Physician 483597 0 10625 0 6689 0 15277 0 24844 0 541032 0 0 0 Jack Bagley Physician 450554 0 0 0 3492 0 11125 0 25757 0 490928 0 0 0 Jonathan Frandsen Physician 454094 0 0 0 3413 0 13956 0 22194 0 493657 0 0 0 Sudy Jahangiri Physician 403130 0 11875 0 3367 0 12618 0 14604 0 445594 0 0 0 Part I, Line 3 The CEO is an employee of Quorum Health Resources. The Board of directors of Colorado West Healthcare System utilizes the methods described on Line 3 in negotiating the contract for CEO services with Quorum. Part I, Line 7 Quorum Health Resources, a management company, compensates the CEO. His compensation includes a set amount plus a bonus if certain criteria are met. The bonus eligibility is based on a scorecard of thirteen metrics, focused around the Pillars of Excellence-quality, service, financial, growth, and people. Physician bonuses are based on Relative value units (RVU) and longevity. RVU is a measure used in Medicare reimbursement formulas for physician services. The Pathology Group PC Board Member Dean Havlik is the sole owner 136956 Payments for pathology contract 0 Diagnostic Radiology Board Member Todd Hegstrom is the owner 150124 Medical Director 0 Form 990, Part VI, Section A, line 1 The Executive Committee shall be composed of the Chairperson, Vice Chairperson, Treasurer, Secretary, Chief of Staff, and the President/CEO. The Executive Commitee shall meet upon the call of the Chairperson to: A. Review upcoming Board of Trustee meetings. B. Act on behalf of the Board of Trustees between regular or special meetings of the Board and then report actions to the Board of Trustees. C. Communicate to keep the Board of Trustees, medical staff and administration of the Hospital aware of pertinent actions taken or contemplated by one or the other, and to make recommendations to the Board of Trustees on major expenditures. D. Consider issues affecting medical care that arise in the operation and affairs of the Hospital. E. Perform the annual evaluation of the President/CEO. F. Perform any other actions the Board of Trustees deems necessary, as instructed by the Board of Trustees. Form 990, Part VI, Section A, line 3 The Hospital has a management agreement with Quorum Health Resources. Christian Thomas, CEO, is compensated by Quorum Health Resources. His compensation for calendar year 2018 was $424,700 plus $86,183 of benefits. Form 990, Part VI, Section B, line 11b The 990 is prepared by the Hospital's independent CPA firm and reviewed by the Hospital's accounting staff and Administration, including the CEO, Controller, and Compliance Officer. A preliminary draft is presented to 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. Form 990, Part VI, Section 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. All board members, officers, and key employees are required to notify the facility of any changes during the year. Form 990, Part VI, Section B, line 15 Community Hospital is a Quorum Health Resources managed hospital whereby the CEO is an employee of the management company. Quorum conducts national wage surveys to suggest market rates for CEO and CFO salaries based on Hospital revenue. The final salary is determined by the Board based on this information and local market conditions. Form 990, Part VI, Section 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. Community Hospital Foundation 2351 G Road Grand Junction CO 81505 742576856 Fundraising CO 501(c)(3) Line 12c, III-FI Colorado West Healthcare System 1 Physicians Choice Real Estate LLC 2012 N 12th St Grand Junction CO 815012980 841601063 Real Estate CO Colorado West Healthcare System Related 63093 1446798 0 0 0.62940 Canyon View ASC 2373 G Road Ste 180 Grand Junction CO 81505 455352976 Ambulatory Surgery Center CO Colorado West Healthcare System Related -93747 -916112 0 0 0.51000 Doctor's Clinic Building Inc 2351 G Rd Grand Junction CO 815059641 840507943 Real Estate Rental CO Colorado West Healthcare System C 201159 439533 1.00000 1 0 1 1 1 1 0 0 0 0 0 1 0 0 1 1 1 1 0 0 Physicians Choice Real Estate LLC K 174012 Cash Doctor's Clinic Building Inc K 201159 Cash