2024-09-06T10:35:06-05:00 2023-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-01-01 825487165 FAMILY HEALTH WEST FOUNDATION FAMI 9708582170 228 N CHERRY STREET FRUITA CO 81521 KORREY KLEIN MD FHW PRESIDENT/CEO 9708582170 2024-09-04 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2024-09-04 2023 2024-08-08 14:25:15Z GLACIA PECK 228 N CHERRY STREET FRUITA CO 81521 289823 0 X FHWFOUNDATION.ORG X 2018 CO FAMILY HEALTH WEST FOUNDATION IS COMMITTED TO PROVIDING WHAT MATTERS MOST TO THOSE WE SERVE. THROUGH FINANCIAL SUPPORT WE PROVIDE RESOURCES THAT BRING WARM, COMPASSIONATE SERVICES TO MAKE EVERY PATIENT'S DAY A LITTLE BIT BETTER. 8 7 0 52 0 0 367162 247085 0 0 144 480 -82760 -35722 284546 211843 261916 41031 0 0 98939 79508 0 0 102680 24611 23172 385466 143711 -100920 68132 304350 375327 130753 133598 173597 241729 X FAMILY HEALTH WEST FOUNDATION IS COMMITTED TO PROVIDING WHAT MATTERS MOST TO THOSE WE SERVE. THROUGH FINANCIAL SUPPORT WE PROVIDE RESOURCES THAT BRING WARM, COMPASSIONATE SERVICES TO MAKE EVERY PATIENT'S DAY A LITTLE BIT BETTER. 0 0 41031 41031 0 SUPPORTING EXTENDED HOSPITAL SERVICES IN THE LOCAL COMMUNITY BY RAISING FUNDS FOR ADDITIONAL HOSPITAL BEDS, THERAPY, AND OUTPATIENT PROCEDURES. 0 0 0 PEDIATRIC THERAPY PROGRAM TO INCLUDE GO BABY GO WHICH PROVIDES ELECTRIC CARS FOR CHILDREN WITH DISABILITIES WHO NEEDED ADJUSTMENTS MADE TO BE ABLE TO DRIVE THE TOY MANUFACTURED CARS. THE AUTISM GROUP TO PROVIDE THERAPY AND TESTING FOR AUTISTIC CHILDREN. 0 0 0 ELDERCARE SUPPORT. PROVIDE SUPPORT FOR NEEDS OF RESIDENTS IN OUR ELDERCARE FACILITIES. 0 0 0 FINANCIAL ASSISTANCE. PROVIDE FUNDS FOR PATIENTS WHO COULD NOT AFFORD RADIOLOGY IMAGING THROUGH THE ASPEN FUND AND THE PINE FUND. SPONSOR A HEALTH FAIR WITH SPORTS PHYSICALS TO LOCAL SCHOOLS. PROVIDE SCHOLARSHIPS FOR ROCK STEADY BOXING. 0 0 0 41031 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CO X THERESA TABOR 9708582228 228 N CHERRY STREET FRUITA CO 81521 ELIZABETH BLAHA BOARD CHAIR 1.00 X X 0 0 0 ROB BURKEY VICE CHAIR 1.00 X X 0 0 0 TOM OLIVER TREASURER 1.00 X X 0 0 0 DEBB FRANCIS SECRETARY 1.00 X X 0 0 0 DIANE DILL MEMBER 1.00 39.00 X 0 180010 7182 KELLEY GRIFFIN MEMBER 1.00 X 0 0 0 JERRY HAMILTON MEMBER 1.00 1.00 X 0 0 0 RANDALL MAY MEMBER 1.00 39.00 X 0 58360 13315 LAUREN MELNICK MEMBER (THRU 03/2023) 1.00 X 0 0 0 SERENE PINGEL MEMBER 1.00 X 0 0 0 TYLER SKEEN MEMBER 1.00 X 0 0 0 DR KORREY KLEIN LVHA CEO 4.00 40.00 X 0 336578 26551 GLACIA PECK DIRECTOR 40.00 X 0 58584 2308 0 633532 49356 0 0 1 0 0 155540 91545 247085 480 480 11328 155540 77980 -66652 -66652 30930 30930 30930 211843 0 0 -35242 41031 41031 67333 67333 1466 1466 7762 7762 2947 2947 448 448 6939 6939 1667 1667 11962 11962 MINOR EQUIPMENT 1971 1971 DUES AND SUBSCRIPTIONS 185 185 143711 41031 0 102680 203922 274799 100428 100528 9627 9627 0 0 304350 375327 130753 133598 130753 133598 X 173597 241729 173597 241729 304350 375327 68132 0 X 0 1 X 1 0 X 240480 110304 282651 367162 247085 1247682 240480 110304 282651 367162 247085 1247682 0 0 0 1247682 70 91 144 480 785 66460 66460 66530 91 144 480 67245 240480 176834 282742 367306 247565 1314927 0.94890 0.99970 0.05110 0.00030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9627 9627 0 0 RED BARRON BALL 134546 127040 7506 65571 OLD FOSSIL GOLF TOURNAMENT 32322 28500 3822 12409 166868 155540 11328 77980 77980 -66652 1 LOWER VALLEY HOSPITAL ASSOCIATION PO BOX 130 FRUITA CO 81521 840447998 501(C)(3) 41031 0 GENERAL SUPPORT 1 0 PART I, LINE 2: FUNDS DISTRIBUTED BASED ON PAID INVOICE RECEIPT. 0 0 0 0 0 0 0 0 0 DR KORREY KLEIN LVHA CEO 0 335708 0 870 0 0 0 13200 0 13351 0 363129 0 0 DIANE DILL MEMBER 0 180010 0 0 0 0 0 7182 0 0 0 187192 0 0 SCHEDULE J, PART I BOARD MEMBERS, OFFICERS, AND DIRECTORS OF THE FOUNDATION AND PERSONS IN POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER DECISIONS OF FHW (KEY EMPLOYEES) ARE REQUIRED TO ANNUALLY DISCLOSE ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THE GOVERNING BOARD AND COMPLIANCE OFFICER THEN REVIEW THE DISCLOSURES TO DETERMINE WHETHER A CONFLICT EXISTS. IF A CONFLICT IS DETERMINED TO EXIST, THE INTERESTED PERSON WILL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE PROPOSED TRANSACTION. FORM 990, PART VI, SECTION A, LINE 6 LOWER VALLEY HOSPITAL ASSOCIATION IS THE SOLE MEMBER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A LOWER VALLEY HOSPITAL ASSOCIATION IS THE SOLE MEMBER OF THE CORPORATION AND HAS THE POWER TO ELECT THE MEMBERS OF THE GOVERNING BODY OF FAMILY HEALTH WEST FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B THE GOVERNING BOARD OF THE LOWER VALLEY HOSPITAL ASSOCIATION APPROVES THE FINANCIAL STATEMENTS AND BUDGETS AS THE PARENT CORPORATION OF THE FAMILY HEALTH WEST FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS MADE AVAILABLE UPON REQUEST TO ALL MEMBERS OF BOTH BOARDS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS, OFFICERS, AND DIRECTORS OF THE FOUNDATION AND PERSONS IN POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER DECISIONS OF FHW (KEY EMPLOYEES) ARE REQUIRED TO ANNUALLY DISCLOSE ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THE GOVERNING BOARD AND COMPLIANCE OFFICER THEN REVIEW THE DISCLOSURES TO DETERMINE WHETHER A CONFLICT EXISTS. IF A CONFLICT IS DETERMINED TO EXIST, THE INTERESTED PERSON WILL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE PROPOSED TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE ORGANIZATION'S CEO IS REVIEWED AND DETERMINED BY THE LOWER VALLEY HOSPITAL GOVERNING BOARD. THE CEO IS PAID BY THE LOWER VALLEY HOSPITAL ASSOCIATION. THE RELATED PARTY PARENT, LOWER VALLEY HOSPITAL ASSOCIATION, IS RESPONSIBLE FOR THIS PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. LOWER VALLEY HOSPITAL ASSOCIATION 228 N CHERRY STREET PO BOX 130 FRUITA CO 81521 840447998 ADDRESS HEALTHCARE NEEDS OF COMMUNITY CO 501(C)(3) LINE 3 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0