2023-12-22T12:15:59-05:00 2022-09-30 200079326 DINGUS ZARECOR & ASSOCIATES PLLC 12015 E MAIN AVE SPOKANE VALLEY WA 99206 990 2021-10-01 454551946 TETON VALLEY HEALTH CARE INC TETO 2083542383 120 EAST HOWARD AVENUE DRIGGS ID 83422 KEITH GNAGEY DIRECTOR/CEO 2083542383 2023-07-24 true KEITH GNAGEY 999009999 THOMAS DINGUS P00951009 5092420874 2023-12-22 2021 2023-04-26 12:10:37Z NATHAN LEVANGER 120 EAST HOWARD AVE DRIGGS ID 83422 25001141 false X WWW.TVHCARE.ORG X 2012 ID TO ENCOURAGE AND SUPPORT A HEALTHIER COMMUNITY. 6 5 226 0 5103107 214638 22705279 24443855 22682 3286 341097 339362 28172165 25001141 6153 15672 0 11482151 14802881 0 403143 10643519 11876032 22131823 26694585 6040342 -1693444 19138827 17925102 2199565 2679284 16939262 15245818 TO ENCOURAGE AND SUPPORT A HEALTHIER COMMUNITY. false false 20107585 15672 24443855 THE HOSPITAL OPERATES A 13-BED CRITICAL ACCESS HOSPITAL (CAH) AND 2 RURAL HEALTH CLINICS WHICH PROVIDE HEALTHCARE SERVICES TO PATIENTS IN THE TETON COUNTY, IDAHO AREA. THE HOSPITAL PROVIDED 413 DAYS OF INPATIENT SERVICES, 24,508 OUTPATIENT VISITS, 2,837 EMERGENCY ROOM VISITS, AND 676 SURGERIES FOR THE YEAR. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 39,234 FOR CHARITY CARE, 4,425,743 FOR MEDICARE, 1,852,909 FOR MEDICAID, AND 2,492,807 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR. 20107585 true true false true false false false false false false true false false false false true false true false false false false false false false false true true false false true false false false false false false false false false false false false true false false false false true 25 0 true 226 true false false false false false false false false false false false false X 6 5 false false false false true true false true true false false true true true true true true true true true true X LETITIA MILLER 2083542383 120 EAST HOWARD AVE DRIGGS ID 83422 MICHAEL WINE CHAIR 2.00 X X 0 0 0 JOANN KAY VICE CHAIR 2.00 X X 0 0 0 KEVIN MAYBERRY SECRETARY 2.00 X X 0 0 0 AARON HANSEN TREASURER 2.00 X X 0 0 0 ANJALI TATE DIRECTOR 2.00 X 0 0 0 KEITH GNAGEY DIRECTOR/CEO 40.00 X X 279505 0 11292 LETITIA MILLER CFO 40.00 X 241267 0 9785 NATHAN LEVANGER CMO 40.00 X 337270 0 13985 MAURICE BROWN PHYSICIAN 32.00 X 601125 0 12000 CHAD HORROCKS PHYSICIAN 36.00 X 410258 0 12000 TAYLOR NELSON CRNA 32.00 X 269500 0 12000 MARIA KENNAH COO 40.00 X 232175 0 9785 JUANITA PRISSEL PHYSICIAN 40.00 X 225035 0 12000 2596135 92847 19 false true false EMERGENCY PHYSICIANS INTEGRATED CAR 333 N 300 W SALT LAKE CITY UT 84103 PHYSICIANS 458600 PM NAGLE CONSULTING LLC 3816 SALISH TRAIL STEVENSVILLE MT 59870 BILLING 360000 PHARMGO LLC 1790 DEER VALLEY DRIVE IDAHO FALLS ID 83401 PHARMACIST 310050 QUALIVIS LLC PO BOX 1180 COLUMBIA SC 29201 CONTRACT LABOR 262124 HEALTHCARE SERVICES GROUP 3220 TILLMAN DRIVE 300 BENSALEM PA 19020 DIETARY SERVICE 260065 10 75496 139142 214638 PATIENT SERVICE REVENUE, NET 624100 24438555 24438555 RENT INCOME 621910 5300 5300 24443855 3286 3286 247744 247744 247744 OTHER REVENUE 900099 46245 46245 CAFETERIA REVENUE 722320 45373 45373 91618 25001141 24443855 342648 X 15672 15672 1046920 363533 683387 11725198 9288983 2260875 175340 188501 142738 43167 2596 927424 631051 279278 17095 914838 712921 188009 13908 26153 26153 65665 65665 4669581 3181947 1475375 12259 262184 262184 518638 273072 159051 86515 598887 328347 190330 80210 141393 99670 41723 12502 12502 893130 838179 54951 226219 191832 34387 MEDICAL SUPPLIES & DRUGS 3761488 3761488 REPAIRS & MAINTENANCE 200507 198617 1890 DUES & SUBSCRIPTIONS 153502 32675 120727 100 346183 34358 296705 15120 26694585 20107585 6183857 403143 8868541 7613752 658730 660423 3631879 3789494 1164085 1085216 87610 93775 15989598 12047156 4007032 3942442 720950 740000 19138827 17925102 1709239 2253120 490326 426164 2199565 2679284 X 16939262 15245818 16939262 15245818 19138827 17925102 -1693444 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1568 1568 false SCHEDULE C, PART II-B, LINE 1 THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. 92671 92671 8094672 5909479 2185193 7802255 6137677 1664578 3942442 X SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE HOSPITAL EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WERE CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF SEPTEMBER 30, 2022 AND 2021, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. true true true X true X true true true false true true 29426 29426 0.00110 2969868 2106915 862953 0.03230 2999294 2106915 892379 0.03340 123059 123059 0.00460 200 200 123259 123259 0.00460 3122553 2106915 1015638 0.03800 1900 1900 0.00010 1900 1900 0.00010 true 1533170 8301703 8380940 -79237 X true true 1 1 TETON VALLEY HEALTH CARE INC 120 EAST HOWARD AVE DRIGGS ID 83422 WWW.TVHCARE.ORG X X X X TETON VALLEY HEALTH CARE INC 1 false false true X X X X X X X X X X 22 true false true true X WWW.TVHCARE.ORG X true 22 true WWW.TVHCARE.ORG false true X 200.000000000000 200.000000000000 X X true true X X X true X WWW.TVHCARE.ORG X WWW.TVHCARE.ORG X WWW.TVHCARE.ORG X X X X X X true X false X X X X true X false false FACILITY 1, TETON VALLEY HEALTH CARE INC. - PART V, LINE 3E IDENTIFICATION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS BEGIN ON PAGE 16 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. FACILITY 1, TETON VALLEY HEALTH CARE INC. - PART V, LINE 5 COMMUNITY OPINION DATA WAS GATHERED THROUGH SURVEYS AND INTERVIEWS. A CHNA SURVEY WAS DEPLOYED TO LOCAL EXPERT ADVISORS AND THE GENERAL PUBLIC TO GAIN INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED ACCORDING TO CRITERIA REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS AND THE HOSPITALS DESIRE TO REPRESENT THE REGIONS GEOGRAPHICALLY DIVERSE POPULATION. 410 SURVEY RESPONSES FROM COMMUNITY MEMBERS WERE GATHERED. FOCUS GROUPS AND INDIVIDUAL INTERVIEWS WERE CONDUCTED TO VALIDATE SURVEY FINDINGS, GATHER ADDITIONAL INFORMATION, AND GAIN ADDITIONAL INPUT FROM PRIORITY POPULATIONS INCLUDING SENIORS, RACIAL AND ETHNIC MINORITY GROUPS, AND YOUNG ADULTS. THE SURVEY RESPONDENTS PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED THE "WISDOM OF CROWDS" METHOD. THIS APPROACH RELIES ON THE ASSUMPTION THAT THE COLLECTIVE WISDOM OF PARTICIPANTS IS SUPERIOR TO THE OPINION OF ANY ONE INDIVIDUAL, REGARDLESS OF THEIR PROFESSIONAL CREDENTIALS. INPUT WAS OBTAINED FROM THE REQUIRED THREE MINIMUM SOURCES AND EXPANDED TO INCLUDE OTHER REPRESENTATIVE GROUPS. TVH ASKED ALL THOSE PARTICIPATING IN THE WRITTEN COMMENT SOLICITATION PROCESS TO SELF-IDENTIFY INTO ANY OF THE FOLLOWING REPRESENTATIVE CLASSIFICATIONS. PARTICIPANTS SELF-IDENTIFIED AS FOLLOWS: 1) PUBLIC HEALTH OFFICIAL 2) GOVERNMENT EMPLOYEE OR REPRESENTATIVE 3) MINORITY OR UNDERSERVED POPULATION 4) CHRONIC DISEASE GROUPS 5) COMMUNITY RESIDENT 6) EDUCATOR 7) HEALTHCARE PROFESSIONAL 8) OTHER INFORMATION ANALYSIS AUGMENTED BY LOCAL OPINIONS SHOWED HOW TETON COUNTY RELATES TO ITS PEERS IN TERMS OF PRIMARY AND CHRONIC NEEDS AS WELL AS OTHER ISSUES OF UNINSURED PERSONS, LOW INCOME PERSONS AND MINORITY GROUPS; RESPONDENTS COMMENTED ON CERTAIN POPULATION GROUPS OR PEOPLE WITH CERTAIN SITUATIONS THAT MAY NEED HELP TO IMPROVE THEIR CONDITION AND IF SO, WHO NEEDS TO DO WHAT. FACILITY 1, TETON VALLEY HEALTH CARE INC. - PART V, LINE 6B TVHC PARTNERED WITH QUORUM HEALTH RESOURCES (QHR) TO COMPLETE A CHNA REPORT. FACILITY 1, TETON VALLEY HEALTH CARE INC. - PART V, LINE 11 THE HOSPITAL DOES NOT HAVE ADEQUATE RESOURCES TO SOLVE ALL THE SIGNIFICANT NEEDS IDENTIFIED. SOME ISSUES ARE BEYOND THE MISSION OF THE HOSPITAL 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 AS A PLAN FOR HOW WE, ALONG WITH OTHER AREA ORGANIZATIONS AND AGENCIES, CAN COLLABORATE TO BRING THE BEST EACH HAS TO OFFER TO SUPPORT CHANGE AND TO ADDRESS THE MOST PRESSING IDENTIFIED NEEDS. THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE LATEST CHNA ARE BEHAVIORAL HEALTH: MENTAL HEALTH AND DRUG/SUBSTANCE ABUSE AFFORDABILITY OF HEALTHCARE ACCESS TO HEALTHCARE SERVICES: PRESENCE OF SERVICES AND SENIOR SERVICES CANCER TVH ADDRESSES THESE AREAS THROUGH IDENTIFIED PROGRAMS AND RESOURCES AS WELL AS COLLABORATION WITH OTHER LOCAL ORGANIZATIONS/AGENCIES. METRICS ARE INCLUDED FOR EACH HEALTH NEED TO TRACK PROGRESS. THE HOSPITAL IS CONTINUALLY ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. 3 DRIGGS HEALTH CLINIC 283 NORTH FIRST EAST DRIGGS ID 83422 RURAL HEALTH CLINIC VICTOR HEALTH CLINIC 83 N MAIN STREET VICTOR ID 83455 RURAL HEALTH CLINIC CACHE CLINIC 852 VALLEY CENTER DRIVE DRIGGS ID 83422 OUTPATIENT CLINIC SCHEDULE H, PART I, LINE 7 THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES DERIVED FROM WORKSHEET 2, FOR AMOUNTS REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, TOTAL COMMUNITY BENEFIT AND TOTAL COMMUNITY BUILDING EXPENSES). SCHEDULE H, PART III, LINE 2 THE COSTING METHODOLOGY USED BY THE HOSPITAL INCLUDES THE COST-TO-CHARGE RATIO OF PATIENT CARE. SCHEDULE H, PART III, LINE 3 THE HOSPITAL DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY BUT FOR WHOM SUFFICIENT INFORMATION WAS NOT OBTAINED TO MAKE DETERMINATION OF THEIR ELIGIBILITY DURING THE YEAR. SCHEDULE H, PART III, LINE 4 THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 4 ON PAGE 12 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 8 ON PAGE 14 OF THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8 ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. SCHEDULE H, PART III, LINE 9B THE HOSPITAL'S BUSINESS OFFICE STAFF FOLLOW UP ON ACCOUNTS 15 TO 30 DAYS AFTER THE ACCOUNTS ARE BILLED. THE STAFF CONTACT THE INSURERS TO VERIFY CLAIMS HAVE BEEN RECEIVED AND TO RESEND THE CLAIMS IF NECESSARY. AFTER VERIFYING CLAIMS HAVE BEEN RECEIVED, THE STAFF CONTINUE TO CONTACT THE INSURERS EVERY 30 DAYS, AS NECESSARY, TO FOLLOW UP ON THE STATUS OF THE CLAIMS. ONCE INSURANCE BALANCES ARE EXHAUSTED, THE REMAINING SELF-PAY BALANCES ARE THEN MANAGED BY THE HOSPITAL SELF PAY DIVISION WHICH ATTEMPTS TO COLLECT FOR 120 DAYS. IF PAYMENT FOR NON-MEDICARE ACCOUNTS IS STILL NOT COLLECTED OR IF PAYMENT TERMS ARE NOT ADHERED TO THEN THE BALANCE IS SENT TO KINUM FOR PRE- COLLECTIONS FOR 30 DAYS AND AT DAY 151 UNPAID ACCOUNTS ARE FORWARDED TO COLLECTIONS OR KINUM. MEDICARE ACCOUNTS ARE RETURNED TO THE HOSPITAL AND WRITTEN OFF AS UNCOLLECTIBLE MEDICARE BAD DEBT. SCHEDULE H, PART VI, LINE 2 MANAGEMENT, HOSPITAL DEPARTMENT STAFF AND MANAGERS, AND THE BOARD OF DIRECTORS ARE COMPRISED OF MEMBERS WITHIN THE COMMUNITY. THEY ARE ABLE TO GATHER AND COMMUNICATE THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES AND CONTINUALLY ADDRESS THEM AT STAFF AND BOARD MEETINGS. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY AND COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT THE FOLLOWING URL: HTTPS://TVHCARE.ORG/WP-CONTENT/UPLOADS/2022/12/TVH-CHNA-FINAL-REPORT.PDF SCHEDULE H, PART VI, LINE 3 IN COMPLIANCE WITH THE COLLECTION POLICIES OF TVHC, AN ANNUAL REVIEW IS PERFORMED FOR ALL CREDIT/COLLECTION AND FINANCIAL ASSISTANCE POLICIES. ONCE REVIEWED AND REVISED, THE INFORMATION IS DISTRIBUTED TO THE COMMUNITY IN A VARIETY OF WAYS. THE FACILITY PUBLISHED A BROCHURE THAT IS PLACED IN PUBLIC AREAS OF ALL THE TVHC FACILITIES, AS WELL AS INCLUDED IN ALL FORMAL ADMISSION PACKETS TO PATIENTS. THE PATIENT ACCOUNT REPRESENTATIVE'S HAND OUT THE INFORMATION DURING PATIENT CONSULTS AS WELL. THE INFORMATION IS ALSO AVAILABLE ON THE TVHC WEBSITE AND INCLUDED WITH EVERY PATIENT ACCOUNT STATEMENT. THE LATEST FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON OUR WEBSITE AT THE FOLLOWING URL: HTTPS://TVHCARE.ORG/HOSPITAL/PRICING-BILLING-INSURANCE/ IT IS UPDATED ANNUALLY WITH NEW POVERTY GUIDELINES. SCHEDULE H, PART VI, LINE 4 TETON COUNTY IDAHO COVERS 450 SQUARE MILES OF SOUTHEASTERN IDAHO. THE 2020 POPULATION WAS 11,630 COMPARED TO A 2010 POPULATION OF 10,170. MEDIAN AGE IS 36.3, MEDIAN HOUSEHOLD INCOME IS 54,896 COMPARED TO 48,905 FOR THE STATE OF IDAHO, AND AN UNEMPLOYMENT RATE OF 4% COMPARED TO 3.9% FOR THE STATE AND 4.9% FOR THE U.S. HISPANICS MAKE UP 17.7% OF THE POPULATION WITH 80.2% WHITE/NON-HISPANIC. TETON VALLEY HEALTH CARE, INC. (TVHC) HAS BEEN SERVING THE HEALTHCARE NEEDS OF THE TETON COUNTY AREA SINCE 1938. THE HOSPITAL IS NOW A NON- PROFIT, THIRTEEN BED CRITICAL ACCESS FACILITY BUILT IN 1997. TVHC OFFERS A CONTINUUM OF CARE INCLUDING INPATIENT HOSPITAL SERVICES, OUTPATIENT SERVICES AS WELL AS OUTPATIENT CLINICS IN THE CITIES OF VICTOR AND DRIGGS. TVHC EMPLOYS OVER 220 INDIVIDUALS, WITH AN ANNUAL PAYROLL IN EXCESS OF 12.5 MILLION. SCHEDULE H, PART VI, LINE 5 TETON VALLEY HEALTH CARE'S BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY MEMBERS REPRESENTING MULTIPLE FACETS OF THE COMMUNITY FROM THE FINANCIAL SECTOR TO SMALL BUSINESS OWNERS TO RETIREES. THE BOARD HAS DEDICATED THEIR TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF GREATER COMMUNITY. MEDICAL STAFF PRIVILEGES AT TVHC ARE OPEN TO ALL MEDICAL PROVIDERS WITH ACTIVE LICENSURE. WHILE THEY HAVE INSTITUTED AN ARDUOUS CREDENTIALING PROCESS TO ENSURE PRACTITIONERS OF THE HIGHEST CALIBER ARE PRIVILEGED, THEY ENCOURAGE PRACTITIONERS FROM NUMEROUS SPECIALTIES TO MEET THE EVER EXPANDING HEALTHCARE NEEDS OF THE COMMUNITY. AS A NON-PROFIT CORPORATION, TVHC DOES NOT HAVE ANY SHAREHOLDERS. THEREFORE SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY'S EQUIPMENT AND EMPLOYEE EDUCATION. THE ABSENCE OF SHAREHOLDERS ELIMINATES THE POTENTIAL FOR CONFLICTS OF INTEREST RELATED TO ATTAINING INFLATED PROFIT MARGINS AND ALLOWS TETON VALLEY HEALTHCARE TO FOCUS ON WHAT IS IMPORTANT; MEETING THE HEALTH AND WELFARE NEEDS OF THE COMMUNITIES THEY SERVE IN AN ECONOMICALLY VIABLE FASHION. THE HOSPITAL PARTICIPATES IN MULTIPLE ACTIVITIES WITHIN ITS COMMUNITY TO PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES INCLUDING DONATING TO AN ANNUAL HEALTH FAIR WHERE MEDICAL TESTS ARE PROVIDED AT REDUCED PRICES TO ENSURE THE COMMUNITY KNOWS THEIR NUMBERS AND RISKS, FOCUSING ON PREVENTION AND INTERVENTION. IN ADDITION, THE HOSPITAL CONTINUES TO COLLABORATE WITH LOCAL OFFICIALS TO PROVIDE NEEDED SERVICES AND DONATE TIME AND EFFORT TO THE COMMUNITY. WE PROVIDE SUBSTANTIAL AMOUNTS OF UNCOMPENSATED CARE TO INDIVIDUALS THAT ARE IN NEED. SCHEDULE H, PART VI, LINE 6 N/A SCHEDULE H, PART VI, LINE 7 IDAHO X X X X X X false false false false false false false true false KEITH GNAGEY DIRECTOR/CEO 236505 43000 11292 290797 LETITIA MILLER CFO 209162 32105 9785 251052 NATHAN LEVANGER CMO 337270 13985 351255 MAURICE BROWN PHYSICIAN 433679 167446 12000 613125 CHAD HORROCKS PHYSICIAN 290189 120069 12000 422258 TAYLOR NELSON CRNA 269500 12000 281500 MARIA KENNAH COO 232175 9785 241960 JUANITA PRISSEL PHYSICIAN 225035 12000 237035 SCHEDULE J, PAGE 1, PART I, LINE 7 IN ADDITION TO BASE COMPENSATION, THE HOSPITAL CEO MAY BE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON PERFORMANCE GOALS OUTLINED IN ANNUAL GOALS AND THE EMPLOYMENT CONTRACT. PERFORMANCE GOALS INCLUDE GROWTH (SUCH AS ADDING SERVICE LINES), COMMUNITY (SUCH AS COMPLETING THE COMMUNITY HEALTH NEEDS ASSESSMENT), AND PROGRAM (SUCH AS ADDING 340(B) PROGRAM). THE INCENTIVE COMPENSATION IS CONTINGENT ON ACHIEVING BASELINE FINANCIAL PERFORMANCE MEASURES. ALSO, CERTAIN MEDICAL PROVIDERS RECEIVE INCENTIVE COMPENSATION THAT IS BASED ON THE AMOUNT OF SERVICES THEY PERFORM. FORM 990, PAGE 6, PART VI, LINE 6 THE MEMBERS OF TETON VALLEY HEALTH CARE, INC. (TVHC) SHALL CONSIST OF A BROAD REPRESENTATION OF THE PUBLIC THAT TVHC SERVES AND THE MAJORITY OF THE MEMBERS MUST BE CITIZENS OF TETON COUNTY, IDAHO, INCLUDING RESIDENTS OF EACH INCORPORATED CITY IN TETON COUNTY, IDAHO, AND THE UNINCORPORATED AREA OF TETON COUNTY. THERE SHALL BE AT LEAST FIVE MEMBERS WHICH ARE ELECTED BY A MAJORITY VOTE OF THE EXISTING MEMBERS. EACH MEMBER IS ENTITLED ONE VOTE ON ANY MATTER SUBMITTED TO A VOTE AT A MEETING OF THE MEMBERS. FORM 990, PAGE 6, PART VI, LINE 7A EACH MEMBER IS ENTITLED TO VOTE ON ANY MATTER SUBMITTED TO A VOTE AT A MEETING OF THE MEMBERS, INCLUDING THE ELECTION OF THE BOARD OF DIRECTORS. MEETINGS ARE HELD ANNUALLY AS WELL AS ANY SPECIAL MEETINGS CALLED BY THE CEO OR AT THE WRITTEN REQUEST OF THE MEMBERS. FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE CFO AND CEO WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PRESENTED TO THE BOARD OF DIRECTORS WHO THEN APPROVE THE 990. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS THE FORM 8879-TE AUTHORIZING THE PREPARER TO E-FILE THE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C ARTICLE 4 OF THE BYLAWS STATES THAT BOARD MEMBERS SHALL NOT USE THEIR POSITION ON THE BOARD OR ANY INFORMATION OBTAINED THROUGH THEIR POSITION FOR PERSONAL ECONOMIC BENEFIT. HOSPITAL BOARD MEMBERS SHALL COMPLY WITH THE CONFLICT OF INTEREST POLICY ADOPTED IN CONNECTION WITH THE HOSPITAL'S APPLICATION FOR TAX EXEMPTION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD REVIEWS AND APPROVES MANAGEMENT WAGES EACH YEAR. THE SOURCES UTILIZED BY TVHC IN REGARDS TO ORIGINAL FAIR MARKET VALUE OF THE CEO SALARY WAS AN EXECUTIVE COMPENSATION SURVEY, PUBLISHED BY CRITICAL DATA, INC., AND THE IDAHO HOSPITAL ASSOCIATION (IHA) ANNUAL SALARY SURVEY. THESE SURVEYS ARE UTILIZED FOR SETTING THE SALARY LEVELS OF EMPLOYEES AT TVHC. THE IHA SURVEY ITEMIZES ALL HOSPITALS AS A GROUP, CAH HOSPITALS, AND HOSPITALS BY REGION. THE CEO BASE SALARY INCREASE IS EQUAL TO THE AVERAGE PERCENT INCREASE OF ALL EMPLOYEES. THE BOARD APPROVES THE ANNUAL INCENTIVE COMPENSATION OF THE CEO. IN REGARD TO SETTING THE SALARY LEVELS OF PHYSICIANS, TVHC UTILIZES THE MGMA PHYSICIAN COMPENSATION AND PRODUCTION SURVEY AS WELL AS OTHER SURVEYS. THIS SURVEY ITEMIZES SALARIES AND PRODUCTIVITY BY PHYSICIAN SPECIALITY, YEARS IN PRACTICE, GEOGRAPHIC REGION, AND OTHER CATEGORIES. FORM 990, PAGE 6, PART VI, LINE 15B TVHC STRIVES TO PAY MARKET LEVEL SALARIES TO ALL EMPLOYEES OF THE ORGANIZATION. IT IS OUR GOAL TO RECRUIT AND RETAIN TOP TALENT IN EVERY VENUE, WHILE CONTROLLING SALARY AND BENEFIT COSTS WITHIN ESTABLISHED TARGETS. SEE FORM 990, PART VI, LINE 15A. FORM 990, PAGE 6, PART VI, LINE 19 TVHC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G 3,181,947 1,475,375 12,259 CACHE CLINIC LLC 120 E HOWARD DRIGGS ID 83422 CLINIC ID TVHC