SURPRISE VALLEY HEALTH CARE DISTRICT: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- SURPRISE VALLEY HEALTH CARE DISTRICT (EIN 68-0008034)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-13
- IRS object ID
- 202401349349309415
- Schema version
- 2022v5.0
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-13T19:49:22-04:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 200079326 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DINGUS ZARECOR & ASSOCIATES PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12015 E MAIN AVE | AddressLine1Txt |
| City | SPOKANE VALLEY | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680008034 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SURPRISE VALLEY HEALTH CARE | BusinessNameLine1Txt |
| Business Name Line2 | DISTRICT | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SURP | BusinessNameControlTxt |
| Phone | 5302796111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 246 | AddressLine1Txt |
| City | CEDARVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96104 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FRANCES HANNAH | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5302796111 | PhoneNum |
| Signature | 2024-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | HANNAH | PersonFirstNm |
| Person Last | FRANCES | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | false | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS DINGUS | PreparerPersonNm |
| PTIN | P00951009 | PTIN |
| Phone | 5092420874 | PhoneNum |
| Preparation | 2024-05-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | FRANCES HANNAH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 246 | AddressLine1Txt |
| City | CEDARVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96104 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,627,859 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SVHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Assoc | Yes (X) | TypeOfOrganizationAssocInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE SAFE, HIGH QUALITY CARE AND PROFESSIONAL EXCELLENCE TO ALL PEOPLE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 105 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $39,829 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,470,459 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,989,152 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,139,576 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,523 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,362 | CYInvestmentIncomeAmt |
| PY Other Revenue | $647,631 | PYOtherRevenueAmt |
| CY Other Revenue | $14,462 | CYOtherRevenueAmt |
| PY Total Revenue | $10,679,135 | PYTotalRevenueAmt |
| CY Total Revenue | $9,627,859 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,877,732 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,433,937 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,942,196 | PYOtherExpensesAmt |
| CY Other Expenses | $4,401,093 | CYOtherExpensesAmt |
| PY Total Expenses | $8,819,928 | PYTotalExpensesAmt |
| CY Total Expenses | $10,835,030 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,859,207 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,207,171 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,837,717 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,402,307 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,739,730 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,755,130 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,097,987 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,352,823 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE SAFE, HIGH QUALITY CARE AND PROFESSIONAL EXCELLENCE TO ALL PEOPLE REGARDLESS OF RACE, COLOR, CREED, GENDER, RELIGION, NATIONAL ORIGIN, AGE, MARITAL STATUS, POLITICAL AFFILIATION, MEDICAL CONDITION OR PHYSICAL OR MENTAL DISABILITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,733,742 | ExpenseAmt |
| Revenue | $8,139,576 | RevenueAmt |
| Desc | SURPRISE VALLEY HEALTH CARE DISTRICT (SVHCD) IS COMPRISED OF A 4-BED CRITICAL ACCESS HOSPITAL (CAH) WITH AN ATTACHED 22-BED LONG-TERM CARE UNIT AND RURAL HEALTH CLINIC SERVING A REMOTE, UNDERSERVED COMMUNITY OF APPROXIMATELY 1,500 PEOPLE WITH 24/7 EMERGENCY ROOM, AMBULANCE, AND GENERAL HEALTH CARE TO ALL CITIZENS OF THE AREA. THE SERVICES ARE DIRECTED TOWARD THE PHYSICAL, EMOTIONAL, AND SPIRITUAL WELL-BEING OF THOSE WE SERVE. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY HEALTH CARE SERVICES, INCLUDING 7,742 SKILLED NURSING PATIENT DAYS, 348 EXTENDED CARE PATIENT DAYS, 1,944 EMERGENCY ROOM VISITS, AND 7,127 OUTPATIENT CLINIC VISITS DURING THE YEAR. | Desc |
| Total Program Service Expenses | $8,733,742 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 105 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CORY RICKARD | PersonNm |
| Phone | 5302796111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 246 | AddressLine1Txt |
| City | CEDARVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96101 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| LOUIED LAGUNAY | |||||||
| LAB MANAGER | 40.00 | Yes (X) | $234,185 | $0 | $5,642 | ||
| ELIZABETH AKINYI | |||||||
| RADIOLOGY MA | 40.00 | Yes (X) | $233,191 | $0 | $8,896 | ||
| MELISSA CARTER | |||||||
| REGISTERED N | 40.00 | Yes (X) | $204,922 | $0 | $20,407 | ||
| FRANCES HANNAH | |||||||
| CEO | 40.00 | $172,851 | $0 | $0 | Yes (X) | ||
| CORY RICKARD | |||||||
| CFO | 40.00 | $118,684 | $0 | $13,391 | Yes (X) | ||
| CHANDA PEDOTTI | |||||||
| HR/ADMIN ASS | 40.00 | Yes (X) | $116,769 | $0 | $7,500 | ||
| CHASE TAYLOR | |||||||
| DIRECTOR OF | 40.00 | Yes (X) | $113,804 | $0 | $15,456 | ||
| JOHN ERQUIAGA | |||||||
| PRESIDENT | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| BRUCE TOZIER | |||||||
| VICE PRESIDE | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| SUSIE BUNYARD | |||||||
| SECRETARY | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| RAY GORZELL | |||||||
| TREASURER | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| JEANNE GOLDMAN | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,194,406 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $71,292 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| FUSION MEDICAL STAFFING | |||||
| PO BOX 30131 | OMAHA | NE | 68103 | STAFFING | $201,819 |
| INFINITE CONSULTING SERVICES | |||||
| 30703 OMA ROAD | VALLEY CENTER | CA | 92082 | IT SERVICES | $178,250 |
| NPH | |||||
| 1801 FOUNDATION LANE | CHICO | CA | 95928 | STAFFING | $149,469 |
| CPSIHEALTHLAND | |||||
| PO BOX 850309 | MOBILE | AL | 36685 | EHR SUPPORT | $123,650 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,451,157 | GovernmentGrantsAmt |
| All Other Contributions | $19,302 | AllOtherContributionsAmt |
| Total Contributions | $1,470,459 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $8,139,576 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,139,576 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,139,576 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,362 | TotalRevenueColumnAmt |
| Exclusion | $3,362 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| DIETARY | 900099 | $9,212 | $9,212 |
| MEDICAL RECORDS & OTHER | 900099 | $3,559 | $3,559 |
| REBATES & REFUNDS | 900099 | $1,691 | $1,691 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $14,462 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,627,859 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,139,576 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $17,824 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $515,308 | TotalAmt |
| Management And General | $515,308 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,615,730 | TotalAmt |
| Program Services | $4,148,641 | ProgramServicesAmt |
| Management And General | $467,089 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $465,204 | TotalAmt |
| Program Services | $426,164 | ProgramServicesAmt |
| Management And General | $39,040 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $837,695 | TotalAmt |
| Program Services | $675,600 | ProgramServicesAmt |
| Management And General | $162,095 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,337 | TotalAmt |
| Management And General | $65,337 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,475 | TotalAmt |
| Management And General | $29,475 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,351,408 | TotalAmt |
| Program Services | $2,243,660 | ProgramServicesAmt |
| Management And General | $107,748 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,542 | TotalAmt |
| Management And General | $1,542 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $397,668 | TotalAmt |
| Program Services | $365,723 | ProgramServicesAmt |
| Management And General | $31,945 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,377 | TotalAmt |
| Program Services | $94,881 | ProgramServicesAmt |
| Management And General | $8,496 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,513 | TotalAmt |
| Program Services | $32,310 | ProgramServicesAmt |
| Management And General | $23,203 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,607 | TotalAmt |
| Program Services | $16,764 | ProgramServicesAmt |
| Management And General | $8,843 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,478 | TotalAmt |
| Program Services | $1,555 | ProgramServicesAmt |
| Management And General | $145,923 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $210,462 | TotalAmt |
| Program Services | $184,996 | ProgramServicesAmt |
| Management And General | $25,466 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,313 | TotalAmt |
| Program Services | $99,114 | ProgramServicesAmt |
| Management And General | $175,199 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $318,027 | $318,027 | |
| REPAIR & MAINTENANCE | $94,589 | $88,971 | $5,618 |
| DUES & SUBSCRIPTIONS | $46,845 | $17,575 | $29,270 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,452 | TotalAmt |
| Program Services | $19,761 | ProgramServicesAmt |
| Management And General | $259,691 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,835,030 | TotalAmt |
| Program Services | $8,733,742 | ProgramServicesAmt |
| Management And General | $2,101,288 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,670,200 | BOYAmt |
| EOY | $2,155,264 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $976,841 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $857,695 | BOYAmt |
| EOY | $290,224 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,736 | BOYAmt |
| EOY | $156,036 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,437 | BOYAmt |
| EOY | $75,703 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,750,243 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,024,224 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,158,450 | BOYAmt |
| EOY | $1,726,019 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,199 | BOYAmt |
| EOY | $22,220 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,837,717 | BOYAmt |
| EOY | $5,402,307 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,683,884 | BOYAmt |
| EOY | $2,851,503 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $864,796 | BOYAmt |
| EOY | $635,532 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,191,050 | BOYAmt |
| EOY | $3,268,095 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,739,730 | BOYAmt |
| EOY | $6,755,130 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,097,987 | BOYAmt |
| EOY | -$1,352,823 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,097,987 | BOYAmt |
| EOY | -$1,352,823 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,837,717 | BOYAmt |
| EOY | $5,402,307 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,207,171 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$2,243,639 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $2,454 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,454 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | SVHCD DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. SVHCD PAYS DUES TO HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA, CALIFORNIA ASSOCIATION OF HEALTH FACILITIES, CALIFORNIA SPECIAL DISTRICTS ASSOCIATION, AND DISTRICT HOSPITAL LEADERSHIP FOUNDATION. THESE ORGANIZATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $57,000 | OtherCostOrOtherBasisAmt |
| Book Value | $57,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,555,540 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,486,276 | DepreciationAmt |
| Book Value | $69,264 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,576,300 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,537,948 | DepreciationAmt |
| Book Value | $1,038,352 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $561,403 | OtherCostOrOtherBasisAmt |
| Book Value | $561,403 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,726,019 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD-PARTY SETTLEMENTS | Desc |
| Amt | $3,268,095 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,268,095 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $9,627,859 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $9,627,859 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $9,627,859 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,835,030 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $10,835,030 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $10,835,030 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | SVHCD IS A PUBLIC ENTITY ORGANIZED UNDER LOCAL HOSPITAL DISTRICT LAW AS SET FORTH IN THE HEALTH AND SAFETY CODE OF THE STATE OF CALIFORNIA. SVHCD IS A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA AND IS GENERALLY NOT SUBJECT TO STATE OR FEDERAL INCOME TAXES. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,148,003 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,860,349 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $287,654 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02650 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,148,003 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,860,349 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $287,654 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02650 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,148,003 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,860,349 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $287,654 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02650 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $330,474 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $2,686,735 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,946,559 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$259,824 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SURPRISE VALLEY HEALTH CARE | BusinessNameLine1Txt |
| Business Name Line2 | DISTRICT | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 246 | AddressLine1Txt |
| City | CEDARVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96104 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://SVHOSPITAL.ORG/ | WebsiteAddressTxt |
| State License | 230000025 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SURPRISE VALLEY HEALTH CARE | BusinessNameLine1Txt |
| Business Name Line2 | DISTRICT | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://SVHOSPITAL.ORG/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C, LINE 7D | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, PAGE 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, PAGE 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | Yes (true) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, SURPRISE VALLEY HEALTH CARE - PART V, LINE 3E | IDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS BEGIN ON PAGE 16 OF THE CHNA LOCATED ON SVHCD'S WEBSITE. |
| FACILITY 1, SURPRISE VALLEY HEALTH CARE - PART V, LINE 5 | A MEETING WAS HELD WITH MEMBERS OF THE COMMUNITY. PEOPLE REPRESENTING THE HEALTHCARE COMMUNITY AS WELL AS ALL DEMOGRAPHICS WERE INVITED TO ATTEND. THE FOCUS GROUP INCLUDED LARGE EMPLOYERS AS WELL AS MEMBERS OF SPECIAL INTEREST GROUPS FROM THE COMMUNITY. THIS ENABLED ALL DEMOGRAPHICS TO BE REPRESENTED. DISCUSSIONS TOOK PLACE TO REVIEW A TEMPLATE OF THE SURVEY TO BE DISTRIBUTED, AND SUGGESTIONS WERE MADE TO ENSURE THE SURVEY WOULD BE ACCEPTABLE TO ALL POTENTIAL RESPONDENTS. THE FOCUS GROUP RECOGNIZED THAT HEALTH CARE NEEDS MAY DIFFER BETWEEN GENDERS, ETHNICITY, SEXUAL PREFERENCE, AND AGE. SPECIAL CARE WAS TAKEN TO ENSURE ALL PEOPLE WOULD BE REPRESENTED IN THE RESULTS OF THE SURVEY. THOSE WHO WERE INVITED WERE PASSIONATE ABOUT HELPING THE HOSPITAL AND EXCITED TO CONTRIBUTE TO THE SURVEY. THE SURVEY WAS WRITTEN GO BEYOND THE CURRENT NATIONAL DATA THAT IS READILY AVAILABLE. SVHCD WANTED TO BE ABLE TO SPECIFICALLY LOOK AT THE RESULTS NEEDED TO MEET THE SERVICE NEEDS OF THE COMMUNITY. AFTER REVIEWING AND REVISING THE CHNA SURVEY, SVHCD SENT A LINK FOR THE SURVEY TO COMMUNITY MEMBERS WHO REPRESENTED THE POPULATION AT LARGE AND SPECIFIC DEMOGRAPHICS WITHIN THE COMMUNITY. THE REPRESENTATIVES THEN FORWARDED THAT LINK TO THEIR RESPECTIVE SOCIAL AND WORK CONNECTIONS IN ORDER TO ENSURE THAT POPULATION WAS APPROPRIATELY REPRESENTED IN THE RESPONSES TO THE SURVEY. ADDITIONAL LINKS TO THE SURVEY WERE ALSO PLACED ON THE HOSPITAL'S WEBSITE, FACEBOOK PAGE AND COMMUNITY GROUPS TO MAKE SURE THE COMMUNITY WOULD KNOW HOW TO ACCESS THE SURVEY. FINALLY, PAPER COPIES WERE PLACED IN THE POST OFFICE SINCE THAT IS THE PLACE WHERE MOST OF THE COMMUNITY GOES TO GET THE IMPORTANT UPDATES FOR THE COMMUNITY. WE ALSO ISSUED A MAILER TO ALL ADDRESSES IN THE COMMUNITY TO INCLUDE A SURVEY. AFTER GIVING THE COMMUNITY SEVERAL WEEKS TO RESPOND TO THE SURVEY, OUR SAMPLE SIZE INCLUDED ENOUGH PEOPLE TO ENSURE THAT THE POPULATION WAS REPRESENTED. THE RESPONSES WERE GATHERED AND ANALYZED TO BE PRESENTED TO THE SENIOR LEADERSHIP AND THEN TAKEN TO THE COMMUNITY TO ENSURE THE NEEDS OF THE POPULATION WERE MET. |
| FACILITY 1, SURPRISE VALLEY HEALTH CARE - PART V, LINE 7D | HTTPS://SITES.GOOGLE.COM/VIEW/SVHEALTHCAREDISTRICT/2021-22-COMMUNITY- HEALTH-NEEDS-ASSESSMENT-AND-STRATEGIC-PLAN |
| FACILITY 1, SURPRISE VALLEY HEALTH CARE - PART V, LINE 11 | SVHCD WAS NOT ABLE TO ADDRESS ALL HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA DUE TO NOT CURRENTLY HAVING THE STAFF OR FINANCIAL RESOURCES TO DEVOTE TO THE NEED. SVHCD HAS BEEN WORKING WITH CYCLE OF BUSINESS SINCE THEIR FIRST CHNA IN 2013. THROUGHOUT THIS TIME, THEY HAVE UTILIZED AN OUTLINE TOOL FOR THE CREATION AND EXECUTION OF THEIR IMPLEMENTATION PLAN. THIS HAS ALLOWED THEM TO TRACK PROGRESS ON THE GOALS AND ACCOMPLISHMENTS THEY HAVE SET OUT TO COMPLETE. ONCE THE COMMUNITY HAD GIVEN ITS FEEDBACK ON THEIR NEEDS, SVHCD STAFF REVIEWED THE DATA AND INPUT FROM THE GROUP AND DECIDED ON 4 AREAS OF FOCUS FOR THE CURRENT CHNA AND IMPLEMENTATION PLAN. THEY INCLUDE RECRUITMENT FOR SPECIFIC HOSPITAL NEEDS,EXPANDING THE TELE-HEALTH PROGRAM, MARKETING, AND OUTREACH FOR SPECIFIC SERVICES, AND EXPLORING HOME HEALTH AND HOSPICE THROUGH THE HOSPITAL SYSTEM. RECRUITMENT THE FIRST GOAL OUTLINED BY THE STAFF AND THE COMMUNITY WAS TO "RECRUIT FOR SPECIFIC STAFFING NEEDS OF THE HOSPITAL". RURAL HOSPITALS TEND TO HAVE PROBLEMS RECRUITING STAFF ESPECIALLY NURSES. SVHCD IS NO DIFFERENT AND IS CURRENTLY IN NEED OF NURSES AND CNAS. THIS IS WHY THE FIRST AREA OF FOCUS FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS TO FIND CNAS AND NURSES TO FILL AREAS OF UNDERSTAFFING AT THE HOSPITAL. EXPAND TELE-HEALTH THE SECOND AREA SVHCD LOOKED TO ADDRESS WAS TO EXPAND THE TELE-HEALTH PROGRAM. TELE-HEALTH IS A WAY THAT RURAL HOSPITALS CAN PROVIDE SPECIALTIES THEY COULD NOT OTHERWISE AFFORD TO BRING IN. IT ALLOWS THEM TO ADDRESS A SPECIFIC NEED WHEN THE OVERALL POPULATION COULD NOT SUPPORT A SPECIALIST. DURING THE COVID-19 PANDEMIC OF 2020-2021, THE GENERAL POPULATION BEGAN TO SEE THE BENEFIT OF TELE-HEALTH. PRIOR TO THE PANDEMIC MANY PEOPLE WERE RETICENT TO TRY TELE-HEALTH, HOWEVER, DURING THE PANDEMIC WHEN HOSPITALS WERE RESTRICTING ACCESS, MANY PEOPLE BEGAN TO MEET WITH THEIR PHYSICIAN OVER SMARTPHONES AND TABLETS OPENING THE DOOR TO WIDESPREAD ACCEPTANCE OF TELE-HEALTH OPTIONS. TELE-PSYCH IS A COMMON TELE-HEALTH SERVICE AND A NEEDED SERVICE IN THE AREA. ESPECIALLY DUE TO THE ISOLATION PEOPLE FELT DURING THE PANDEMIC. SVHCD HAS DECIDED TO EXPAND THEIR TELE-HEALTH OFFERINGS TO INCLUDE TELE- PSYCH FOR YOUTH AND ADULTS TO HELP THEM ADDRESS AREAS SUCH AS DEPRESSION AND ANXIETY, FAMILY COUNSELING, AND SUBSTANCE ABUSE ISSUES. IN ORDER TO BETTER FACILITATE THE TELE-HEALTH PROGRAM, IT WAS DECIDED A TELE-HEALTH CARE COORDINATOR SHOULD BE ASSIGNED TO HELP FACILITATE THE APPOINTMENTS AND HELP THE LESS TECH SAVVY. MARKETING AND OUTREACH THE SURVEY MADE CLEAR SOME OF THE SERVICES SVHCD OFFERS, THE COMMUNITY DID NOT KNOW WERE PROVIDED BY THE HOSPITAL. PEOPLE WERE TRAVELING OUTSIDE OF THE AREA FOR SERVICES THEY COULD HAVE EASILY RECEIVED LOCALLY. THESE SERVICES INCLUDED LABORATORY WORK, SOME SPECIALTIES SERVICES AND IMAGING. WITH THE PURCHASE OF THE CT SCANNER, SVHCD WILL WANT TO PROMOTE THESE SERVICES TO RESIDENTS TO SAVE THEM TIME AND MONEY. ESPECIALLY DURING THE WINTER MONTHS WHEN TRAVEL TO OTHER HOSPITALS CAN BE DANGEROUS. THIS MARKETING CAMPAIGN WILL ALSO BE USED TO EDUCATE THE PUBLIC ON COMMON AILMENTS AS WELL AS CLEAR UP ANY MISINFORMATION IN THE COMMUNITY ABOUT THE HOSPITAL AND THE QUALITY OF SERVICES RECEIVED AT SVHCD. HOME HEALTH AND HOSPICE THE POPULATION OF CEDARVILLE IS GROWING DUE TO MORE PEOPLE BEING ABLE TO WORK REMOTELY. HOWEVER, THE AVERAGE AGE OF CEDARVILLE AND THE SURROUNDING AREAS IS RISING. AS THE POPULATION AGES THE NEED FOR SERVICES TO TREAT THE ELDERLY BECOME MORE IMPORTANT. ONE OF THE FINDINGS WITHIN THE SURVEY WAS THE DESIRE FOR THE COMMUNITY TO EXPAND THE ASSISTED LIVING OPTIONS IN THE COMMUNITY AND PROVIDE A HOME HEALTH AND HOSPICE SOLUTION. SVHCD ALREADY HAS DEDICATED MOST OF ITS BEDS TO ASSISTED LIVING, HOWEVER, THERE ARE COMMUNITY MEMBERS WHO WOULD LIKE TO SEE THIS EXPAND AND FOR MORE OPTIONS TO EXIST. HOME HEALTH AND HOSPICE IS ALREADY PROVIDED THROUGH IHSS, BUT IT MAY NEED TO BE PROMOTED TO THOSE IN NEED. THIS COULD BE DONE IN PARTNERSHIP WITH THE HOSPITAL. BY FOCUSING ON THESE 4 AREAS, SURPRISE VALLEY HEALTH CARE DISTRICT LOOKS TO MEET THE NEEDS OF THE COMMUNITY, THEY WILL BE TAKING A FISCALLY RESPONSIBLE APPROACH TO ENSURE THE HOSPITAL NEVER AGAIN FACES POTENTIAL CLOSURE. SVHCD IS TOO IMPORTANT TO THE COMMUNITY IT SERVES. BY TAKING CARE OF THE COMMUNITY, SVHCD HOPES TO REMAIN A VIABLE HEALTH CARE FACILITY FOR DECADES TO COME. SVHCD IS CONTINUALLY ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. |
| FACILITY 1, SURPRISE VALLEY HEALTH CARE - PART V, LINE 15E | PATIENTS ARE REQUIRED TO PROVIDE FINANCIAL DATA SUCH AS APPLICATION, PROOF OF INCOME, BANK STATEMENTS, ETC. THE APPLICATIONS ARE REVIEWED AND EVALUATED FOR CHARITY CARE STATUS AND WRITTEN OFF WHEN APPROPRIATE. |
| FACILITY 1, SURPRISE VALLEY HEALTH CARE - PART V, LINE 16J | THE FINANCIAL ASSISTANCE POLICY IS ALSO VERBALLY DISCUSSED TO A PATIENT WHEN THEY CALL SVHCD OR SVHCD CALLS THEM FOR FOLLOW UP ON PAYMENT STATUS. THE LATEST FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON THE WEBSITE AS FOLLOWS: HTTPS://SITES.GOOGLE.COM/VIEW/SVHEALTHCAREDISTRICT/FINANCIAL-ASSISTANCE |
| FACILITY 1, SURPRISE VALLEY HEALTH CARE - PART V, LINE 24 | THE HOSPITAL CHARGES ALL OF ITS PATIENTS THE SAME RATES. IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE BILL IS ADJUSTED AS DETERMINED BY OUR CHARITY CARE POLICY GUIDELINES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SURPRISE VALLEY RURAL HEALTH CLINIC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 741 N MAIN STREET | AddressLine1Txt |
| City | CEDARVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96104 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | RURAL HEALTH CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART II | MODOC COUNTY IS DESIGNATED AS MEDICALLY UNDERSERVED AND HAS A SHORTAGE IN THE AREA OF HEALTH PROFESSIONALS. THE HOSPITAL IS CONTINUALLY RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ITS RURAL SERVICE AREA TO HELP IMPROVE ACCESS TO HEALTHCARE SERVICES AS IDENTIFIED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT. |
| SCHEDULE H, PART III, LINE 3 | SVHCD 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 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 NOTE C, ON PAGE 15, OF THE AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, LINE 8 | ANY SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. SVHCD'S MEDICARE COST REPORT WAS USED TO DETERMINE THE TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO THE PAYMENTS. THE COSTING METHODOLOGY USED ON THE MEDICARE COST REPORT IS BASED ON CALCULATED COST TO CHARGE RATIOS. |
| SCHEDULE H, PART III, LINE 9B | EVERY REASONABLE EFFORT IS MADE TO DETERMINE THE PATIENT'S ABILITY TO PAY AND TO GIVE PATIENTS INFORMATION ABOUT OUR CHARITY CARE POLICIES. |
| SCHEDULE H, PART VI, LINE 2 | SVHCD ASSESSES THE HEALTH NEEDS OF THE COMMUNITY IT SERVES THROUGH PUBLIC MEETINGS, BOARD MEETINGS, PERFORMANCE IMPROVEMENT AND QUALITY ASSURANCE MEETINGS, AND ACUTE CARE PATIENTS QUESTIONNAIRES. WE ARE CONTINUALLY TAKING IN INFORMATION AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. A COPY OF THE MOST RECENTLY ADOPTED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE AVAILABLE AT THE HOSPITAL UPON REQUEST OR CAN BE FOUND ON THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTPS://SITES.GOOGLE.COM/VIEW/SVHEALTHCAREDISTRICT/2021-22-COMMUNITY- HEALTH-NEEDS-ASSESSMENT-AND-STRATEGIC-PLAN |
| SCHEDULE H, PART VI, LINE 3 | SVHCD PROVIDES PATIENT'S RIGHTS INFORMATION AND COLLECTS ADMISSIONS CRITERIA INFORMATION FROM PATIENTS TO ASSIST THE PATIENT IN UNDERSTANDING THEIR ELIGIBILITY OF ASSISTANCE. |
| SCHEDULE H, PART VI, LINE 4 | THE FACILITY SERVES A RURAL, REMOTE AREA CONSISTING OF UNDERSERVED, FARMING, RANCHING, BUREAU OF LAND MANAGEMENT, FOREST SERVICE, SMALL SCHOOLS, SMALL BUSINESSES, TOURIST TRADE, LOW INCOME, RETIRED AND SEMI- RETIRED RESIDENTS. THE POPULATION OF MODOC COUNTY IS HOVERING BETWEEN 8,506 AND 8,841. ONLY ABOUT 1,200 PEOPLE LIVE IN SVHCD'S PRIMARY SERVICE AREA. |
| SCHEDULE H, PART VI, LINE 5 | BOARD MEMBERS RESIDE IN THE PRIMARY SERVICE AREA RANGING FROM BUSINESS OWNERS TO HOMEMAKERS TO RETIREES REPRESENTING THE COMMUNITY IT SERVES. THIS ELECTED BOARD DEDICATES TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. MEDICAL STAFF PRIVILEGES AT THE HOSPITAL ARE OPEN TO ALL MEDICAL PROVIDERS WITH ACTIVE LICENSURE. WHILE THE CREDENTIALING PROCESS ENSURES PRACTITIONERS OF THE HIGHEST CALIBER ARE PRIVILEGED, PRACTITIONERS FROM NUMEROUS SPECIALTIES ARE ENCOURAGED TO MEET THE EVER EXPANDING HEALTHCARE NEEDS OF THE COMMUNITY. THE HOSPITAL CURRENTLY DOES NOT HAVE ANY SURPLUS FUNDS, HOWEVER ANY SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY, EQUIPMENT, AND EMPLOYEE EDUCATION. WHEN ECONOMICALLY ABLE, THE HOSPITAL WILL HOLD HEALTH FAIRS WHERE FREE OR REDUCED PRICES ARE OFFERED. |
| SCHEDULE H, PART VI, LINE 6 | N/A |
| SCHEDULE H, PART VI, LINE 7 | CALIFORNIA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| LOUIED LAGUNAY | ||||
| LAB MANAGER | $233,685 | $500 | $5,642 | $239,827 |
| ELIZABETH AKINYI | ||||
| RADIOLOGY MANAGER | $232,691 | $500 | $8,896 | $242,087 |
| MELISSA CARTER | ||||
| REGISTERED NURSE | $204,422 | $500 | $20,407 | $225,329 |
| FRANCES HANNAH | ||||
| CEO | $172,351 | $500 | $172,851 | |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KAYLA ERQUIAGA | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY RELATION | RelationshipDescriptionTxt |
| Transaction | $53,954 | TransactionAmt |
| Transaction | EMPLOYMENT | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | TO PROVIDE SAFE, HIGH QUALITY CARE AND PROFESSIONAL EXCELLENCE TO ALL PEOPLE REGARDLESS OF RACE, COLOR, CREED, GENDER, RELIGION, NATIONAL ORIGIN, AGE, MARITAL STATUS, POLITICAL AFFILIATION, MEDICAL CONDITION OR PHYSICAL OR MENTAL DISABILITY. |
| 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. ONCE THE 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 | THE BOARD OF DIRECTORS ARE REQUIRED TO READ AND SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY DISCLOSING ANY CONFLICTS OF INTEREST. IF A POTENTIAL CONFLICT ARISES, THAT BOARD MEMBER OBSTAINS FROM VOTING ON THE ISSUE. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE GOVERNING BOARD DETERMINES THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL USING VARIOUS COMPENSATION DATA FOR THE HEALTH CARE INDUSTRY. DECISIONS ARE MADE BY THOSE WITHOUT CONFLICT AND THE DECISIONS ARE DOCUMENTED. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE PART VI, SECTION B, LINE 15A |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO PUT ON OUR WEBSITE. |
| FORM 990, PART IX, LINE 11G | OTHER FEES 2,243,660 107,748 0 |