CARIBOU MEDICAL CENTER INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- CARIBOU MEDICAL CENTER INC (EIN 86-3190906)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-14
- IRS object ID
- 202413199349310651
- Schema version
- 2023v5.0
- 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 | 2024-11-14T14:45:36-05:00 | ReturnTs |
| Tax Period End | 2023-12-31 | 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 | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 863190906 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARIBOU MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CARI | BusinessNameControlTxt |
| Phone | 2085473341 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 S 3RD WEST | AddressLine1Txt |
| City | SODA SPRINGS | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83276 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KENT LOOSLE | PersonNm |
| Person Title | CEO FROM NOV | PersonTitleTxt |
| Phone | 2085473341 | PhoneNum |
| Signature | 2024-11-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
| 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 | 2024-11-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KENT LOOSLE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 S 3RD WEST | AddressLine1Txt |
| City | SODA SPRINGS | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83276 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $29,491,202 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | CARIBOUMC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2021 | FormationYr |
| Legal Domicile State | ID | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HOSPITAL SERVICES TO THE RESIDENTS OF CARIBOU COUNTY, IDAHO AND THE SURROUNDING COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 227 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $36,786 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,840 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,826,783 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $26,131,415 | CYProgramServiceRevenueAmt |
| PY Investment Income | $77,087 | PYInvestmentIncomeAmt |
| CY Investment Income | $208,369 | CYInvestmentIncomeAmt |
| PY Other Revenue | $202,001 | PYOtherRevenueAmt |
| CY Other Revenue | $163,201 | CYOtherRevenueAmt |
| PY Total Revenue | $23,142,657 | PYTotalRevenueAmt |
| CY Total Revenue | $26,513,825 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $1,000 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $14,514,981 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,943,918 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,572,452 | PYOtherExpensesAmt |
| CY Other Expenses | $10,874,352 | CYOtherExpensesAmt |
| PY Total Expenses | $24,087,433 | PYTotalExpensesAmt |
| CY Total Expenses | $26,819,270 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$944,776 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$305,445 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $20,024,821 | TotalAssetsBOYAmt |
| Total Assets EOY | $21,367,328 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,002,038 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,472,311 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $18,022,783 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $18,895,017 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE HOSPITAL SERVICES TO THE RESIDENTS OF CARIBOU COUNTY, IDAHO AND THE SURROUNDING COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $21,681,779 | ExpenseAmt |
| Grant | $1,000 | GrantAmt |
| Revenue | $26,131,415 | RevenueAmt |
| Desc | CARIBOU MEDICAL CENTER (CMC) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL AND THREE HEALTH CLINICS. CMC PROVIDED 1,222 DAYS OF INPATIENT SERVICES, 15,954 OUTPATIENT VISITS, 2,404 EMERGENCY VISITS, 20 BIRTHS, AND 12,320 CLINIC VISITS. CMC TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY PROVIDING 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 70,895 FOR CHARITY CARE, 2,227,992 FOR MEDICAID, 5,314,010 FOR MEDICARE, AND 2,130,062 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR. | Desc |
| Total Program Service Expenses | $21,681,779 | 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 | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | 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 | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 227 | 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 | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | Yes (true) | LocalChaptersInd |
| Policies Reference Chapters | Yes (true) | PoliciesReferenceChaptersInd |
| 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 | Yes (true) | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RYAN SPEAS | PersonNm |
| Phone | 2085473341 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 S 3RD WEST | AddressLine1Txt |
| City | SODA SPRINGS | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83276 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 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 |
|---|---|---|---|---|---|---|---|
| GREGORY JENSEN | |||||||
| PHYSICIAN | 40.00 | Yes (X) | $488,167 | $0 | $31,148 | ||
| JONATHAN HOUSLEY | |||||||
| PHYSICIAN/CM | 40.00 | Yes (X) | $339,275 | $0 | $46,547 | ||
| ALAN ROBINSON | |||||||
| CFO THRU OCT | 40.00 | $297,076 | $0 | $0 | Yes (X) | ||
| DAVID EDWARDS | |||||||
| PHYSICIAN AS | 40.00 | Yes (X) | $257,000 | $0 | $13,481 | ||
| JENNA JENSEN | |||||||
| PHYSICIAN | 40.00 | Yes (X) | $244,676 | $0 | $28,888 | ||
| JOSHUA TORMAN | |||||||
| PHYSICIAN | 40.00 | Yes (X) | $244,568 | $0 | $40,865 | ||
| DILLON LIECHTY | |||||||
| CEO MAY TO O | 40.00 | $200,323 | $0 | $36,303 | Yes (X) | ||
| CHRISTINA THOMAS | |||||||
| CEO THRU APR | 40.00 | $165,293 | $0 | $7,467 | Yes (X) | ||
| RYAN SPEAS | |||||||
| CFO FROM OCT | 40.00 | $51,419 | $0 | $4,102 | Yes (X) | ||
| KENT LOOSLE | |||||||
| CEO FROM NOV | 40.00 | $37,629 | $0 | $0 | Yes (X) | ||
| WESLEY BROWN | |||||||
| CHAIR | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| LORRAINE MYERS | |||||||
| VICE CHAIR | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| STEPHANIE RINDLISBAKER | |||||||
| SECRETARY/TR | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| CRAIG MANSFIELD | |||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| CURTIS TOONE | |||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| CHARLENE MCCULLOCH | |||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,325,426 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $208,801 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 27 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DIAGNOSTIC IMAGING OF IDAHO LLC | |||||
| 1951 BENCH RD STE F | POCATELLO | ID | 83201 | IMAGING | $377,271 |
| HEALTHCARE SERVICES GROUP INC | |||||
| PO BOX 829677 | PHILADELPHIA | PA | 19182 | DIETARY | $338,778 |
| ALAN ROBINSON | |||||
| 1370 RED FOX TRACE | LOGAN | UT | 84321 | FINANCIAL | $297,076 |
| CERIUM NETWORKS | |||||
| 1636 WEST 1ST AVE | SPOKANE | WA | 99201 | IT SOLUTIONS | $187,757 |
| JUDY PC | |||||
| 3668 SUMMITT DRIVE | POCATELLO | ID | 83201 | SURGEON | $175,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $10,840 | GovernmentGrantsAmt |
| Total Contributions | $10,840 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $26,131,415 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,131,415 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $26,131,415 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $193,718 | TotalRevenueColumnAmt |
| Exclusion | $193,718 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,432 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,432 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,432 | TotalRevenueColumnAmt |
| Exclusion | $9,432 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,992,028 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,977,377 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14,651 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,651 | TotalRevenueColumnAmt |
| Exclusion | $14,651 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| OTHER | 900099 | $85,903 | $85,903 |
| CAFETERIA | 722514 | $67,866 | $67,866 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $153,769 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,513,825 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,131,415 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $371,570 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Program Services | $1,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $454,664 | TotalAmt |
| Management And General | $454,664 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,426,580 | TotalAmt |
| Program Services | $10,722,147 | ProgramServicesAmt |
| Management And General | $1,704,433 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $653,122 | TotalAmt |
| Program Services | $543,649 | ProgramServicesAmt |
| Management And General | $109,473 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,414,546 | TotalAmt |
| Program Services | $1,177,447 | ProgramServicesAmt |
| Management And General | $237,099 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $995,006 | TotalAmt |
| Program Services | $828,227 | ProgramServicesAmt |
| Management And General | $166,779 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,079 | TotalAmt |
| Management And General | $11,079 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $184,431 | TotalAmt |
| Management And General | $184,431 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,332,788 | TotalAmt |
| Program Services | $2,777,153 | ProgramServicesAmt |
| Management And General | $1,555,635 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,532 | TotalAmt |
| Management And General | $32,532 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $582,978 | TotalAmt |
| Program Services | $478,720 | ProgramServicesAmt |
| Management And General | $104,258 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $312,761 | TotalAmt |
| Program Services | $270,408 | ProgramServicesAmt |
| Management And General | $42,353 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192,176 | TotalAmt |
| Program Services | $106,998 | ProgramServicesAmt |
| Management And General | $85,178 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,048 | TotalAmt |
| Program Services | $7,048 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,071,773 | TotalAmt |
| Program Services | $967,890 | ProgramServicesAmt |
| Management And General | $103,883 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,947 | TotalAmt |
| Program Services | $30,653 | ProgramServicesAmt |
| Management And General | $165,294 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $3,409,045 | $3,409,045 | |
| REPAIRS & MAINTENANCE | $278,925 | $266,249 | $12,676 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,869 | TotalAmt |
| Program Services | $95,145 | ProgramServicesAmt |
| Management And General | $167,724 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,819,270 | TotalAmt |
| Program Services | $21,681,779 | ProgramServicesAmt |
| Management And General | $5,137,491 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $514,085 | BOYAmt |
| EOY | $44,168 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,460 | BOYAmt |
| EOY | $37,561 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,175,413 | BOYAmt |
| EOY | $5,573,291 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $385,083 | BOYAmt |
| EOY | $290,382 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $353,890 | BOYAmt |
| EOY | $413,321 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,559,654 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,494,735 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,374,290 | BOYAmt |
| EOY | $10,064,919 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,283,535 | BOYAmt |
| EOY | $2,635,900 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $847,065 | BOYAmt |
| EOY | $2,307,786 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,024,821 | BOYAmt |
| EOY | $21,367,328 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,002,038 | BOYAmt |
| EOY | $2,472,311 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,002,038 | BOYAmt |
| EOY | $2,472,311 | 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 | $18,022,783 | BOYAmt |
| EOY | $18,895,017 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,022,783 | BOYAmt |
| EOY | $18,895,017 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,024,821 | BOYAmt |
| EOY | $21,367,328 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$305,445 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $272,343 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $905,336 | 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 | $2,040 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,040 | 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 | CMC DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. CMC PAYS MEMBERSHIP DUES TO STATE AND NATIONAL HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS 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 | $560,000 | OtherCostOrOtherBasisAmt |
| Book Value | $560,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,910,180 | OtherCostOrOtherBasisAmt |
| Depreciation | $733,793 | DepreciationAmt |
| Book Value | $4,176,387 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,124,356 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,760,942 | DepreciationAmt |
| Book Value | $3,363,414 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,965,118 | OtherCostOrOtherBasisAmt |
| Book Value | $1,965,118 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,064,919 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ESTIMATED THIRD-PARTY SETTLEMENTS | $2,119,000 |
| OTHER RECEIVABLES | $188,786 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,307,786 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $26,786,168 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $272,343 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $272,343 | RevenueNotReportedAmt |
| Revenue Subtotal | $26,513,825 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $26,513,825 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $25,913,934 | TotExpnsEtcAuditedFinclStmtAmt |
| Prior Year Adjustments | -$905,336 | PriorYearAdjustmentsAmt |
| Expenses Not Reported | -$905,336 | ExpensesNotReportedAmt |
| Expenses Subtotal | $26,819,270 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $26,819,270 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL IS ORGANIZED AS AN IDAHO NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOSPITAL IS REQUIRED TO FILE AN ANNUAL 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 HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. AS OF DECEMBER 31, 2023, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. | 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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| 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 |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $48,209 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $48,209 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,275,533 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,588,968 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $686,565 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02560 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,323,742 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,588,968 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $734,774 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02740 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,313 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,313 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,701,137 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $454,189 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,246,948 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04650 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,556 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,556 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,734,006 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $454,189 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,279,817 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04770 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,057,748 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,043,157 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,014,591 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07510 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,513 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,513 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,645 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,645 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,944 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $88,944 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $115,102 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $115,102 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00430 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,054,976 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $9,525,329 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,609,240 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$83,911 | 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 | CARIBOU MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 S 3RD WEST | AddressLine1Txt |
| City | SODA SPRINGS | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83276 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | CARIBOUMC.ORG | WebsiteAddressTxt |
| State License | 37 | 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 | CARIBOU MEDICAL CENTER | BusinessNameLine1Txt |
| 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 | 23 | 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 | HTTPS://CARIBOUMC.ORG/CHNA/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 23 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://CARIBOUMC.ORG/CHNA/ | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | CARIBOUMC.ORG/SERVICES/PAYMENTCOUNSELI | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | CARIBOUMC.ORG/SERVICES/PAYMENTCOUNSELI | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | CARIBOUMC.ORG/SERVICES/PAYMENTCOUNSELI | 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 |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| 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 Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, CARIBOU MEDICAL CENTER - PART V, LINE 3E | IDENTIFICATION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS BEGIN ON PAGE 17 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. |
| FACILITY 1, CARIBOU MEDICAL CENTER - PART V, LINE 5 | QUALITATIVE AND QUANTITATIVE DATA WERE USED TO COMPLETE THE 2023 CHNA AND IDENTIFY COMMUNITY HEALTH PRIORITIES. THE ASSESSMENT WAS DESIGNED TO PROVIDE A COMPREHENSIVE AND BROAD PICTURE OF THE HEALTH IN THE OVERALL COMMUNITY SERVED. CMC TOOK INTO ACCOUNT INPUT FROM COMMUNITY MEMBERS REGARDING THE HEALTH NEEDS OF CARIBOU COUNTY. A GROUP OF INDIVIDUALS THAT REPRESENTED THE INTERESTS OF THE COUNTY AND/OR HAD SPECIFIC EXPERTISE REGARDING THE HEALTH NEEDS OF VULNERABLE AND UNDERSERVED POPULATIONS WERE ASKED TO PARTICIPATE IN IDENTIFYING PRIORITY HEALTH NEEDS AND SERVICES. REPRESENTATIVES INCLUDE LOCAL GOVERNMENT, THE CHURCH, MEDICAL PROVIDERS, CMC BOARD OF DIRECTORS, CMC FOUNDATION BOARD OF DIRECTORS, AND CMC. |
| FACILITY 1, CARIBOU MEDICAL CENTER - PART V, LINE 11 | TO PRIORITIZE THE SIGNIFICANT HEALTH NEEDS AND SERVICES OF CARIBOU COUNTY, THE TOP THREE SELECTIONS MADE BY EACH MEETING PARTICIPANT WERE SUBMITTED AND THEN GROUPED TOGETHER BY LIKE TOPIC. THE GROUP DISCUSSED THE OUTCOME AND DETERMINED THAT THE TOPICS WITH THE HIGHEST NUMBER OF SELECTIONS WERE THE TOP PRIORITIES. BELOW IS THE LIST OF PRIORITIZED HEALTH NEEDS AND SERVICES FOR CARIBOU COUNTY THAT WERE GENERATED BY THE COMMUNITY PARTNERS MEETING PARTICIPANTS. CHRONIC DISEASE BEHAVIORAL/MENTAL HEALTH PREVENTIVE CARE/HEALTH EDUCATION ALL PRIORITY HEALTH NEEDS WILL BE ADDRESSED USING THE FOLLOWING STRATEGIES: IMPLEMENT EDUCATIONAL PROGRAMS ABOUT CHRONIC DISEASE IN COLLABORATION WITH PARTNERS. ASK PROVIDERS TO ASSIST AND BE MORE INVOLVED AS COMMUNITY HEALTH EDUCATORS. SEEK LOCAL GRANTS TO FUND CHRONIC DISEASE PREVENTION INITIATIVES. LEVERAGE THE EXISTING CARE MANAGEMENT PROGRAM TO FURTHER ASSIST PATIENTS WITH CHRONIC DISEASE. TRAIN APPROPRIATE STAFF TO COMPLETE AN ANNUAL WELLNESS VISIT TO ESTABLISH PATIENT CARE PLANS AND DEVELOP A METHODOLOGY TO FOLLOW UP AND MAKE SURE THE PATIENTS CARE MANAGEMENT PLAN IS EXECUTED. PROVIDE EARLY EDUCATION ON BEHAVIORAL/MENTAL HEALTH AND SUPPORT NETWORKS THAT INCLUDES UTILIZATION OF SOCIAL MEDIA AND OTHER PLATFORMS TO PROMOTE BEHAVIORAL/MENTAL HEALTH PROGRAMMING USING A COHESIVE APPROACH WITH OTHER PARTNERS FOR IMPROVED REACH AND IMPACT. IMPROVE ACCESS AND AWARENESS OF MENTAL HEALTH SERVICES FOR THE CARE MANAGEMENT POPULATION USING COLLABORATIVE CARE MANAGEMENT. PROVIDE INCREASED AWARENESS AND ACCESS TO GENERAL BEHAVIORAL HEALTH NEEDS BY ENCOURAGING PATIENTS TO GET INITIAL BEHAVIORAL SCREENINGS AT THE CLINICS WITH THEIR PCP FOR THE PCP TO REFER TO RESOURCES IN THE COMMUNITY. CONDUCT HEALTH FAIRS AND WELLNESS PROGRAMS. EDUCATE THE COMMUNITY THROUGH SOCIAL MEDIA AND LOCAL EVENTS. COLLABORATE WITH INSURANCE PROVIDERS TO PROMOTE PREVENTIVE HEALTHCARE BENEFITS SUCH THAT THE PATIENTS WHO QUALIFY ARE AWARE, ENROLL AND USE THE BENEFIT. WE ARE CONTINUALLY ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. |
| FACILITY 1, CARIBOU MEDICAL CENTER - PART V, LINE 16J | THE FINANCIAL ASSISTANCE POLICY IS ALSO VERBALLY DISCUSSED TO A PATIENT WHEN THEY CALL THE HOSPITAL OR THE HOSPITAL CALLS THEM FOR FOLLOW UP ON PAYMENT STATUS. THE LATEST FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON THE HOSPITAL WEBSITE. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7G | THE HOSPITAL HAS INCLUDED COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES IN PART I, LINE 7G IN THE AMOUNT OF 660,786 IN COLUMN C AND 200,557 IN COLUMN D. |
| 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 II | CARIBOU 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 |
| SCHEDULE H, PART III, LINE 2 | BAD DEBT EXPENSE ON LINE 2 IS REPORTED AT CHARGES. |
| 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 5 ON PAGE 11 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 8 BEGINNING ON PAGE 13 OF THE AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, LINE 8 | MEDICARE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. PROVIDING THESE SERVICES IS ESSENTIAL TO PATIENTS AND THE COMMUNITY AND INCREASES ACCESS TO HEALTHCARE SERVICES REGARDLESS OF PATIENTS ABILITY TO PAY AND/OR THE REIMBURSEMENT EXPECTED TO BE RECEIVED FROM MEDICARE, MEDICAID OR OTHER PAYERS. THEREFORE, ANY MEDICARE PATIENT CARE SHORTFALLS SHOULD BE INCLUDED AS COMMUNITY BENEFIT. |
| SCHEDULE H, PART III, LINE 9B | IF A PATIENT IS UNABLE TO PAY THEIR BILL AS SPECIFIED IN THE BILLING/COLLECTION POLICY, THE HOSPITAL COLLECTS CHARITY CARE AND MEDICAID APPLICATIONS. IF THE PATIENT IS SELF PAY WITHOUT INSURANCE AND DOES NOT QUALIFY FOR ANY GOVERNMENT PROGRAMS SUCH AS MEDICAID, MEDICARE, ETC, WE DETERMINE IF THEY ARE ELIGIBLE FOR OUR FINANCIAL ASSISTANCE PROGRAM WITH THE ASSISTANCE OF A PATIENT FINANCIAL COUNSELOR (PFC). A PFC WILL ALSO HELP SET UP A PAYMENT PLAN OR HELP WITH OTHER SOURCES OF FINANCIAL ASSISTANCE AND GOES OVER THE IN-HOUSE CHARITY CARE GUIDELINES AND APPLICATION WITH THE PATIENT. PATIENTS ARE REQUIRED TO PROVIDE FINANCIAL DATA SUCH AS TAX INFORMATION AND ASSET DETAIL AND WILL NOT BE CONSIDERED CHARITY CARE UNTIL MEDICAID DENIES THEIR CLAIM. THE APPLICATIONS ARE REVIEWED AND EVALUATED FOR CHARITY CARE STATUS AND WRITTEN OFF WHEN APPROPRIATE. ONCE A PATIENT APPLIES FOR FINANCIAL ASSISTANCE, WE HOLD ALL COLLECTIONS EFFORTS UNTIL A DETERMINATION IS MADE. |
| SCHEDULE H, PART VI, LINE 2 | THE BOARD OF DIRECTORS, MANAGEMENT, AND HOSPITAL DEPARTMENT STAFF AND MANAGERS 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 HOSPITAL ALSO REVIEWS LOCAL THIRD PARTY HEALTH DATA, SUCH AS DATA FROM THE HEALTH DEPARTMENT. COPIES ARE AVAILABLE AT THE HOSPITAL UPON REQUEST OR THE MOST RECENTLY ADOPTED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY OR A COPY CAN BE FOUND AT THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTPS://CARIBOUMC.ORG/CHNA/ |
| SCHEDULE H, PART VI, LINE 3 | THE HOSPITAL DISTRIBUTES ITS CHARITY CARE AND FINANCIAL ASSISTANCE POLICY INFORMATION TO THE COMMUNITY IN A VARIETY OF WAYS. IT IS DISPLAYED IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. IT ALSO PROVIDES A COPY OF THE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ITS ADMISSION PACKET AS PART OF THE INTAKE PROCESS AND ALSO INCLUDED WITH DISCHARGE MATERIALS. ASSIGNED HOSPITAL STAFF ALSO DISCUSSES WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, AS APPLICABLE. THE INFORMATION IS ALSO AVAILABLE ON THE HOSPITAL WEBSITE AND INCLUDED WITH EVERY PATIENT ACCOUNT STATEMENT. THE LATEST FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON OUR WEBSITE AT THE FOLLOWING URL: HTTPS://CARIBOUMC.ORG/WP-CONTENT/UPLOADS/CMC-%E2%80%93-FINANCIAL- ASSISTANCE-PROGRAM-POLICY.PDF |
| SCHEDULE H, PART VI, LINE 4 | THE HOSPITAL IS CURRENTLY THE ONLY HOSPITAL PROVIDER IN SODA SPRINGS, IDAHO AND SERVES RESIDENTS OF CARIBOU COUNTY, IDAHO AND THE SURROUNDING COMMUNITY. CARIBOU COUNTY IS FEDERALLY-DESIGNATED A MEDICALLY UNDERSERVED AREA WHICH HAS A LOW INCOME RURAL POPULATION. THE COUNTY COVERS 1,766 SQUARE MILES WITH A POPULATION OF APPROXIMATELY 7,000. AS OF THE 2023 CENSUS, THE RACIAL MAKEUP OF THE COUNTY WAS 92.3% WHITE, 0.7% AMERICAN INDIAN, 0.2% PACIFIC ISLANDER, 0.2% ASIAN, 0.1% BLACK OR AFRICAN AMERICAN, 2.3% FROM OTHER RACES, AND 1.5% FROM TWO OR MORE RACES. THOSE OF HISPANIC OR LATINO ORIGIN MADE UP 4.8% OF THE POPULATION. THE MEDIAN INCOME FOR A HOUSEHOLD IN THE COUNTY WAS 65,528 AND THE AVERAGE INCOME FOR A HOUSEHOLD WAS 76,059. THE PER CAPITA INCOME FOR THE COUNTY WAS 27,357. ABOUT 7.9% OF FAMILIES AND 7.9% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 8.86% OF THOSE UNDER AGE 18 AND 5.0% OF THOSE AGE 65 OR OVER. THE HOSPITAL HAS BEEN SERVING THE HEALTHCARE NEEDS OF CARIBOU COUNTY AREA SINCE 1923. THE 25 BED CRITICAL ACCESS HOSPITAL FACILITY WAS BUILT IN 1969 ALONG ALEXANDER RESERVOIR. IN AUGUST 2021, COUNTY-OWNED CARIBOU MEMORIAL HOSPITAL TRANSITIONED TO A NON-PROFIT 501(C)(3) ENTITY CALLED CARIBOU MEDICAL CENTER. THE HOSPITAL OFFERS A CONTINUUM OF CARE INCLUDING INPATIENT HOSPITAL SERVICES, OUTPATIENT SERVICES AS WELL AS AN OUTPATIENT CLINIC IN THE CITY OF GRACE, IDAHO. |
| SCHEDULE H, PART VI, LINE 5 | THE HOSPITAL'S BOARD MEMBERS RESIDE IN THE PRIMARY SERVICE AREA INCLUDING BANCROFT, GRACE, SODA SPRINGS AND OTHER INCORPORATED AND UNICORPORATED AREAS OF THE COUNTY RANGING FROM BUSINESS OWNERS TO RETIREES REPRESENTING THE COMMUNITY IT SERVES. THIS VOLUNTEER 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. AS A NON-PROFIT CORPORATION, THE HOSPITAL DOES NOT HAVE ANY SHAREHOLDERS AND SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY, EQUIPMENT, AND EMPLOYEE EDUCATION. THE ABSENCE OF SHAREHOLDERS ELIMINATES THE POTENTIAL FOR CONFLICTS OF INTEREST RELATED TO INFLATED PROFIT MARGINS AND ALLOWS THE HOSPITAL TO FOCUS ON MEETING THE HEALTH AND WELFARE NEEDS OF THE COMMUNITIES WE SERVE. THE HOSPITAL PARTICIPATES IN MULTIPLE ACTIVITIES WITHIN ITS COMMUNITY TO PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES INCLUDING A HEALTH FAIR EACH YEAR WHERE MEDICAL TESTS ARE PROVIDED AT REDUCED PRICES TO ENSURE THE COMMUNITY KNOWS THEIR NUMBERS AND RISKS, FOCUSING ON PREVENTION AND INTERVENTION. CMC PAUSED ITS COMMUNITY HEALTH FAIR DURING THE COVID PANDEMIC, AND RESUMED OFFERING A HEALTH FAIR TO THE COMMUNITY ON MAY 10, 2024. THE HOSPITAL ALSO PROVIDES VARIOUS SEMINARS, CLASSES AND EVENTS FREE OF CHARGE TO THE COMMUNITY TO PROMOTE HEALTH WITHIN THE COMMUNITY. IN ADDITION, THE HOSPITAL IS CONTINUALLY WORKING 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 J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| GREGORY JENSEN | ||||
| PHYSICIAN | $488,167 | $22,500 | $8,648 | $519,315 |
| JONATHAN HOUSLEY | ||||
| PHYSICIAN/CMO | $339,275 | $26,199 | $20,348 | $385,822 |
| ALAN ROBINSON | ||||
| CFO THRU OCT | $297,076 | $297,076 | ||
| DAVID EDWARDS | ||||
| PHYSICIAN ASSIST | $257,000 | $13,481 | $270,481 | |
| JENNA JENSEN | ||||
| PHYSICIAN | $244,676 | $15,728 | $13,160 | $273,564 |
| JOSHUA TORMAN | ||||
| PHYSICIAN | $244,568 | $20,464 | $20,401 | $285,433 |
| DILLON LIECHTY | ||||
| CEO MAY TO OCT | $200,323 | $15,955 | $20,348 | $236,626 |
| CHRISTINA THOMAS | ||||
| CEO THRU APR | $165,293 | $4,247 | $3,220 | $172,760 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WHITNEY LIECHTY | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY | RelationshipDescriptionTxt |
| Transaction | $35,074 | TransactionAmt |
| Transaction | EMPLOYMENT | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE 990 IS PROVIDED TO THE CEO, CFO, AND THE BOARD CHAIR, WHO REVIEW THE FORM, SCHEDULES, AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER. ONCE MANAGEMENT IS SATISFIED WITH THE 990, A FINAL APPROVAL IS GIVEN TO THE PREPARER BEFORE FINALIZING THE RETURN. |
| FORM 990, PAGE 6, PART VI, LINE 12C | CMC SHALL DISCLOSE ANY EXISTING OR POTENTIAL CONFLICTS OF INTEREST FOR THOSE WHO PROVIDE CARE, TREATMENT AND SERVICES AS WELL AS MANAGEMENT AND GOVERNANCE ACTIVITIES. ALL CONFLICTS OF INTEREST, INCLUDING POTENTIAL CONFLICTS OF INTEREST, SHALL BE RESEARCHED AND ADDRESSED IN AN EFFORT TO RESOLVE THE CONFLICT OF INTEREST ABIDING BY STATE AND FEDERAL LEGAL REGULATIONS AND REQUIREMENTS. A MEMBER OF THE GOVERNING BODY OR A MEMBER OF A COMMITTEE, WHEN CALLED UPON TO CAST A VOTE FOR OR AGAINST A MATTER WHICH PERSONALLY INVOLVES SUCH INDIVIDUAL, SHALL DISCLOSE HIMSELF/HERSELF INELIGIBLE TO VOTE ON THE GROUNDS OF CONFLICT OF INTEREST. IN CASES WHERE CONFLICT OF INTEREST IS NOT CLEARLY APPARENT, OR WHEN SUCH CONFLICT IS NOT DECLARED BY A PERSON WHO IN THE OPINION OF OTHER MEMBERS HAS POTENTIAL CONFLICT, THE CONFLICT OF INTEREST ISSUE MAY BE BROUGHT BEFORE THE BODY WHO SHALL VOTE ON SUCH ISSUE TO DETERMINE WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. SHOULD THERE BECOME KNOWN, AT ANY TIME, A CONFLICT OF INTEREST BETWEEN ANY MEMBER OF THE GOVERNING BODY AND THE HOSPITAL OR ANY OF ITS AGENTS, THE INDIVIDUAL(S) MAY EXCUSE HIMSELF/HERSELF FROM DISCUSSIONS AND/OR DETERMINATIONS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE MAIN SOURCES AVAILABLE TO THE HOSPITAL IN REGARD TO FAIR MARKET VALUE IN SALARIES IS THE IDAHO HOSPITAL ASSOCIATION (IHA) ANNUAL SURVEY AND MGMA DATA. THIS DATA IS UTILIZED BY THE HOSPITAL TO ESTABLISH WAGE SCALES AND TO DETERMINE THE CEO'S COMPENSATION. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE CEO ALSO UTILIZES THE ANNUAL EVALUATION PROCESS AND THE IHA SURVEY AND MGMA DATA TO REVIEW AND APPROVE THE CFO AND SUPERVISORS' COMPENSATION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | CMC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | 2,777,153 1,555,635 0 |