2024-11-14T11:19:00-06:00 2023-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-01-01 880405927 Washoe Barton Medical Clinic WASH 7757821500 1107 Hwy 395 Gardnerville NV 89410 Colleen Reid CFO 7757821500 2024-11-14 1 1 Kim Hunwardsen CPA P00484560 6122536500 2024-11-12 2023 2024-10-15 13:58:12Z Carson Valley Health Colleen Reid 1107 Hwy 395 Gardnerville NV 89410 122895089 0 X carsonvalleyhealth.org X 1999 NV Nevada non-profit corporation which operates as the sole hospital in the county. 6 6 661 17 0 0 2626560 9745 85245101 97664271 1306012 3649978 249518 205286 89427191 101529280 0 0 0 0 36402214 41035958 0 0 157279 42215350 48205772 78617564 89241730 10809627 12287550 162865064 182067455 59630726 63965167 103234338 118102288 X Our mission is to care for your health and wellness. Our vision is to strengthen our community by providing accessible, affordable, high quality healthcare to all. 0 0 53448381 0 53615094 Washoe Barton Medical Clinic dba Carson Valley Health:Carson Valley Health, a 23-bed critical access hospital, covers a service area that includes approximately 50,000 residents. A focus on patient centered care and quality have resulted in Carson Valley Health consistently ranking high in patient satisfaction on both inpatient and outpatient consumer satisfaction surveys. Carson Valley Health facilities include a full-service hospital, Emergency Room, Infusion, Lab, Medical Imaging, Physical and Respiratory Therapy, Senior Mental Health, Sleep & Neurodiagnostic Lab, Wound Care and Telemedicine. Clinics include Carson Valley Health Senior Care (a provider-based clinic servicing patients over 65), (continued on Schedule O)Job's Peak Internal Medicine & Family Practice, Topaz Ranch Medical Clinic, Minden Family Medicine and Complete Care, Ironwood Primary Care, Ironwood Urgent Care and Occupational Health Clinics. 10853132 0 28685837 Pharmacy:Program expenses are used in the provision of health care services to the community. Carson Valley Health provides inpatient and outpatient pharmaceutical services for the hospital and outpatient clinics. In 2023, there were higher patient acuities and more patient volume than the previous year. In 2023 213,698 pharmacy orders were processed. 9602727 0 15363340 Surgery:Program expenses are used in the provision of surgical services to the community. Carson Valley Health provides inpatient and outpatient surgery services. Emergency and elective surgeries are performed by general and specialty surgeons. In 2023, 1,875 surgeries were performed at Carson Valley Health. 73904240 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 191 0 1 661 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 X Colleen Reid 7757821649 1107 Highway 395 N Gardnerville NV 89410 Clint Purvance Chairman 0.50 0.00 X X 0 0 0 Kelly Neiger Secretary 0.50 0.00 X X 0 0 0 Ann Beck Board Member 0.50 0.00 X 0 0 0 Brian Earling MD Board Member 0.50 0.00 X 0 0 0 Paul Fry III MD Board Member 0.50 0.00 X 0 0 0 Rahul Mediwala Board Member 0.50 0.00 X 0 0 0 Jeff Prater CEO 40.00 1.00 X 474697 0 43529 Colleen Reid CFO 40.00 0.00 X 283128 0 43928 Brandon Battis Pharmacy Manager 40.00 0.00 X 202645 0 51644 Leslie McGraw Physician Assistant 40.00 0.00 X 182790 0 35178 Shannon Rogers Director of Operations 40.00 0.00 X 200140 0 36369 Valerie Harrell Medical Imaging Supervisor 40.00 0.00 X 175848 0 33543 Andrea Highfill Chief Nursing Officer 40.00 0.00 X 171130 0 20941 1690378 0 265132 62 0 1 0 Renown Health Medical Group 780 Kuenzli St Suite 202 Reno NV 89502 Physician Salaries, Physician Read Fees 6274145 Leman Medical Corp 1122 Monterra Drive Minden NV 89423 ER Physician Group 2919070 Aya Healthcare Inc Po Box 123519 Dallas TX 75312 Contract Labor 1049981 Renown Health 1155 Mill Street - Z5 Reno NV 89502 EMR Support 1000081 Barton Healthcare Systems 2170 South Ave South Lake Tahoe CA 96150 I.T. Services and Equipment, Lab Service 766256 23 9745 9745 Net Patient Services 621400 96457338 96457338 Other Supporting Revenue 900099 1206933 1206933 97664271 3640301 3640301 205286 0 205286 205286 205286 21375486 21365809 9677 9677 9677 101529280 97664271 0 3855264 X 845283 845283 31231633 25772006 5362666 96961 677186 506467 168300 2419 5943129 4740758 1168792 33579 2338727 1908278 423975 6474 53540 53540 124281 124281 120689 120689 978 978 19126 19126 19491541 16044831 3443410 3300 572006 22440 542046 7520 842063 494689 344261 3113 385396 21849 363531 16 1138497 853455 284463 579 56391 21442 32147 2802 327148 145377 181646 125 189660 163673 25987 4070907 3513117 557790 564888 22410 542478 Medical Supplies 19192201 19045427 146774 NV Provider Fee 325464 325464 Equipment Rental/Lease 163309 152577 10732 Licenses & Taxes 70818 56061 14757 496869 92941 403537 391 89241730 73904240 15180211 157279 30648729 40060520 1465248 0 14828176 13827623 2089362 2186380 579773 769959 101197674 37067588 43569976 64130086 68976170 57423553 707630 854410 0 2814924 162865064 182067455 10166001 14421725 46370760 45915586 410139 502004 2683826 3125852 59630726 63965167 X 99237037 114474876 3997301 3627412 103234338 118102288 162865064 182067455 X 12287550 2590460 -10060 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 978 978 0 Form 990, Schedule C, Part II-B, Line 1i: Dues paid to associations that are required to report lobbying activities. The portion attributable to lobbyng activities as reported by the associations was $978. 187000 3428979 3615979 42892349 22689724 20202625 18841254 13477941 5363313 35848092 899923 34948169 64130086 Estimated Third Party Payor Settlements 1981560 Finance Lease 1144292 3125852 X 104227593 2590460 126979 2717439 101510154 19126 19126 101529280 89250745 28141 28141 89222604 19126 19126 89241730 Part X, Line 2: The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Eliminate Foundation Activity for Separately Filed Form 990 126,979. Part XII, Line 2d - Other Adjustments: Eliminate Foundation Activity for Separately Filed Form 990 28,141. 1 1 X 1 X 1 X 1 1 1 0 0 995000 995000 0.01110 6714810 5078893 1635917 0.01830 7709810 5078893 2630917 0.02940 952704 84277 868427 0.00970 26122849 17409619 8713230 0.09760 27075553 17493896 9581657 0.10730 34785363 22572789 12212574 0.13670 4 840 840 0.00000 1 600 600 0.00000 5 1440 1440 0.00000 1 2594907 29365 30474566 30380027 94539 X 1 1 1 1 Washoe Barton Medical Clinic 1107 Hwy 395 Gardnerville NV 89410 carsonvalleyhealth.org 3986RUH-14 X X X X 2 provider based clinics Carson Valley Health 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X See Section C, line 7d X 1 22 1 See Section C, line 7d 0 1 X 200.000000000000 350.000000000000 X X X 1 1 X X X X 1 X See Part V, Line 16a X See Part V, Line 16b X See Part V, Line 16c X X X X X X X 1 X 0 X X X X 1 X 0 0 Carson Valley Health Part V, Section B, Line 5: To solicit input from community stakeholders (key informants), those individuals who have a broad interest in the health of the community, an Online Key Informant Survey was implemented as part of this process. A list of recommended participants was provided by Carson Valley Health; this list included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey, and providing a link to take the survey online. Carson Valley Health Part V, Section B, Line 7d: https://www.carsonvalleyhealth.org/about-us/health-needs-assessment/ Carson Valley Health Part V, Section B, Line 11: In the 2022 CVH Community Health Needs Assessment, the overall health of Douglas County was found to be favorable in comparison to the state and country. The report identifies the following 9 areas of health needs for Douglas County: 1. Mental Health 2. Potentially Disabling Conditions 3. Substance Abuse 4. Heart Disease and Stroke 5. Nutrition, Physical Activity, and Weight 6. Access to Healthcare Services 7. Cancer 8. Oral Health 9. Infant Health and Family Planning The following health needs identified in the Community Health Needs Assessment are better suited for other community organizations to address and CVH will support these organizations in their efforts: 1. Potentially Disabling Conditions 2. Substance Abuse 3. Oral Health 4. Infant Health & Family Planning In 2023 we addressed the following from our 2022 CHNA:Mental Health:1) Increase Number of Mental Health Providers: In 2023 we employed eight mental health providers. 2) Increase Number of Patients Served Dealing with Depression: In 2023 we treated 16% more patients with the primary diagnosis of depression.3) Support Local Partners. CVH supports the Suicide Prevention Network through assigning Erin Dudley, CVH Behavioral Health Manager, as a board member. CVH also donated $5000 in 2023 to support Suicide Prevention Network's programs and initiatives. Heart Disease and Stroke:1) Increase Cardiology Providers at CVH: In 2023, CVH contracted with a cardiology group who provided four cardiologists to cover the Carson Valley, seeing patients in two CVH clinics. 2) Increase Heart Health Community Screenings: In 2023, we provided 23 heart health discounted wellness screenings.Nutrition, Physical Activity and Weight:1) Host Community Education: In 2023 we included nutritional advice and resources in our bi-annual community mailer as well as our monthly e-newsletter and social media.2) Support Groups: In 2023 we offered 12 sessions of our Weight Management for Diabetics support group and provided 59 discounted nutritional counseling sessions.Access to Health Care Services: 1) Recruit New Primary Care Physicians: In 2023 CVH added four new primary care providers to serve the community.2) Increase number of primary care visits: In 2023 we saw a 7% increase in primary care visits.Cancer:1) Increase number of mammograms performed: In 2023, CVH performed 2715 mammograms. This was a decrease from the previous year due to staffing levels. Carson Valley Health Part V, Section B, Line 16j: English and Spanish are readily available and if another language is needed, then the FAP is translated into that language. Part V, Line 16a-16c Line 16a: https://www.carsonvalleyhealth.org/documents/content/COMMUNITY-CARE-POLICY-0223.pdfLine 16b: https://www.carsonvalleyhealth.org/documents/content/FinancialAssitanceApplication.pdfLine 16c: https://www.carsonvalleyhealth.org/documents/content/FAP-English.docx.2).pdf 7 1 - Carson Valley Health at Minden Village 1649 Lucerne St Unites A B Minden NV 89423 Medical Clinic 2 - CVH Primary Care at Ironwood 897 Ironwood Dr Minden NV 89423 Medical Clinic 3 - CVH Occupational Medicine 897 Ironwood Drive Minden NV 89243 Medical Clinic 4 - Carson Valley Health Urgent Care 897 Ironwood Dr Minden NV 89423 Medical Clinic 5 - CVH Primary Care Virginia Ranch 1520 Virginia Ranch Rd Unit B Gardnerville NV 89410 Medical Clinic 6 - CVH Primary Care at Topaz Ranch 3919 Carter Wellington NV 89444 Medical Clinic 7 - Specialty Care 897 Ironwood Dr Minden NV 89423 Medical Clinic Part I, Line 7: Line 7a:Financial Assistance was calculated by multiplying the ratio of cost to gross charges for the Organization by the gross uncompensated charges associated with providing charity care to its patients.Line 7b and 7g:Unreimbursed Medicaid and Subsidized Health Services are calculated using the cost report and analyzing the Medicare ratio of cost to charge for the respective cost centers. Line 7e:Community health improvement services are actual costs reported in the general ledger. Line 7i:Cash and in-kind donations are actual costs reported in the general ledger. Part I, Line 7g: Carson Valley Health runs seven physician clinics to treat patients in the community. The clinics need to be subsidized by the hospital to meet their payroll and other monthly expense needs. The subsidized health services amount includes $4,832,040 associated with two rural health clinics and $7,779,967 from physician clinics. Part II, Community Building Activities: Community Support includes support groups provided to the community including nutrition, weight loss, grief and mental health. Coalition building includes participation in a community mental health coalition. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Part III, Line 3: The Hospital estimated the amount of implicit price concessions attributable to patients eligible under the organization's financial assistance policy by applying the percentage of charity care to total patient gross charges to the implicit price concessions. Part III, Line 4: The financial statement footnote regarding implicit price concessions may be found on page 16 and 17 of the attached financial statements. Part III, Line 8: Total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: The general billings and collections policy applies to all patients, including any application under the charity care policy. The Hospital does not send patient accounts to collections before 120 days of the date of the first invoice. The Hospital will pull back patient accounts from collections if a patient submits a financial assistance application within 240 days of the date of the first invoice. Part VI, Line 2: In addition to the community health needs assessment, CVH regularly assesses data trends and utilization data from internal sources as well as secondary sources (state and local agencies, Nevada Rural Hospital Partners, Nevada Hospital Association, etc.) to assess community need. CVH partners with local development authority, Chambers of Commerce, and government committees to ensure CVH is responding to the needs of the community. Part VI, Line 3: Communication is via website, brochures, telephone and in person. Website is https://www.carsonvalleyhealth.org/patients-visitors/financial-assistance/ Part VI, Line 4: Carson Valley Health (CVH), serves Douglas County which is an area spanning 710 square miles and includes eight ZIP codes: 89705 (south Carson City), 89460 (Gardnerville Ranchos), 89411 (Genoa), 89423 (Minden), 89448 (Zephyr Cove), 89449 (Stateline), 89444 (Topaz Ranch) and 89410 (Gardnerville). It also includes outlying areas that include Wellington NV, Markleeville, CA and Coleville, CA. This broad area encompasses various neighborhood settings, including both rural and suburban areas. CVH is in Douglas County, NV, which has a population of 49,463 (80% white, 14% Hispanic, 2% Native American). Median household income is $61,176, with 9.8 percent of population in poverty. (Data from Carson City Health & Human Services: Primary & Secondary Data Sets, 2019). Part VI, Line 5: The majority of the organization's board of directors is comprised of persons serving in the medical community of the greater Northern Nevada area. The organization extends medical staff privileges to credentialed and approved practitioners in its community. The organization's mission is to promote the health and wellness of the Carson Valley and its visitors. Surplus funds are used to acquire equipment and resources that improve patient care.CVH Emergency Room available to all patients, regardless of ability to pay.CVH is committed - as the community hospital - to promote the health of the members of the community. We do so through community outreach and wellness programs, including reaching out to local employers in our workplace wellness programs and offering low cost and free screenings to detect and prevent illness and disease. The hospital operates a 24 hour emergency room for medically necessary care to all regardless of ability to pay. The hospital participates in education and training of healthcare professionals. The hospital participates in government-sponsored health programs such as all Medicaid, Medicare, Tricare, all Veterans Administration healthcare and Indian Health Services. The organization is the sole community hospital in Douglas County. The organization currently has 17 active volunteers. The organization has numerous employees involved in local and state community programs including Douglas County Business Council, Minden Rotary, Carson Valley Chamber of Commerce, Nevada Rural Hospital Partners, National Association for Healthcare Quality, American Hospital Association, MGMA, Boy Scouts of America, Family Support Council of Douglas County, Partnership of Community Resources, Tahoe Youth and Family Services, Kiwanis, and the Douglas County Community and Senior Center.Community outreach and education are provided to our community members to increase awareness of prevalent health issues and promote healthy behaviors and lifestyles. Programs include workplace wellness, health fairs, career days, and services provided at large-scale community events. The organization is responsive to the community needs such as opportunities for community involvement in governance and advisory groups. The organization serves as a vehicle for attracting and effectively using donated funds. Part VI, Line 6: Although this hospital is not in an affiliated health system, it does have two members, each about 45 miles away serving different communities. X X 0 0 0 0 0 0 0 0 0 Jeff Prater CEO 384628 0 88275 0 1794 0 11550 0 31979 0 518226 0 0 0 Colleen Reid CFO 235765 0 44602 0 2761 0 10021 0 33907 0 327056 0 0 0 Brandon Battis Pharmacy Manager 202375 0 0 0 270 0 7283 0 44361 0 254289 0 0 0 Shannon Rogers Director of Operations 199690 0 0 0 450 0 5284 0 31085 0 236509 0 0 0 Leslie McGraw Physician Assistant 180810 0 1980 0 0 0 6523 0 28654 0 217967 0 0 0 Valerie Harrell Medical Imaging Supervisor 175848 0 0 0 0 0 2287 0 31256 0 209391 0 0 0 Andrea Highfill Chief Nursing Officer 170680 0 450 0 0 0 5775 0 15166 0 192071 0 0 0 A Public Finance Authority 273866124 074442CH4 2021-07-28 47811942 Refund 2013 TE Bonds; Payoff Mortgage; Build Inpatient, Imaging, Surgery,ER 0 0 0 A 47811942 2652012 21947614 5200742 18011574 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 1 0 0 0 1 A 1 Form 990, Part VI, Section A, line 2 Clint Purvance and Kelly Neiger have a business relationship. Brian Earling, Ann Beck and Rahul Mediwala have a business relationship. Form 990, Part VI, Section A, line 6 The Corporation shall have two (2) Members, which shall be Renown Health and Barton Healthcare System. Form 990, Part VI, Section A, line 7a Each member shall have the right to appoint 50% of the board members. Each member has the right to remove any or all of its designated directors at any time and from time to time. Form 990, Part VI, Section A, line 7b The following actions or items will require the approval of the Members prior to implementation or becoming effective: (a) Adoption and amendment of a strategic plan; (b) Development and adoption of investment policies; (c) Amendment, restatement or repeal of the Articles or these Bylaws; (d) Purchase, sale, transfer, conveyance, assignment, pledge, hypothcatio, encumbrance, gift or lease of any asset of the Corporation, which involves the receipt or payment of $1,000,000 or more; (e) Incurrence of debt or equity financing for any prupose in the amount of $1,000,000 or more; (f) Purchase or acquistion of another orgranization; (g) Joint venture with any other organization, entity or person; (h) Merger, consolidation, or dissolution of the Corporation. (i) The sale, lease, conveyance or other transfer of all or substantially all of the Corporation's assets; and (j) Admission of additional members. Form 990, Part VI, Section A, line 8b The organization does not have any committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b A draft copy of the Form 990 is reviewed in detail by the organization's Chief Finance Officer. An electronic copy of the Form 990 is sent to all voting members of the board of directors for their review and comments prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c The conflict of interest policy covers directors, officers and managing employees of Carson Valley Health. According to established policies there is an on-going review of contracts and enforcement is handled by the Corporate Compliance Officer. If a potential conflict is disclosed the interested person is required to leave the Board or committee meeting while the matter is discussed and voted upon. The remaining Board or committee members determine if a conflict does exist. Form 990, Part VI, Section B, line 15a The CEO, CFO, and key employees' compensation are determined using a regionally recognized market survey and competitor comparisons. The CEO's compensation is also reviewed and approved by the board of directors. The compensation is reviewed annually. The CEO and Human Resources review the compensation of the CFO. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Consulting: Program service expenses 131,694. Management and general expenses 314,825. Fundraising expenses 0. Total expenses 446,519. Contract Labor: Program service expenses 1,368,573. Management and general expenses 15,716. Fundraising expenses 0. Total expenses 1,384,289. Medical Professional Fees: Program service expenses 12,651,596. Management and general expenses 168,970. Fundraising expenses 0. Total expenses 12,820,566. Other Professional Fees: Program service expenses 93,277. Management and general expenses 285,447. Fundraising expenses 3,102. Total expenses 381,826. Other Purchased Services: Program service expenses 516,504. Management and general expenses 2,624,259. Fundraising expenses 0. Total expenses 3,140,763. Repairs and Maintenance: Program service expenses 1,283,187. Management and general expenses 34,193. Fundraising expenses 198. Total expenses 1,317,578. Form 990, Part XI, line 9: Other Change in Foundation Net Assets -10,060. Carson Valley Medical Center Rural Health Clinic LLC 1107 Highway 395 Gardnerville NV 89410 261513495 Rural health and senior care clinic NV 0 0 Washoe Barton Medical Clinic Carson Valley Health Foundation 1107 Highway 395 Gardnerville NV 89410 364649725 Charitable Foundation NV 501(c)(3) Line 7 Washoe Barton Medical Clinic 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0