2023-10-03T10:48:07-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2022-01-01 261635811 CARSON TAHOE CONTINUING CARE HOSPITAL INC CARS 7754458000 PO BOX 2168 CARSON CITY NV 89702 KATIE KUCERA VP, CFO 7754458000 2023-10-02 1 KATIE KUCERA 999009999 0 KURT BENNION CPA P01469618 4252506100 2023-10-02 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MONICA GREEN PO BOX 2168 CARSON CITY NV 89702 9916849 0 X WWW.CARSONTAHOE.COM/LTACH X 2007 DE TO ENHANCE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE. 4 3 55 4 0 0 4550189 4784518 5043533 5131329 0 -13711 -127 1002 9593595 9903138 0 0 0 0 4587734 4429341 0 0 0 5719420 4860789 10307154 9290130 -713559 613008 2059248 5650314 1592170 4570228 467078 1080086 PROVIDE AN APPROPRIATE VENUE IN THE CONTINUUM OF CARE FOR PATIENTS REQUIRING AN EXTENDED STAY IN AN ACUTE CARE SETTING AND WHO RESIDE IN OR AROUND CARSON CITY, NEVADA. 0 0 5409645 0 5131329 CARSON TAHOE CONTINUING CARE HOSPITAL, INC. ("CTCCH") IS A 29-BED LONG-TERM ACUTE CARE HOSPITAL IN CARSON CITY, NEVADA. CTCCH PROVIDES MEDICAL CARE TO PATIENTS WHO REQUIRE TREATMENT IN AN ACUTE CARE SETTING FOR AN EXTENDED PERIOD OF TIME. CONDITIONS APPROPRIATE FOR TREATMENT IN A LTACH INCLUDE THE FOLLOWING: MEDICALLY COMPLEX RESPIRATORY DISORDERS INCLUDING TRACHEOTOMY, VENTILATOR DEPENDENT, CARDIAC/CARDIOVASCULAR CONDITIONS, RENAL DISEASE, AND ONCOLOGY. IN 2022, CTCCH DISCHARGED 138 PATIENTS AND PROVIDED 3,954 DAYS OF PATIENT CARE. 5409645 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 10 0 55 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 NV X STEFANIE STIEBER 7754458000 PO BOX 2168 CARSON CITY NV 89702 MICHELLE JOY DIRECTOR VP & COO (THROUGH AUG 2022) 5.00 35.00 X 0 698784 172637 MITCHELL WATSON TREASURER & CFO (THROUGH FEB 2022) 5.00 35.00 X 0 400770 102441 KATIE KUCERA TREASURER & CFO (AS OF FEB 2022) 10.00 30.00 X 0 415366 52291 MICHELLE MILLER SECRETARY, VP & H.R. OFFICER 5.00 35.00 X X 0 311403 74167 MONICA GREEN DIRECTOR OF NURSING, THEN ADMINISTRATOR 40.00 0.00 X 189659 0 38392 ROBIN WINGATE SUPERVISOR PHARMACIST IN CHARGE 40.00 0.00 X 173989 0 39375 HEATHER WICKWARE SUPERVISOR NURSING RN 40.00 0.00 X 130909 0 26217 TERESA GODWIN CHARGE REGISTERED NURSE 40.00 0.00 X 112147 0 40832 JAMES MCFARLANE REGISTERED NURSE 40.00 0.00 X 123670 0 9601 CYNTHIA PARKER ADMINISTRATOR (THROUGH JUNE 2022) 40.00 0.00 X 113381 0 28108 KATHY TRIPLETT CHAIR 1.00 1.00 X X 0 0 0 REX BAGGETT MD SECRETARY (THROUGH JULY 2022) 1.00 0.00 X X 0 0 0 CHARLES BORDERS DIRECTOR 1.00 0.00 X 0 0 0 DON HATAWAY DIRECTOR 1.00 0.00 X 0 0 0 843755 1826323 584061 11 0 1 0 PROLINK HEALTHCARE LLC 4600 MONTGOMERY ROAD SUITE 300 CINCINNATI OH 45212 TRAVELER SERVICES 385066 LIBERTY DIALYSIS 16343 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 MEDICAL SERVICES 119322 4 4600000 184518 4784518 PATIENT SERVICE REVENU 623000 5131329 5131329 5131329 13711 -13711 -13711 -13711 MISCELLANEOUS REVENUE 900099 1002 1002 1002 9903138 5131329 0 -12709 X 141489 141489 3370962 3103663 267299 129507 127572 1935 516040 477351 38689 271343 240344 30999 1072108 655198 416910 99088 95931 3157 1411504 1411504 240 88 152 158332 106706 51626 SHARED SERVICES 1481999 1481999 MEDICAL SUPPLIES 551783 551783 LINEN/BEDDING 30536 30536 FOOD 17766 3227 14539 37433 17246 20187 9290130 5409645 3880485 0 252057 297919 1074470 1145334 153997 116099 133589 134769 1479947 1166603 445135 313344 0 3642849 2059248 5650314 1456395 640186 3872447 135775 57595 1592170 4570228 X 467078 1080086 467078 1080086 2059248 5650314 613008 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 98 98 0 PART II-B, LINE 1: A PORTION OF THE MEMBERSHIP DUES PAID TO THE NEVADA HOSPITAL ASSOCIATION WERE USED BY THAT GROUP TO LOBBY ON BEHALF OF CARSON TAHOE CONTINUING CARE HOSPITAL AND OTHER MEMBERS. 75971 26478 49493 1403976 1140125 263851 313344 RIGHT OF USE ASSETS 3642849 3642849 DUE TO AFFILIATES 57595 57595 X PART X, LINE 2: THE ORGANIZATION HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, THE ORGANIZATION IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. UNDER FASB ASC 740, INCOME TAXES, THE ORGANIZATION IS REQUIRED TO RECOGNIZE A LIABILITY FOR EACH UNCERTAIN TAX POSITION AT THE AMOUNT ESTIMATED TO BE REQUIRED TO SETTLE THE ISSUES. THERE WERE NO LIABILITIES RECORDED FOR UNCERTAIN TAX POSITIONS FOR THE YEAR ENDED DECEMBER 31, 2022. 1 1 X 1 X 250.000000000000 1 X 1 1 0 0 1446017 1002350 443667 0.04780 1446017 1002350 443667 0.04780 1446017 1002350 443667 0.04780 1 17246 0 2674480 6314840 -3640360 X 1 1 1 1 CARSON TAHOE CONTINUING CARE HOSPITAL 775 FLEISCHMANN WAY CARSON CITY NV 89703 WWW.CARSONTAHOE.COM/LTACH 5213-HOS-12 X LONG-TERM ACUTE CARE CARSON TAHOE CONTINUING CARE HOSPITAL 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE PART V, SECTION B, LINE 7D X X 1 22 1 SEE PART V, SECTION B, LINE 7D 0 1 X 250.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X WWW.CARSONTAHOE.COM/FINANCIALSERVICES.HTML X WWW.CARSONTAHOE.COM/FINANCIALSERVICES.HTML X WWW.CARSONTAHOE.COM/FINANCIALSERVICES.HTML X X X X X 1 X 0 X X X X 1 X 0 0 CARSON TAHOE CONTINUING CARE HOSPITAL PART V, SECTION B, LINE 5: THE QUAD-COUNTY CHNA PLANNING COMMITTEE WORKED WITH ITS ASSESSMENT PARTNER CRESCENDO CONSULTING GROUP TO FORMALIZE AND DEPLOY A HIGHLY INCLUSIVE ASSESSMENT-AS-ACTION-CYCLE FRAMEWORK THAT INCLUDED A COMMUNITY-WIDE EMAIL SURVEY (ENGLISH & SPANISH), STAKEHOLDER INTERVIEWS, FOCUS GROUPS, AN ACCESS AUDIT, EQUITY CHAMPIONS OUTREACH, SECONDARY RESEARCH, AND STAKEHOLDER COMMITMENT TO COLLABORATIVELY DEVELOP STRATEGIES AND SOLUTIONS IN RESPONSE TO IDENTIFIED NEEDS.- 46 STAKEHOLDER INTERVIEWS ACROSS THE REGION- 15 FOCUS GROUPS WITH OVER 125 PARTICIPANTS TOTAL- 1,551 COMMUNITY SURVEY RESPONDENTS- 400 PARTICIPANTS IN RANDOM DIGIT DIALING TELEPHONE SURVEY CARSON TAHOE CONTINUING CARE HOSPITAL PART V, SECTION B, LINE 6A: A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH CARSON TAHOE REGIONAL HEALTHCARE (DBA: CARSON TAHOE REGIONAL MEDICAL CENTER), THE OTHER HOSPITAL OWNED BY CARSON-TAHOE HEALTH SYSTEM. CARSON TAHOE CONTINUING CARE HOSPITAL PART V, SECTION B, LINE 6B: A COALITION OF EIGHT COMMUNITY AGENCIES CAME TOGETHER TO PLAN THE COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING:- CARSON CITY HEALTH & HUMAN SERVICES- COMMUNITY CHEST, INC.- NEVADA ASSOCIATION OF COUNTIES- PARTNERSHIP DOUGLAS COUNTY- LYON COUNTY HUMAN SERVICES- QUAD-COUNTY PUBLIC HEALTH PREPAREDNESS- DOUGLAS COUNTY COMMUNITY SERVICES, PARKS, & RECREATION CARSON TAHOE CONTINUING CARE HOSPITAL PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT WWW.CARSONTAHOE.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTML. CARSON TAHOE CONTINUING CARE HOSPITAL PART V, SECTION B, LINE 11: CARSON TAHOE CONTINUED TO RESPOND TO COVID-19 PANDEMIC SURGES WITHIN THE COMMUNITY BUT ALSO BEGAN TO ADDRESS AREAS IDENTIFIED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT WITH RESOURCES AND PARTNERSHIPS IN THE COMMUNITY. THE AREA ADDRESSED AT THIS FACILITY WAS ACCESS TO HEALTH SERVICES. PART I, LINE 3C: AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE IS PRIMARILY BASED ON A COMPARISON OF HOUSEHOLD INCOME TO THE FEDERAL POVERTY LEVEL. HOWEVER, A PATIENT MAY PRESUMPTIVELY QUALIFY FOR FINANCIAL ASSISTANCE IN THE FOLLOWING SITUATIOSN: (A) PARTICIPATE IN STATE ASSISTANCE PROGRAMS, SUCH AS FOOD STAMPS, WELFARE, AND PHARMACEUTICAL ASSISTANCE; (B) CURRENTLY COVERED UNDER MEDICAID, BUT NOT ELIGIBLE ON THE DATE OF SERVICE; AND (C) ELIGIBLE FOR MEDICAID EMERGENCY OR PREGNANCY SERVICES ONLY. FOR PATIENTS WITH INSURANCE, A PAYMENT, DENIAL OR BENEFIT SUMMARY FROM THE INSURER MUST BE PROVIDED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE. AVAILABLE NON-ESSENTIAL ASSETS ARE ALSO TAKEN INTO CONSIDERATION IN DETERMINING AN INDIVIDUAL'S ABILITY TO PAY. PART I, LINE 7: THE COMMUNITY BENEFIT EXPENSES AND REVENUES WERE CALCULATED USING THE IRS WORKSHEETS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 17,246. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 3: THE HOSPITAL CANNOT ESTIMATE WITH REASONABLE ACCURACY THE PORTION OF THE BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT DID NOT COMPLETE AN APPLICATION. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLE" PARAGRAPH IN NOTE 2 ON PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICAL ALLOWABLE COSTS WERE DETERMINED BY THE FILED 2022 MEDICARE COST REPORT.CARSON TAHOE CONTINUING CARE HOSPITAL CONSIDERS THE MEDICARE SHORTFALL TO BE A COMMUNITY BENEFIT. THE COMMUNITY MEMBERS UTILIZING MEDICARE TEND TO BE MEDICALLY UNDERSERVED AND MAY NOT BE ABLE TO AFFORD HEALTHCARE IF NOT FOR THE MEDICARE PROGRAM. PART III, LINE 9B: POLICIES IN EFFECT DURING 2022 ARE THE SAME AS CARSON-TAHOE HEALTH SYSTEM AND CARSON TAHOE REGIONAL HEALTHCARE. THE APPLICATION PERIOD FOR COMPLETION OF A FINANCIAL ASSISTANCE APPLICATION IS AVAILABLE FOR A MINIMUM OF 240 DAYS FROM THE TIME OF PATIENT SERVICE. PART VI, LINE 2: THE MOST CURRENT NEEDS ASSESSMENT WAS CONDUCTED IN 2022. NEEDS WERE IDENTIFIED USING DIRECT PATIENT AND PHYSICIAN FEEDBACK, SURVEY RESPONSES AND BEST PRACTICE INFORMATION FROM OTHER ORGANIZATIONS. INFORMATION OBTAINED FROM THE NEEDS ASSESSMENT RECOGNIZED THE COMMUNITY'S NEED FOR BETTER ACCESS TO HEALTHCARE. THE HEALTHCARE SYSTEM RELIES ON TRILLIANT SERVICES TO REPORT INFORMATION ON MIGRATION OF SERVICES WITHIN THE PRIMARY AND SECONDARY MARKETS THEN UTILIZES INFORMATION GATHERED TO FORMULATE NEEDS ASSESSMENT. WE WORK WITH NEVADA STATE HEALTH AND HUMAN SERVICES IN IDENTIFYING AREAS OF NEED. CDC AND INFECTION CONTROL MONITOR INDUSTRY TRENDS AND ADVISE POSSIBLE AREAS OF FOCUS. PART VI, LINE 3: INFORMATION IS PROVIDED TO THE PATIENT AT THE TIME OF REGISTRATION, BOTH IN WRITING AND THROUGH DIRECT DISCUSSION WITH PATIENTS. INFORMATION IS PROVIDED IN THE PATIENT'S BILL. ELIGIBILITY REPRESENTATIVES AND FINANCIAL COUNSELORS ARE LOCATED ON SITE. PART VI, LINE 4: THE HOSPITAL'S COMMUNITY CONSISTS OF A SMALL URBAN AREA AND A LARGE RURAL POPULATION IN EXCESS OF 250,000 PEOPLE, COVERING NORTHERN NEVADA AND EASTERN CALIFORNIA. THE LARGEST DEMOGRAPHIC AGE GROUP IS 50 AND OLDER. PART VI, LINE 5: USE OF SURPLUS FUNDS ALLOWS THE HOSPITAL TO UPDATE MEDICAL EQUIPMENT AND TECHNOLOGY, WHICH PROVIDE ADVANCEMENTS IN PATIENT CARE. CARSON TAHOE PARTICIPATES WITH CARSON CITY HEALTH AND HUMAN SERVICES IN THE COMMUNITY HEALTH IMPROVEMENT PLAN 2020. CARSON TAHOE PROVIDES OUTREACH PROGRAMS, HEALTH FAIRS, WELLNESS PROGRAMS, BUSINESS HEALTH PARTNERSHIPS, SEMINARS, LECTURES AND EDUCATIONAL FORUMS TO HELP PROMOTE A HEALTHIER COMMUNITY. THE WOMEN'S HEALTH INSTITUTE PROVIDES FREE HEALTH RESOURCES, CLASSES AND GUIDANCE. CARSON TAHOE IS COMMITTED TO PROVIDING THE BEST HEALTHCARE AVAILABLE TO ALL COMMUNITY MEMBERS REGARDLESS OF THEIR ABILITY TO PAY. PART VI, LINE 6: CARSON TAHOE CONTINUING CARE HOSPITAL IS A PART OF CARSON-TAHOE HEALTH SYSTEM IN CARSON CITY, NEVADA. THE SYSTEM IS COMPRISED OF THE FOLLOWING ENTITIES:CARSON TAHOE CONTINUING CARE HOSPITAL IS A LONG-TERM ACUTE CARE HOSPITAL LICENSED FOR 29 BEDS.CARSON TAHOE REGIONAL HEALTHCARE OWNS AND OPERATES:- CARSON TAHOE REGIONAL MEDICAL CENTER IS AN ACUTE CARE HOSPITAL LICENSED FOR 211 BEDS WITH A 24-HOUR EMERGENCY ROOM.- CANCER CENTER PROVIDES FOR EVERY ASPECT OF CANCER CARE FROM A MEDICAL AND RADIATION ONCOLOGY PRACTICE ALONGSIDE A COMPREHENSIVE CANCER RESOURCE CENTER AND INFUSION CENTER.- SPECIALTY MEDICAL CENTER PROVIDES OUTPATIENT LABORATORY, WOUND CARE AND BEHAVIORAL HEALTH SERVICES AND INPATIENT PSYCHIATRICT SERVICES.- MINDEN MEDICAL CENTER INCLUDES PHYSICIAN OFFICES, THE MINDEN EMERGENT AND URGENT CARE CENTER, AND OUTPATIENT LABORATORY AND RADIOLOGY SERVICES.- THREE WALK-IN CLINICS AT WALMARTS- TWO CENTERS FOR WOUND HEALING- TWO URGENT CARE CLINICS- TWO THERAPY CLINICS- ONE CARDIAC REHAB FACILITYCARSON TAHOE PHYSICIAN CLINICS IS A MULTISPECIALTY MEDICAL GROUP THAT EMPLOYS 83 PROVIDERS AT 14 LOCATIONS WITH SPECIALTIES THAT INCLUDE NEUROSURGERY, CARDIOLOGY, ENDOCRINOLOGY, FAMLIY MEDICINE, INTERNAL MEDICINE, ONCOLOGY, PSYCHIATRY, RHEUMATOLOGY, PAIN MANAGEMENT, INTERVENTIONAL RADIOLOGY AND CARDIOTHORACIC SURGERY.CARSON-TAHOE HEALTH SYSTEM IS THE PARENT ORGANIZATION AND PROVIDES MANAGEMENT AND ADMINISTRATIVE SERVICES TO THE REST OF THE SYSTEM. 1 1 0 0 0 1 1 0 0 MICHELLE JOY DIRECTOR VP & COO (THROUGH AUG 2022) 0 626342 0 61550 0 10892 0 136441 0 36196 0 871421 0 0 MITCHELL WATSON TREASURER & CFO (THROUGH FEB 2022) 0 130623 0 43764 0 226383 0 79567 0 22874 0 503211 0 0 KATIE KUCERA TREASURER & CFO (AS OF FEB 2022) 0 381635 0 23956 0 9775 0 16095 0 36196 0 467657 0 0 MICHELLE MILLER SECRETARY, VP & H.R. OFFICER 0 287234 0 13969 0 10200 0 34518 0 39649 0 385570 0 0 MONICA GREEN DIRECTOR OF NURSING, THEN ADMINISTRATOR 176944 0 12715 0 0 0 29982 0 8410 0 228051 0 0 0 ROBIN WINGATE SUPERVISOR PHARMACIST IN CHARGE 166587 0 7402 0 0 0 22431 0 16944 0 213364 0 0 0 HEATHER WICKWARE SUPERVISOR NURSING RN 122882 0 8027 0 0 0 14400 0 11817 0 157126 0 0 0 TERESA GODWIN CHARGE REGISTERED NURSE 111937 0 210 0 0 0 25871 0 14961 0 152979 0 0 0 PART I, LINES 4A-B IN 2022, MITCHELL WATSON RECEIVED SEVERANCE PAYMENTS OF $226,383 FROM CARSON-TAHOE HEALTH SYSTEM. IN 2022, THE FOLLOWING AMOUNTS WERE CONTRIBUTED TO 457(F) PLANS ADMINISTERED BY CARSON-TAHOE HEALTH SYSTEM: MITCHELL WATSON - $9,050 MICHELLE JOY - $70,851 KATIE KUCERA - $42,500 IN 2022, THE FOLLOWING AMOUNTS WERE DISTRIBUTED OUT OF 457(F) PLANS ADMINISTERED BY CARSON-TAHOE HEALTH SYSTEM: MITCHELL WATSON - $43,817 MICHELLE JOY - $100,691 PART I, LINE 6 NET INCOME IS A TRIGGER FEATURE FOR THE AT-RISK INCENTIVE PLAN FOR CARSON-TAHOE HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS CARSON-TAHOE HEALTH SYSTEM, A TAX EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A CARSON-TAHOE HEALTH SYSTEM, THE SOLE MEMBER, HAS THE RIGHT TO APPOINT TWO CORPORATE MEMBER DIRECTORS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS OF CARSON TAHOE CONTINUING CARE HOSPITAL ("THE HOSPITAL") MAY NOT, WITHOUT THE EXPRESS WRITTEN CONSENT OF CARSON-TAHOE HEALTH SYSTEM, THE SOLE MEMBER, HAVE THE POWER TO TAKE ANY OF THE FOLLOWING ACTIONS: (1) ANY FUNDAMENTAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE HOSPITAL; (2) THE INCURRENCE OF DEBT, INCLUDING WITHOUT LIMITATION, BORROWINGS, GUARANTEES, LOANS, ENCUMBRANCES, OPERATING LEASES, PURCHASE OR LEASE OF REAL ESTATE, AND CAPITAL LEASES, IN EXCESS OF $250,000, MEASURED IN AN ANNUAL AGGREGATE; (3) ANY MERGER OR CONSOLIDATION TO WHICH THE HOSPITAL IS A PARTY; (4) THE SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE HOSPITAL; (5) POLICIES PERTAINING TO CHARITY CARE; (6) ANY RELEASE OR CANCELLATION OF INDIVIDUAL CLAIMS IN EXCESS OF $250,000; (7) ANY CAPITAL EXPENDITURES WHICH IN THE AGGREGATE EXCEED $250,000 ANNUALLY; (8) APPOINTMENT AND REMOVAL OF THE SOLE CORPORATE MEMBER DIRECTORS; (9) THE DEFENSE, SETTLEMENT OR RESOLUTION OF ANY DISPUTE INVOLVING THE HOSPITAL IN WHICH THE AMOUNT IN CONTROVERSY IS IN EXCESS OF $250,000; (10) THE DEFENSE, SETTLEMENT OR RESOLUTION OF ANY REGULATORY CHALLENGES TO THE LEGAL STRUCTURE OF THE HOSPITAL, ALLEGED OVERPAYMENTS FROM ANY GOVERNMENTAL AGENCY OR ANY ALLEGATIONS FROM A GOVERNMENTAL AGENCY OF FRAUD AND ABUSE; AND (11) AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND REVIEW THE 990. THE 990 WAS THEN REVIEWED BY THE ORGANIZATION'S OFFICERS AND THE ACCOUNTING PERSONNEL WITH THE INDEPENDENT ACCOUNTING FIRM. THROUGH THE REVIEW PROCESS, ANY CLARIFICATIONS OR CORRECTIONS THAT NEEDED TO BE MADE WERE MADE. THE FORM 990 WAS THEN REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD WITH THE INDEPENDENT ACCOUNTING FIRM. ANY QUESTIONS OR CONCERNS THE FINANCE COMMITTEE RAISED WERE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEEDED TO BE MADE WERE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES WAS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C ACTUAL OR POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED BY THE INTERESTED PARTY TO THE BOARD OR A COMMITTEE. IF ANY INTERESTED PERSON BECOMES AWARE OF A POTENTIAL CONFLICT BEFORE THE MATTER IS UNDER CONSIDERATION BY THE GOVERNING BODY OR THE COMMITTEE THEN THE INTERESTED PERSON MAY DISCLOSE THE POTENTIAL CONFLICT OF INTEREST TO THE HOSPITAL'S MANAGEMENT PERSONNEL OR THE CHAIR OF THE BOARD. AN INTERESTED PERSON MAY MAKE A PRESENTATION AND ANSWER QUESTIONS POSED AT A BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE OR SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POTENTIAL CONFLICT OF INTEREST. THE CHAIR OF THE BOARD OR COMMITTEE SHALL, IF HE OR SHE DEEMS APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT OR OTHER RESOLUTION OF A POTENTIAL CONFLICT OF INTEREST. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE ORGANIZATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE HOSPITAL'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS REASONABLE. EMPLOYEES AND OTHERS ENGAGED BY THE BOARD MUST SEEK GUIDANCE AND APPROVAL FROM APPROPRIATE MANAGEMENT PERSONNEL PRIOR TO PURSUING ANY BUSINESS OR PERSONAL ACTIVITY THAT MIGHT CONSTITUTE A CONFLICT OF INTEREST. CARSON TAHOE CONTINUING CARE HOSPITAL'S CHIEF EXECUTIVE, WORKING WITH THE CHAIR, WILL BE RESPONSIBLE TO ENSURE THOSE CONDUCTING AUDITING AND MONITORING REVIEWS OF INTERNAL CONTROL ARE FREE FROM ANY CONFLICTS OF INTEREST OR OTHER INFLUENCES THAT WOULD IMPAIR THEIR ABILITY TO OBJECTIVELY CARRY OUT THEIR DUTIES WITHOUT BIAS. IF THE BOARD OR COMMITTEE OF CARSON TAHOE CONTINUING CARE HOSPITAL HAS REASONABLE CAUSE TO BELIEVE A BOARD OR COMMITTEE MEMBER OR EMPLOYEE HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, THE MEMBER OR EMPLOYEE WILL BE INFORMED OF THE BASIS FOR SUCH BELIEF AND AFFORDED AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING AN EMPLOYEE'S OR DIRECTOR'S RESPONSE, AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, IT IS DETERMINED THAT THERE WAS A FAILURE TO DISCLOSE, THERE WILL BE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION, WHICH COULD INCLUDE, WITHOUT LIMITATION, TERMINATION OF THE PERSON'S EMPLOYMENT OR DIRECTORSHIP. THE CEO OR HIS OR HER DESIGNEE SHALL PROVIDE TO THE BOARD AND ALL EXECUTIVE OFFICERS, STAFF, AND VOLUNTEERS, A COPY OF THE CONFLICT OF INTEREST POLICY AND THE APPLICABLE CONFLICT OF INTEREST DISCLOSURE FORM AND QUESTIONNAIRE, WHICH SHALL BE COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES WHEREIN IT IS BELIEVED A CONFLICT MAY ARISE. SUCH ANNUAL MONITORING AND REVIEW PROCEDURES SHALL BE PART OF THE CORPORATE COMPLIANCE PLAN. AN APPROPRIATE REPORT SHALL BE SUBMITTED TO THE BOARD CONCERNING ANY INTEREST DISCLOSED. EACH MEMBER OF THE BOARD AND ALL EXECUTIVE MANAGEMENT SHALL DISCLOSE FULLY AND FRANKLY ANY AND ALL ACTUAL OR POTENTIAL CONFLICTS OF DUALITY OF INTEREST OR RESPONSIBILITY, WHETHER INDIVIDUAL, PERSONAL, OR BUSINESS, WHICH MAY EXIST OR APPEAR TO EXIST TO CARSON TAHOE CONTINUING CARE HOSPITAL ON ANY MATTER OF BUSINESS WHICH MAY COME BEFORE THE BOARD (INCLUDING ITS COMMITTEES.) FORM 990, PART VI, SECTION B, LINE 15 CARSON-TAHOE HEALTH SYSTEM'S EXECUTIVE COMPENSATION COMMITTEE DETERMINES THE TOTAL COMPENSATION PACKAGE FOR THE CEO BASED ON MARKET SURVEYS POSITIONED SO THAT MIDPOINT WILL TARGET THE 50TH PERCENTILE. INCENTIVES WILL BE POSITIONED TO PROVIDE TOTAL CASH COMPENSATION AT THE 50TH PERCENTILE FOR ON-PLAN PERFORMANCE. BENEFITS WILL BE POSITIONED AT MARKET COMPETITIVE LEVELS. THE LAST REVIEW WAS CONDUCTED BY LONGNECKER IN 2022. BASE SALARIES FOR OTHER OFFICERS AND KEY EMPLOYEES WILL BE POSITIONED SO THAT MIDPOINTS TARGET THE 50TH PERCENTILE. EXECUTIVE SALARIES WILL BE ADMINISTERED WITHIN RANGES BUILT AROUND THE 50TH PERCENTILE AND BASED ON PERFORMANCE, EXPERIENCE, TENURE, AND OTHER RELEVANT FACTORS AS EVALUATED BY CEO. INCENTIVES WILL BE POSITIONED TO PROVIDE TOTAL CASH COMPENSATION AT THE 50TH PERCENTILE FOR ON-PLAN PERFORMANCE. ACHIEVING MAXIMUM INCENTIVES MAY RAISE TOTAL COMPENSATION TO APPROXIMATELY THE 65TH PERCENTILE. BENEFITS WILL BE POSITIONED AT MARKET COMPETITIVE LEVELS. THE LAST REVIEW WAS CONDUCTED BY LONGNECKER IN 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 329,761. MANAGEMENT AND GENERAL EXPENSES 266,910. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 596,671. LAB FEES: PROGRAM SERVICE EXPENSES 150,705. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 150,705. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 30,649. MANAGEMENT AND GENERAL EXPENSES 150,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 180,649. DIALYSIS: PROGRAM SERVICE EXPENSES 137,007. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 137,007. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 7,076. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,076. CARSON-TAHOE HEALTH SYSTEM 1600 MEDICAL PARKWAY CARSON CITY NV 89703 880502318 PARENT ORGANIZATION NV 501(C)(3) LINE 12B, II N/A 0 CARSON TAHOE REGIONAL HEALTHCARE 1600 MEDICAL PARKWAY CARSON CITY NV 89703 880502320 HOSPITAL NV 501(C)(3) LINE 3 CARSON-TAHOE HEALTH SYSTEM 0 CTRH AUXILIARY 1600 MEDICAL PARKWAY CARSON CITY NV 89703 886007118 SUPPORT CTRH NV 501(C)(3) LINE 12D, III-O CARSON TAHOE REGIONAL HEALTHCARE 0 CTH PHYSICIANS CLINIC 1600 MEDICAL PARKWAY CARSON CITY NV 89703 872781421 CLINICAL MEDICAL SERVICES NV 501(C)(3) LINE 10 CARSON-TAHOE HEALTH SYSTEM 0 CARSON TAHOE PHYSICIAN CLINICS 1600 MEDICAL PARKWAY CARSON CITY NV 89703 020566741 PHYSICIAN GROUP NV N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0