CLEARWATER VALLEY HOSPITAL & CLINICS INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: CLEARWATER VALLEY HOSPITAL & CLINICS INC (EIN 82-0497771)
Tax period: 2022-01-01 to 2022-12-31
Filed: 2023-10-04
IRS object ID: 202342779349301209
Schema version: 2022v5.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-10-04T11:24:50-04:00	ReturnTs
Tax Period End	2022-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	DINGUS ZARECOR & ASSOCIATES PLLC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	12015 E MAIN AVE	AddressLine1Txt
City	SPOKANE VALLEY	CityNm
State Abbreviation	WA	StateAbbreviationCd
ZIP	99206	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	820497771	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CLEARWATER VALLEY HOSPITAL AND	BusinessNameLine1Txt
Business Name Line2	CLINICS INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	CLEA	BusinessNameControlTxt
Phone	2084764555	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	301 CEDAR	AddressLine1Txt
City	OROFINO	CityNm
State Abbreviation	ID	StateAbbreviationCd
ZIP	83544	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JYL RULAND	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	2084764555	PhoneNum
Signature	2023-09-11	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	JYL	PersonFirstNm
Person Last	RULAND	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	false	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	THOMAS DINGUS	PreparerPersonNm
PTIN	P00951009	PTIN
Phone	5092420874	PhoneNum
Preparation	2023-10-04	PreparationDt

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	CLEARWATER VALLEY HEALTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	LENNE BONNER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	301 CEDAR	AddressLine1Txt
City	OROFINO	CityNm
State Abbreviation	ID	StateAbbreviationCd
ZIP	83544	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$25,785,085	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.SMH-CVH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1997	FormationYr
Legal Domicile State	ID	LegalDomicileStateCd
Activity Or Mission	TO IMPROVE HEALTH ONE PATIENT AT A TIME IN A FRIENDLY AND PROFESSIONAL CULTURE COMMITTED TO SUPERIOR QUALITY AND SAFETY.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	247	TotalEmployeeCnt
Total Volunteers	15	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$3,194,244	PYContributionsGrantsAmt
CY Contributions Grants	$1,636,826	CYContributionsGrantsAmt
PY Program Service Revenue	$22,835,961	PYProgramServiceRevenueAmt
CY Program Service Revenue	$23,861,320	CYProgramServiceRevenueAmt
PY Investment Income	$41,770	PYInvestmentIncomeAmt
CY Investment Income	$43,157	CYInvestmentIncomeAmt
PY Other Revenue	$26,760	PYOtherRevenueAmt
CY Other Revenue	$243,782	CYOtherRevenueAmt
PY Total Revenue	$26,098,735	PYTotalRevenueAmt
CY Total Revenue	$25,785,085	CYTotalRevenueAmt
PY Grants And Similar Paid	$192,867	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$163,265	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$14,847,043	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$15,327,162	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$8,306	CYTotalFundraisingExpenseAmt
PY Other Expenses	$6,935,428	PYOtherExpensesAmt
CY Other Expenses	$8,457,162	CYOtherExpensesAmt
PY Total Expenses	$21,975,338	PYTotalExpensesAmt
CY Total Expenses	$23,947,589	CYTotalExpensesAmt
PY Revenues Less Expenses	$4,123,397	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,837,496	CYRevenuesLessExpensesAmt
Total Assets BOY	$23,124,731	TotalAssetsBOYAmt
Total Assets EOY	$18,858,651	TotalAssetsEOYAmt
Total Liabilities BOY	$11,584,644	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$5,621,877	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$11,540,087	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$13,236,774	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TO IMPROVE HEALTH ONE PATIENT AT A TIME IN A FRIENDLY AND PROFESSIONAL CULTURE COMMITTED TO SUPERIOR QUALITY AND SAFETY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$19,411,645	ExpenseAmt
Grant	$163,265	GrantAmt
Revenue	$23,861,320	RevenueAmt
Desc	CLEARWATER VALLEY HOSPITAL AND CLINICS (CVHC) IS CREATED AND ORGANIZED TO OWN, MAINTAIN, OPERATE AND CONDUCT, DIRECTLY OR INDIRECTLY, AND TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, CARE FOR THE AGED AND SOCIAL SERVICES, INCLUDING CHARITABLE CARE TO PERSONS UNABLE TO PAY. CVHC OPERATES A 23-BED CRITICAL ACCESS HOSPITAL THAT PROVIDES GENERAL MEDICAL AND SURGICAL CARE FOR INPATIENT, OUTPATIENT, AND EMERGENCY ROOM PATIENTS IN CLEARWATER COUNTY AND THE SURROUNDING AREAS AND PRIMARY CARE CLINICS IN OROFINO AND PIERCE. CVHC PROVIDED 2,188 HOSPITAL PATIENT DAYS, 14,987 OUTPATIENT VISITS, 4,133 ER VISITS, AND 16,518 CLINIC ENCOUNTERS DURING THE YEAR.	Desc
Total Program Service Expenses	$19,411,645	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	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	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	Yes (true)	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	false	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	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	125	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	247	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	12	GoverningBodyVotingMembersCnt
Independent Voting Member	11	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	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	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	JYL RULAND	PersonNm
Phone	2084764555	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	301 CEDAR	AddressLine1Txt
City	OROFINO	CityNm
State Abbreviation	ID	StateAbbreviationCd
ZIP	83544	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd
KARIN SCHMIDOVA
SURGEON	40.00	Yes (X)	$384,467	$0	$49,049
KELLY MCGRATH
BOARD DIRECT	20.00		$349,933	$0	$85,007	20.00	Yes (X)
COLLEEN SHOLAR
PHYSICIAN	40.00	Yes (X)	$345,789	$0	$59,627
REBECCA KATZMAN
PHYSICIAN	40.00	Yes (X)	$318,515	$0	$42,325
LENNE BONNER
PRESIDENT/CE	30.00		$0	$300,932	$18,317	30.00		Yes (X)
SHELLY FRAYSER
PHYSICIAN	40.00	Yes (X)	$260,952	$0	$24,972
ANN LIMA
PHYSICIAN	40.00	Yes (X)	$246,903	$0	$45,486
JYL RULAND
CFO	30.00		$176,724	$0	$58,286	30.00		Yes (X)
CINDY O'BRIEN
CHAIR	1.00		$0	$0	$0	1.00	Yes (X)	Yes (X)
KIM INGRAM
VICE CHAIR	1.00		$0	$0	$0	1.00	Yes (X)	Yes (X)
CHRISTINA ULMER
SECRETARY	1.00		$0	$0	$0	1.00	Yes (X)	Yes (X)
MATT SARTINI
BOARD DIRECT	1.00		$0	$0	$0	1.00	Yes (X)
PAUL NUSSER
BOARD DIRECT	1.00		$0	$0	$0	1.00	Yes (X)
SISTER LISA MAURER
BOARD DIRECT	1.00		$0	$0	$0	1.00	Yes (X)
RENE FORSMAN
BOARD MEMBER	1.00		$0	$0	$0	1.00	Yes (X)
JEREMY EVANS
BOARD DIRECT	1.00		$0	$0	$0	1.00	Yes (X)
SISTER BARBARA JEAN GLODOWSKI
BOARD DIRECT	1.00		$0	$0	$0	1.00	Yes (X)
MARK IMUS
BOARD DIRECT	1.00		$0	$0	$0	1.00	Yes (X)
CHRISTOPHER RIGGERS
BOARD DIRECT	1.00		$0	$0	$0	1.00	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,083,283	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$300,932	TotReportableCompRltdOrgAmt
Total Other Compensation	$383,069	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	33	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	Address Line2ContractorAddress/USAddress/AddressLine2Txt
KENASTON CORPORATION
2517 MAIN ST	LEWISTON	ID	83501	CONTRACTORS	$1,544,715
QUALIVIS LLC
5930 CORNORSTONE COURT WEST	SAN DIEGO	CA	92121	MD COVERAGE	$622,243	SUITE 300
PALOUSE IMAGING CONSULTANTS PLLC
PO BOX 9583	MOSCOW	ID	83843	IMAGING READS	$338,523
DMS IMAGING
PO BOX 670747	DALLAS	TX	75267	MRI	$298,734
RICHARD ENTERPRISES INC
PO BOX 1916	OROFINO	ID	83544	ANESTHIA	$264,166

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	7	CntrctRcvdGreaterThan100KCnt
Related Organizations	$1,063	RelatedOrganizationsAmt
Government Grants	$1,224,711	GovernmentGrantsAmt
All Other Contributions	$411,052	AllOtherContributionsAmt
Total Contributions	$1,636,826	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	NET PATIENT SERVICE REVENUE	Desc
Business	621110	BusinessCd
Total Revenue Column	$23,861,320	TotalRevenueColumnAmt
Related Or Exempt Func Income	$23,861,320	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$23,861,320	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$43,030	TotalRevenueColumnAmt
Exclusion	$43,030	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,200	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$1,200	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,200	TotalRevenueColumnAmt
Exclusion	$1,200	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$127	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$127	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$127	TotalRevenueColumnAmt
Exclusion	$127	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
MEDICARE SHARED SAVINGS PROG	900099	$233,184	$233,184
OTHER	900099	$9,398	$9,398

Field	Value	IRS element (for citing)
Other Revenue Total	$242,582	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$25,785,085	TotalRevenueColumnAmt
Related Or Exempt Func Income	$23,861,320	RelatedOrExemptFuncIncomeAmt
Exclusion	$286,939	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	$163,265	TotalAmt
Program Services	$163,265	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$669,949	TotalAmt
Program Services	$434,939	ProgramServicesAmt
Management And General	$235,010	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$12,389,394	TotalAmt
Program Services	$9,790,497	ProgramServicesAmt
Management And General	$2,592,210	ManagementAndGeneralAmt
Fundraising	$6,687	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$331,672	TotalAmt
Program Services	$274,379	ProgramServicesAmt
Management And General	$57,075	ManagementAndGeneralAmt
Fundraising	$218	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$777,128	TotalAmt
Program Services	$623,637	ProgramServicesAmt
Management And General	$153,062	ManagementAndGeneralAmt
Fundraising	$429	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,159,019	TotalAmt
Program Services	$909,949	ProgramServicesAmt
Management And General	$248,470	ManagementAndGeneralAmt
Fundraising	$600	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,523	TotalAmt
Management And General	$1,523	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$41,472	TotalAmt
Management And General	$41,472	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$206	TotalAmt
Management And General	$206	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,252,216	TotalAmt
Program Services	$2,857,017	ProgramServicesAmt
Management And General	$395,157	ManagementAndGeneralAmt
Fundraising	$42	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$65,053	TotalAmt
Management And General	$65,053	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$431,840	TotalAmt
Program Services	$270,490	ProgramServicesAmt
Management And General	$161,350	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$130,409	TotalAmt
Program Services	$16,646	ProgramServicesAmt
Management And General	$113,762	ManagementAndGeneralAmt
Fundraising	$1	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$193,277	TotalAmt
Program Services	$166,128	ProgramServicesAmt
Management And General	$27,100	ManagementAndGeneralAmt
Fundraising	$49	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$76,558	TotalAmt
Program Services	$50,938	ProgramServicesAmt
Management And General	$25,619	ManagementAndGeneralAmt
Fundraising	$1	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$96,224	TotalAmt
Program Services	$59,196	ProgramServicesAmt
Management And General	$37,028	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$62,718	TotalAmt
Management And General	$62,718	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$711,669	TotalAmt
Program Services	$547,867	ProgramServicesAmt
Management And General	$163,574	ManagementAndGeneralAmt
Fundraising	$228	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$61,164	TotalAmt
Program Services	$53,526	ProgramServicesAmt
Management And General	$7,630	ManagementAndGeneralAmt
Fundraising	$8	FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$2,302,609	$2,302,609
DUES & SUBSCRIPTIONS	$640,941	$561,203	$79,738
REPAIR & MAINTENANCE	$339,020	$306,083	$32,894	$43

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$50,263	TotalAmt
Program Services	$23,276	ProgramServicesAmt
Management And General	$26,987	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$23,947,589	TotalAmt
Program Services	$19,411,645	ProgramServicesAmt
Management And General	$4,527,638	ManagementAndGeneralAmt
Fundraising	$8,306	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,007,932	BOYAmt
EOY	$1,961,530	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$7,268,665	BOYAmt
EOY	$2,011,175	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$86,571	BOYAmt
EOY	$78,211	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$3,795,171	BOYAmt
EOY	$3,220,162	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$11,260	BOYAmt
EOY	$16,000	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$352,665	BOYAmt
EOY	$225,373	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$238,290	BOYAmt
EOY	$350,287	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$20,135,936	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$10,611,110	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$8,213,075	BOYAmt
EOY	$9,524,826	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$1,107,124	BOYAmt
EOY	$998,737	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$43,978	BOYAmt
EOY	$472,350	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$23,124,731	BOYAmt
EOY	$18,858,651	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$2,100,744	BOYAmt
EOY	$1,795,189	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$130,775	BOYAmt
EOY	$2,694	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$1,779,020	BOYAmt
EOY	$1,319,887	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$7,574,105	BOYAmt
EOY	$2,504,107	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$11,584,644	BOYAmt
EOY	$5,621,877	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	$11,540,087	BOYAmt
EOY	$13,236,774	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$11,540,087	BOYAmt
EOY	$13,236,774	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$23,124,731	BOYAmt
EOY	$18,858,651	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$1,837,496	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$132,845	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$7,964	OtherChangesInNetAssetsAmt
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)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

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	$1,219	OtherActivitiesAmt
Total Lobbying Expenditures	$1,219	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	THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$116,169	OtherCostOrOtherBasisAmt
Book Value	$116,169	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,913,155	OtherCostOrOtherBasisAmt
Depreciation	$3,578,047	DepreciationAmt
Book Value	$3,335,108	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,211	OtherCostOrOtherBasisAmt
Depreciation	$6,211	DepreciationAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,576,229	OtherCostOrOtherBasisAmt
Depreciation	$6,442,877	DepreciationAmt
Book Value	$1,133,352	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,524,172	OtherCostOrOtherBasisAmt
Depreciation	$583,975	DepreciationAmt
Book Value	$4,940,197	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$9,524,826	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Book Value	$998,737	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$998,737	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
DUE TO RELATED ORGANIZATION	$2,184,385
CAPITAL LEASE OBLIGATION	$319,722

Field	Value	IRS element (for citing)
Total Liability	$2,504,107	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE D, PAGE 3, PART X	FormAndLineReferenceDesc
Explanation	CVHC AND SMH ARE NON-PROFIT 501(C)(3) CRITICAL ACCESS HOSPITALS AND ASSOCIATED CLINICS LOCATED IN IDAHO.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	2.250000000000	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$66,078	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$66,078	NetCommunityBenefitExpnsAmt
Total Expense	0.00280	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,599,523	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,762,623	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$836,900	NetCommunityBenefitExpnsAmt
Total Expense	0.03490	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,665,601	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,762,623	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$902,978	NetCommunityBenefitExpnsAmt
Total Expense	0.03770	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,436	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$26,436	NetCommunityBenefitExpnsAmt
Total Expense	0.00110	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,597,273	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,184,041	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$413,232	NetCommunityBenefitExpnsAmt
Total Expense	0.01730	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,623,709	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,184,041	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$439,668	NetCommunityBenefitExpnsAmt
Total Expense	0.01840	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,289,310	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,946,664	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,342,646	NetCommunityBenefitExpnsAmt
Total Expense	0.05610	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$882,404	BadDebtExpenseAmt
Bad Debt Expense Attributable	$2,467	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$12,210,014	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$12,217,483	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$7,469	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	CLEARWATER VALLEY HOSPITAL & CLINIC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	301 CEDAR	AddressLine1Txt
City	OROFINO	CityNm
State Abbreviation	ID	StateAbbreviationCd
ZIP	83544	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.SMH-CVH.ORG	WebsiteAddressTxt
State License	01	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
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	CLEARWATER VALLEY HOSPITAL & CLINIC	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	20	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.SMH-CVH.ORG	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	20	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.SMH-CVH.ORG	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	225.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.SMH-CVH.ORG	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.SMH-CVH.ORG	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.SMH-CVH.ORG	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FACILITY 1, CLEARWATER VALLEY HOSPITAL & CLINIC - PART V, LINE 3E	IDENTIFICATION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS BEGIN ON PAGE 14 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE.
FACILITY 1, CLEARWATER VALLEY HOSPITAL & CLINIC - PART V, LINE 5	A STEERING COMMITTEE WAS FORMED BY CLEARWATER VALLEY HOSPITAL & CLINICS, INC. TO LEAD THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. PARTNERS WERE SELECTED FOR THE STEERING COMMITTEE TO ENSURE THE ASSESSMENT PROCESS WAS GUIDED BY COMMUNITY STAKEHOLDERS THAT REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. AS SUCH, THE PARTNERS REPRESENTED THE PUBLIC HEALTH PERSPECTIVE AND THE INTERESTS OF MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, OR INDIVIDUALS. OTHER ORGANIZATIONS REPRESENTED ON THE STEERING COMMITTEE INCLUDED: OROFINO BOARD OF EDUCATION, CLEARWATER ECONOMIC DEVELOPMENT COUNCIL, OROFINO AMBULANCE, LOCAL BUSINESS LEADERS, OROFINO CHAMBER OF COMMERCE, OROFINO POLICE DEPARTMENT, CITY OF OROFINO, FAITH-BASED ORGANIZATIONS. A COMMUNITY SURVEY WAS PUBLISHED ONLINE AND DISTRIBUTED BY THE ADVISORY COMMITTEE AND CLEARWATER VALLEY HOSPITAL STAFF. THE SURVEY WAS DEVELOPED BASED ON AN EXISTING TEMPLATE UTILIZED BY IDAHO PUBLIC HEALTH, NORTH CENTRAL REGION AMONG ITS AFFILIATES AND CITIZENS, AND AUGMENTED TO CAPTURE INPUT REGARDING UNIQUE HEALTH-RELATED CHARACTERISTICS THAT EXISTS WITHIN THE CLEARWATER VALLEY HOSPITAL SERVICE AREA. MORE THAN 300 COMMUNITY MEMBERS RESPONDED TO THE SURVEY. THE SURVEY WAS COMPLETED BY A WIDE VARIETY OF AGES AND LOCATIONS. SIGNIFICANT EFFORT WAS TAKEN TO ENSURE THAT THE SURVEY WAS ACCESSIBLE TO INDIVIDUALS WHO ARE PART OF THE MEDICALLY UNDERSERVED, LOW-INCOME, OR MINORITY POPULATIONS. CLEARWATER VALLEY HOSPITAL & CLINICS, INC. DID NOT RECEIVE ANY COMMENTS ON THEIR PREVIOUS CHNA. ANY COMMENTS WOULD HAVE BEEN TAKEN INTO CONSIDERATION IN THE DEVELOPMENT OF THE CHNA.
FACILITY 1, CLEARWATER VALLEY HOSPITAL & CLINIC - PART V, LINE 6A	THE CHNA WAS CONDUCTED IN COLLABORATION WITH ESSENTIA HEALTH CARE SYSTEMS INCLUDING ST. MARY'S HOSPITAL, INC., A RELATED ORGANIZATION, IN ORDER TO ALIGN RESOURCES AND STRENGTHS TO BETTER SERVE OUR COMMUNITY.
FACILITY 1, CLEARWATER VALLEY HOSPITAL & CLINIC - PART V, LINE 6B	TO HAVE THE GREATEST IMPACT ON THE COMMUNITY SERVED, CLEARWATER VALLEY HOSPITAL AND CLINICS, INC. WORKED COLLABORATIVELY ON THE ASSESSMENT PROCESS WITH IDAHO PUBLIC HEALTH AND NORTH CENTRAL REGION. NOT ONLY DID THIS ENSURE FEEDBACK FROM A REPRESENTATIVE OF PUBLIC HEALTH THROUGHOUT THE ENTIRE COMMUNITY HEALTH NEEDS ASSESSMENT, IT ALSO PROVIDED THE BACKBONE FOR CONTINUED COLLABORATION ON THE IMPLEMENTATION PLANS.
FACILITY 1, CLEARWATER VALLEY HOSPITAL & CLINIC - PART V, LINE 11	CLEARWATER VALLEY HOSPITAL AND CLINICS, INC. ADDRESSED THE SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENT ASSESSMENT: MENTAL HEALTH EDUCATION AND SUPPORT; CHILDREN ARE ACTIVE AND HEALTHY; ACCESS TO RELIABLE TRANSPORTATION. WITH FEW EXCEPTIONS THE HOSPITALS PLAY A PRIMARY ROLE IN ESTABLISHING THE FRAMEWORK FOR PROGRESS IN EACH OF THESE AREAS. PRIORITY AREA 1: MENTAL HEALTH EDUCATION AND SUPPORT CLEARWATER COUNTY CURRENTLY DOEES NOT HAVE SPECIFIC SERVICES AIMED AT ADDRESSING MENTAL HEALTH ISSUES IN CHILDREN UNDER AGE 18; HOWEVER, IN THIS SMALL, RURAL POPULATION THERE ARE MANY FAITH-BASED ORGANIZATIONS, YOUTH GROUPS, AND A STRONG 4-H PROGRAM TO HELP ENGAGE CHILDREN AND GIVE THEM A SENSE OF PURPOSE. IN CLEARWATER COUNTY, THE COMMUNITY HEALTH ACTION TEAM OFFERS SUICIDE PREVENTION TRAINING FOR THE COMMUNITY, DISTRIBUTES GUNLOCKS FOR THOSE THAT WANT THEM, AND THE SCHOOL DISTRICT PROVIDES TRAINING TO TEACHERS TO HELP IDENTIFY AND DEAL WITH MENTAL HEALTH ISSUES IN STUDENTS. ADDITIONALLY, A CRISIS INTERVENTION FACILITY WILL BE CREATED TO HELP THE HOSPITAL PROVIDE RESPITE CARE ON A SHORT-TERM BASIS. PRIORITY AREA 2: CHILDREN ARE ACTIVE AND HEALTHY OROFINO OFFERS A ROBUST OUTDOOR LIFESTYLE FOR ITS CITIZENS AND GUESTS. FISHING, HUNTING, SWIMMING, AND HIKING ARE ALL AVAILABLE RIGHT OUTSIDE YOUR DOOR. STRONG YOUTH PROGRAMS SUCH AS BASEBALL AND SOCCER ARE ALSO AVAILABLE TO THE AREAS CHILDREN, AND A SKATE PARK AND A PUBLIC SWIMMING POOL ARE IN PROCESS OF BEING BUILT TO ADD TO THE COMMUNITIES ALREADY RICH RESOURCES. OROFINO WAS AWARDED A 250,000 COMMUNITY TRANSFORMATION GRANT (CTB) FROM THE BLUE CROSS OF IDAHO FOUNDATION FOR HEALTH. CTG IS A THREE-YEAR GRANT FOCUSED ON IMPROVING YOUTH ACCESS TO HEALTHY FOODS AND ACTIVE LIVING. YEAR ONE WAS SPENT LEARNING, BOTH FROM THE OROFINO COMMUNITY AND FROM COMMUNITY HEALTH EXPERTS, WITH ONE PROJECT INITIATED. AS WE ENTER YEAR TWO, WE ARE WORKING TO EXPAND THE ACTION PLAN THAT WILL GUIDE HOW FUNDS WILL BE SPENT. AREAS OF SPECIFIC FOCUS INCLUDE: A - POLICIES: ORDINANCES, RULES, REGULATIONS, PRACTICES, AND PROCEDURES. PUBLIC POLICIES INCLUDE ZONING CODES, SUBDIVISION RULES AND REGULATIONS, SITE DESIGN GUIDELINES, ROADWAY DESIGN STANDARDS, ETC.; PRIVATE POLICES INCLUDE FARMERS MARKET REGULATIONS, SCHOOL WELLNESS POLICIES, WORKSITE POLICIES, ETC. B - PROGRAMS: OUTREACH, EDUCATION AND BEHAVIOR CHANGE ACTIVITIES; EVENTS AND EDUCATION; POP-UPS, DEMONSTRATIONS, AND TRIALS. C - PROJECTS: CHANGES TO PHYSICAL INFRASTRUCTURE AND THE BUILT ENVIRONMENT; VENDING AND CONCESSION OPTIONS, GARDEN OF MARKET SPACE, FOOD LABELING, PRICING STRATEGIES, ETC. D - PARTNERSHIPS: ENGAGED ORGANIZATIONS AND COMMUNITY MEMBERS WITH ALIGNED RESOURCES WORKING TOGETHER TOWARD A COMMON GOAL (I.E. TO IMPROVE YOUTH ACCESS TO HEALTHY, AFFORDABLE FOOD AND INCREASED PHYSICAL ACTIVITY). THE PROPOSED PROJECTS CURRENTLY IDENTIFIED FOR THE AWARDED GRANT FUNDS ARE A NEW SKATE PARK, UPGRADED TENNIS/PICKLEBALL COURTS, SCHOOL GARDENS, WALK/BIKE PROGRAMS, OPEN GYM AVAILABILITY, AND EXPANDED CITY PARK FACILITIES AND EQUIPMENT. THE PROJECTS WILL TIE INTO THE GOALS OF OFFERING A HEALTHIER LIFESTYLE THROUGH PHYSICAL FITNESS, GROUP ACTIVITIES, AND BETTER NUTRITION. PRIORITY AREA 3: ACCESS TO RELIABLE TRANSPORTATION THIS IS A LARGELY UNADDRESSED PRIORITY IN THE REGION AND WORK ON THIS IS IN ITS INFANCY. WITH THE ABSENCE OF ANY TYPE OF PUBLIC TRANSPORTATION, SIGNIFICANT WORK WILL NEED TO BE DONE. THERE IS ONE HOME-DELIVERY OPTION PROVIDED BY AN INDEPENDENT COMPANY BUT THEIR SCOPE OF SERVICE AND AREA IS INADEQUATE TO MEET THE DEMAND. ISSUES IDENTIFIED THROUGH THE PROCESS BUT NOT INCLUDED AMONG THE TOP THREE PRIORITIES INCLUDED LACK OF MENTAL HEALTH COUNSELORS, SCHOOL NURSES, ASSISTED LIVING HOUSING, FAMILY HOUSING, AND MEMORY CARE FACILITIES. WHENEVER POSSIBLE WE WILL SEEK TO ADDRESS THESE NEEDS, IN PART, THROUGH THE SELECTED PRIORITIES AS SOME OF THEM ARE INTERRELATED. OTHER IDENTIFIED ISSUES WILL CONTINUE TO BE EVALUATED AND STRATEGIES WILL BE SOUGHT WHENEVER POSSIBLE.

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
CLEARWATER VALLEY OROFINO HEALTH CT
1055 RIVERSIDE AVE	OROFINO	ID	83544	OUTPATIENT CLINIC
CLEARWATER VALLEY PIONEER MEDICAL
105 W CARLE STREET	PIERCE	ID	83546	OUTPATIENT CLINIC

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3C	ASSETS WILL BE CONSIDERED ALONG WITH THE PATIENT'S INCOME TO DETERMINE ELIGIBILITY FOR THE FINANCIAL ASSISTANCE PROGRAM. ASSETS MAY INCLUDE, BUT ARE NOT LIMITED TO, SUCH ITEMS AS CHECKING AND SAVINGS ACCOUNTS, IRAS, 401(K)S, 403(B)S, PENSIONS, HEALTH SAVINGS ACCOUNTS, ADDITIONAL PROPERTY, AND ANY OTHER RETIREMENT FUNDING.
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 2,597,273 IN COLUMN C AND 2,184,041 IN COLUMN D.
SCHEDULE H, PART I, LINE 7	THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES (WORKSHEET 2) FOR FIGURES REPORTED IN THE TABLE RELATED TO CHARITY CARE AND UNREIMBURSED MEDICAID (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, TOTAL COMMUNITY BENEFIT, AND TOTAL COMMUNITY BUILDING EXPENSES). ACTUAL COSTS WERE USED FOR THE REMAINDER OF THE COMMUNITY BENEFITS REPORTED.
SCHEDULE H, PART III, LINE 2	THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE.
SCHEDULE H, PART III, LINE 3	BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE DISCOUNTS, CHARITY CARE, AND BAD DEBT EXPENSE ARE ACCOUNTED FOR AS REDUCTIONS TO REVENUE. BAD DEBT EXPENSE ON PATIENT ACCOUNTS WOULD BE IDENTIFIED AS ANY BALANCE ON THE ACCOUNT, LESS ANY PREVIOUS PAYMENTS AND DISCOUNTS, THAT HAS AGED AND IS ABSENT OF ANY PAYMENTS. IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE. THE HOSPITAL APPLIED A HIGH-LEVEL, CONSERVATIVE ANALYTICAL REVIEW BY MULTIPLYING THE RATIO OF CHARITABLE ALLOWANCES TO GROSS PATIENT REVENUE AGAINST BAD DEBT EXPENSE TO ARRIVE AT AN APPROXIMATION OF CHARITY CARE THAT RESIDES IN BAD DEBT. THE HOSPITAL INCORPORATES THE COST OF BAD DEBT AS A COMMUNITY BENEFIT. AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE THE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THAT CARE. IN DOING SO, WE MAKE QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS.
SCHEDULE H, PART III, LINE 4	THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 1 ON PAGE 24 OF THE KOOTENAI HEALTH CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS ALSO INCLUDED IN FOOTNOTE 1.
SCHEDULE H, PART III, LINE 8	THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. THE REPORTED MEDICARE ALLOWABLE COSTS ARE OBTAINED FROM THE HOSPITAL'S GENERAL LEDGER AND THEN ADJUSTED AND REPORTED IN ACCORDANCE WITH CENTERS FOR MEDICARE SERVICES (CMS) "COST FINDING" GUIDELINES AS PUBLISHED IN THEIR PROVIDER REIMBURSEMENT MANUAL. ONCE THE MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE HOSPITAL'S COST REPORT, ANY COSTS ATTRIBUTED TO SUBSIDIZED HEALTH SERVICES, AND MEDICAL EDUCATION, ARE REMOVED AND REPORTED SEPARATELY. EXPLANATION FOR ANY PRIOR YEAR SETTLEMENTS FOR MEDICARE-RELATED SERVICES IN THE CURRENT TAX YEAR: THE HOSPITAL IS REQUIRED TO FILE A MEDICARE COST REPORT 5 MONTHS AFTER THE CLOSE OF THEIR FISCAL YEAR. THE COST REPORT PROVIDES MEDICARE WITH INFORMATION THAT IS USED TO DETERMINE UTILIZATION AND SPENDING TRENDS BUT ALSO IS USED TO SET FUTURE PAYMENT RATES FOR MOST MEDICARE SERVICES. IF THE INTERIM PAYMENTS PAID TO A HOSPITAL ARE HIGHER OR LOWER THAN THE FILED COST REPORT ALLOWABLE REIMBURSEMENT THERE WILL BE A SETTLEMENT FOR THAT FISCAL YEAR. THIS CAN BE DUE TO CHANGES IN UTILIZATION OR COST OF PROVIDING SERVICES FOR CRITICAL ACCESS HOSPITALS (CAH) OR DIFFERENCES BETWEEN INTERIM AND FINAL PAYMENT FACTORS FOR DISPROPORTIONATE SHARE, BAD DEBTS, OR INDIRECT MEDICAL EDUCATION FOR NON-CAH HOSPITALS. AN ESTIMATE FOR THESE SETTLEMENTS IS RECORDED AT THE CLOSE OF THE FISCAL YEAR. IF THE ESTIMATE VARIES FROM THE FINAL SETTLEMENT RECEIVED 6-7 MONTHS AFTER THE FISCAL YEAR ENDS, THEN THESE AMOUNTS ARE RECORDED AS PRIOR YEAR MEDICARE REVENUE. ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS REPORTED IN PART III, LINE 7 ARE TREATED AS COMMUNITY BENEFIT. THE RATIONALE FOR THE HOSPITAL'S OPINION IS PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE AND IT IS LIKELY TO GET WORSE. MANY MEDICARE BENEFICIARIES ARE POOR AND ARE ELIGIBLE FOR MEDICAID IN ADDITION TO MEDICARE. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY.
SCHEDULE H, PART III, LINE 9B	THE POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR THE FINANCIAL ASSISTANCE POLICY (FAP) AND FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR FINANCIAL ASSISTANCE, AND THE PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS. THE HOSPITAL OFFERS EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS AND WILL NOT CHARGE A PATIENT THE GROSS AMOUNT OF CHARGES FOR ANY UNINSURED TREATMENT. UNINSURED DISCOUNTS WILL BE APPLIED TO THE GROSS CHARGES PRIOR TO ANY FINANCIAL ASSISTANCE OR OTHER DISCOUNTS. IF AT ANY TIME THE HOSPITAL RECOGNIZES THAT A PATIENT MAY BE ELIGIBLE FOR STATE OR FEDERAL PROGRAMS, A REPRESENTATIVE WILL ASSIST THE PATIENT IN OBTAINING INFORMATION ABOUT THESE PROGRAMS OR PROVIDE CONTACT INFORMATION FOR THESE PROGRAMS. THE HOSPITAL CONTRACTS WITH AN OUTSIDE PATIENT ADVOCACY AGENCY, WHICH MAY PROVIDE ASSISTANCE TO THE UNINSURED PATIENT IN APPLYING TO CERTAIN STATE AND FEDERAL PROGRAMS. AT ANY STAGE OF THE PATIENT EXPERIENCE AND UP THROUGH THE COLLECTION PROCESS, THE PATIENT MAY EXPRESS A CONCERN THAT THEY ARE UNABLE TO PAY THEIR BILL IN FULL OR MEET THE PAYMENT PLAN REQUIREMENTS. AT THAT TIME, THE PATIENT WILL BE GIVEN EVERY OPPORTUNITY TO COMPLETE AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE HOSPITAL TRAINS ITS OUTSIDE DEBT COLLECTION AGENCIES AND ATTORNEYS ABOUT THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION ABOUT THE FAP OR SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE HOSPITAL REQUIRES IT'S OUTSIDE COLLECTION AGENCIES AND ATTORNEYS TO REFER PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BACK TO THE HOSPITAL. IF A PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, THE HOSPITAL SUSPENDS ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND THE HOSPITAL HAS NOTIFIED THE PATIENT OF ITS DECISION. PATIENTS ARE ADVISED AT THAT TIME TO NOTIFY THE COLLECTION AGENCY TO HOLD THEIR ACCOUNT. THE OUTSIDE DEBT COLLECTION AGENCIES ARE NOTIFIED BY THE HOSPITAL ONCE AN ACCOUNT ADJUSTMENT HAS BEEN MADE.
SCHEDULE H, PART VI, LINE 2	WE ASSESS AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE THROUGH MANY WAYS INCLUDING THE FOLLOWING: MARKETING RESEARCH - CLEARWATER VALLEY HOSPITAL AND CLINICS, INC. AND ST. MARY'S HOSPITAL, INC. REVIEW INTERNAL DATA TO BETTER UNDERSTAND THE NEEDS AND USES(S) OF OUR SERVICES. THIS INCLUDES ACCESS TO SERVICE AREAS (I.E. PRIMARY CARE), PAYOR INFORMATION, AND OVERALL GAPS IN SERVICES. ASSESSMENTS HAVE RESULTED IN STRATEGIC PLANS FOR GROWING SERVICES, AS WELL AS, CHANGES TO INTERNAL PROCESSES FOR HEALTH CARE ACCESS. POPULATION CARE MANAGEMENT - WE REGULARLY COMPARE OUR HEALTH RANKINGS AND RATINGS TO STATE AND NATIONAL DATA TO IDENTIFY GREATEST AREAS OF HEALTH CARE NEEDS. WE PREPARE INTERVENTIONS TARGETED TO AREAS OF GREATEST NEED, SUCH AS UNCONTROLLED DIABETES OR PRE-DIABETES. WE THEN MEASURE THE EFFECT OF INTERVENTIONS COMPARED TO OVERALL COUNTY RANKINGS. WE USE THIS DATA TO ASSESS THE IMPLICATIONS OF EXPANDING PILOT PROGRAMS. PLANNED INTERACTION WITH VARIOUS COMMUNITY HEALTH, HEALTHCARE, AND SOCIAL WELFARE GROUPS - AN UMBRELLA COALITION OF COMMUNITY HEALTH, HEALTHCARE, AND SOCIAL WELFARE GROUPS MEETS REGULARLY TO SHARE PERSPECTIVES ON COMMUNITY NEEDS AND THE ROLE THE HOSPITAL CAN PLAY IN ADDRESSING THOSE NEEDS AS A COLLABORATIVE PARTNER. INTERACTIONS HAVE RESULTED IN SUCCESSFUL PROGRAMS FOR NURSE CASE MANAGEMENT, COMMUNITY REFERRAL COORDINATOR, COMMUNITY HEALTH WORKER, AND BENEFITS COUNSELOR POSITIONS. INTERNAL QUALITY INDICATORS - WE TRACK DATA THAT LEAD TO THE IMPROVED CARE AND TREATMENT OF PATIENTS WITH CHRONIC DISEASES, TOBACCO USE, AND MENTAL HEALTH CONDITIONS. THIS INCLUDES PATIENT ACTIVITY AND OUTCOMES, ALLOWING FOR THE HOSPITAL TO BETTER IDENTIFY THE NEEDS OF THE PATIENTS, WHICH CAN BE UTILIZED TO ASSESS THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. HEALTH DATA PROVIDED BY PAYOR ORGANIZATIONS, NAMELY GOVERNMENT AND COMMERCIAL HEALTH INSURERS - THIS HEALTH DATA TYPICALLY INVOLVES MEDICAL TREATMENT AND OUTCOMES THAT REFLECT TRENDS OF UNHEALTHY LIFESTYLES AND BEHAVIORS. OUR OBJECTIVE IS TO UNDERSTAND THESE RELATIONSHIPS AND TO DEVELOP ACTION STEPS TO INTERVENE ON THE FRONT END TO PREVENT SUCH MEDICAL SITUATIONS FROM OCCURRING. EXAMPLES INCLUDE MANAGEMENT OF CARDIOVASCULAR HEALTH AND OPIOID USE. THE CHNA CAN BE FOUND ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTPS://SMH-CVH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
SCHEDULE H, PART VI, LINE 3	THE HOSPITAL MAKES INFORMATION ON ITS FINANCIAL ASSISTANCE POLICY (FAP) READILY AVAILABLE TO PATIENTS. INFORMATION ABOUT FINANCIALS ASSISTANCE PROGRAMS IS AVAILABLE ON THE HOSPITAL WEBSITE (SMH-CVH.ORG) WHERE THE INFORMATION AND APPLICATION IS EASILY ACCESSIBLE TO BE VIEWED, DOWNLOADED, AND PRINTED AT NO CHARGE TO THE PATIENT. NOTICES ON THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE CONSPICUOUSLY POSTED IN EMERGENCY ROOM DEPARTMENTS. FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE DURING THE PRE-ADMISSION FINANCIAL SCREENING, AT THE TIME OF REGISTRATION, AND PRIOR TO A HOSPITAL DISCHARGE. INFORMATION ABOUT THE FAP IS IN COLLECTION LETTERS AND PATIENT STATEMENTS. FAP INFORMATION AND/OR APPLICATIONS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. THE HOSPITAL EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS PROVIDING DIRECT PATIENT TREATMENT AND WHO WORK IN ADMISSIONS, BILLING, AND COLLECTIONS, ABOUT THE EXISTENCE OF THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION. ANNUAL EDUCATION/AWARENESS OF THE FAP IS PROVIDED TO ENSURE ALL EMPLOYEES WITH PATIENT CONTACT ARE AWARE OF THE PROGRAM AND HOW PATIENTS CAN OBTAIN ADDITIONAL INFORMATION. CLINICAL AND HOSPITAL STAFF WHO PROVIDE DIRECT PATIENT CARE HAVE KNOWLEDGE OF THE FAP AND KNOW TO DIRECT PATIENTS TO A REGISTRATION INTERVIEWER OR BUSINESS OFFICE REPRESENTATIVE. REGISTRATION STAFF HAVE AN UNDERSTANDING OF THE POLICY, KNOWLEDGE OF WHERE THE RELATED DOCUMENTS ARE LOCATED, AND WHERE TO DIRECT THE PATIENT FOR MORE INFORMATION ON THE FAP. DESIGNATED EMPLOYEES (FINANCIAL COUNSELORS & PATIENT ACCOUNTS REPRESENTATIVES) HAVE A THOROUGH UNDERSTANDING OF THE FAP AND OFFER THE INFORMATION ON THE FAP TO THOSE PATIENTS WHO MAKE AN INQUIRY ABOUT THE PROGRAM OR ARE DETERMINED THROUGH A FINANCIAL SCREENING TO BE ELIGIBLE FOR THIS PROGRAM. PATIENT ADVOCACY SERVICES ALSO INFORM THE PATIENT ABOUT THE AVAILABILITY OF ASSISTANCE. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT, A PATIENT'S GUARANTOR, A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. THE ORGANIZATION RESPONDS TO ANY ORAL OR WRITTEN REQUESTS FOR MORE GENERAL INFORMATION ON THE FAP MADE BY A PATIENT OR ANY INTERESTED PARTY. DUE TO THE SMALL SIZES OF THE LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS OF THE COMMUNITIES SERVED BY THE HOSPITAL, SMH WAS NOT REQUIRED TO TRANSLATE THE FINANCIAL ASSISTANCE POLICY (FAP), THE FAP APPLICATION FORM, OR THE PLAIN LANGUAGE SUMMARY OF THE FAP TO OTHER LANGUAGES. THE FAP, FAP APPLICATION AND FAP PLAIN LANGUAGE SUMMARY CAN BE FOUND ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTPS://APPS.PARA- HCFS.COM/PTT/FINALLINKS/STMARYS_V2.ASPX
SCHEDULE H, PART VI, LINE 4	THE HOSPITAL IS LOCATED IN OROFINO, IDAHO AND OPERATES A CRITICAL ACCESS HOSPITAL AND 3 CLINICS THAT SERVE THE COMMUNITIES OF IDAHO IN LEWIS AND CLEARWATER COUNTIES COVERING 2,400 SQUARE MILES. THE OVERALL COMMUNITY IS DESIGNATED NOT ONLY AS RURAL, BUT ALSO AS FRONTIER. FRONTIER REGIONS ARE DEFINED AS THE MOST GEOGRAPHICALLY REMOTE, SPARSELY POPULATED, AND UNDEVELOPED TERRAIN IN THE UNITED STATES. THE SERVICE AREA IS APPROXIMATELY 27,000 PEOPLE WITH AN AGE DISTRIBUTION OF 19% UNDER THE AGE OF 18; 56% BETWEEN THE AGES OF 18 AND 65; AND 25% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE AREA IS 91% CAUCASIAN; 3% HISPANIC, AND 6% OTHER. THE GENDER SPLIT RATIO IS 48% WOMEN AND 52% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY 40,000. THE HOSPITAL IS COMMITTED TO SERVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. APPROXIMATELY 3.9% GROSS REVENUE DOLLARS WERE FROM SELF-PAY PATIENTS AND 12.6% FROM MEDICAID RECIPIENTS. THE HOSPITAL HAS A CLINIC IN THE PIERCE-WEIPPE SERVICE AREA THAT IS CURRENTLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA. THERE ARE 4 OTHER HOSPITALS THAT SERVE THE COMMUNITY.
SCHEDULE H, PART VI, LINE 5	THE HOSPITAL BOARD OF DIRECTORS IS COMPOSED MAINLY OF VOLUNTEER REPRESENTATIVES FROM THE PRIMARY SERVICE AREA AND DEDICATE TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY WHO ARE PROPERLY SCREENED. ALL APPLICANTS THAT APPLY MUST MEET THE CREDENTIALING STANDARDS AND BE APPROVED BY THE GOVERNING BOARD IN ORDER TO PROVIDE SERVICES AT THE HOSPITAL. IN ADDITION, THE HOSPITAL SERVES AS A CLINICAL PRACTICE SITE FOR MANY STUDENTS IN X-RAY TECHNOLOGY, NURSING, PHYSICIAN ASSISTANT, NURSE PRACTITIONER, AND MEDICAL RESIDENCY PROGRAMS. THIS IS ESPECIALLY IMPORTANT BECAUSE IDAHO HAS ONE OF THE LOWEST PHYSICIAN PER CAPITAL RATES IN THE NATION. ANY SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY, EQUIPMENT, AND EMPLOYEE EDUCATION. WE REGULARLY REVIEW FACILITIES AND EQUIPMENT AND DEVELOP AN ATTRITION PROCESS TO REPLACE AGING PLANT OPERATIONS AND EQUIPMENT. WE ALSO LOOK FOR OPPORTUNITIES TO BRING NEW SERVICES TO THE COMMUNITIES VIA INVESTING IN NEW SKILLS AND TECHNOLOGY WHERE APPROPRIATE. THE HOSPITAL ENGAGED COMMUNITIES IN COMING TOGETHER AND CREATING SOCIAL CONNECTIVITY THROUGH SUPPORT OF LOCAL EVENTS AND COMMUNITY PROGRAMS. THESE INCLUDE THE FORMATION OF COMMUNITY AND SCHOOL GARDENS, HEALTH TALKS, SPONSORSHIP OF RACES, AND PARTICIPATION IN COUNTY FAIR ACTIVITIES. WE PROMOTE BETTER MENTAL HEALTH BY BRINGING CHILD AND ADULT PSYCHIATRISTS TO OUR FRONTIER COMMUNITIES USING TELEMEDICINE. THIS MODEL HAS WON STATE AND NATIONAL AWARDS FOR INNOVATION IN REACHING THE MEDICALLY UNDERSERVED. WE ARE ALSO ACTIVE PARTICIPANTS IN NATIONAL DEMONSTRATION PROJECTS AND OTHER COLLABORATIONS TO PROVIDE AN EVIDENCE BASE FOR EFFECTIVE PROCESSES TO PROMOTE RURAL HEALTH. IN ADDITION TO THE ACTIVITIES LISTED IN PART I, LINE 7 AS WELL AS PART V, SECTION B, LINE 11, SOME OTHER PROJECTS UNDERTAKEN BY SMH INCLUDE THE FOLLOWING: MOST MONTHS WE HAVE AN OVERALL THEME TARGETING A CHRONIC DISEASE STATE WITH SPECIAL PROGRAMS AND OUTREACH TO OUR COMMUNITIES (I.E. FEBRUARY IS HEART MONTH, OCTOBER IS BREAST CANCER AWARENESS, NOVEMBER IS DIABETES AWARENESS, ETC.). DOC TALKS ARE GEARED TO THE MONTHLY THEME WITH SCREENINGS AND INFORMATION PROVIDED AT THE EVENTS. OUR CARE MANAGERS, REFERRAL COORDINATORS, AND QUALITY DIRECTORS ARE ESPECIALLY ACTIVE IN COORDINATING THESE ACTIVITIES AND REACHING OUT TO PATIENTS WHO MAY NOT BE AWARE OF THE SERVICES OFFERED. COMMUNITY HEALTH WORKERS ARE HOSTING CHRONIC DISEASE SELF-MANAGEMENT AND CHRONIC PAIN SELF-MANAGEMENT CLASSES THROUGHOUT OUR SERVICE AREA. COLON CANCER AWARENESS AND SCREENING HAS BEEN A MAJOR OUTREACH EFFORT AT HEALTH FAIRS, LOCAL BAZAARS, SOME OF THE FARMER'S MARKET DAYS, AND WITHIN ALL OF THE CLINICS OVER THE PAST YEAR. THE HOSPITAL IS AN ACTIVE PARTICIPANT IN ATTENDING AND SITTING ON THE BOARDS OF THE LOCAL HUMAN NEED COUNCILS WITHIN THE SERVICE AREAS. WE HAVE A PRESENCE ON MULTIPLE COALITIONS THROUGHOUT THE NORTHERN AND NORTH CENTRAL IDAHO. THIS IS OFTEN ACCOMPLISHED BY PHONE CONFERENCING IN ORDER TO PARTICIPATE IN THE DISCUSSIONS AND GROWTH WITHOUT INCURRING TRAVEL EXPENSE. WE ARE ALSO ACTIVELY ENGAGED IN STATE COALITIONS ON CHRONIC DISEASE AND COMMUNITY HEALTH WORKER PROGRAMS (OFTEN SEEN AS MENTORS WITHIN THESE GROUPS FOR THE ACCOMPLISHMENTS ACHIEVED OVER THE PAST FEW YEARS). FUNDRAISERS AND VOLUNTEER EFFORTS ARE ESTABLISHED AND ONGOING WITH LOCAL FOOD BANKS, CLOTHING DISTRIBUTION DRIVES, AND OTHER VOLUNTEERS THAT ARE GEARED AROUND NATURAL DISASTERS AND OTHER NEEDS WITHIN OUR AREA. EFFORTS ARE BEING MADE TO BRING SAFE WALKING AND BIKE TRAILS TO COMMUNITIES WITHIN OUR SERVICE AREAS. A RESULT OF ALMOST EVERY SURVEY AND CONVERSATION IS THAT THE COMMUNITIES WANT MORE WAYS TO ENGAGE SAFELY IN PHYSICAL ACTIVITY AT LITTLE OR NO EXPENSE. COMMUNITY HEALTH WORKERS HAVE WORKED WITH COMMUNITY PARTNERS TO HOST WEEKLY WALKS THROUGHOUT THE REGION PROVIDING BOTH AN EDUCATION COMPONENT AND A SAFE WALKING PATH FOR THE DAY. COMMUNITY HEALTH WORKERS COORDINATE AND HOST SCREENING EVENTS IN VARIOUS LOCATIONS THROUGHOUT THE SERVICE AREA TO HELP SCREEN FOR DIABETES, DEPRESSIONS, SDOH ISSUES, AND COLON CANCER. SOME OF THE SCREENING EVENTS ARE HELD IN CONJUNCTION WITH A FOOD BANK DISTRIBUTION SITE. THE HOSPITAL IS PART OF KOOTENAI HOSPITAL DISTRICT DBA KOOTENAI HEALTH, A FULLY INTEGRATED HEALTH SYSTEM WITH FACILITIES IN IDAHO. KOOTENAI HEALTH REINVESTS SURPLUS REVENUES INTO TECHNOLOGY, INFRASTRUCTURE AND CLINICAL PROGRAMS TO INCREASE THE HEALTH AND VITALITY OF THE COMMUNITIES WE SERVE. KOOTENAI HEALTH PROVIDES SERVICES IN RURAL COMMUNITIES AND IS COMMITTED TO ELIMINATING GEOGRAPHIC BARRIERS TO CARE. WE INVEST IN FACILITY UPGRADES, TECHNOLOGY, AND STAFFING THAT ENHANCE CARE IN THESE COMMUNITIES TO ENSURE PATIENTS CAN RECEIVE AS MUCH CARE AS POSSIBLE CLOSE TO HOME. TELEHEALTH ALLOWS PATIENTS TO RECEIVE CARE FROM A PROVIDER IN THEIR HOME. TELEHEALTH APPOINTMENTS TAKE PLACE IN LOCAL CLINICS OR HOSPITALS THROUGH SECURE INTERACTIVE VIDEOCONFERENCING. PATIENTS FEEL LIKE THEY ARE IN THE SAME ROOM WITH THEIR DOCTOR. THIS EXPERIENCE OFFERS THE SAME HIGH-QUALITY CARE THAT PATIENTS EXPECT DURING AN IN-PERSON VISIT. ON MAY 26, 2015, THE DISTRICT BOARD VOTED TO DEVELOP A CLINICAL INTEGRATION NETWORK CALLED KOOTENAI CARE NETWORK, LLC, (KCN) A NON-PROFIT, WHOLLY-OWNED SUBSIDIARY. THE GOAL OF THE NETWORK IS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY THROUGH THE DELIVERY OF EFFICIENT, HIGH QUALITY CARE THROUGH THE INTEGRATION OF INDEPENDENT AND EMPLOYED PHYSICIANS, HOSPITALS, POST-ACUTE CARE PROVIDERS AND PAYERS. AS OF DECEMBER 31, 2022, THERE WERE OVER 609 PARTICIPATING PROVIDERS AND 61,500 COVERED LIVES IN THE NETWORK. KOOTENAI ACCOUNTABLE CARE, LLC WAS FORMED IN 2017 WITH KCN AS ITS SOLE MEMBER, FOR PURPOSES OF PARTICIPATING AS A MEDICARE SHARED SAVINGS PROGRAM. IN ADDITION, KOOTENAI VALUE CARE, LLC WAS FORMED IN 2021 WITH KCN AS ITS SOLE MEMBER, FOR PURPOSES OF PARTICIPATING IN THE IDAHO MEDICAID VALUE CARE PROGRAM. KCN HAS A TEAM OF CARE MANAGERS TO HELP PATIENTS WITH CHRONIC CONDITIONS TO MANAGE THEIR CARE. THESE CHRONIC CONDITIONS INCLUDE CHRONIC OBSTRUCTIVE PULMONARY DISEASE, HEART FAILURE, DEPRESSION, AND ANXIETY. THE CARE MANAGERS WORK WITH A VARIETY OF PATIENTS, CAREGIVERS, AND HEALTHCARE EXPERTS WITHIN KCH TO PROVIDE EFFICIENT, HIGH QUALITY CARE FOR THE COMMUNITY. EACH YEAR KOOTENAI HEALTH MAKES SUBSTANTIAL FINANCIAL AND IN-KIND DONATIONS THAT BENEFIT THE COMMUNITY. THESE INCLUDE DONATIONS TO GROUPS SUCH AS THE SUICIDE PREVENTION ACTION NETWORK AND THE COMMUNITY CANCER FUND. KOOTENAI HEALTH PROVIDES FREE AND LOW COST HEALTH SCREENINGS AND SUPPORT GROUPS FOR PATIENTS WITH DIABETES, CANCER, MENDED HEARTS, PARKINSON'S, AND PULMONARY DISEASE. KOOTENAI HEALTH PROVIDES TRAINING OPPORTUNITIES FOR PHYSICIANS, NURSES, AND OTHER HEALTHCARE WORKERS. TOGETHER, THESE SERVICES ARE IMPROVING HOW PEOPLE ARE CARED FOR IN THE GEOGRAPHICALLY DIVERSE COMMUNITIES WE SERVE.
SCHEDULE H, PART VI, LINE 6	CLEARWATER VALLEY HEALTH IS PART OF KOOTENAI HOSPITAL DISTRICT (THE DISTRICT). THE DISTRICT IS ORGANIZED AND EXISTS AS A POLITICAL SUBDIVISION UNDER THE LAWS OF THE STATE OF IDAHO TO PROVIDE HEALTH CARE SERVICES WITHIN THE DISTRICT WHICH INCLUDES ALL OF KOOTENAI COUNTY AS WELL AS ADDITIONAL COUNTIES WITHIN IDAHO. THE DISTRICT IS INVOLVED IN SEVERAL JOINT RELATIONSHIPS TO PROVIDE NEEDED HEALTH SERVICES TO NORTH IDAHO RESIDENTS. THESE RELATIONSHIPS ARE IN THE AREAS OF IMAGING SERVICES, MAGNETIC RESONANCE IMAGING SERVICES, REHABILITATION SERVICES, AMBULATORY SURGICAL SERVICES, AND RADIATION THERAPY SERVICES. WE ALSO SUPPORT COMMUNITY HEALTH THROUGH THE KOOTENAI HEALTH FOUNDATION AND THROUGH CONTRIBUTIONS THAT FOCUS ON PROGRAMS AND SERVICES THAT BENEFIT THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
ST MARY'S HOSPITAL INC
701 LEWISTON STREET	COTTONWOOD	ID	83522	820226453	501C3	$145,318	GRANT PASSTHROUGH
KOOTENAI HEALTH FOUNDATION
2271 W IRONWOOD CENTER DR	COEURDALENE	ID	83814	820380784	501C3	$6,470	FINANCIAL SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PAGE 1, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	CLEARWATER VALLEY HOSPITAL AND CLINICS, INC.'S MANAGEMENT REVIEWS THE GRANT ACTIVITY BY REVIEWING AND DOCUMENTING EACH EXPENDITURE REQUEST AND APPROVING THE EXPENSE.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
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	Bonus Filing OrganizationBonusFilingOrganizationAmount	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
KARIN SCHMIDOVA
SURGEON	$378,830	$100	$5,537	$31,900	$17,149	$433,516
KELLY MCGRATH
BOARD DIRECTOR/CMO	$317,725	$15,007	$17,201	$57,420	$27,587	$434,940
COLLEEN SHOLAR
PHYSICIAN	$259,912	$75,750	$10,127	$30,926	$28,701	$405,416
REBECCA KATZMAN
PHYSICIAN	$254,578	$58,168	$5,769	$29,162	$13,163	$360,840
LENNE BONNER
PRESIDENT/CEO							$261,726	$39,206	$5,664	$12,653	$319,249
SHELLY FRAYSER
PHYSICIAN	$260,852	$100		$3,294	$21,678	$285,924
ANN LIMA
PHYSICIAN	$210,547	$28,417	$7,939	$21,801	$23,685	$292,389
JYL RULAND
CFO	$157,998	$9,906	$8,820	$33,526	$24,760	$235,010

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III	PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) CVHC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 104,885 FOR CHARITY CARE, 6,608,848 FOR MEDICARE, 2,950,906 FOR MEDICAID, AND 3,113,324 FOR OTHER THIRD-PARTY PAYORS FOR THE YEAR.
FORM 990, PAGE 6, PART VI, LINE 6	KOOTENAI HOSPITAL DISTRICT DBA KOOTENAI HEALTH IS THE SOLE MEMBER OF CLEARWATER VALLEY HOSPITAL AND CLINICS, INC. AND MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7A. KOOTENAI HOSPITAL DISTRICT HAS RESERVED POWERS WITH RESPECT TO CLEARWATER VALLEY HOSPITAL AND CLINICS, INC. AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7B.
FORM 990, PAGE 6, PART VI, LINE 7A	KOOTENAI HOSPITAL DISTRICT APPOINTS AND REMOVES CLEARWATER VALLEY HOSPITAL AND CLINICS, INC. GOVERNING BODY.
FORM 990, PAGE 6, PART VI, LINE 7B	KOOTENAI HOSPITAL DISTRICT HAS RESERVED POWERS AS FOLLOWS: STRATEGIC AND BUSINESS PLANS - AUTHORITY TO CREATE AND TO APPROVE CLEARWATER VALLEY'S STRATEGIC AND BUSINESS PLANS. MISSION - AUTHORITY TO CREATE AND TO APPROVE THE MISSION PURPOSE AND VISION STATEMENT FOR CLEARWATER VALLEY. DEBT - APPROVAL OF THE INCURRENCE OF DEBT BY AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE ASSETS OF CLEARWATER VALLEY IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE KH BOARD OF DIRECTORS. GOVERNING INSTRUMENTS - AUTHORITY TO CAUSE AND APPROVE AMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS OF CLEARWATER VALLEY. MERGERS AND ACQUISITIONS - AUTHORITY TO CAUSE AND TO APPROVE ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTION OF CLEARWATER VALLEY. AFFILIATIONS AND JOINT VENTURES - AUTHORITY TO CAUSE AND APPROVE ALL AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES BETWEEN THIRD PARTIES AND CLEARWATER VALLEY. TRANSFER OF ASSETS - AUTHORITY TO CAUSE AND TO APPROVE THE SALE, LEASE OR OTHER TRANSFER OF CLEARWATER VALLEY ASSETS WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE KH BOARD OF DIRECTORS. SERVICES - AUTHORITY TO CAUSE AND TO APPROVE THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS OF CLEARWATER VALLEY. BUDGETS - APPROVAL OF CAPITAL AND OPERATING BUDGETS OF CLEARWATER VALLEY. PROFESSIONAL SERVICES - SELECTION OF THE GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS OF CLEARWATER VALLEY. ACQUISITIONS - AUTHORITY TO CAUSE AND TO APPROVE ALL ACQUISITIONS BY AND FORMATIONS OF ENTITIES BY CLEARWATER VALLEY. MARKETING AND BRANDING - AUTHORITY TO IMPLEMENT CLEARWATER VALLEY MARKETING, BRANDING, AND PROMOTIONAL ACTIVITIES. COMPLIANCE PLANS - AUTHORITY TO CREATE AND TO APPROVE CORPORATE COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS FOR CLEARWATER VALLEY. QUALITY PLAN - AUTHORITY TO CREATE AND TO APPROVE CLEARWATER VALLEY'S QUALITY PLAN. NON-BUDGETED PURCHASES - APPROVAL OF NON-BUDGETED CAPITAL PURCHASES, OPERATING EXPENSES, AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY KH FOR CLEARWATER VALLEY. HUMAN RESOURCES - AUTHORITY TO CREATE HUMAN RESOURCE POLICIES AND PROCEDURES FOR CLEARWATER VALLEY. RESERVED POWERS - AUTHORITY TO CREATE ADDITIONAL KH RESERVED POWERS BY THE AFFIRMATIVE VOTE OF AT LEAST 75% OF THE KH BOARD OF DIRECTORS (EXCLUDING THE KH PRESIDENT).
FORM 990, PAGE 6, PART VI, LINE 11B	A COPY OF THE 990 IS PROVIDED TO THE CEO AND CFO WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PROVIDED TO THE BOARD OF DIRECTORS. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CFO SIGNS THE FORM 8879-TE AUTHORIZING THE PREPARER TO E-FILE THE RETURN.
FORM 990, PAGE 6, PART VI, LINE 12C	CVHC REQUIRES BOARD MEMBERS AND OFFICERS OF THE ORGANIZATION TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS. IF A POTENTIAL CONFLICT EXISTS THEY ARE REVIEWED BY THE BOARD AND THE INDIVIDUAL WITH THE POTENTIAL CONFLICT ABSTAINS FROM VOTING ON THE ISSUE.
FORM 990, PAGE 6, PART VI, LINE 15A	COMPENSATION OF THE CEO IS SET BY THE INDEPENDENT, EXECUTIVE COMPENSATION COMMITTEE OF KOOTENAI HEALTH'S BOARD OF DIRECTORS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINIONS ON TOTAL COMPENSATION REASONABLENESS. THE INDEPENDENT ADVISOR MONITORS COMPARABLILTY DATA AND MARKETPLACE TRENDS, MAKES APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES, AND PERIODICALLY REVIEWS THE MARKET COMPETITIVENESS OF KOOTENAI HEALTH EXECUTIVE COMPENSATION PACKAGES. CEO COMPENSATION RANGE IS DERIVED FROM STATE HOSPITAL ASSOCIATION SALARY SURVEYS AND OTHER REGIONAL COMPENSATION SURVEYS. ADDITIONALLY, CEO COMPENSATION IS DETERMINED UNDER A YEARLY PERFORMANCE EVALUATION. THIS PRACTICE IS ALSO FOLLOWED FOR THE CFO POSITION AND FOR OTHER COMPENSATED OFFICERS AND KEY EMPLOYEES. THE ANNUAL DELIBERATION AND DECISION PROCESS IS SUBSTANTIATED.
FORM 990, PAGE 6, PART VI, LINE 15B	SEE FORM 990, PART VI, LINE 15A
FORM 990, PAGE 6, PART VI, LINE 19	THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G	2,857,017 395,157 42
FORM 990, PART XI, LINE 9	TRANSFER OF NET POSITION -7,964

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
ST MARY'S HOSPITAL INC
PO BOX 137	COTTONWOOD	ID	83522	820226453	HOSPITAL	ID	501C3	3	KOOTENAI	Yes (true)
KOOTENAI HEALTH FOUNDATION INC
2003 KOOTENAI HEALTH WAY	COEURDALENE	ID	83814	820380784	FOUNDATION	ID	501C3	7	KOOTENAI	Yes (true)
KOOTENAI HEALTH
2003 KOOTENAI HEALTH WAY	COEURDALENE	ID	83814		HOSPITAL	ID	GOV			false	N/A

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
KOOTENAI URGENT CARE LLC
700 IRONWOOD DR SUITE 120E	COEURDALENE	ID	83814	MEDICAL	ID	N/A	false	false
KOOTENAI OUTPATIENT SURGERY
707 IRONWOOD DRIVE	COEURDALENE	ID	83814	SURGERY	ID	N/A	false	false
KOOTENAI OUTPATIENT IMAGING
700 W IRONWOOD DR SUITE 175	COEURDALENE	ID	83814	IMAGING	ID	N/A	false	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
ST MARY'S HOSPITAL INC
B	$145,318	GAAP
KOOTENAI HEALTH
E	$2,112,115	GAAP
ST MARY'S HOSPITAL INC
E	$72,273	GAAP
ST MARY'S HOSPITAL INC
O	$855,247	GAAP
KOOTENAI HEALTH
O	$300,932	GAAP
ST MARY'S HOSPITAL INC
P	$958,541	GAAP
ST MARY'S HOSPITAL INC
Q	$1,735,236	GAAP