UINTAH BASIN MEDICAL CENTER: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- UINTAH BASIN MEDICAL CENTER (EIN 87-0276435)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-13
- IRS object ID
- 202201339349310150
- Schema version
- 2020v4.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-13T17:57:08-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 200079326 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DINGUS ZARECOR & ASSOCIATES PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12015 E MAIN AVE | AddressLine1Txt |
| City | SPOKANE VALLEY | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 870276435 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UINTAH BASIN MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UINT | BusinessNameControlTxt |
| Phone | 4357224691 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 W 300 N | AddressLine1Txt |
| City | ROOSEVELT | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84066 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRENT HALES | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4357224691 | PhoneNum |
| Signature | 2022-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | BRENT | PersonFirstNm |
| Person Last | HALES | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS DINGUS | PreparerPersonNm |
| PTIN | P00951009 | PTIN |
| Phone | 5092420874 | PhoneNum |
| Preparation | 2022-05-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES MARSHALL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 W 300 N | AddressLine1Txt |
| City | ROOSEVELT | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84066 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $105,109,453 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UBH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | UT | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPREHENSIVE HEALTHCARE SERVICES TO RESIDENTS OF THE UINTAH BASIN THROUGH ITS ACUTE CARE AND SPECIALTY CARE OPERATIONS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 942 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,420,660 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,984,962 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $90,085,654 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $99,142,366 | CYProgramServiceRevenueAmt |
| PY Investment Income | $910,550 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,554 | CYInvestmentIncomeAmt |
| CY Other Revenue | $691,188 | CYOtherRevenueAmt |
| PY Total Revenue | $93,416,864 | PYTotalRevenueAmt |
| CY Total Revenue | $104,820,070 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $39,137,460 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $42,696,004 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $47,812,421 | PYOtherExpensesAmt |
| CY Other Expenses | $50,736,201 | CYOtherExpensesAmt |
| PY Total Expenses | $86,949,881 | PYTotalExpensesAmt |
| CY Total Expenses | $93,432,205 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,466,983 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,387,865 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $110,436,328 | TotalAssetsBOYAmt |
| Total Assets EOY | $123,876,812 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $30,790,351 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $30,423,357 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $79,645,977 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $93,453,455 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE COMPREHENSIVE HEALTHCARE SERVICES TO RESIDENTS OF THE UINTAH BASIN THROUGH ITS ACUTE CARE AND SPECIALTY CARE OPERATIONS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $70,495,713 | ExpenseAmt |
| Revenue | $99,142,366 | RevenueAmt |
| Desc | UINTAH BASIN MEDICAL CENTER (UBMC) IS A 49-BED GENERAL ACUTE CARE HOSPITAL THAT OFFERS HOSPITAL SERVICES, EMERGENCY MEDICAL CARE, INPATIENT AND OUTPATIENT PHARMACEUTICAL SERVICES, LONG-TERM HEALTH CARE, REHABILITATION, AND OTHER ESSENTIAL MEDICAL SERVICES. UBMC PROVIDED APPROXIMATELY 4,400 PATIENT DAYS, 10,500 ER VISITS, 2,600 SURGERIES AND 13,700 HOME HEALTH/ HOSPICE VISITS DURING THE YEAR. THE MEDICAL CENTER 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 DURING THE YEAR WAS 1,329,655 FOR CHARITY CARE, 28,176,064 FOR MEDICARE, 17,222,742 FOR MEDICAID AND 40,437,353 FOR OTHER THIRD-PARTY PAYORS. | Desc |
| Total Program Service Expenses | $70,495,713 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 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 | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 101 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 942 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | false | 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 | BRENT HALES | PersonNm |
| Phone | 4357224691 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 W 300 N | AddressLine1Txt |
| City | ROOSEVELT | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84066 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ROBERT GILBERT | ||||||||
| CHAIR | 1.00 | Yes (X) | $5,000 | $0 | $0 | |||
| TYLER RASMUSSEN | ||||||||
| 1ST VICE CHA | 1.00 | Yes (X) | $4,500 | $0 | $0 | |||
| TYLER ALLRED | ||||||||
| 2ND VICE CHA | 1.00 | Yes (X) | $4,500 | $0 | $0 | |||
| ALARIK MYRIN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $3,996 | $0 | $0 | |||
| SEAN PAULSEN | ||||||||
| DIRECTOR/CHI | 40.00 | Yes (X) | $708,798 | $0 | $0 | |||
| SHELLEY FENN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $3,996 | $0 | $0 | |||
| IRENE HANSEN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $3,996 | $0 | $0 | |||
| TIMOTHY NEGUS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $3,996 | $0 | $0 | |||
| JASON LARSON | ||||||||
| DIRECTOR/CMO | 40.00 | Yes (X) | $638,675 | $0 | $0 | |||
| JAMES MARSHALL | ||||||||
| PRESIDENT & | 40.00 | $430,347 | $0 | $46,707 | Yes (X) | |||
| BRENT HALES | ||||||||
| CFO | 40.00 | $271,622 | $0 | $47,918 | Yes (X) | |||
| RANDALL BENNETT | ||||||||
| HR DIRECTOR | 40.00 | $231,485 | $0 | $44,442 | Yes (X) | |||
| ROGER MARETT | ||||||||
| VP PHYSICIAN | 40.00 | $201,075 | $0 | $39,740 | Yes (X) | |||
| BOBBY RICHARDSON | ||||||||
| CNO | 40.00 | $190,370 | $0 | $38,036 | Yes (X) | |||
| JOSEPH GARCIA | ||||||||
| PHYSICIAN | 40.00 | $434,990 | $0 | $42,328 | Yes (X) | |||
| KERRY BAUM | ||||||||
| SURGEON | 40.00 | $401,420 | $0 | $46,886 | Yes (X) | |||
| KENT SMITH | ||||||||
| INTERNAL MED | 40.00 | $323,811 | $0 | $36,874 | Yes (X) | |||
| SHANE POWELL | ||||||||
| OPHTHALMOLOG | 40.00 | $300,077 | $0 | $40,757 | Yes (X) | |||
| BRUCE ARNOLD | ||||||||
| PATHOLOGIST | 40.00 | $286,477 | $0 | $40,997 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,449,131 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $424,685 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 40 | 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 |
|---|---|---|---|---|---|
| CERNER CORPORATION | |||||
| PO BOX 959156 | ST LOUIS | MO | 631959156 | SOFTWARE MAINT | $2,818,436 |
| ARUP LABORATORIES | |||||
| PO BOX 27964 | SALT LAKE CITY | UT | 841270964 | LAB TESTING | $1,165,251 |
| SEAN PAULSEN MD | |||||
| 250 N 300 W | ROOSEVELT | UT | 84066 | PHYSICIAN | $708,798 |
| GORDON OLSEN MD | |||||
| 1188 N 1350 EAST | HEBER CITY | UT | 84032 | PHYSICIAN | $706,268 |
| JASON LARSON MD PC | |||||
| PO BOX 265 | NEOLA | UT | 84053 | PHYSICIAN | $638,675 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 52 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,833,402 | GovernmentGrantsAmt |
| All Other Contributions | $151,560 | AllOtherContributionsAmt |
| Total Contributions | $4,984,962 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $98,987,091 | $98,987,091 |
| OTHER MEDICAL SERVICES | 621110 | $155,275 | $155,275 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $99,142,366 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $290,608 | TotalRevenueColumnAmt |
| Exclusion | $290,608 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $102,702 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $102,702 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $102,702 | TotalRevenueColumnAmt |
| Exclusion | $102,702 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $329 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $289,383 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$289,054 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$289,054 | TotalRevenueColumnAmt |
| Exclusion | -$289,054 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| OTHER REVENUE | 900099 | $320,574 | $320,574 |
| CAFETERIA REVENUE | 722514 | $267,912 | $267,912 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $588,486 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $104,820,070 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $99,142,366 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $692,742 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,446,440 | TotalAmt |
| Program Services | $424,852 | ProgramServicesAmt |
| Management And General | $1,021,588 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,690,173 | TotalAmt |
| Program Services | $21,326,744 | ProgramServicesAmt |
| Management And General | $8,363,429 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,360,191 | TotalAmt |
| Program Services | $1,237,241 | ProgramServicesAmt |
| Management And General | $1,122,950 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,082,278 | TotalAmt |
| Program Services | $4,646,792 | ProgramServicesAmt |
| Management And General | $2,435,486 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,116,922 | TotalAmt |
| Program Services | $1,492,228 | ProgramServicesAmt |
| Management And General | $624,694 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,474 | TotalAmt |
| Management And General | $87,474 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,340 | TotalAmt |
| Management And General | $108,340 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,035,688 | TotalAmt |
| Program Services | $16,497,742 | ProgramServicesAmt |
| Management And General | $1,537,946 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,229 | TotalAmt |
| Program Services | $37,475 | ProgramServicesAmt |
| Management And General | $233,754 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,466,355 | TotalAmt |
| Program Services | $583,660 | ProgramServicesAmt |
| Management And General | $1,882,695 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $615,434 | TotalAmt |
| Program Services | $313,399 | ProgramServicesAmt |
| Management And General | $302,035 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,159 | TotalAmt |
| Program Services | $326,819 | ProgramServicesAmt |
| Management And General | $33,340 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,740 | TotalAmt |
| Program Services | $43,830 | ProgramServicesAmt |
| Management And General | $20,910 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,027,649 | TotalAmt |
| Management And General | $1,027,649 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,589,740 | TotalAmt |
| Program Services | $2,549,110 | ProgramServicesAmt |
| Management And General | $2,040,630 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $428,497 | TotalAmt |
| Program Services | $68,348 | ProgramServicesAmt |
| Management And General | $360,149 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $17,723,364 | $17,723,364 | |
| REPAIR & MAINTENANCE | $1,226,879 | $1,108,976 | $117,903 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,730,653 | TotalAmt |
| Program Services | $2,115,133 | ProgramServicesAmt |
| Management And General | $1,615,520 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,432,205 | TotalAmt |
| Program Services | $70,495,713 | ProgramServicesAmt |
| Management And General | $22,936,492 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,134,042 | BOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,277,027 | BOYAmt |
| EOY | $4,613,680 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,503,694 | BOYAmt |
| EOY | $19,492,129 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,613,230 | BOYAmt |
| EOY | $2,068,690 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $437,734 | BOYAmt |
| EOY | $828,010 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $110,167,476 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $53,834,344 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,930,766 | BOYAmt |
| EOY | $56,333,132 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $33,966,010 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,917,462 | BOYAmt |
| EOY | $3,370,227 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,622,373 | BOYAmt |
| EOY | $3,204,934 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,436,328 | BOYAmt |
| EOY | $123,876,812 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,500,438 | BOYAmt |
| EOY | $6,187,708 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,242,067 | BOYAmt |
| EOY | $100,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,278,233 | BOYAmt |
| EOY | $23,170,649 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,769,613 | BOYAmt |
| EOY | $965,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,790,351 | BOYAmt |
| EOY | $30,423,357 | 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 | $78,145,977 | BOYAmt |
| EOY | $93,453,455 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500,000 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,645,977 | BOYAmt |
| EOY | $93,453,455 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,436,328 | BOYAmt |
| EOY | $123,876,812 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $11,387,865 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2,419,613 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
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 | $7,713 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,713 | 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 | $4,392,784 | OtherCostOrOtherBasisAmt |
| Book Value | $4,392,784 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $58,816,860 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,013,772 | DepreciationAmt |
| Book Value | $31,803,088 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,695,278 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,820,572 | DepreciationAmt |
| Book Value | $7,874,706 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,262,554 | OtherCostOrOtherBasisAmt |
| Book Value | $12,262,554 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $56,333,132 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INDEMNITY AND EXPENSE RESERVE | Desc |
| Amt | $965,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $965,000 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $107,239,683 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $2,419,613 | OtherRevenueAmt |
| Revenue Not Reported | $2,419,613 | RevenueNotReportedAmt |
| Revenue Subtotal | $104,820,070 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $104,820,070 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $93,432,205 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $93,432,205 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $93,432,205 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 3, PART X | THE MEDICAL CENTER IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE MEDICAL CENTER EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF JUNE 30, 2021 AND 2020, THE MEDICAL CENTER HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. |
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | GAIN ON TERMINATION OF INTEREST RATE SWAP 2,419,613 |
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 |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | 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 | $624,938 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $624,938 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00670 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,632,403 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,632,403 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,257,341 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,632,403 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $624,938 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00670 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,213 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,213 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $120,964 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $120,964 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,489 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $34,489 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $169,666 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $169,666 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,427,007 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,632,403 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $794,604 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00850 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $126,409 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $126,409 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $168,434 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $168,434 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $294,843 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $294,843 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $10,089,725 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $2,245,382 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $12,354,662 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,934,962 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $419,700 | 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 | UINTAH BASIN MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 W 300 N | AddressLine1Txt |
| City | ROOSEVELT | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84066 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.UBH.ORG | WebsiteAddressTxt |
| State License | 2008-HOSP-180 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UINTAH BASIN MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 20 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.UBH.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.UBH.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| 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 | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.UBH.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.UBH.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.UBH.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 Translated | Yes (X) | FAPTranslatedInd |
| 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 (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, UINTAH BASIN MEDICAL CENTER - PART V, LINE 3E | IDENTIFICATION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS BEGIN ON PAGE 6 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. |
| FACILITY 1, UINTAH BASIN MEDICAL CENTER - PART V, LINE 5 | IN CONNECTION WITH ITS MOST RECENT CHNA, UINTAH BASIN MEDICAL CENTER (UBMC) TOOK INTO ACCOUNT INPUT FROM A VARIETY OF PERSONS WHO REPRESENTED THE BROAD INTEREST OF THE COMMUNITY SERVED BY UBMC. UINTAH BASIN HEALTHCARE PARTNERED WITH THE NATIONAL RURAL HEALTH RESOURCE CENTER (NRHRC) AND THE UNIVERSITY OF DULUTH THE PAST THREE CYCLES (NINE YEARS) TO CONDUCT A THIRD-PARTY COMMUNITY HEALTH NEEDS ASSESSMENT. A SURVEY OF 800 RESIDENTS WAS CONDUCTED WITH AN 17.5% RESPONSE RATE IN THE YEAR 2020. IN ADDITION, 12 KEY PARTICIPANTS COMPLETED A PHONE SURVEY CONDUCTED BY NRHRC. INDIVIDUALS INCLUDED THOSE WITH KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH INCLUDING STATE, LOCAL AND TRIBAL PUBLIC HEALTH ORGANIZATIONS AS WELL AS ORGANIZATIONS SUCH AS UINTAH BASIN ASSOCIATION OF GOVERNMENTS (REPRESENTING UNDERSERVED, LOW-INCOME, UNINSURED AND MINORITY POPULATIONS), TRICOUNTY HEALTH, INDIVIDUALS FROM NONPROFIT AND COMMUNITY-BASED ORGANIZATIONS, LOCAL GOVERNMENTAL ORGANIZATIONS, LOCAL SCHOOL DISTRICTS AND A LOCAL COUNSELING CENTER. HOSPITAL PERSONNEL ATTENDED A COMMUNITY HEALTH NEEDS VIRTUAL MEETING HOSTED BY NRHRC TO DISCUSS THE OUTCOMES OF COMMUNITY PRINT AND PHONE SURVEYS INDICATING SIGNIFICANT HEALTH NEEDS AND DISPARITIES WITHIN THE MEDICAL CENTERS COMMUNITY SERVICE AREA. UBMC DISCLOSED THE RESULTS OF ITS CHNA SURVEY TO PARTICIPANTS, OUR BOARD/LEADERSHIP, AND OUR COMMUNITY. THE MEDICAL CENTER DISCUSSED TOP HEALTH CONCERNS, AND SOLICITED AND GATHERED INPUT REGARDING POSSIBLE SOLUTIONS TO THE HEALTH CONCERNS IDENTIFIED IN THE MEDICAL CENTERS CHNA SURVEY AND FINDINGS. |
| FACILITY 1, UINTAH BASIN MEDICAL CENTER - PART V, LINE 11 | AS OUTLINED BELOW, ALL ASSESSED NEEDS WERE ADDRESSED BY THE HOSPITAL. AS IDENTIFIED IN THE HOSPITAL'S CHNA, THE SIGNIFICANT NEEDS ARE AS FOLLOWS WITH A DESCRIPTION OF THE CHNA PROPOSED METHODS TO ADDRESS THE CONCERNS. ALL PROPOSED NEEDS WERE ADDRESSED ACCORDING TO THE PUBLISHED CHNA. THE TOP THREE CONCERNS WERE DIABETES, ALCOHOL ABUSE AND DRUG USE. 1.DIABETES - UBMC WILL ADDRESS DIABETES BY GROWING OUR DIABETES EDUCATION AND REGISTERED DIETITIAN OFFERINGS, HOSTING A 5K/FUN RUN ANNUALLY, PROMOTING AN EMPLOYEE WELLNESS PROGRAM, AND SPONSORING WELLNESS ACTIVITIES (I.E. YOUTH AND HIGH SCHOOL SPORTS, WALKING TRAILS, THE AQUATIC CENTER, EAT WELL PROGRAMS, HEALTH FAIRS, ETC). OUR PROVIDERS WILL MONITOR CHILDRENS WEIGHT/HEIGHT/BM ROUTINELY AND CONNECT OR REFER FAMILIES TO BREASTFEEDING SUPPORT (SUCH AS OUR OB DEPARTMENTS CERTIFIED LACTATION COUNSELORS) OR NUTRITION EDUCATION (THROUGH OUR DIABETES EDUCATION PROGRAM). OUR PROVIDERS/DEPARTMENTS ARE ALSO IMPLEMENTING MONITORING SYSTEMS FOR PATIENTS AT RISK FOR DIABETES. 2.ALCOHOL ABUSE & 3. DRUG USE - AT UINTAH BASIN HEALTHCARE, WE ARE IMPLEMENTING SEVERAL INITIATIVES TO ADDRESS DRUG MISUSE AND ALCOHOL ABUSE. OUR HOSPITAL AND CLINIC AREAS ARE WORKING TO EDUCATE AND OFFER ALTERNATIVES TO OPIOIDS, AS WELL AS PROMOTE SAFE DISPOSAL OF UNUSED MEDICATIONS BY PROVIDING A DROPBOX AT THE UBMC PHARMACY AND DVMC PHARMACY. WE WILL RAISE AWARENESS THROUGH INCREASED COMMUNITY EDUCATION AND COLLABORATION, WHILE IDENTIFYING AND PROMOTING RESOURCES FOR DRUG AND ALCOHOL RECOVERY.I.UBMC PARTNERED WITH THE THOMPSON HOUSE OF HOPE (A LOCAL RECOVERY CENTER) TO PROVIDE A WEBSITE, BUSINESS CARDS, EVENT BANNER, VEHICLE DECALS, AND MARKETING ASSISTANCE TO RAISE AWARENESS FOR LOCAL RECOVERY OPTIONS TO THOSE AFFECTED BY SUBSTANCE ABUSE.THE NEXT RANKING ITEMS INCLUDED TOBACCO/SMOKING/VAPING, MENTAL HEALTH, ADULT OBESITY, CANCER, OPIOID ADDICTION, HEART DISEASE AND CHILDHOOD OBESITY. EACH DEPARTMENT MANAGER AT UBMC SUBMITTED A GOAL TO ADDRESS TOP HEALTH CONCERNS TO ESTABLISH A SHARED VISION OF OUR ABILITY TO MAKE AN IMPACT. GOALS/PROJECTS ARE MONITORED OVER A THREE-YEAR PROCESS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BASIN CARE & REHABILITATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 260 W 200 N | AddressLine1Txt |
| City | ROOSEVELT | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84066 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | LONG-TERM CARE & REHABILITATION CENTER | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7 | UBMC APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES DERIVED FROM WORKSHEET 2, FOR AMOUNTS REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, TOTAL COMMUNITY BENEFIT AND TOTAL COMMUNITY BUILDING EXPENSES). |
| SCHEDULE H, PART II | THE HOSPITAL RECENTLY PURCHASED SOME PROPERTY TO DEVELOP A COMMUNITY WALKING PATH TO PROMOTE PHYSICAL ACTIVITY IN THE COMMUNITY SERVED BY THE HOSPITAL. DUCHESNE COUNTY IS FEDERALLY DESIGNATED AS A HEALTH PROFESSIONAL SHORTAGE AREA BY HRSA. THE HOSPITAL IS CONTINUALLY RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ITS RURAL SERVICE AREA TO HELP IMPROVE ACCESS TO HEALTHCARE SERVICES AS IDENTIFIED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT. |
| SCHEDULE H, PART III, LINE 2 | UBMC REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. UBMC PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. |
| SCHEDULE H, PART III, LINE 3 | UBMC ANALYZED BAD DEBT ACCOUNTS AND ESTIMATED BAD DEBT EXPENSE THAT IS REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE MEDICAL CENTER'S CHARITY CARE POLICY BUT FOR WHOM INSUFFICIENT INFORMATION WAS OBTAINED TO DETERMINE THEIR ELIGIBILITY. UBMC CALCULATED THE PRIOR YEAR CHARITY CARE AS A PERCENTAGE OF SELF PAY A/R AND APPLIED THAT PERCENTAGE TO THE SELF PAY A/R FOR 2021. |
| SCHEDULE H, PART III, LINE 4 | THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 4 ON PAGE 13 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IN INCLUDED IN FOOTNOTE 9 STARTING ON PAGE 17 OF THE AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, LINE 8 | ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. |
| SCHEDULE H, PART III, LINE 9B | THE ACCOUNTS OF UNINSURED OR UNDER-INSURED PATIENTS WHO HAVE APPLIED FOR MEDICAL ASSISTANCE OR FINANCIAL ASSISTANCE ARE HELD WITHOUT FURTHER COLLECTION ACTION, UNTIL THE APPLICATION PROCESS HAS BEEN COMPLETE. |
| SCHEDULE H, PART VI, LINE 2 | SERVICES USES LOCAL AND STATE BASED DATA TO ASSIST ITS MEDICAL STAFF IN ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES AND PROVIDES BASIC FAMILY BASED PRIMARY CARE. WE ARE CONTINUALLY TAKING IN INFORMATION AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. COPIES ARE AVAILABLE AT THE HOSPITAL UPON REQUEST OF THE MOST RECENTLY ADOPTED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY OR A COPY CAN BE FOUND AT THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTPS://UBH.ORG/WP-CONTENT/UPLOADS/SITES/534/2020/08/CH NA_2020_ WEBSUMMARY.PPTX.PDF |
| SCHEDULE H, PART VI, LINE 3 | ALL PATIENTS PRESENTING TO OUR FACILITY WHO ARE UNINSURED/UNDER-INSURED ARE PRESENTED WITH THE OPPORTUNITY FOR FINANCIAL ASSISTANCE APPLICATION. A PATIENT FINANCIAL ASSISTANCE COUNSELOR IS AVAILABLE FULL TIME FOR INQUIRIES AND CONSULTING REGARDING ALL AVAILABLE FINANCIAL AID PROGRAMS. |
| SCHEDULE H, PART VI, LINE 4 | THE HOSPITAL PROVIDES SERVICES TO RESIDENTS OF THE UINTAH BASIN LOCATED IN ROOSEVELT, UT WHICH IS LOCATED IN DUCHESNE AND UINTAH COUNTIES. DUCHESNE COUNTY IS FEDERALLY DESIGNATED AS A HEALTH PROFESSIONAL SHORTAGE AREA BY HRSA. THE COUNTY POPULATION IS APPROXIMATELY 20,000 WITH A MEDIAN HOUSEHOLD INCOME OF 63,000. 11.1% OF DUCHESNE COUNTY FAMILIES LIVE IN POVERTY. UINTAH COUNTY IS FEDERALLY DESIGNATED AS A HEALTH PROFESSIONAL AND MEDICALLY UNDERSERVED PROVIDER SHORTAGE AREA BY HRSA. THE COUNTY POPULATION IS APPROXIMATELY 36,000 WITH A MEDIAN HOUSEHOLD INCOME OF 65,000. 9.8% OF UINTAH COUNTY FAMILIES LIVE IN POVERTY. THE UNEMPLOYMENT RATE WAS 7.8% IN 2021. |
| SCHEDULE H, PART VI, LINE 5 | THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. THE HOSPITAL'S BOARD MEMBERS RESIDE IN THE PRIMARY SERVICE AREA AND DEDICATE TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. THE HOSPITAL DOES NOT HAVE ANY SHAREHOLDERS AND ANY SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY, EQUIPMENT, AND EMPLOYEE EDUCATION. THE HOSPITAL HOLDS NUMEROUS COMMUNITY ACTIVITIES SUCH AS HEALTH FAIRS, FREE FLU SHOT CLINICS, PROMOTES SCHOOL PROGRAMS, AND PROVIDES NUMEROUS HEALTH, WELLNESS, AND EDUCATION ACTIVITIES TO PROMOTE HEALTH WITHIN THE COMMUNITY. IN ADDITION, THE HOSPITAL IS CONTINUALLY COLLABORATING WITH OTHER FACILITIES AND ORGANIZATIONS TO PROVIDE NEEDED SERVICES AND DONATE TIME AND EFFORT TO THE COMMUNITY. WE PROVIDE SUBSTANTIAL AMOUNTS OF UNCOMPENSATED CARE TO INDIVIDUALS THAT ARE IN NEED. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt |
|---|---|---|---|---|
| SEAN PAULSEN | ||||
| DIRECTOR/CHIEF RADIO | $708,798 | $708,798 | ||
| JASON LARSON | ||||
| DIRECTOR/CMO | $638,675 | $638,675 | ||
| JAMES MARSHALL | ||||
| PRESIDENT & CEO | $365,546 | $477,054 | $64,801 | $46,707 |
| BRENT HALES | ||||
| CFO | $254,018 | $319,540 | $17,604 | $47,918 |
| RANDALL BENNETT | ||||
| HR DIRECTOR | $216,603 | $275,927 | $14,882 | $44,442 |
| ROGER MARETT | ||||
| VP PHYSICIANS SVS | $187,362 | $240,815 | $13,713 | $39,740 |
| BOBBY RICHARDSON | ||||
| CNO | $177,120 | $228,406 | $13,250 | $38,036 |
| JOSEPH GARCIA | ||||
| PHYSICIAN | $434,990 | $477,318 | $42,328 | |
| KERRY BAUM | ||||
| SURGEON | $401,420 | $448,306 | $46,886 | |
| KENT SMITH | ||||
| INTERNAL MEDICINE | $323,811 | $360,685 | $36,874 | |
| SHANE POWELL | ||||
| OPHTHALMOLOGY | $300,077 | $340,834 | $40,757 | |
| BRUCE ARNOLD | ||||
| PATHOLOGIST | $286,477 | $327,474 | $40,997 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 6 | THE SOLE MEMBER OF UBMC IS UINTAH BASIN HEALTHCARE (UBH). |
| FORM 990, PAGE 6, PART VI, LINE 7B | UBMC SHALL NOT SELL ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION OR OTHERWISE MERGE WITH A THIRD PARTY OR TO BE ACQUIRED BY A THIRD PARTY WITHOUT HTE APPROVAL OF UBH. |
| 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 REALTED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER. THE 990 IS ALSO REVIEWED BY THE BOARD OF DIRECTORS. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CFO SIGNS THE FORM 8879-EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN. |
| FORM 990, PAGE 6, PART VI, LINE 12C | CONFLICT QUESTIONNAIRES ARE COMPLETED ANNUALLY. IF CONFLICTS ARE PRESENT, ROBERTS RULES OF ORDER (RRO) ARE FOLLOWED AND THEY ARE RECUSED FROM VOTING. IF IT IS DETERMINED THAT THERE WAS A CONFLICT NOT REPORTED, THEY ARE SUBJECT TO DISCIPLINARY ACTION. |
| FORM 990, PAGE 6, PART VI, LINE 15A | AN INDEPENDENT COMPENSATION CONSULTANT IS HIRED WHO USES A SURVEY FOR BOTH CEO AND CFO COMPENSATION. THOSE RESULTS ARE REVIEWED BY THE COMPENSATION COMMITTEE AND THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE FORM 990, PART VI, LINE 15A. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | 16,497,742 1,537,946 0 |
| FORM 990, PART XI, LINE 9 | GAIN ON TERMINATION OF INTEREST RATE SWAP 2,419,613 |