TETON VALLEY HEALTH CARE INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- TETON VALLEY HEALTH CARE INC (EIN 45-4551946)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-29
- IRS object ID
- 202212419349300871
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-29T11:24:50-04:00 | ReturnTs |
| Tax Period End | 2021-09-30 | 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 | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454551946 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TETON VALLEY HEALTH CARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TETO | BusinessNameControlTxt |
| Phone | 2083542383 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 EAST HOWARD AVENUE | AddressLine1Txt |
| City | DRIGGS | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83422 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEITH GNAGEY | PersonNm |
| Person Title | DIRECTOR/CEO | PersonTitleTxt |
| Phone | 2083542383 | PhoneNum |
| Signature | 2022-08-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KEITH | PersonFirstNm |
| Person Last | GNAGEY | 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 | 2022-08-29 | 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 | KEITH GNAGEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 EAST HOWARD AVE | AddressLine1Txt |
| City | DRIGGS | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83422 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $28,172,165 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TVHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | ID | LegalDomicileStateCd |
| Activity Or Mission | TO ENCOURAGE AND SUPPORT A HEALTHIER COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 204 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,056,752 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,103,107 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,462,375 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $22,705,279 | CYProgramServiceRevenueAmt |
| PY Investment Income | $20,668 | PYInvestmentIncomeAmt |
| CY Investment Income | $22,682 | CYInvestmentIncomeAmt |
| PY Other Revenue | $368,282 | PYOtherRevenueAmt |
| CY Other Revenue | $341,097 | CYOtherRevenueAmt |
| PY Total Revenue | $19,908,077 | PYTotalRevenueAmt |
| CY Total Revenue | $28,172,165 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $9,272 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,153 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,813,468 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,482,151 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $279,054 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,086,173 | PYOtherExpensesAmt |
| CY Other Expenses | $10,643,519 | CYOtherExpensesAmt |
| PY Total Expenses | $19,908,913 | PYTotalExpensesAmt |
| CY Total Expenses | $22,131,823 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$836 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,040,342 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,702,730 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,138,827 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,803,810 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,199,565 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,898,920 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $16,939,262 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO ENCOURAGE AND SUPPORT A HEALTHIER COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $17,111,639 | ExpenseAmt |
| Grant | $6,153 | GrantAmt |
| Revenue | $22,705,279 | RevenueAmt |
| Desc | THE HOSPITAL OPERATES A 13-BED CRITICAL ACCESS HOSPITAL (CAH) AND 2 RURAL HEALTH CLINICS WHICH PROVIDE HEALTHCARE SERVICES TO PATIENTS IN THE TETON COUNTY, IDAHO AREA. THE HOSPITAL PROVIDED 376 DAYS OF INPATIENT SERVICES, 24,564 OUTPATIENT VISITS, 2,722 EMERGENCY ROOM VISITS, AND 566 SURGERIES FOR THE YEAR. THE HOSPITAL 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 58,366 FOR CHARITY CARE, 3,893,204 FOR MEDICARE, 1,812,215 FOR MEDICAID, AND 2,568,010 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR. | Desc |
| Total Program Service Expenses | $17,111,639 | 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 | false | 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 | 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 | Yes (true) | 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 | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 204 | 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | 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 | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEITH GNAGEY | PersonNm |
| Phone | 2083542383 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 EAST HOWARD AVE | AddressLine1Txt |
| City | DRIGGS | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83422 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ROBERT WHIPPLE | ||||||||
| CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL WINE | ||||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOANN KAY | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| AARON HANSEN | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JONI PARANKA | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| LISA PIERSON | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KEITH GNAGEY | ||||||||
| DIRECTOR/CEO | 40.00 | Yes (X) | Yes (X) | $285,347 | $0 | $10,138 | ||
| LETITIA MILLER | ||||||||
| CFO | 40.00 | Yes (X) | $208,268 | $0 | $9,974 | |||
| NATHAN LEVANGER | ||||||||
| CMO | 40.00 | $343,390 | $0 | $14,350 | Yes (X) | |||
| MAURICE BROWN MD | ||||||||
| PHYSICIAN | 32.00 | $673,378 | $0 | $22,084 | Yes (X) | |||
| CHAD HORROCKS MD | ||||||||
| PHYSICIAN | 36.00 | $394,673 | $0 | $20,521 | Yes (X) | |||
| TAYLOR NELSON | ||||||||
| CRNA | 32.00 | $290,403 | $0 | $18,463 | Yes (X) | |||
| JUANITA PRISSEL | ||||||||
| PHYSICIAN | 36.00 | $246,462 | $0 | $10,007 | Yes (X) | |||
| TROY WESTON | ||||||||
| PHYSICIAN AS | 36.00 | $197,235 | $0 | $11,086 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,639,156 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $116,623 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | 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 |
|---|---|---|---|---|---|
| EMERGENCY PHYSICIANS INTEGRATED CAR | |||||
| 333 N 300 W | SALT LAKE CITY | UT | 84103 | PHYSICIANS | $458,600 |
| PM NAGLE CONSULTING LLC | |||||
| 3816 SALISH TRAIL | STEVENSVILLE | MT | 59870 | BILLING | $360,000 |
| PHARMGO LLC | |||||
| 1790 DEER VALLEY DRIVE | IDAHO FALLS | ID | 83401 | PHARMACIST | $310,050 |
| QUALIVIS LLC | |||||
| PO BOX 1180 | COLUMBIA | SC | 29201 | CONTRACT LABOR | $262,124 |
| HEALTHCARE SERVICES GROUP | |||||
| 3220 TILLMAN DRIVE 300 | BENSALEM | PA | 19020 | DIETARY SERVICE | $260,065 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,908,280 | GovernmentGrantsAmt |
| All Other Contributions | $194,827 | AllOtherContributionsAmt |
| Total Contributions | $5,103,107 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE, NET | 624100 | $22,700,621 | $22,700,621 |
| RENT INCOME | 621910 | $4,658 | $4,658 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $22,705,279 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,682 | TotalRevenueColumnAmt |
| Exclusion | $22,682 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $271,616 | GrossSalesOfInventoryAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $271,616 | TotalRevenueColumnAmt |
| Exclusion | $271,616 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 722320 | $45,402 | $45,402 |
| OTHER REVENUE | 900099 | $24,079 | $24,079 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $69,481 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,172,165 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $22,705,279 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $363,779 | 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 | $6,153 | TotalAmt |
| Program Services | $6,153 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $891,082 | TotalAmt |
| Program Services | $359,310 | ProgramServicesAmt |
| Management And General | $531,772 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,042,969 | TotalAmt |
| Program Services | $7,338,237 | ProgramServicesAmt |
| Management And General | $1,562,657 | ManagementAndGeneralAmt |
| Fundraising | $142,075 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,680 | TotalAmt |
| Program Services | $137,915 | ProgramServicesAmt |
| Management And General | $37,215 | ManagementAndGeneralAmt |
| Fundraising | $2,550 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $671,279 | TotalAmt |
| Program Services | $482,511 | ProgramServicesAmt |
| Management And General | $176,215 | ManagementAndGeneralAmt |
| Fundraising | $12,553 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $699,141 | TotalAmt |
| Program Services | $552,236 | ProgramServicesAmt |
| Management And General | $135,621 | ManagementAndGeneralAmt |
| Fundraising | $11,284 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,016 | TotalAmt |
| Management And General | $24,016 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,998 | TotalAmt |
| Management And General | $168,998 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,218,175 | TotalAmt |
| Program Services | $2,935,441 | ProgramServicesAmt |
| Management And General | $1,278,860 | ManagementAndGeneralAmt |
| Fundraising | $3,874 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,134 | TotalAmt |
| Program Services | $817 | ProgramServicesAmt |
| Management And General | $116,317 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $643,324 | TotalAmt |
| Program Services | $451,962 | ProgramServicesAmt |
| Management And General | $180,591 | ManagementAndGeneralAmt |
| Fundraising | $10,771 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $461,964 | TotalAmt |
| Program Services | $279,310 | ProgramServicesAmt |
| Management And General | $106,869 | ManagementAndGeneralAmt |
| Fundraising | $75,785 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,603 | TotalAmt |
| Program Services | $46,233 | ProgramServicesAmt |
| Management And General | $26,367 | ManagementAndGeneralAmt |
| Fundraising | $3 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,236 | TotalAmt |
| Program Services | $13,236 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $901,253 | TotalAmt |
| Program Services | $829,705 | ProgramServicesAmt |
| Management And General | $68,835 | ManagementAndGeneralAmt |
| Fundraising | $2,713 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,485 | TotalAmt |
| Program Services | $127,559 | ProgramServicesAmt |
| Management And General | $31,926 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $3,290,441 | $3,290,441 | ||
| REPAIRS & MAINTENANCE | $202,079 | $195,823 | $5,565 | $691 |
| DUES & SUBSCRIPTIONS | $85,915 | $34,601 | $51,132 | $182 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,896 | TotalAmt |
| Program Services | $30,149 | ProgramServicesAmt |
| Management And General | $238,174 | ManagementAndGeneralAmt |
| Fundraising | $16,573 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,131,823 | TotalAmt |
| Program Services | $17,111,639 | ProgramServicesAmt |
| Management And General | $4,741,130 | ManagementAndGeneralAmt |
| Fundraising | $279,054 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,391,022 | BOYAmt |
| EOY | $8,868,541 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $653,638 | BOYAmt |
| EOY | $658,730 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,300,373 | BOYAmt |
| EOY | $3,631,879 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,140,755 | BOYAmt |
| EOY | $1,164,085 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,367 | BOYAmt |
| EOY | $87,610 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,161,059 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,154,027 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,434,237 | BOYAmt |
| EOY | $4,007,032 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $759,338 | BOYAmt |
| EOY | $720,950 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,702,730 | BOYAmt |
| EOY | $19,138,827 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,845,579 | BOYAmt |
| EOY | $1,709,239 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,094,945 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,863,286 | BOYAmt |
| EOY | $490,326 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,803,810 | BOYAmt |
| EOY | $2,199,565 | 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 | $10,798,920 | BOYAmt |
| EOY | $16,939,262 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,000 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,898,920 | BOYAmt |
| EOY | $16,939,262 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,702,730 | BOYAmt |
| EOY | $19,138,827 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,040,342 | ReconcilationRevenueExpnssAmt |
| 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 | 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 | $2,329 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,329 | 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 | $92,671 | OtherCostOrOtherBasisAmt |
| Book Value | $92,671 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,683,943 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,569,947 | DepreciationAmt |
| Book Value | $2,113,996 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,241,999 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,584,080 | DepreciationAmt |
| Book Value | $1,657,919 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $142,446 | OtherCostOrOtherBasisAmt |
| Book Value | $142,446 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,007,032 | TotalBookValueLandBuildingsAmt |
| 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 | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND 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 HOSPITAL EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WERE CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF SEPTEMBER 30, 2021 AND 2020, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | 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 | $39,105 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $39,105 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,484,810 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,896,458 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $588,352 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02660 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,523,915 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,896,458 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $627,457 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02840 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $428,136 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $428,136 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01930 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $428,136 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $428,136 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01930 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,952,051 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,896,458 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,055,593 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04770 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,826 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,826 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,826 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,826 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $913,255 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $7,339,307 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,339,390 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$83 | 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 | TETON VALLEY HEALTH CARE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 EAST HOWARD AVE | AddressLine1Txt |
| City | DRIGGS | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83422 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.TVHCARE.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TETON VALLEY HEALTH CARE INC | 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 | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | 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.TVHCARE.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.TVHCARE.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 | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| 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.TVHCARE.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.TVHCARE.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.TVHCARE.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 Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, TETON VALLEY HEALTH CARE INC. - PART V, LINE 3E | IDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS BEGIN ON PAGE 51 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. |
| FACILITY 1, TETON VALLEY HEALTH CARE INC. - PART V, LINE 5 | TVHC PARTNERED WITH QUORUM HEALTH RESOURCES (QHR) TO DEPLOY A CHNA SURVEY TO LOCAL EXPERT ADVISORS TO GAIN LOCAL INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. THE METHODOLOGY TAKES A COMPREHENSIVE APPROACH TO THE SOLICITATION OF WRITTEN COMMENTS. WRITTEN COMMENT PARTICIPANTS SELF-IDENTIFIED INTO THE FOLLOWING CLASSIFICATIONS: (1) PUBLIC HEALTH PERSONS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH (2) DEPARTMENTS AND AGENCIES FEDERAL, TRIBAL, REGIONAL, STATE, OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES, WITH CURRENT DATA OR OTHER RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY (3) PRIORITY POPULATIONS LEADERS, REPRESENTATIVES, OR MEMBERS OF MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS IN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY. ALSO, IN OTHER FEDERAL REGULATIONS THE TERM PRIORITY POPULATIONS, WHICH INCLUDE RURAL RESIDENTS AND LGBTQ INTERESTS, IS EMPLOYED AND FOR CONSISTENCY IS INCLUDED IN THIS DEFINITION (4) CHRONIC DISEASE GROUPS REPRESENTATIVE OF OR MEMBER OF CHRONIC DISEASE GROUP OR ORGANIZATION, INCLUDING MENTAL AND ORAL HEALTH (5) BROAD INTEREST OF THE COMMUNITY INDIVIDUALS, VOLUNTEERS, CIVIC LEADERS, MEDICAL PERSONNEL, AND OTHERS TO FULFILL THE SPIRIT OF BROAD INPUT REQUIRED BY THE FEDERAL REGULATIONS. A CHNA SURVEY WAS DEPLOYED TO THE HOSPITALS LOCAL EXPERT ADVISORS TO GAIN INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED ACCORDING TO CRITERIA REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS AND THE HOSPITALS DESIRE TO REPRESENT THE REGIONS GEOGRAPHICALLY AND ETHNICALLY DIVERSE POPULATION. QHR RECEIVED COMMUNITY INPUT FROM 29 LOCAL EXPERT ADVISORS. HAVING TAKEN STEPS TO IDENTIFY POTENTIAL COMMUNITY NEEDS, THE LOCAL EXPERTS THEN PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED A "WISDOM OF CROWDS" METHOD. THE PREMISE OF THIS APPROACH RELIES ON A PANEL OF EXPERTS WITH THE ASSUMPTION THAT THE COLLECTIVE WISDOM OF PARTICIPANTS IS SUPERIOR TO THE OPINION OF ANY ONE INDIVIDUAL, REGARDLESS OF THEIR PROFESSIONAL CREDENTIALS. INFORMATION ANALYSIS AUGMENTED BY LOCAL OPINIONS SHOWED HOW TETON COUNTY RELATES TO ITS PEERS IN TERMS OF PRIMARY AND CHRONIC NEEDS AS WELL AS OTHER ISSUES OF UNINSURED PERSONS, LOW INCOME PERSONS AND MINORITY GROUPS; RESPONDENTS COMMENTED ON CERTAIN POPULATION GROUPS OR PEOPLE WITH CERTAIN SITUATIONS THAT MAY NEED HELP TO IMPROVE THEIR CONDITION AND IF SO, WHO NEEDS TO DO WHAT. |
| FACILITY 1, TETON VALLEY HEALTH CARE INC. - PART V, LINE 6B | TVHC PARTNERED WITH QUORUM HEALTH RESOURCES (QHR) TO COMPLETE A CHNA REPORT. |
| FACILITY 1, TETON VALLEY HEALTH CARE INC. - PART V, LINE 11 | THE HOSPITAL DOES NOT HAVE ADEQUATE RESOURCES TO SOLVE ALL THE SIGNIFICANT NEEDS IDENTIFIED. SOME ISSUES ARE BEYOND THE MISSION OF THE HOSPITAL AND ACTION IS BEST SUITED FOR A RESPONSE BY OTHERS. SOME IMPROVEMENTS WILL REQUIRE PERSONAL ACTIONS BY INDIVIDUALS RATHER THAN THE RESPONSE OF AN ORGANIZATION. WE VIEW THIS AS A PLAN FOR HOW WE, ALONG WITH OTHER AREA ORGANIZATIONS AND AGENCIES, CAN COLLABORATE TO BRING THE BEST EACH HAS TO OFFER TO SUPPORT CHANGE AND TO ADDRESS THE MOST PRESSING IDENTIFIED NEEDS. THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE LATEST CHNA ARE AFFORDABILITY/ACCESSIBILITY, MENTAL HEALTH/SUICIDE, PREVENTION/WELLNESS, DRUGS/SUBSTANCE ABUSE, ALCHOHOL USE, AND ACCIDENTS. STRATEGIES THE HOSPITAL IS USING TO ADDRESS IDENTIFIED HEALTH NEEDS INCLUDE THE FOLLOWING: COMMUNITY ASSISTANCE PROGRAM AND CLINIC SLIDING FEE SCALE FOR CLINICS AND HOSPITAL BILLS FREE MAMMOGRAPHY SCREENING FOR THOSE UNABLE TO AFFORD IT TELEMEDICINE INCREASE INDIVIDUALS IN CHRONIC CARE AND PAIN MANAGEMENT PROGRAMS EXTENDED CLINIC HOURS PROVIDER WITH PSYCHIATRY/MENTAL HEALTH SPECIALIZATION STANDARDIZED DEPRESSION SCREENING PARTNERSHIPS WITH EIRMC, SCHOOL SYSTEMS AND MENTAL HEALTH COUNSELORS PUBLIC AND STAFF EDUCATION ON COLON CANCER AND OPIOID ADDICTION SMOKING CESSATION CLASSES BUNDLED, DISCOUNTED PRICING FOR COLONOSCOPY SCREENINGS LOW-COST/STATE FUNDED VACCINES AND SPORTS PHYSICALS PAIN MANAGEMENT SPECIALIST MARKETING CAMPAIGN OPIOID OPT OUT AND "GOT BRAINS" FOR SAFETY REGARDING HELMET USE DURING ACTIVITIES LIKE SKIING, SNOWBOARDING, AND ATV USE COMMUNITY PRESENTATIONS REGARDING ADDICTION AND ABUSE CONCUSSION BASELINE SCREENINGS CPR TRAINING THE HOSPITAL IS CONTINUALLY ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| DRIGGS HEALTH CLINIC | ||||
| 283 NORTH FIRST EAST | DRIGGS | ID | 83422 | RURAL HEALTH CLINIC |
| VICTOR HEALTH CLINIC | ||||
| 83 N MAIN STREET | VICTOR | ID | 83455 | RURAL HEALTH CLINIC |
| CACHE CLINIC | ||||
| 852 VALLEY CENTER DRIVE | DRIGGS | ID | 83422 | OUTPATIENT CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7 | THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES DERIVED FROM WORKSHEET 2, FOR AMOUNTS REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, TOTAL COMMUNITY BENEFIT AND TOTAL COMMUNITY BUILDING EXPENSES). |
| SCHEDULE H, PART III, LINE 2 | THE COSTING METHODOLOGY USED BY THE HOSPITAL INCLUDES THE COST-TO-CHARGE RATIO OF PATIENT CARE. |
| SCHEDULE H, PART III, LINE 3 | THE HOSPITAL DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY BUT FOR WHOM SUFFICIENT INFORMATION WAS NOT OBTAINED TO MAKE DETERMINATION OF THEIR ELIGIBILITY DURING THE YEAR. |
| SCHEDULE H, PART III, LINE 4 | THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 4 ON PAGE 13 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 8 ON PAGE 16 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 HOSPITAL'S BUSINESS OFFICE STAFF FOLLOW UP ON ACCOUNTS 15 TO 30 DAYS AFTER THE ACCOUNTS ARE BILLED. THE STAFF CONTACT THE INSURERS TO VERIFY CLAIMS HAVE BEEN RECEIVED AND TO RESEND THE CLAIMS IF NECESSARY. AFTER VERIFYING CLAIMS HAVE BEEN RECEIVED, THE STAFF CONTINUE TO CONTACT THE INSURERS EVERY 30 DAYS, AS NECESSARY, TO FOLLOW UP ON THE STATUS OF THE CLAIMS. ONCE INSURANCE BALANCES ARE EXHAUSTED, THE REMAINING SELF-PAY BALANCES ARE THEN MANAGED BY THE HOSPITAL SELF PAY DIVISION WHICH ATTEMPTS TO COLLECT FOR 120 DAYS. IF PAYMENT FOR NON-MEDICARE ACCOUNTS IS STILL NOT COLLECTED OR IF PAYMENT TERMS ARE NOT ADHERED TO THEN THE BALANCE IS SENT TO KINUM FOR PRE- COLLECTIONS FOR 30 DAYS AND AT DAY 151 UNPAID ACCOUNTS ARE FORWARDED TO COLLECTIONS OR KINUM. MEDICARE ACCOUNTS ARE RETURNED TO THE HOSPITAL AND WRITTEN OFF AS UNCOLLECTIBLE MEDICARE BAD DEBT. |
| SCHEDULE H, PART VI, LINE 2 | MANAGEMENT, HOSPITAL DEPARTMENT STAFF AND MANAGERS, AND THE BOARD OF DIRECTORS ARE COMPRISED OF MEMBERS WITHIN THE COMMUNITY. THEY ARE ABLE TO GATHER AND COMMUNICATE THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES AND CONTINUALLY ADDRESS THEM AT STAFF AND BOARD MEETINGS. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY AND COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT THE FOLLOWING URL: HTTPS://ISSUU.COM/TVHEALTHCARE/DOCS/09.27.19_- _TETON_VALLEY_HEALTH_CHNA_FINAL_REPORT |
| SCHEDULE H, PART VI, LINE 3 | IN COMPLIANCE WITH THE COLLECTION POLICIES OF TVHC, AN ANNUAL REVIEW IS PERFORMED FOR ALL CREDIT/COLLECTION AND FINANCIAL ASSISTANCE POLICIES. ONCE REVIEWED AND REVISED, THE INFORMATION IS DISTRIBUTED TO THE COMMUNITY IN A VARIETY OF WAYS. THE FACILITY PUBLISHED A BROCHURE THAT IS PLACED IN PUBLIC AREAS OF ALL THE TVHC FACILITIES, AS WELL AS INCLUDED IN ALL FORMAL ADMISSION PACKETS TO PATIENTS. THE PATIENT ACCOUNT REPRESENTATIVE'S HAND OUT THE INFORMATION DURING PATIENT CONSULTS AS WELL. THE INFORMATION IS ALSO AVAILABLE ON THE TVHC WEBSITE AND INCLUDED WITH EVERY PATIENT ACCOUNT STATEMENT. THE LATEST FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON OUR WEBSITE. IT IS UPDATED ANNUALLY WITH NEW POVERTY GUIDELINES. |
| SCHEDULE H, PART VI, LINE 4 | TETON COUNTY IDAHO COVERS 450 SQUARE MILES OF SOUTHEASTERN IDAHO. THE 2016 POPULATION WAS 10,430 COMPARED TO A 2000 POPULATION OF 5,999 REPRESENTING A POPULATION GAIN OF 74% SINCE 2000. MEDIAN AGE IS 36.3, MEDIAN HOUSEHOLD INCOME IS 54,896 COMPARED TO 48,905 FOR THE STATE OF IDAHO, AND AN UNEMPLOYMENT RATE OF 4% COMPARED TO 3.9% FOR THE STATE AND 4.9% FOR THE U.S. HISPANICS MAKE UP 17.7% OF THE POPULATION WITH 80.2% WHITE/NON-HISPANIC. TETON VALLEY HEALTH CARE, INC. (TVHC) HAS BEEN SERVING THE HEALTHCARE NEEDS OF THE TETON COUNTY AREA SINCE 1938. THE HOSPITAL IS NOW A NON- PROFIT, THIRTEEN BED CRITICAL ACCESS FACILITY BUILT IN 1997. TVHC OFFERS A CONTINUUM OF CARE INCLUDING INPATIENT HOSPITAL SERVICES, OUTPATIENT SERVICES AS WELL AS OUTPATIENT CLINICS IN THE CITIES OF VICTOR AND DRIGGS. TVHC EMPLOYS OVER 180 INDIVIDUALS, WITH AN ANNUAL PAYROLL IN EXCESS OF 8.4 MILLION. |
| SCHEDULE H, PART VI, LINE 5 | TETON VALLEY HEALTH CARE'S BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY MEMBERS REPRESENTING MULTIPLE FACETS OF THE COMMUNITY FROM THE FINANCIAL SECTOR TO SMALL BUSINESS OWNERS TO RETIREES. THE BOARD HAS DEDICATED THEIR TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF GREATER COMMUNITY. MEDICAL STAFF PRIVILEGES AT TVHC ARE OPEN TO ALL MEDICAL PROVIDERS WITH ACTIVE LICENSURE. WHILE THEY HAVE INSTITUTED AN ARDUOUS CREDENTIALING PROCESS TO ENSURE PRACTITIONERS OF THE HIGHEST CALIBER ARE PRIVILEGED, THEY ENCOURAGE PRACTITIONERS FROM NUMEROUS SPECIALTIES TO MEET THE EVER EXPANDING HEALTHCARE NEEDS OF THE COMMUNITY. AS A NON-PROFIT CORPORATION, TVHC DOES NOT HAVE ANY SHAREHOLDERS. THEREFORE SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY'S EQUIPMENT AND EMPLOYEE EDUCATION. THE ABSENCE OF SHAREHOLDERS ELIMINATES THE POTENTIAL FOR CONFLICTS OF INTEREST RELATED TO ATTAINING INFLATED PROFIT MARGINS AND ALLOWS TETON VALLEY HEALTHCARE TO FOCUS ON WHAT IS IMPORTANT; MEETING THE HEALTH AND WELFARE NEEDS OF THE COMMUNITIES THEY SERVE IN AN ECONOMICALLY VIABLE FASHION. THE HOSPITAL PARTICIPATES IN MULTIPLE ACTIVITIES WITHIN ITS COMMUNITY TO PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES INCLUDING DONATING TO AN ANNUAL HEALTH FAIR WHERE MEDICAL TESTS ARE PROVIDED AT REDUCED PRICES TO ENSURE THE COMMUNITY KNOWS THEIR NUMBERS AND RISKS, FOCUSING ON PREVENTION AND INTERVENTION. IN ADDITION, THE HOSPITAL CONTINUES TO COLLABORATE WITH LOCAL OFFICIALS TO PROVIDE NEEDED SERVICES AND DONATE TIME AND EFFORT TO THE COMMUNITY. WE PROVIDE SUBSTANTIAL AMOUNTS OF UNCOMPENSATED CARE TO INDIVIDUALS THAT ARE IN NEED. |
| SCHEDULE H, PART VI, LINE 6 | N/A |
| SCHEDULE H, PART VI, LINE 7 | IDAHO |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| KEITH GNAGEY | ||||
| DIRECTOR/CEO | $242,347 | $43,000 | $10,138 | $295,485 |
| LETITIA MILLER | ||||
| CFO | $176,164 | $32,104 | $9,974 | $218,242 |
| NATHAN LEVANGER | ||||
| CMO | $343,390 | $14,350 | $357,740 | |
| MAURICE BROWN MD | ||||
| PHYSICIAN | $496,753 | $176,625 | $22,084 | $695,462 |
| CHAD HORROCKS MD | ||||
| PHYSICIAN | $274,604 | $120,069 | $20,521 | $415,194 |
| TAYLOR NELSON | ||||
| CRNA | $290,403 | $18,463 | $308,866 | |
| JUANITA PRISSEL | ||||
| PHYSICIAN | $246,462 | $10,007 | $256,469 | |
| TROY WESTON | ||||
| PHYSICIAN ASSISTANT | $197,235 | $11,086 | $208,321 | |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | IN ADDITION TO BASE COMPENSATION, THE HOSPITAL CEO MAY BE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON PERFORMANCE GOALS OUTLINED IN ANNUAL GOALS AND THE EMPLOYMENT CONTRACT. PERFORMANCE GOALS INCLUDE GROWTH (SUCH AS ADDING SERVICE LINES), COMMUNITY (SUCH AS COMPLETING THE COMMUNITY HEALTH NEEDS ASSESSMENT), AND PROGRAM (SUCH AS ADDING 340(B) PROGRAM). THE INCENTIVE COMPENSATION IS CONTINGENT ON ACHIEVING BASELINE FINANCIAL PERFORMANCE MEASURES. ALSO, CERTAIN MEDICAL PROVIDERS RECEIVE INCENTIVE COMPENSATION THAT IS BASED ON THE AMOUNT OF SERVICES THEY PERFORM. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 6 | THE MEMBERS OF TETON VALLEY HEALTH CARE, INC. (TVHC) SHALL CONSIST OF A BROAD REPRESENTATION OF THE PUBLIC THAT TVHC SERVES AND THE MAJORITY OF THE MEMBERS MUST BE CITIZENS OF TETON COUNTY, IDAHO, INCLUDING RESIDENTS OF EACH INCORPORATED CITY IN TETON COUNTY, IDAHO, AND THE UNINCORPORATED AREA OF TETON COUNTY. THERE SHALL BE AT LEAST FIVE MEMBERS WHICH ARE ELECTED BY A MAJORITY VOTE OF THE EXISTING MEMBERS. EACH MEMBER IS ENTITLED ONE VOTE ON ANY MATTER SUBMITTED TO A VOTE AT A MEETING OF THE MEMBERS. |
| FORM 990, PAGE 6, PART VI, LINE 7A | EACH MEMBER IS ENTITLED TO VOTE ON ANY MATTER SUBMITTED TO A VOTE AT A MEETING OF THE MEMBERS, INCLUDING THE ELECTION OF THE BOARD OF DIRECTORS. MEETINGS ARE HELD ANNUALLY AS WELL AS ANY SPECIAL MEETINGS CALLED BY THE CEO OR AT THE WRITTEN REQUEST OF THE MEMBERS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE 990 IS PROVIDED TO THE CFO AND CEO WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PRESENTED TO THE BOARD OF DIRECTORS WHO THEN APPROVE THE 990. 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 | ARTICLE 4 OF THE BYLAWS STATES THAT BOARD MEMBERS SHALL NOT USE THEIR POSITION ON THE BOARD OR ANY INFORMATION OBTAINED THROUGH THEIR POSITION FOR PERSONAL ECONOMIC BENEFIT. HOSPITAL BOARD MEMBERS SHALL COMPLY WITH THE CONFLICT OF INTEREST POLICY ADOPTED IN CONNECTION WITH THE HOSPITAL'S APPLICATION FOR TAX EXEMPTION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD REVIEWS AND APPROVES MANAGEMENT WAGES EACH YEAR. THE SOURCES UTILIZED BY TVHC IN REGARDS TO ORIGINAL FAIR MARKET VALUE OF THE CEO SALARY WAS AN EXECUTIVE COMPENSATION SURVEY, PUBLISHED BY CRITICAL DATA, INC., AND THE IDAHO HOSPITAL ASSOCIATION (IHA) ANNUAL SALARY SURVEY. THESE SURVEYS ARE UTILIZED FOR SETTING THE SALARY LEVELS OF EMPLOYEES AT TVHC. THE IHA SURVEY ITEMIZES ALL HOSPITALS AS A GROUP, CAH HOSPITALS, AND HOSPITALS BY REGION. THE CEO BASE SALARY INCREASE IS EQUAL TO THE AVERAGE PERCENT INCREASE OF ALL EMPLOYEES. THE BOARD APPROVES THE ANNUAL INCENTIVE COMPENSATION OF THE CEO. IN REGARD TO SETTING THE SALARY LEVELS OF PHYSICIANS, TVHC UTILIZES THE MGMA PHYSICIAN COMPENSATION AND PRODUCTION SURVEY AS WELL AS OTHER SURVEYS. THIS SURVEY ITEMIZES SALARIES AND PRODUCTIVITY BY PHYSICIAN SPECIALITY, YEARS IN PRACTICE, GEOGRAPHIC REGION, AND OTHER CATEGORIES. |
| FORM 990, PAGE 6, PART VI, LINE 15B | TVHC STRIVES TO PAY MARKET LEVEL SALARIES TO ALL EMPLOYEES OF THE ORGANIZATION. IT IS OUR GOAL TO RECRUIT AND RETAIN TOP TALENT IN EVERY VENUE, WHILE CONTROLLING SALARY AND BENEFIT COSTS WITHIN ESTABLISHED TARGETS. SEE FORM 990, PART VI, LINE 15A. |
| FORM 990, PAGE 6, PART VI, LINE 19 | TVHC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | 2,935,441 1,278,860 3,874 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CACHE CLINIC LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 E HOWARD | AddressLine1Txt |
| City | DRIGGS | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83422 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | CLINIC | PrimaryActivitiesTxt |
| Legal Domicile State | ID | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TVHC | BusinessNameLine1Txt |