2025-07-15T11:22:01-05:00 2024-09-30 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2023-10-01 454551946 Teton Valley Health Care TETO 2083542383 120 East Howard Avenue Driggs ID 83422 Troy Christensen CEO 2083542383 2025-07-09 1 1 Lisa Chaffee CPA P00193453 7012551091 2025-07-09 2023 2025-03-06 01:10:19Z Troy Christensen 120 East Howard Avenue Driggs ID 83422 33521490 0 X www.tvhcare.org X 2012 ID To encourage and support a healthier community. 7 7 274 7 0 0 2998346 645987 24400569 32816989 1998 28521 13878 22111 27414791 33513608 66763 5200 0 0 15992584 19223828 0 0 151902 13247548 14404671 29306895 33633699 -1892104 -120091 17374110 17664503 4020396 4430880 13353714 13233623 To encourage and support a healthier community. 0 0 28072247 5200 32839100 The organization operates a critical access hospital and two rural health clinics. The hospital admitted 166 patients that spent 1,098 cumulative days on the acute floor. The emergency department experienced 3,565 visits. 606 surgical procedures and 377 colonoscopies were performed in our operating suite. The two rural health clinics provided 26,228 visits during this same period. 28072247 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 41 0 1 274 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Leianne Everett 2083546340 120 East Howard Avenue Driggs ID 83422 JoAnne Kay Chair 1.00 0.00 X X 0 0 0 Janet Conway Treasurer 1.00 0.00 X X 0 0 0 Ken Dunn Secretary 1.00 1.00 X X 0 0 0 Kevin Mayberry Director 1.00 0.00 X 0 0 0 Tyler McKellar Director (July 2024-Sept 2024) 1.00 0.00 X 0 0 0 Gene Marcowka Director (Jan 2024-Sept 2024) 1.00 0.00 X 0 0 0 Anjali Tate Director 1.00 0.00 X 0 0 0 Troy Christensen CEO 40.00 0.00 X 92214 0 9951 Lori Leianne Everett CFO 40.00 0.00 X 133840 0 0 Lisa Loughran Carlson CNO/COO 40.00 0.00 X 330243 0 14688 Nathan Levanger CMO 40.00 0.00 X 375122 0 32370 Stefan Turkula Orthopedic Surgeon 40.00 0.00 X 472431 0 19437 Joshua Clutter ER Physician 32.00 0.00 X 319948 0 0 Stephen Houmes ER Physician, Director 48.00 0.00 X 399619 0 31679 Jacob Moss Family Practice Physician, Director 40.00 0.00 X 301474 0 30544 Keith Gnagey Former Officer 0.00 0.00 X 165777 0 0 Letitia Miller Former CFO 0.00 0.00 X 176097 0 6873 2766765 0 145542 34 1 1 1 PMNagle Consulting LLC 3816 Salish Trail Stevensville MT 59870 Revenue Cycle Services 395000 Quest Diagnostics PO Box 912400 Pasadena CA 91110 Reference Labs 321389 Russell H McUne MD PC 3835 E 530 N Rigby ID 83442 ER Physician Services 264411 Qualivis LLC PO Box 674913 Dallas TX 75267 Nurse Staffing Services 237328 Mountain View Hospital 2325 Coronado Street Idaho Falls ID 83404 Physician Staffing Services 225044 15 562538 83449 645987 Patient Service Revenue 624100 31981980 31981980 340B Revenue 456110 447433 447433 387576 387576 32816989 36403 36403 22111 0 22111 22111 22111 7882 -7882 -7882 -7882 33513608 32839100 0 28521 X 1923 1923 3277 3277 889292 889292 348784 348784 15178099 13449531 1650348 78220 261013 239856 20775 382 1458696 1214308 244198 190 1087944 858137 223234 6573 68141 68141 5744937 4462519 1281149 1269 154024 154024 162979 88438 69778 4763 298286 202531 95755 165686 96048 69638 13779 13779 1385583 1305618 79965 293538 293538 Medical Supplies 5239290 5169581 69709 Lease and Rental Expens 351799 271126 20168 60505 Repairs and Maintenance 330079 326763 3316 Recruitment Expense 90792 60709 30083 105758 14565 91193 33633699 28072247 5409550 151902 580971 2232732 3417948 1427981 21194 0 4829124 5895662 1184320 1588169 54753 146590 9492844 6374881 3429880 3117963 3855920 3255406 17374110 17664503 2469154 3416524 282825 262533 1268417 751823 4020396 4430880 X 13353714 13233623 13353714 13233623 17374110 17664503 -120091 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1165 1165 0 Schedule C, Part II-B, Line 1 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. 92671 92671 3836941 2147112 1689829 5475863 4185121 1290742 87369 42648 44721 3117963 ERC Receivable 2500190 Operating ROU Assets 684804 Financing ROU Assets 67913 Related Party Receivable 2499 3255406 Operating Lease Liability 701394 Financing Lease Liability 50429 751823 X 33513608 0 33513608 0 33513608 33633699 0 33633699 0 33633699 Part X, Line 2: The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 1 1 0 0 152000 152000 0.00450 2559969 1755950 804019 0.02390 2711969 1755950 956019 0.02840 15635 15635 0.00050 13638160 6359145 7279015 0.21640 13653795 6359145 7294650 0.21690 16365764 8115095 8250669 0.24530 5563 5563 0.00020 1739 1739 0.00010 7302 7302 0.00030 1 2216456 22165 7708674 7744164 -35490 X 1 1 1 1 Teton Valley Health Care Inc 120 East Howard Ave Driggs ID 83422 www.tvhcare.org 31 X X X X Teton Valley Health Care Inc 1 0 0 1 X X X X X X X X X 21 1 0 1 1 X https://tvhcare.org/about/community-engagement/ X 1 21 1 https://tvhcare.org/about/community-engagement/ 0 1 X 100.000000000000 350.000000000000 X X X 1 1 X X X 1 X www.tvhcare.org X www.tvhcare.org X www.tvhcare.org X X X X X X X 1 X 0 X X X X 1 X 0 1 Teton Valley Health Care Inc. Part V, Section B, Line 5: Community opinion data was gathered through surveys and interviews. A CHNA survey was deployed to local expert advisors and the general public 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 Hospital's desire to represent the region's geographically diverse population. 410 survey responses from community members were gathered.Focus groups and individual interviews were conducted to validate survey findings, gather additional information, and gain additional input from priority populations including seniors, racial and ethnic minority groups, and young adults.The survey respondents participated in a structured communication technique called the "Wisdom of Crowds" method. This approach relies on the assumption that the collective wisdom of participants is superior to the opinion of any one individual, regardless of their professional credentials.Input was obtained from the required three minimum sources and expanded to include other representative groups. TVHC asked all those participating in the written comment solicitation process to self-identify into any of thefollowing representative classifications. Participants self-identified as follows:1) Public Health Official2) Government Employee or Representative3) Minority or Underserved Population4) Chronic Disease Groups5) Community Resident6) Educator7) Healthcare Professional8) OtherInformation 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; espondents 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. Teton Valley Health Care Inc. Part V, Section B, Line 6b: TVHC partnered with QHR Health to complete a CHNA report. Teton Valley Health Care Inc. Part V, Section B, 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 were: * Affordable Housing * Behavior Health: Mental Health and Drug/Substance Abuse * Affordability of Healthcare * Education System * Access to Healthcare Services: Presence of Services * Access to Senior Services * Livable Wage * Access to Childcare, * Access to Healthy Food * CancerThe only item identified that will not be directly addressed by the facility is basic needs (affordable housing, food, transportation). We do not engage in these activities but rely on our community partners to address this and we support their efforts however possible. In this current tax year, TVHC engaged in the following activities to address the needs identified in the 2021 CHNA: 1. Expanded the hours of our tele-mental health services in our clinics, to meet an increasing need. 2. Increased our infusion offerings and hired an oncologist on-site to support cancer services. 3. Implemented cardio-pulmonary services to support cardiology. 4. Improved our financial support services to support lower income care. Teton Valley Health Care Inc. Part V, Section B, Line 13h: The organization considers other assets the patient may have, as well as proof of eligibility for Medicaid and/or state-funded medical coverage. Teton Valley Health Care Inc. Part V, Section B, Line 16j: TVHC collaborates with the Community Resource Center of Teton Valley to ensure that they are aware of our resources so that they can share our FAP with their clientele. Teton Valley Health Care Inc. Part V, Section B, Line 20e: The organization does not use presumptive eligibility for hospital services. The organization does use presumptive eligibility for the rural health clinic services. Teton Valley Health Care Inc. Part V, Section B, Line 24: The financial assistance policy clearly states that it provides free or discounted services for medically necessary care. We do not discount services provided in our aesthetics department. 2 1 - Driggs Health Clinic 283 North First East Driggs ID 83422 Rural Health Clinic 2 - Victor Health Clinic 83 N Main Street Victor ID 83455 Rural Health Clinic Part I, Line 3c: The organization considers other assets the patient may have, as well as proof of eligibility for Medicaid and/or state-funded medical coverage. Part I, Line 7: The Organization calculated the cost for providing financial assistance reported in Part I, line 7a by multiplying the ratio of cost to gross charges for the Hospital by the gross uncompensated charges associated with providing charity care to its patients. Medicaid on line 7b and subsidized health services on line 7g are reported according to costs allocated to the relevant costs centers on the Medicare Cost Report. The Organization used actual expenses to determine the cost for Community Health Improvement Services line 7e. Part II, Community Building Activities: Teton Valley Health Care provided a community breakfast for breast cancer awareness, as well a hosted Tough Enough to Wear Pink for breast cancer awareness. In addition, the organization hosted a community booth to recruit staff to their area, and hosted high school field trips to the hospital to provide education about medical careers. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Part III, Line 3: The Hospital estimated the amount of implicit price concessions that would qualify for community benefit if patients completed the financial assistance application by multiplying the line 2 implicit price concessions by the estimated ten percent of the population that is under the FPG. Part III, Line 4: The footnote to the Organization's financial statements can be found on pages 12 and 13 of the attached audited financial statements. Part III, Line 8: Any shortfall should be treated as community benefit. A facility must be able to recover its costs in order to continue to provide quality care to Medicare patients and the community as a whole. Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall, if any, is considered a community benefit.Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.Hospital services rendered on a fee schedule are not included in the Medicare calculations per the 990 instructions. Had this been reported the Hospital would have had a greater loss from Medicare services of $102,583.Medicare fee schedule revenue $283,095Medicare estimated costs of care relating to payments $385,948Net (shortage) $(102,853) Part III, Line 9b: Our first 3 billing statements sent to the patient contain a reference to our financial assistance program and direct patients to contact our office for financial assistance information and applications. Once the patient's balance reaches 90 days past due from their first billing statement received, their account is sent to an early out program vendor wherein they will receive a minimum of two phone calls and 3 written notices offering the option to apply for financial assistance. When the patient's unpaid balance is past 180 days from first date of billing it becomes eligible for collections and is transferred to an outside collection agency, however, once in collections, if the patient wants to still pursue financial assistance, they will have 365 days from first date of billing to apply. During the application process their account is cancelled with the collection agency and no further ECA efforts are pursued until their application has been processed, finalized and a determination has been made they do not qualify for financial assistance. 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 itserves and continually address them at staff and board meetings. TVHC has providers on boards, such as Ski Patrol and Search & Rescue, and TVHC participaties in several Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) Patients' Perspectives of Care Surveys throughout the year. 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.Signs and/or Rack Cards are posted at each point of patient registration and in waiting areas. Financial Assistance information is posted on the organization's website and on patient statements. CFO and/or Revenue Cycle representatives attend community functions to inform the community of financial assistance programs. Medical staff and managers are educated annually on the policy to promote at time of care if appropriate. Patient Financial Advocates promote and provide financial counseling. Part VI, Line 4: Teton County Idaho covers 450 square miles of Southeastern Idaho. The 2020 population was 11,630 compared to a 2010 population of 10,170. Median age is 36.3, median household income is $54,896 compared to $48,905for 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 nonprofit, 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 220 individuals, with an annual payroll in excess of 12.5 million. 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 dedicatedtheir 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 and focusing on prevention and intervention.In addition, the Hospital continues to collaborate with local officials to provide needed services and donates time and effort to the community. We provide substantial amounts of uncompensated care to individuals that are in need.One of the services provided to patients is Chronic Care Management. The Hospital has two nurses who create care plans with patients from referrals of our Primary care providers in the clinics. The provide monthly follow up phone calls with these patients to check on them and make sure they have what they need to follow their care plans. They also educate patients on how to best manage their chronic conditions. They do A1c testing for patients. They also meet face to face with patients throughout the week to help them overcome barriers to their care plans. The Hospital also hosts a booth at several area events to promote health, hospital services, and provide resources. In addition the Hospital provides sponsorships for several area events such as Snowscapes Downtown, 4th of July Parade, Teton County Fair, Music on Main, Turkey Trot fun run, Shakespeare in the Park, Plein Air Festival, Downtown Sounds, Downtown Driggs Association Scarecrow and Meet and Greet for Community. X X 1 0 0 0 0 0 0 0 0 Stefan Turkula Orthopedic Surgeon 442309 0 30122 0 0 0 0 0 19455 0 491886 0 0 0 Stephen Houmes ER Physician, Director 399497 0 122 0 0 0 0 0 31706 0 431325 0 0 0 Nathan Levanger CMO 308034 0 50122 0 16966 0 9292 0 23125 0 407539 0 0 0 Lisa Loughran Carlson CNO/COO 225996 0 104247 0 0 0 1756 0 13006 0 345005 0 0 0 Jacob Moss Family Practice Physician, Director 301352 0 122 0 0 0 1800 0 28818 0 332092 0 0 0 Joshua Clutter ER Physician 319826 0 122 0 0 0 0 0 28 0 319976 0 0 0 Letitia Miller Former CFO 136498 0 39599 0 0 0 2665 0 4245 0 183007 0 0 0 Keith Gnagey Former Officer 0 0 0 0 165777 0 0 0 0 0 165777 0 0 0 Part I, Line 4a Keith Gnagney received $165,777 in severance pay for calendar year 2023. Form 990, Part VII, Section A, Line 5: The Organization paid $128,936 to an unrelated organization, LLD Associates, LLC, for CFO services of Lori Leianne Everett for calendar year 2023. Form 990, Part VI, Section A, line 1a The Executive Committee consists of the officers of the board and immediate past Chair of the Hospital Board. The Executive Committee can transact regular business on behalf of the board between the governing board meetings. Any matters of substantial importance must be ratified by the governing board. Form 990, Part VI, Section A, 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, Part VI, Section A, 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, Part VI, Section B, 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 CEO signs the Form 8879-TE authorizing the preparer to e-file the return. Form 990, Part VI, Section B, line 12c TVCH has officers and board members annually review the conflict of interest policy. An individual is required to disclose to the Board of Directors if a potential conflict arises. The remaining board members discuss the situation with the absence of the individual to determine if a conflict of enough significance and materiality exists. If a conflict with a board member is signficant and material enough, the individual may be suspended or terminated. Form 990, Part VI, Section B, 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. The CEO reviews and approves the CFO compensation based on similar compensation survey sources. 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. 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. Form 990, Part VI, Section C, 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 Others: Program service expenses 4,462,519. Management and general expenses 1,281,149. Fundraising expenses 1,269. Total expenses 5,744,937. Teton Valley Health Care Foundation 120 E Howard Ave Driggs ID 83422 932017214 Foundation ID 501(c)(3) Line 7 Teton Valley Health Care Inc 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 Teton Valley Health Care Foundation C 562538 Accrual Method