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UINTAH BASIN MEDICAL CENTER: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
UINTAH BASIN MEDICAL CENTER (EIN 87-0276435)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-13
IRS object ID
202121339349302502
Schema version
2019v5.0
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

FieldValueIRS element (for citing)
Return2021-05-13T08:48:54-07:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN870514498PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Aycock Miles & Assoc CPAsBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line158 East 100 North 83-13AddressLine1Txt
CityRooseveltCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84066ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN870276435EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Uintah Basin Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlUINTBusinessNameControlTxt
Phone4357224691PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 W 300 NAddressLine1Txt
CityRooseveltCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84066ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBrent H HalesPersonNm
Person TitleCFOPersonTitleTxt
Signature2021-05-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMichael J MilesPreparerPersonNm
PTINP00153639PTIN
Phone4357225153PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 W 300 NAddressLine1Txt
CityRooseveltCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84066ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$93,416,864GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.ubh.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2003FormationYr
Legal Domicile StateUTLegalDomicileStateCd
Activity Or MissionHospital services, long-term health care, rehabilitation, emergency medical care, inpatient and outpatient pharmaceutical services, and other essential medical services.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee905TotalEmployeeCnt
Total Volunteers65TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,581,150PYContributionsGrantsAmt
CY Contributions Grants$2,420,660CYContributionsGrantsAmt
PY Program Service Revenue$86,842,142PYProgramServiceRevenueAmt
CY Program Service Revenue$90,085,654CYProgramServiceRevenueAmt
PY Investment Income$1,046,949PYInvestmentIncomeAmt
CY Investment Income$910,550CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$89,470,241PYTotalRevenueAmt
CY Total Revenue$93,416,864CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$36,011,214PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$39,137,460CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$46,139,467PYOtherExpensesAmt
CY Other Expenses$47,812,421CYOtherExpensesAmt
PY Total Expenses$82,150,681PYTotalExpensesAmt
CY Total Expenses$86,949,881CYTotalExpensesAmt
PY Revenues Less Expenses$7,319,560PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,466,983CYRevenuesLessExpensesAmt
Total Assets BOY$99,460,262TotalAssetsBOYAmt
Total Assets EOY$110,436,328TotalAssetsEOYAmt
Total Liabilities BOY$25,355,904TotalLiabilitiesBOYAmt
Total Liabilities EOY$30,790,351TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$74,104,358NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$79,645,977NetAssetsOrFundBalancesEOYAmt
MissionHospital services, long-term health care, rehabilitation, emergency medical care, inpatient and outpatient pharmaceutical services, and other essential medical services.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$63,705,894ExpenseAmt
Revenue$92,506,314RevenueAmt
DescHospital services, long-term health care, rehabilitation, emergency medical care, inpatient and outpatient pharmaceutical services, and other essential medical services. The Hospital provided approximately 4,300 patient days, 13,200 home health/hospice visits, 10,800 ER visits, and 2,500 surgeries during the year.Desc
Total Program Service Expenses$63,705,894TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document129IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee905EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressYes (true)OfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldUTStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBrent H Hales CFOPersonNm
Phone4357224691PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 W 300 NAddressLine1Txt
CityRooseveltCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84066ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
Dr John Blake
Chief of Staff1.000.00Yes (X)$533,840$0$0
Dr Sean Paulsen
Board member1.000.00Yes (X)$480,816$0$0
Joseph Garcia
Physician40.000.00$419,956$0$20,250
Jim Marshall
President & CEO50.000.00$369,586$0$20,250Yes (X)
Kerry Baum
Physician40.000.00$361,917$0$20,250
Shane Powell
Physician40.000.00$257,902$0$14,858
Bruce Arnold
Pathologist40.000.00$230,653$0$14,955
Brent H Hales
CFO50.000.00$220,499$0$19,225Yes (X)
Manpreet Kaur
Physician40.000.00$208,572$0$14,115
Randall Bennett
Senior Vice President40.000.00$183,566$0$15,964
Roger Marett
Senior Vice President40.000.00$161,621$0$14,485
Bobby Richardson
Senior VP40.000.00$161,333$0$14,137
Robert Gilbert
Vice Chair1.000.00Yes (X)$5,000$0$0
Mindi Crowley
Director1.000.00Yes (X)$4,500$0$0
Tyler Rasmussen
Director1.000.00Yes (X)$4,500$0$0
Tyler Allred
Director1.000.00Yes (X)$4,000$0$0
Ryan Snow
Director1.000.00Yes (X)$4,000$0$0
Gregory Todd
2nd Vice Chair1.000.00Yes (X)$4,000$0$0
Alarik Myrin
Chairman1.000.00Yes (X)$3,900$0$0Yes (X)
Dr Jason Larson
Chief of Staff1.000.00Yes (X)$0$0$0
Shelly Fenn
Director1.000.00Yes (X)$0$0$0
Irene Hansen
Director1.000.00Yes (X)$0$0$0
Tim Negus
Director1.000.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,620,161TotalReportableCompFromOrgAmt
Total Other Compensation$168,489TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K12IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Cerner Corporation
2800 Rock Creek PkwyKansas CityMO64117Software, IT$2,818,436
ARUP Laboratories
500 Chipeta WaySalt Lake CityUT84108Lab testing$1,165,251
Gordon Olsen MD
250 N 300 WRooseveltUT84066Physician$706,268
Peter Tanner MD
250 N 300 WRooseveltUT84066Physician$604,039
Jason Larson MD PC
250 N 300 WRooseveltUT84066E.R. Physician$638,675
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Government Grants$2,414,165GovernmentGrantsAmt
All Other Contributions$6,495AllOtherContributionsAmt
Total Contributions$2,420,660TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net patient services621110$88,420,652$88,420,652
Other medical services621110$1,665,002$1,665,002
FieldValueIRS element (for citing)
Total Program Service Revenue$90,085,654TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$910,550TotalRevenueColumnAmt
Related Or Exempt Func Income$910,550RelatedOrExemptFuncIncomeAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$93,416,864TotalRevenueColumnAmt
Related Or Exempt Func Income$90,996,204RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,225,222TotalAmt
Program Services$1,057,822ProgramServicesAmt
Management And General$1,167,400ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$26,284,737TotalAmt
Program Services$19,088,821ProgramServicesAmt
Management And General$7,195,916ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$10,627,501TotalAmt
Program Services$6,638,562ProgramServicesAmt
Management And General$3,988,939ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$11,110,527TotalAmt
Program Services$10,962,426ProgramServicesAmt
Management And General$148,101ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,050,422TotalAmt
Management And General$1,050,422ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,606,919TotalAmt
Program Services$2,023,028ProgramServicesAmt
Management And General$3,583,891ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$406,543TotalAmt
Program Services$99,459ProgramServicesAmt
Management And General$307,084ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Pharmaceuticals$9,466,056$9,413,090$52,966
Supplies & Materials$8,478,105$7,335,943$1,142,162
Other$4,678,116$2,654,988$2,023,128
Purchased services$4,648,415$2,618,116$2,030,299

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,367,318TotalAmt
Program Services$1,813,639ProgramServicesAmt
Management And General$553,679ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$86,949,881TotalAmt
Program Services$63,705,894ProgramServicesAmt
Management And General$23,243,987ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,486,422BOYAmt
EOY$5,134,042EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$31,003,776BOYAmt
EOY$34,277,027EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$15,021,515BOYAmt
EOY$16,503,694EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,590,019BOYAmt
EOY$1,613,230EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$680,455BOYAmt
EOY$437,734EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$98,644,266LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$51,713,500LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$46,408,961BOYAmt
EOY$46,930,766EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$1,647,197BOYAmt
EOY$3,917,462EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,621,917BOYAmt
EOY$1,622,373EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$99,460,262BOYAmt
EOY$110,436,328EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,994,814BOYAmt
EOY$5,500,438EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$4,242,067EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$17,516,841BOYAmt
EOY$17,278,233EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,844,249BOYAmt
EOY$3,769,613EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,355,904BOYAmt
EOY$30,790,351EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$72,604,358BOYAmt
EOY$78,145,977EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,500,000BOYAmt
EOY$1,500,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$74,104,358BOYAmt
EOY$79,645,977EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$99,460,262BOYAmt
EOY$110,436,328EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$6,466,983ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$925,364NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,969,998OtherCostOrOtherBasisAmt
Book Value$3,969,998BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$60,179,593OtherCostOrOtherBasisAmt
Depreciation$51,713,500DepreciationAmt
Book Value$8,466,093BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$34,494,675OtherCostOrOtherBasisAmt
Book Value$34,494,675BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$46,930,766TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescInterest rate swapDesc
Amt$3,769,613Amt
FieldValueIRS element (for citing)
Total Liability$3,769,613TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$92,491,500TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$925,364NetUnrealizedGainsInvstAmt
Revenue Not Reported-$925,364RevenueNotReportedAmt
Revenue Subtotal$93,416,864RevenueSubtotalAmt
Total Revenue Per Form990$93,416,864TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$86,949,881TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$86,949,881ExpensesSubtotalAmt
Total Expenses Per Form990$86,949,881TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X : FIN48 FootnoteFormAndLineReferenceDesc
ExplanationThe 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, 2019 and 2018, the Medical Center had no uncertain tax positions requiring accrual.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
Most Hospitals PolicyYes (X)MostHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent250Yes (X)Percent250Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,270,197TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,270,197NetCommunityBenefitExpnsAmt
Total Expense0.01460TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,559,285TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,509,014DirectOffsettingRevenueAmt
Net Community Benefit Expns$50,271NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,829,482TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,509,014DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,320,468NetCommunityBenefitExpnsAmt
Total Expense0.01520TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$272,781TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$272,781NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$272,781TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$272,781NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,102,263TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,509,014DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,593,249NetCommunityBenefitExpnsAmt
Total Expense0.01830TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,514,919TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,514,919NetCommunityBenefitExpnsAmt
Total Expense0.09790TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,514,919TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,514,919NetCommunityBenefitExpnsAmt
Total Expense0.09790TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$7,831,070BadDebtExpenseAmt
Bad Debt Expense Attributable$2,871,816BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,033,713ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$10,415,504CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$381,791MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnfalseFinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Uintah Basin Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 W 300 NAddressLine1Txt
CityRooseveltCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84066ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.ubh.orgWebsiteAddressTxt
State License2008-HOSP-180StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

FieldValueIRS element (for citing)
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted20CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLwww.ubh.orgStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.0000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care250.0000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLwww.ubh.orgFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.ubh.orgFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.ubh.orgFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Facility: - Part V, Section B, Line 5In 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. UBMC 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: - Part V, Section B, Line 7dWebsite complete URL:https://ubh.org/wp-content/uploads/sites/534/2020/08/CHNA_2020_WebSummary.pptx.pdf
Facility: - Part V, Section B, Line 11As outlined below, all assessed needs were addressed by the hospital.As identified in the Hospitals 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.Diabetesa.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/BMI 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 Usea.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.

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Basin Care & RehabilitationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1260 W 200 NAddressLine1Txt
CityRooseveltCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84066ZIPCd
FieldValueIRS element (for citing)
FacilityLong-term care and rehabilitation centerFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part III, Line 2 - Methodology Used To Estimate Bad Debt ExpensePlease refer to note disclosure No. 4 and No. 8 of the audited financial statements.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community BenefitThe UBMC analyzed bad debt accounts and estimated bad debt expense that reasonably is 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.The UBMC calculated the prior 2 years' charity predictions as a perecentage of self pay a/r and applied that percentage to the self pay a/r for 2020. A calculation of that percentage to total a/r was in line with the percentages from the prior 2 years as well. The amount of bad debt expense attributable to the Hospital's charity care policy for year ending June 30, 2020 is $2,871,816.
Part III, Line 4 - Bad Debt ExpensePlease refer to note disclosure No. 4 and No. 8 of the audited financial statements.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
Bobby Richardson
Senior VP$104,994$56,339$14,137$175,470
Brent H Hales
CFO$206,927$13,572$19,225$239,724
Bruce Arnold
Pathologist$230,653$14,955$245,608
Dr Sean Paulsen
Board member$480,816$480,816
Dr John Blake
Chief of Staff$533,840$533,840
Jim Marshall
President & CEO$307,668$61,918$20,250$389,836
Joseph Garcia
Physician$419,956$20,250$440,206
Kerry Baum
Physician$361,917$20,250$382,167
Manpreet Kaur
Physician$208,572$14,115$222,687
Randall Bennett
Senior Vice President$172,368$11,198$15,964$199,530
Roger Marett
Senior Vice President$151,424$10,197$14,485$176,106
Shane Powell
Physician$257,902$14,858$272,760

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessReview is conducted by the CFO and Board Members.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsConflict 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, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementAn independent compensation consultant is hired who uses a survey. Those results are reviewed by our compensation committee and the Board of Directors.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesAn independent compensation consultant is hired who uses a survey. Those results are reviewed by our compensation committee and the Board of Directors.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableSome governing documents and conflict of interest policy are available to the public upon written request to the Board of Directors. The IRS Form 990 information return is public record.