2021-08-12T10:43:01-05:00 2020-09-30 200079326 DINGUS ZARECOR & ASSOCIATES PLLC 12015 E MAIN AVE SPOKANE VALLEY WA 99206 990 2019-10-01 454551946 TETON VALLEY HEALTH CARE INC TETO 2083542383 120 EAST HOWARD AVENUE DRIGGS ID 83422 KEITH GNAGEY BOARD MEMBER/CEO 2083542383 2021-08-11 true THOMAS DINGUS P00951009 5092420874 2021-08-12 2019 2022-09-23 18:48:47Z KEITH GNAGEY 120 EAST HOWARD AVE DRIGGS ID 83422 19908077 false X WWW.TVHCARE.ORG X 2012 ID TO ENCOURAGE AND SUPPORT A HEALTHIER COMMUNITY. 6 5 211 0 214218 1056752 18401674 18462375 56698 20668 216926 368282 18889516 19908077 9272 0 10346171 10813468 0 336712 8563135 9086173 18909306 19908913 -19790 -836 12972206 17702730 2072450 6803810 10899756 10898920 TO ENCOURAGE AND SUPPORT A HEALTHIER COMMUNITY. false false 15287205 9272 18462375 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 267 DAYS OF INPATIENT SERVICES, 23,864 OUTPATIENT VISITS, 2,263 EMERGENCY ROOM VISITS, AND 588 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 152,932 FOR CHARITY CARE, 3,372,577 FOR MEDICARE, 1,291,897 FOR MEDICAID, AND 2,703,127 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR. 15287205 true true false true false false false false false false true false false false false true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true false false false true 33 0 true 211 true false false false false false false false false false false false false X 6 5 false false false false true true false true true false false true true true true true true true true true true X KEITH GNAGEY 2083542383 120 EAST HOWARD AVE DRIGGS ID 83422 ROBERT WHIPPLE CHAIR 2.00 X X 0 0 0 MICHAEL WINE VICE CHAIR 2.00 X X 0 0 0 JO ANNE KAY TREASURER 2.00 X X 0 0 0 AARON HANSEN SECRETARY 2.00 X X 0 0 0 JONI PARANKA MEMBER 2.00 X 0 0 0 KEITH GNAGEY BOARD MEMBER 40.00 X X 260426 0 11195 LETITIA MILLER CFO 40.00 X 204076 0 10108 NATHAN LEVANGER CMO 40.00 X 280562 0 14984 MAURICE BROWN MD PHYSICIAN 32.00 X 618681 0 19624 CHAD HORROCKS MD PHYSICIAN 36.00 X 425046 0 18798 TAYLOR NELSON CRNA 32.00 X 237497 0 13603 JUANITA PRISSEL PHYSICIAN 36.00 X 281683 0 11948 MARC POROT PHYSICIAN 40.00 X 176750 0 0 2484721 100260 17 false true false HEALTH SERVICES GROUP 3220 TILLMAN DRIVE 300 BENSALEM PA 19020 ENVIRONMENTAL 790706 EMERGENCY PHYSICIANS INTEGRATED CAR 333 N 300 W SALT LAKE CITY UT 84103 PHYSICIANS 535800 PHARMGO LLC 1790 DEER VALLEY DRIVE IDAHO FALLS ID 83401 PHARMACIST 315300 PM NAGLE CONSULTING LLC 3816 SALISH TRAIL STEVENSVILLE MT 59870 BILLING 293899 FUSION MEDICAL STAFFING PO BOX 82674 LINCOLN NE 68501 NURSING STAFF 157871 7 858158 198594 1056752 PATIENT SERVICE REVENUE, NET 624100 18461900 18461900 RENT INCOME 621910 475 475 18462375 20668 20668 307380 307380 307380 CAFETERIA REVENUE 722320 44741 44741 OTHER REVENUE 900099 16161 16161 60902 19908077 18769755 81570 X 9272 9272 859715 362122 497593 8459173 6923540 1366772 168861 177134 138743 35168 3223 668695 496654 147859 24182 648751 499476 135163 14112 28702 28702 133715 133715 3807288 2493069 1309465 4754 132116 2111 129967 38 558263 417612 120586 20065 442378 275986 90909 75483 100630 38471 60762 1397 27491 27491 813496 738474 70790 4232 130899 99774 31125 MEDICAL SUPPLIES & DRUGS 2415849 2415849 REPAIRS & MAINTENANCE 273268 258679 13676 913 DUES & SUBSCRIPTIONS 84414 28697 55619 98 137664 61185 57125 19354 19908913 15287205 4284996 336712 3716060 8391022 648332 653638 2785104 2300373 1029413 1140755 203371 23367 14699012 10264775 3906769 4434237 683157 759338 12972206 17702730 1694450 1845579 3094945 1863286 378000 2072450 6803810 X 10799756 10798920 100000 100000 10899756 10898920 12972206 17702730 -836 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2110 2110 false 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 7632584 5222618 2409966 6973757 5042157 1931600 4434237 X SCHEDULE D, PAGE 3, PART X THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND ARE 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 AND FOUNDATION EVALUATE 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, 2020 AND 2019, THE HOSPITAL AND FOUNDATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. true true true X true X true true true false true true 108582 108582 0.00550 1635475 1011589 623886 0.03130 1744057 1011589 732468 0.03680 183445 183445 0.00920 1538766 1488601 50165 0.00250 1722211 1488601 233610 0.01170 3466268 2500190 966078 0.04850 29592 29592 0.00150 29592 29592 0.00150 true 852214 6752023 6817841 -65818 X true true 1 1 TETON VALLEY HEALTH CARE INC 120 EAST HOWARD AVE DRIGGS ID 83422 WWW.TVHCARE.ORG X X X X TETON VALLEY HEALTH CARE INC 1 false false true X X X X X X X X X X 19 true false true true X WWW.TVHCARE.ORG X true 19 true WWW.TVHCARE.ORG false true X 200.000000000000 200.000000000000 X X true true X X X true X WWW.TVHCARE.ORG X WWW.TVHCARE.ORG X WWW.TVHCARE.ORG X X X X X X true X false X X X X true X false false 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 HEALTH FAIRS WITH REDUCED-COST LAB SCREENINGS AND FREE PREVENTIVE SCREENINGS 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. 3 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 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 15 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 (ACSI) 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 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 X X X X X false false false false false false false true false KEITH GNAGEY BOARD MEMBER/CEO 202522 57904 11195 271621 LETITIA MILLER CFO 178360 25716 10108 214184 NATHAN LEVANGER CMO 181395 99167 14984 295546 MAURICE BROWN MD PHYSICIAN 348319 270362 19624 638305 CHAD HORROCKS MD PHYSICIAN 170196 254850 18798 443844 TAYLOR NELSON CRNA 177903 59594 13603 251100 JUANITA PRISSEL PHYSICIAN 205133 76550 11948 293631 MARC POROT PHYSICIAN 175250 1500 176750 SCHEDULE J, PAGE 1, PART I, LINE 7 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. 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 2,493,069 1,309,465 4,754 CACHE CLINIC LLC 120 E HOWARD DRIGGS ID 83422 CLINIC ID 27935 13219 TVHC TETON VALLEY HEALTH CARE FOUNDATION 120 EAST HOWARD AVE DRIGGS ID 83422 820471064 SUPPORT ID 501C3 12A COMMUNITY false false false true false false false false false false false false true true true true false false false false