2020-05-15T09:25:28-05:00 2019-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-07-01 201347269 Renown Skilled Nursing RENO 7759826488 1155 Mill St C/O Tax Treasury Z-4 Reno NV 89502 Ann Beck Chief Financial Officer 7759826488 2020-05-14 1 Kim Hunwardsen CPA P00484560 6122536500 2020-05-13 216.147.181.49 2020-05-14 16:09:10 CD P 159D60DA7C19331A7948BEBC6B1067FF5545FF60 F9BEE9501A3B4F00F190E63700B8BF2BC70C7B96 2018 2020-11-19 02:30:22Z X Ann Beck 1155 Mill St C/O Tax Treasury Z-4 Reno NV 89502 2393041 0 X www.renown.org X 2004 NV A 160 bed long-term acute care nursing facility specializing in rehabilitative care. X 15 14 0 6 0 0 2854991 354627 5913664 2038414 -2419 -215715 0 0 8766236 2177326 0 0 0 0 6929832 2392741 0 0 0 4573511 1730008 11503343 4122749 -2737107 -1945423 1740442 0 25520103 0 -23779661 0 X Renown Health makes a genuine difference in the health and well-being of the people and communities we serve. 0 1 3082461 2038414 See Schedule ORenown Skilled Nursing is a 160-bed nursing facility designed to serve the healthcare needs of long and short-term, acute-care patients. Services include 24/7 licensed nursing care and physical, occupational, speech and restorative therapy in-house seven days a week. This valuable facility serves a need that otherwise would be unmet in northern Nevada. By accepting the long-term, acute-care patients for rehabilitative services, other hospital beds in the health network are available for higher-acuity, shorter-term care. As of November 30, 2018, all operations at Renown Skilled Nursing ceased, and the corporation was dissolved on June 30, 2019. During the 5 months Renown Skilled Nursing was operating in FY19, they provided 7,640 patient care days for patients transferred from other hospital beds in the health network because they required a level of care delivered most appropriately in a skilled nursing facility. For the fiscal year ending June 30, 2019, Renown Skilled Nursing, along with its parent, Renown Health and its subsidiaries, provided more than $158 million in benefit to the community (using community benefit numbers gathered by the Nevada Hospital Association using state-approved criteria to ensure consistency). For a full report on the benefit Renown Health provided to our community, as well as our community needs assessment and community benefit plan, go to www.renown.org/communitybenefit. 3082461 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 X Ann Beck 7759826488 1155 Mill St Z-4 Reno NV 89502 Anthony Slonim President/CEO 3.00 57.00 X X 0 1560947 184005 James De Volld - Treas Vice Chair (Jul-Dec)/Chair (Jan-Jun) 3.00 12.00 X X 0 29408 0 Kimberly Cooney Secretary 3.00 12.00 X X 0 24000 0 G Blake Smith Chair (Jul-Dec)/Director (Jan-Jun) 3.00 12.00 X X 0 46678 0 Adam Kramer - Director (Jul-Dec)/Vice Chair (Jan-Jun) 3.00 12.00 X X 0 15000 0 Todd McKenzie Director (Aug-Jun)/Treas (Jan-Jun) 3.00 15.00 X X 0 12917 0 Michael Peterson Director 3.00 12.00 X 0 15000 0 Jeff Resnik Director 3.00 12.00 X 0 35195 0 Joanne Olson Director 3.00 12.00 X 0 24000 0 Alvaro Devia Director 3.00 12.00 X 0 28974 0 Christi Matteoni Director 3.00 12.00 X 0 15000 0 Steven Johnson Director 3.00 12.00 X 0 35195 0 Thomas Deveny Director 3.00 12.00 X 0 15000 0 Harvey Fennell Director (Jan-Jun) 3.00 15.00 X 0 10918 0 Tammy Dermody Director (Jan-Jun) 3.00 12.00 X 0 0 0 Brian Loy Director (Jul-Dec) 3.00 12.00 X 0 27065 0 William Newberg Director (Jul-Dec) 3.00 12.00 X 0 24121 0 Bernie Carter Director (Jul-Dec) 3.00 12.00 X 0 25391 0 Richard Bostdorff Director (Jul-Dec) 3.00 15.00 X 0 24000 0 Hakeem Olanrewaju Chief Financial Officer 2.00 58.00 X 0 366968 14776 Barbara Coruna Registered Nurse 60.00 0.00 X 116198 0 12706 Imee Barrett Nursing Supervisor 60.00 0.00 X 111429 0 22743 Constante Basallo Geriatrics Registered Nurse 60.00 0.00 X 110244 0 18921 Rhodora Garrett Geriatrics Registered Nurse 60.00 0.00 X 107718 0 10896 Dawn Ahner - Former Officer Current COO Acute Services 0.00 60.00 X 0 896573 128435 445589 3232350 392482 4 1 1 0 0 354627 354627 Patient Service Revenue 623000 2021404 2021404 Other Revenue 900099 17010 17010 2038414 215715 -215715 -215715 -215715 2177326 2038414 0 -215715 X 1982728 1620409 362319 410013 334752 75261 443395 87996 355399 194564 184244 10320 284129 65493 218636 1049 1049 464 464 195082 195082 4546 4546 Provider Tax 264881 264881 Medical Supplies 213417 213417 Bad Debt 112885 112885 Misc License, Tax & Sub 7683 1492 6191 7913 297 7616 4122749 3082461 1040288 0 0 12715 0 0 482657 0 0 0 0 9346 0 9357 0 0 0 1217999 0 0 0 0 0 8368 0 1740442 0 601892 0 11315 0 24906896 0 25520103 0 X -23779661 0 -23779661 0 1740442 0 X -1945423 25725084 X X 0 1 X 1 0 X 2633559 2809233 2866391 2854991 354627 11518801 6992793 7159343 7935288 5913664 2038414 30039502 9626352 9968576 10801679 8768655 2393041 41558303 0 1434 125560 126994 1434 125560 126994 41431309 9626352 9968576 10801679 8768655 2393041 41558303 0.99690 1.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 0 X Part IV, Line 2b: The organization acts as custodian for the funds of the residents of the skilled nursing facility. During the year, the funds were included in cash and custodial liability in the financial statements. Part X, Line 2: Renown Skilled Nursing is organized as a Nevada nonprofit entity and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). This entity must annually file Returns of Organizations Exempt from Income Tax (Form 990) with the IRS. In addition, Renown Skilled Nursing is subject to income tax on net income derived from business activities that are unrelated to its tax exempt purpose. Renown Skilled Nursing 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 combined financial statements. Renown Skilled Nursing 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. X X X X 0 1 0 0 0 0 0 0 0 Anthony Slonim President/CEO 0 1006488 0 550373 0 4086 0 162674 0 21332 0 1744953 0 0 Hakeem Olanrewaju Chief Financial Officer 0 315480 0 50000 0 1488 0 2077 0 12699 0 381744 0 0 Dawn Ahner - Former Officer Current COO Acute Services 0 645073 0 240658 0 10842 0 108380 0 22122 0 1027075 0 0 Part I, Line 3 Renown Skilled Nursing relies on Renown Health, a related organization, to establish compensation for officers and other key employees. Renown Health uses the identified methods to establish compensation. See Schedule O, Form 990, Part VI, Section B, Line 15 for a description of the process utilized by Renown Health. Part I, Line 4b Anthony Slonim and Dawn Ahner are parties to a supplemental nonqualified retirement plan. Contribution of $151,674 to Anthony Slonim and $97,380 to Dawn Ahner were included in Schedule J, Part II, Column (C). Property, Plant & Equipment 2019-06-30 587329 Net Book Value 942972845 Renown Health 1155 Mill Street Reno NV 89502 501(c)(3) Property, Plant & Equipment 2019-06-30 128747 Net Book Value 880213754 Renown Regional Medical Center 1155 Mill Street Reno NV 89502 501(c)(3) Property, Plant & Equipment 2019-06-30 112804 Net Book Value 460517825 Renown South Meadows Medical Center 1155 Mill Street Reno NV 89502 501(c)(3) 1 1 0 0 1 1 1 1 0 Part I, Line 2e: Person(s) Involved: Board of Directors Part I, Line 2e: Explanation of Involvement: Renown Skilled Nursing is a related entity to the recipients of the assets. Upon dissolution, all of the assets were transferred to Renown Health, Renown Regional Medical Center, and Renown South Meadows Medical Center. The governing board and officers of Renown Skilled Nursing and the related entities were the same prior to the transfer and remained the same after the dissolution. Form 990, Part III, line 3 Renown Skilled Nursing was dissolved as of June 30, 2019. Form 990, Part V, Line 1a, Number reported in Box 3 of Form 1096: Renown Skilled Nursing has independent contractors, however, Renown Health, the parent organization, pays all the independent contractors directly. The actual expense of each independent contractor is directly charged to the assigned entity. Form 990, Part V, Line 2a, Number of employees on W-3: Renown Skilled Nursing has its own employees, however, Renown Health, the parent organization, pays all compensation and employee benefit amounts under a common paymaster arrangement. The actual compensation of each employee is directly charged to their assigned entity. Salaries are reported on line 7 of Part IX. Form 990, Part VI, Section A, line 2 Anthony Slonim and Hakeem Olanrewaju have a business relationship with each other and all of the members on the board. Steven Johnson and Brian Loy have a business relationship. Steven Johnson and G Blake Smith have a business relationship. Form 990, Part VI, Section A, line 6 Renown Health is the sole corporate member of Renown Skilled Nursing. Form 990, Part VI, Section A, line 7a Renown Health, acting through its Board of Directors, appoints the members of the Board of Governors of Renown Skilled Nursing. Form 990, Part VI, Section A, line 7b Renown Health must approve any merger, consolidation or dissolution of Renown Skilled Nursing, any borrowing in excess of $1 million in any fiscal year, and encumbrances of assets and certain other actions not in the ordinary course of business. Form 990, Part VI, Section A, line 8b There was no committee during the year that had the broad authority to act on behalf of the board. Form 990, Part VI, Section B, line 11b The Form 990 is prepared by the organization's tax department with support from a certified tax preparer. The form is reviewed by the organization's current VP of Finance and current Chief Financial Officer prior to the final Form 990 being sent to the board. The IRS Form 990, as filed with the IRS, is sent to each voting member of the Renown Health Board prior to filing. Along with the forms, the Renown Health board is provided with a narrative that explains the various parts of the Form and their content. Form 990, Part VI, Section B, line 12c On an annual basis at or prior to the first regular meeting following the election of new board members, the members of the Renown Skilled Nursing Board are given an Annual Disclosure Statement. They are expected to perform a reasonable investigation into their business, financial, family or significant personal relationships to disclose any actual or potential conflicts of interest. If, in connection with a proposed transaction or arrangement involving a Renown Health entity, a board member discovers that an actual or possible conflict of interest has arisen that was not disclosed on the Annual Statement, then the board member must disclose the existence and nature of his or her financial interests to the remaining directors that are considering the proposed transaction or arrangement in a timely manner. If a board member discloses an actual or possible conflict of interest, the board member shall leave the board or committee meeting while the remaining board members discuss the financial interest. The remaining board members shall vote upon and decide whether a conflict of interest actually exists. If the remaining board members determine that a conflict does exist, then appropriate measures are taken to ensure the issue is addressed. Form 990, Part VI, Section B, line 15a Renown Health's executive compensation, including compensation for the CEO and certain executives, is reviewed and approved by the Renown Health Executive Committee. As a member of the executive committee, the CEO abstains from any decisions or discussions related to their own compensation. All decisions are submitted for final ratification at the next scheduled board meeting. The discussion is documented in the Executive Committee minutes and Board minutes. Total cash compensation for the organization's executives is targeted at competitive compensation levels, relative to market surveys of comparable healthcare organizations, based upon the level of performance required to achieve the targeted compensation levels. Base compensation and total cash compensation is reviewed at a minimum of every two years in comparison to the surveys for comparable businesses and responsibilities and adjusted as to maintain equity with the survey information. The Executive Committee undertook the process outlined above for the fiscal year 2019 executive compensation. Form 990, Part VI, Section C, line 19 Renown Skilled Nursing does not make its governing documents, conflict of interest policy, or financial statements available to the general public. Form 990, Part IX, line 11g Other: Program service expenses 87,996. Management and general expenses 355,399. Fundraising expenses 0. Total expenses 443,395. Form 990, Part XI, line 9: Intercompany Settlements 25,725,084. Renown Health 1155 Mill Street Z-4 Reno NV 89502 942972845 Health Care NV 501(c)(3) III-Fi N/A 0 Renown Health Foundation 1155 Mill Street Z-4 Reno NV 89502 942972749 Foundation NV 501(c)(3) 7 Renown Health 0 Renown Regional Medical Center 1155 Mill Street Z-4 Reno NV 89502 880213754 Hospital NV 501(c)(3) 3 Renown Health 0 Renown South Meadows Medical Center 1155 Mill Street Z-4 Reno NV 89502 460517825 Hospital NV 501(c)(3) 3 Renown Health 0 Hometown Health Plan 1155 Mill Street Z-4 Reno NV 89502 880231433 HMO NV 501(c)(4) Renown Health 0 Renown Transitional Care Services 1155 Mill Street Z-4 Reno NV 89502 880231828 Pregnancy Center NV 501(c)(3) 3 Renown Health 0 Routt Dialysis LLC 1155 Mill St Z-4 Reno NV 89502 263558729 Kidney Dialysis NV N/A Renown Businesses 1155 Mill St Z-4 Reno NV 89502 880228030 Health Care NV N/A C 0 Hometown Health Managment Company 1155 Mill St Z-4 Reno NV 89502 880236758 Management Services NV N/A C 0 Hometown Health Providers Insurance Co 1155 Mill St Z-4 Reno NV 89502 880177026 Insurance NV N/A C 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 1 1 0 1 1 Hometown Health Plan Inc L 132699 General Ledger