WASHOE BARTON MEDICAL CLINIC A NEVADA NONPROFIT CORPORATION: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- WASHOE BARTON MEDICAL CLINIC A NEVADA NONPROFIT CORPORATION (EIN 88-0405927)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-16
- IRS object ID
- 202013219349301326
- Schema version
- 2019v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-16T07:22:14-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 880405927 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Washoe Barton Medical Clinic | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WASH | BusinessNameControlTxt |
| Phone | 7757821500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1107 Hwy 395 | AddressLine1Txt |
| City | Gardnerville | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89410 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Colleen Reid | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7757821500 | PhoneNum |
| Signature | 2020-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2020-11-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 64.83.233.163 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-13 | IPDt |
| IP Tm | 12:09:25 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 818E7D27379BF4EE6921138ED2990C81DED2D31F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carson Valley Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Colleen Reid | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1107 Hwy 395 | AddressLine1Txt |
| City | Gardnerville | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89410 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $85,516,569 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | carsonvalleymedicalcenter.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | NV | LegalDomicileStateCd |
| Activity Or Mission | Nevada non-profit corporation which operates as the sole hospital in the county. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 553 | TotalEmployeeCnt |
| Total Volunteers | 27 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $61,417 | PYContributionsGrantsAmt |
| CY Contributions Grants | $171,543 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $61,778,124 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $67,220,850 | CYProgramServiceRevenueAmt |
| PY Investment Income | $232,575 | PYInvestmentIncomeAmt |
| CY Investment Income | $955,002 | CYInvestmentIncomeAmt |
| PY Other Revenue | $106,056 | PYOtherRevenueAmt |
| CY Other Revenue | $268,744 | CYOtherRevenueAmt |
| PY Total Revenue | $62,178,172 | PYTotalRevenueAmt |
| CY Total Revenue | $68,616,139 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $25,868,556 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,250,977 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $130,227 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $31,933,298 | PYOtherExpensesAmt |
| CY Other Expenses | $32,423,768 | CYOtherExpensesAmt |
| PY Total Expenses | $57,801,854 | PYTotalExpensesAmt |
| CY Total Expenses | $60,674,745 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,376,318 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,941,394 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $69,734,332 | TotalAssetsBOYAmt |
| Total Assets EOY | $78,608,203 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,723,713 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,113,203 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $57,010,619 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $65,495,000 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Our mission is to care for your health and wellness. Our vision is to strengthen our community by providing accessible, affordable, high quality healthcare to all. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $38,031,183 | ExpenseAmt |
| Revenue | $39,608,653 | RevenueAmt |
| Desc | Washoe Barton Medical Clinic dba Carson Valley Medical Center:Carson Valley Medical Center covers a service area that includes approximately 50,000 residents. A focus on patient centered care and quality have resulted in Carson Valley Medical Center consistently ranking high in patient satisfaction on both inpatient and outpatient consumer satisfaction surveys. Carson Valley Medical Center facilities include a full-service hospital, Emergency Room, Infusion, Lab, Medical Imaging, Physical and Respiratory Therapy, Senior Mental Health, Sleep & Neurodiagnostic Lab, Wound Care and Telemedicine. Clinics include Carson Valley Medical Center Senior Care (a provider-based clinic (Continued on SCH O)servicing patients over 65), Job's Peak Internal Medicine & Family Practice, Topaz Ranch Medical Clinic, Minden Family Medicine and Complete Care, Ironwood Primary Care, Ironwood Urgent Care and Occupational Health Clinics. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,978,412 | ExpenseAmt |
| Revenue | $19,530,794 | RevenueAmt |
| Desc | Pharmacy:Program expenses are used in the provision of health care services to the community. Carson Valley Medical Center provides inpatient and outpatient pharmaceutical services for the hospital and outpatient clinics. In 2019, there were higher patient acuities and more chemotherapy patients than the previous year. In 2019, 149,362 pharmacy orders were processed. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,740,456 | ExpenseAmt |
| Revenue | $8,081,403 | RevenueAmt |
| Desc | Surgery:Program expenses are used in the provision of surgical services to the community. Carson Valley Medical Center provides inpatient and outpatient surgery services. Emergency and elective surgeries are performed by general and specialty surgeons. In 2019, 1,529 surgeries were performed at Carson Valley Medical Center. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $52,750,051 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 108 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 553 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jeff Prater | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7757821500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1107 Highway 395 N | AddressLine1Txt |
| City | Gardnerville | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89410 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| Jeff Prater | ||||||||
| CEO | 40.00 | 0.00 | Yes (X) | $238,472 | $0 | $18,983 | ||
| Colleen Reid | ||||||||
| CFO | 40.00 | 0.00 | Yes (X) | $190,531 | $0 | $29,315 | ||
| Brandon Battis | ||||||||
| Pharmacist | 40.00 | 0.00 | $165,545 | $0 | $35,211 | Yes (X) | ||
| Greg Ponsness | ||||||||
| Pharmacy Manager | 40.00 | 0.00 | $162,518 | $0 | $35,089 | Yes (X) | ||
| Aaron Teachout | ||||||||
| Director of Finance | 40.00 | 0.00 | $165,096 | $0 | $11,696 | Yes (X) | ||
| Kathryn Cocking | ||||||||
| Chief Nursing Officer | 40.00 | 0.00 | $154,688 | $0 | $17,239 | Yes (X) | ||
| Shannon Albert | ||||||||
| Director of Operations | 40.00 | 0.00 | $148,023 | $0 | $24,006 | Yes (X) | ||
| Dr Paul Fry III | ||||||||
| Board Member | 0.50 | 0.00 | $5,500 | $0 | $0 | Yes (X) | ||
| Dawn Ahner | ||||||||
| Chair | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Clint Purvance-Board MemberJan- | ||||||||
| May,Oct-Dec)/Secretary(June-Sep) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Kelly Neiger | ||||||||
| Secretary (Oct-Dec) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Preston Becker | ||||||||
| Board Member (Jan-Jul) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Sy Johnson | ||||||||
| Board Member | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Hakeem Olanrewaju | ||||||||
| Board Member (Jan-Oct) | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,230,373 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $171,539 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 32 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Renown Health Medical Group | |||||
| 780 Kuenzli St Ste 202 | Reno | NV | 89502 | Physician Salary, IT, Physician Read Fee | $2,146,537 |
| Leman Medical Corporation | |||||
| 1122 Monterra Dr | Minden | NV | 89423 | ER Physician Group | $2,132,732 |
| The Neenan Company LLLP | |||||
| 3325 South Timberline Road Suite 10 | Fort Collins | CO | 80525 | Constructions/Design | $1,776,456 |
| Barton Healthcare Systems | |||||
| 2170 South Ave | South Lake Tahoe | CA | 96150 | IT, Lab, Pathology | $962,014 |
| AYA Healthcare Inc | |||||
| PO Box 123519 | Dallas | TX | 753123519 | Contract Staffing | $939,855 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 25 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $113,672 | RelatedOrganizationsAmt |
| All Other Contributions | $57,871 | AllOtherContributionsAmt |
| Total Contributions | $171,543 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Services | 621400 | $66,566,493 | $66,566,493 |
| Other Supporting Revenue | 900099 | $654,357 | $654,357 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $67,220,850 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $482,931 | TotalRevenueColumnAmt |
| Exclusion | $482,931 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $268,744 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $268,744 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $268,744 | TotalRevenueColumnAmt |
| Exclusion | $268,744 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $17,372,501 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,893,228 | SecuritiesAmt |
| Other | $7,202 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $479,273 | SecuritiesAmt |
| Other | -$7,202 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $472,071 | TotalRevenueColumnAmt |
| Exclusion | $472,071 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,616,139 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $67,220,850 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,223,746 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $487,258 | TotalAmt |
| Management And General | $487,258 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,407,376 | TotalAmt |
| Program Services | $18,009,300 | ProgramServicesAmt |
| Management And General | $3,325,810 | ManagementAndGeneralAmt |
| Fundraising | $72,266 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $392,633 | TotalAmt |
| Program Services | $315,073 | ProgramServicesAmt |
| Management And General | $77,560 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,365,648 | TotalAmt |
| Program Services | $3,597,596 | ProgramServicesAmt |
| Management And General | $767,597 | ManagementAndGeneralAmt |
| Fundraising | $455 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,598,062 | TotalAmt |
| Program Services | $1,333,929 | ProgramServicesAmt |
| Management And General | $258,729 | ManagementAndGeneralAmt |
| Fundraising | $5,404 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,415 | TotalAmt |
| Program Services | $6,729 | ProgramServicesAmt |
| Management And General | $85,686 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,033 | TotalAmt |
| Management And General | $76,033 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,629 | TotalAmt |
| Program Services | $3,629 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,759 | TotalAmt |
| Management And General | $11,759 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,854,505 | TotalAmt |
| Program Services | $11,182,515 | ProgramServicesAmt |
| Management And General | $1,667,299 | ManagementAndGeneralAmt |
| Fundraising | $4,691 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $295,161 | TotalAmt |
| Program Services | $263,548 | ProgramServicesAmt |
| Management And General | $20,408 | ManagementAndGeneralAmt |
| Fundraising | $11,205 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,237,294 | TotalAmt |
| Program Services | $1,124,928 | ProgramServicesAmt |
| Management And General | $81,760 | ManagementAndGeneralAmt |
| Fundraising | $30,606 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,249 | TotalAmt |
| Program Services | $100,071 | ProgramServicesAmt |
| Management And General | $120,178 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $477,480 | TotalAmt |
| Program Services | $340,060 | ProgramServicesAmt |
| Management And General | $136,689 | ManagementAndGeneralAmt |
| Fundraising | $731 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,966 | TotalAmt |
| Program Services | $24,149 | ProgramServicesAmt |
| Management And General | $34,677 | ManagementAndGeneralAmt |
| Fundraising | $1,140 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,286 | TotalAmt |
| Program Services | $126,847 | ProgramServicesAmt |
| Management And General | $73,659 | ManagementAndGeneralAmt |
| Fundraising | $2,780 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300,883 | TotalAmt |
| Program Services | $259,656 | ProgramServicesAmt |
| Management And General | $41,227 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,492,257 | TotalAmt |
| Program Services | $2,409,443 | ProgramServicesAmt |
| Management And General | $82,814 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,308 | TotalAmt |
| Program Services | $27,821 | ProgramServicesAmt |
| Management And General | $260,487 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $12,912,350 | $12,909,846 | $2,504 |
| Equipment Rental/Lease | $231,560 | $203,000 | $28,560 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $666,633 | TotalAmt |
| Program Services | $511,911 | ProgramServicesAmt |
| Management And General | $153,773 | ManagementAndGeneralAmt |
| Fundraising | $949 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,674,745 | TotalAmt |
| Program Services | $52,750,051 | ProgramServicesAmt |
| Management And General | $7,794,467 | ManagementAndGeneralAmt |
| Fundraising | $130,227 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,869,145 | BOYAmt |
| EOY | $15,024,168 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,746,177 | BOYAmt |
| EOY | $9,321,148 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,531,019 | BOYAmt |
| EOY | $1,704,310 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $497,358 | BOYAmt |
| EOY | $511,759 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $55,289,168 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $27,311,010 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,417,671 | BOYAmt |
| EOY | $27,978,158 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,257,258 | BOYAmt |
| EOY | $22,662,660 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $415,704 | BOYAmt |
| EOY | $1,406,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,734,332 | BOYAmt |
| EOY | $78,608,203 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,315,663 | BOYAmt |
| EOY | $5,432,538 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,703,816 | BOYAmt |
| EOY | $5,160,539 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,249,000 | BOYAmt |
| EOY | $2,061,247 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $455,234 | BOYAmt |
| EOY | $458,879 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,723,713 | BOYAmt |
| EOY | $13,113,203 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,974,970 | BOYAmt |
| EOY | $65,433,824 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,649 | BOYAmt |
| EOY | $61,176 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,010,619 | BOYAmt |
| EOY | $65,495,000 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,734,332 | BOYAmt |
| EOY | $78,608,203 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $7,941,394 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $548,113 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$5,126 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,629 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,629 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Dues paid to associations that are required to report lobby activities. Total dues paid was $118,974. The portion attributable to lobbying activities as reported by the associations was $3,629. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $187,000 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $3,428,979 | OtherCostOrOtherBasisAmt |
| Book Value | $3,615,979 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $37,331,237 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,022,975 | DepreciationAmt |
| Book Value | $20,308,262 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,213,832 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,412,185 | DepreciationAmt |
| Book Value | $3,801,647 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,128,120 | OtherCostOrOtherBasisAmt |
| Depreciation | $875,850 | DepreciationAmt |
| Book Value | $252,270 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $27,978,158 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other Liabilities | Desc |
| Amt | $458,879 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $458,879 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $69,259,005 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $548,113 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $99,310 | OtherRevenueAmt |
| Revenue Not Reported | $647,423 | RevenueNotReportedAmt |
| Revenue Subtotal | $68,611,582 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $11,759 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | -$7,202 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $4,557 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $68,616,139 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $60,808,234 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $145,248 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $145,248 | ExpensesNotReportedAmt |
| Expenses Subtotal | $60,662,986 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $11,759 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $11,759 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $60,674,745 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Organization 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 Organization 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. |
| Part XI, Line 2d - Other Adjustments: | Foundation Revenue Included in Consolidated Financial 99,310. |
| Part XI, Line 4b - Other Adjustments: | Loss Included in Expenses on Financial Statements -7,202. |
| Part XII, Line 2d - Other Adjustments: | Foundation Expenses Included in Consolidated Financial Statements 138,046. Loss Included in Revenue on Form 990 7,202. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $622,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $622,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01030 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,755,674 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,694,448 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,061,226 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03400 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,377,674 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,694,448 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,683,226 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04430 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $605,748 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $49,621 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $556,127 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00920 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,745,757 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,967,712 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,778,045 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06230 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $72,403 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $72,403 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,423,908 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,017,333 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,406,575 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07270 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,801,582 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,711,781 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,089,801 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11700 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,607,436 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $25,594,318 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $25,590,511 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $3,807 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Washoe Barton Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1107 Hwy 395 | AddressLine1Txt |
| City | Gardnerville | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89410 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.cvmchospital.org | WebsiteAddressTxt |
| State License | 3986RUH-14 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | 1 provider based clinic | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carson Valley Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Section C, line 7d | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Section C, line 7d | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.cvmchospital.org/patients_visitors/financial_assistance.aspx | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.cvmchospital.org/patients_visitors/financial_assistance.aspx | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.cvmchospital.org/patients_visitors/financial_assistance.aspx | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Carson Valley Medical Center | Part V, Section B, Line 5: In 2019, A Community Health Needs Assessment was conducted on behalf of Carson Valley Medical Center by Professional Research Consultants, Inc. (PRC). Methodology: This assessment incorporates data from both quantitative and qualitative sources. Quantitative data input includes secondary research (vital statistics and other existing health related data) that allows for comparison to benchmark data at the state and national levels. Qualitative data input includes primary research gathered through the Online Key Informant Survey. The study area for this effort is Douglas County, Nevada. This community definition was determined based on the areas of residence of most recent patients of Carson Valley Medical Center.To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey was implemented as part of this process. A list of recommended participants was provided by Carson Valley Medical Center; this list included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall.Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. In all, 33 community stakeholders took part in the Online Key Informant Survey.Through this process, input was gathered from several individuals whose organizations work with low-income, minority, or other medically underserved populations. In the online survey, key informants were asked to rate the degree to which various health issues are a problem in their own community. Follow-up questions asked them to describe why they identify problem areas as such, and how these might better be addressed. Results of their ratings, as well as their verbatim comments, are included throughout this report as they relate to the various other data presented. NOTE: The Online Key Informant Survey was designed to gather input regarding participants' opinions and perceptions of the health needs of the residents in the area. Thus, these findings are based on perceptions, not facts. |
| Carson Valley Medical Center | Part V, Section B, Line 6b: Final participation included representatives of the organizations: Carson Valley Medical Center/ Minden Family Medicine, Carson Valley Chamber of Commerce, Douglas County School District, Douglas County Sheriff's Office, DP Consulting, East Fork Fire Protection District, Me for Incredible Youth (MEFIYI), Minden Family Medicine, Rural Health Clinic (CVMC), REMSA/Care Flight, Renown Health, Senior Care, Sierra Nevada ENT and Hearing Aid Center, Tahoe Fracture and Orthopedics, The RecordCourier Newspaper. |
| Carson Valley Medical Center | Part V, Section B, Line 7d: http://cvmchospital.org/about_us/health_needs_assessment.aspx |
| Carson Valley Medical Center | Part V, Section B, Line 11: For the 2019 Community Health Needs Assessment - the following were the community needs identified and addressed in the 2019 - 2020 implementation plan as well as actions that CVMC has taken to address these areas.The Areas of Opportunity were determined after consideration of various criteria, including: standing in comparison with benchmark data; the preponderance of significant findings within topic areas; the magnitude of the issue in terms of the number of persons affected; and the potential health impact of a given issue. These also take into account those issues of greatest concern to the community stakeholders (key informants) giving input to this process.1.) Access to Health Services - lack of health insurance for children and adults and the primary care physician ratio2.) Heart Disease & Stroke - high blood cholesterol3.) Infant Health & Family Planning - low-weight births4.) Injury & Violence - unitentional injury deaths5.) Mental Health - suicide deaths *ranked as a top concern in the Online Key Informant Survey 6.) Nutrition, Physical Activity & Weight - low food access *ranked as a top concern in the Online Key Informant Survey7.) Substance Abuse - excessive drinking *ranked as a top concern in the Online Key Informant Survey 8.) Tobacco Use - cigarette smoking prevalenceCVMC did not address infant health and family planning as that is covered in our community by the community health department, who we work closely with. In 2019, for substance abuse and tobacco use, CVMC continued to partner and support the area's non-profit whose mission is substance abuse and tobacco use - the Partnership of Community Resources. We host a fundraiser for them annually and our leadership sits on their governing board to ensure full support of their efforts. For access to healthcare, in 2019 we extended primary care and physical therapy hours; as well as supporting and partnering with DART the regional transportation service to ensure patients can get to their medical appointments. In 2019 CVMC also added 2 new primary care providers. For mental health services, CVMC opened the area's first behavioral health clinic to serve the community. We offer intensive individual and group outpatient sessions to meet this community need. To address nutrition and obesity, CVMC hired a dietitian intern in 2019 to offer more nutritional seminars and outreach services. To address heart disease and stroke, CVMC purchased a new CT machine in 2019 that enabled us to perform cardiac calcium screenings for our community. |
| Carson Valley Medical Center | Part V, Section B, Line 16j: English and Spanish are readily available and if another language is needed, then the FAP is translated into that language. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Ironwood Primary Care | ||||
| 897 Ironwood Dr | Minden | NV | 89423 | Medical Clinic |
| 2 - Occupational Medicine | ||||
| 897 Ironwood Drive | Minden | NV | 89243 | Medical Clinic |
| 3 - Ironwood Urgent Care | ||||
| 897 Ironwood Dr | Minden | NV | 89423 | Medical Clinic |
| 4 - Job's Peak Internal Medicine & Family | ||||
| 1520 Virginia Ranch Rd Unit B | Gardnerville | NV | 89410 | Medical Clinic |
| 5 - Minden Family Medicine | ||||
| 1649 Lucerne St Unites A B | Minden | NV | 89423 | Medical Clinic |
| 6 - Topaz Ranch Medical Center | ||||
| 3919 Carter | Wellington | NV | 89444 | Medical Clinic |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | The organization's community benefit report is available upon request and is posted at www.cvcmhospital.org/about_us/ |
| Part I, Line 7: | Part I, Line 7a:Financial Assistance was calculated using the cost-to-charge ratio. All patient segments are addressed using this method. The methodology used is to be in compliance with laws and regulations set forth by Medicare and the filing of the annual cost report. Part I, Line 7b and 7g:Unreimbursed Medicaid and Subsidized Health Services was calculated using the cost report and analyzing the Medicare ratio of cost to charge for the respective cost centers.Part I, line 7e:Community health improvement services are actual costs reported in the general ledger. Part I, line 7i:Cash and in-kind donations are actual costs reported in the general ledger. |
| Part I, Line 7g: | Carson Valley Medical Center runs 8 physician clinics to treat patients in the community. The clinics need to be subsidized by the hospital to meet their payroll and other monthly expense needs. The subsidized health services amount includes $3,020,492 associated with two rural health clinics and $3,572,961 from physician clinics. |
| 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 reported bad debt in accordance with HFMA Statement 15, and therefore, bad debt expense does not include charity care. |
| Part III, Line 4: | The financial statement footnote regarding implicit price concessions may be found on page 11 and 12 of the attached financial statements. |
| Part III, Line 8: | Total revenue received from Medicare and the Medicare allowable costs are reported from 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. |
| Part III, Line 9b: | The general billings and collections policy applies to all patients, including any application under the charity care policy. The Hospital does not send patient accounts to collections before 120 days of the date of the first invoice. The Hospital will pull back patient accounts from collections if a patient submits a financial assistance application within 240 days of the date of the first invoice. |
| Part VI, Line 2: | In addition to the community health needs assessment, CVMC regularly assesses data trends and utilization data from internal sources as well as secondary sources (state and local agencies, Nevada Rural Hospital Partners, Nevada Hospital Association, etc.) to assess community need. CVMC partners with local development authority, Chambers of Commerce, and government committees to ensure CVMC is responding to the needs of the community. |
| Part VI, Line 3: | Communication is via website, brochures, telephone and in person. Website is www.cvmchospital.org/patients_visitors/financial_assistance.aspx |
| Part VI, Line 4: | Carson Valley Medical Center (CVMC), serves Douglas County which is an area spanning 710 square miles and includes eight ZIP codes: 89705 (south Carson City), 89460 (Gardnerville Ranchos), 89411 (Genoa), 89423 (Minden), 89448 (Zephyr Cove), 89449 (Stateline), 89444 (Topaz Ranch) and 89410 (Gardnerville). It also includes outlying areas that include Wellington NV, Markleeville, CA and Coleville, CA. This broad area encompasses various neighborhood settings, including both rural and suburban areas. CVMC is in Douglas County, NV, which has a population of 49,463 (80% white, 14% Hispanic, 2% Native American). Median household income is $61,176, with 9.8 percent of population in poverty. (Data from Carson City Health & Human Services: Primary & Secondary Data Sets, 2019). |
| Part VI, Line 5: | The majority of the organization's board of directors is comprised of persons serving in the medical community of the greater Northern Nevada area. The organization extends medical staff privileges to credentialed and approved practitioners in its community. The organization's mission is to promote the health and wellness of the Carson Valley and its visitors. Surplus funds are used to acquire equipment and resources that improve patient care.Carson Valley Medical Center Emergency Room is available to all patients, regardless of ability to pay.CVMC is committed - as the community hospital - to promote the health of the members of the community. We do so through community outreach and wellness programs, including reaching out to local employers in our workplace wellness programs and offering low cost and free screenings to detect and prevent illness and disease. The hospital operates a 24 hour emergency room for medically necessary care to all regardless of ability to pay. The hospital participates in education and training of healthcare professionals. The hospital participates in government-sponsored health programs such as all Medicaid, Medicare, Tricare, all Veterans Administration healthcare and Indian Health Services. The organization is the sole community hospital in Douglas County. The organization currently has 21 active volunteers. The organization has numerous employees involved in local and state community programs including Kiwanis, Douglas County Business Council, Minden Rotary, Carson Valley Chamber of Commerce, Nevada Rural Hospital Partners, National Association for Healthcare Quality, American Hospital Association, MGMA, Boy Scouts of America, Family Support Council of Douglas County, Partnership of Community Resources, Tahoe Youth and Family Services, and the Douglas County Community and Senior Center.Community outreach and education are provided to our community members to increase awareness of prevalent health issues and promote healthy behaviors and lifestyles. Programs include workplace wellness, health fairs, career days, and services provided at large-scale community events. The organization is responsive to the community needs such as opportunities for community involvement in governance and advisory groups. The organization serves as a vehicle for attracting and effectively uses donated funds. Carson Valley Medical Center offers a series of community support groups provided as a free service to engage our community members in education, guidance, and support to improve their health and their quality of life. The support groups include weight management, Alzheimer's support, coping with change, grief, and diabetes. |
| Part VI, Line 6: | Although this hospital is not in an affiliated health system, it does have two parent companies each about 45 miles away serving different communities. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jeff Prater | ||||||||||||||
| CEO | $220,444 | $0 | $16,942 | $0 | $1,086 | $0 | $4,662 | $0 | $14,321 | $0 | $257,455 | $0 | $0 | $0 |
| Colleen Reid | ||||||||||||||
| CFO | $185,456 | $0 | $3,737 | $0 | $1,338 | $0 | $6,694 | $0 | $22,621 | $0 | $219,846 | $0 | $0 | $0 |
| Brandon Battis | ||||||||||||||
| Pharmacist | $163,134 | $0 | $2,411 | $0 | $0 | $0 | $5,962 | $0 | $29,249 | $0 | $200,756 | $0 | $0 | $0 |
| Greg Ponsness | ||||||||||||||
| Pharmacy Manager | $157,211 | $0 | $4,857 | $0 | $450 | $0 | $5,840 | $0 | $29,249 | $0 | $197,607 | $0 | $0 | $0 |
| Aaron Teachout | ||||||||||||||
| Director of Finance | $164,832 | $0 | $0 | $0 | $264 | $0 | $0 | $0 | $11,696 | $0 | $176,792 | $0 | $0 | $0 |
| Kathryn Cocking | ||||||||||||||
| Chief Nursing Officer | $150,003 | $0 | $2,647 | $0 | $2,038 | $0 | $5,450 | $0 | $11,789 | $0 | $171,927 | $0 | $0 | $0 |
| Shannon Albert | ||||||||||||||
| Director of Operations | $147,727 | $0 | $0 | $0 | $296 | $0 | $4,909 | $0 | $19,097 | $0 | $172,029 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Douglas County Nevada | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 886000031 | BondIssuerEIN |
| Bond Issued | 2013-04-17 | BondIssuedDt |
| Issue Price | $8,700,000 | IssuePriceAmt |
| Purpose | Refinance 2003 bond issued 04/15/2003; purchase & build urgent care center | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $3,412,167 | RetiredAmt |
| Total Proceeds | $8,700,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $174,000 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $2,621,962 | CapitalExpendituresAmt |
| Other Spent Proceeds | $5,904,038 | OtherSpentProceedsAmt |
| Substantial Completion | 2013 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Date Rebate Computation Performed | FormAndLineReferenceDesc |
| Explanation | Issuer Name: Douglas County, Nevada Date the Rebate Computation was Performed: 10/08/2018 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Clint Purvance, Kelly Neiger and Preston Becker have a business relationship. Hakeem Olanrewaju has a business relationship with Sy Johnson and Dawn Ahner. |
| Form 990, Part VI, Section A, line 6 | The Corporation shall have two (2) Members, which shall be Renown Health and Barton Healthcare System. |
| Form 990, Part VI, Section A, line 7a | Each member shall have the right to appoint 50% of the board members. Each member has the right to remove any or all of its designated directors at any time and from time to time. |
| Form 990, Part VI, Section A, line 7b | The following actions or items will require the approval of the Members prior to implementation or becoming effective: (a) Approval of long-term or material agreements involving more than two hundred fifty thousand dollars, including but not limited to borrowings, equity financings or capitalized leases, and agreements involving the sale or disposition of assets which involve the receipt or payment of more than two hundred fifty thousand dollars; (b) Approval of the Corporation's strategic plan and selection or approval of the manager or senior executives of the Corporation; (c) Any amendment or modification of the Corporation's Articles of Incorporation or the Bylaws; (d) Approval of the Corporation's operating and capital budgets (e) Admit any additional members; (f) Approval of any capital or other investment (including real property) or purchase in excess of the amount approved in the annual budget and any revisions thereto; (g) A sale, lease, conveyance or other transfer of all or substantially all of the assets of the Corporation; and (h) A merger, consolidation, reorganization or dissolution of the Corporation. |
| Form 990, Part VI, Section A, line 8b | The organization does not have any committees with the authority to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11b | A draft copy of the Form 990 is reviewed in detail by the organization's Chief Finance Officer. An electronic copy of the Form 990 is sent to all voting members of the board of directors for their review and comments prior to filing with the Internal Revenue Service. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy covers directors, officers and managing employees of Carson Valley Medical Center. According to established policies there is an on-going review of contracts and enforcement is handled by the Corporate Compliance Officer. If a potential conflict is disclosed the interested person is required to leave the Board or committee meeting while the matter is discussed and voted upon. The remaining Board or committee members determine if a conflict does exist. |
| Form 990, Part VI, Section B, line 15a | The CEO, CFO, and key employees' compensation are determined using a regionally recognized market survey and competitor comparisons. The CEO's compensation is also reviewed and approved by the board of directors. The compensation is reviewed annually. The CEO and Human Resources review the compensation of the CFO. |
| Form 990, Part VI, Section C, line 19 | The governing documents, conflict of interest policy, and financial statements are available to the public upon request. |
| Form 990, Part IX, line 11g | Repairs and Maintenance: Program service expenses 876,451. Management and general expenses 143,376. Fundraising expenses 6. Total expenses 1,019,833. Consulting: Program service expenses 84,761. Management and general expenses 612,812. Fundraising expenses 0. Total expenses 697,573. Other: Program service expenses 1,365,309. Management and general expenses 664,165. Fundraising expenses 4,685. Total expenses 2,034,159. Purchased Services: Program service expenses 432,407. Management and general expenses 94,618. Fundraising expenses 0. Total expenses 527,025. Contract: Program service expenses 1,026,602. Management and general expenses 529. Fundraising expenses 0. Total expenses 1,027,131. Consulting-401K: Program service expenses 0. Management and general expenses 19,352. Fundraising expenses 0. Total expenses 19,352. Medical Purchased Services: Program service expenses 7,396,985. Management and general expenses 132,447. Fundraising expenses 0. Total expenses 7,529,432. |
| Form 990, Part XI, line 9: | Net Assets Adjustment -5,126. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carson Valley Medical Center Rural Health Clinic LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1107 Highway 395 | AddressLine1Txt |
| City | Gardnerville | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89410 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261513495 | EIN |
| Primary Activities | Rural health and senior care clinic | PrimaryActivitiesTxt |
| Legal Domicile State | NV | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Washoe Barton Medical Clinic | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carson Valley Medical Center Foundation Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1107 Highway 395 | AddressLine1Txt |
| City | Gardnerville | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89410 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364649725 | EIN |
| Primary Activities | Charitable Foundation | PrimaryActivitiesTxt |
| Legal Domicile State | NV | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Washoe Barton Medical Clinic | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carson Valley Medical Center Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $113,672 | InvolvedAmt |
| Method Of Amount Determination | General Ledger | MethodOfAmountDeterminationTxt |