2019-11-05T20:07:00-06:00 2018-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2018-01-01 880502320 CARSON TAHOE REGIONAL HEALTHCARE CARS 7754457902 PO BOX 2168 CARSON CITY NV 89702 MITCHELL WATSON CFO 7754457902 2019-10-30 1 KURT BENNION CPA P01469618 4252506100 2019-10-30 67.137.57.251 2019-10-30 13:13:21 PD P 87BD3611550E1D67138C53841B1C9A886D50C97E 0A137849BC389FB7B51D6FC2D6742665ACC5CBED 2018 2020-01-14 16:20:31Z ALAN GARRETT PO BOX 2168 CARSON CITY NV 89702 380267601 0 X WWW.CARSONTAHOE.COM X 2001 NV TO ENHANCE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE. 10 9 1866 178 0 0 564759 1394905 306785909 316886569 3593431 4550427 158717 770672 311102816 323602573 19581306 19659520 0 0 109895423 110776529 0 0 988341 162462668 176653839 291939397 307089888 19163419 16512685 422409825 423237912 191702320 184601296 230707505 238636616 X TO ENHANCE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE. 0 0 214126573 19659520 316886569 CARSON TAHOE REGIONAL MEDICAL CENTER IS THE MAIN HUB OF CARSON TAHOE HEALTH SYSTEM. LOCATED IN NORTH CARSON CITY, NEVADA, THE REGIONAL MEDICAL CENTER PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES FOR OVER 250,000 PEOPLE. THESE SERVICES ARE PROVIDED REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, AGE, OR ABILITY TO PAY. CARSON TAHOE'S MISSION IS TO ENHANCE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVICE.THE REGIONAL MEDICAL CENTER PROVIDES CARE TO PERSONS, SOME OF WHOM ARE COVERED BY GOVERNMENTAL PROGRAMS INCLUDING MEDICARE AND MEDICAID, AS WELL AS MEDICALLY INDIGENT PATIENTS UNABLE TO PAY. THE COST OF DIRECT AND INDIRECT COSTS FOR SERVICES FURNISHED UNDER ITS CHARITY CARE POLICY WERE APPROXIMATELY $3.7 MILLION IN 2018. THE HOSPITAL ALSO SPONSORS HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY INCLUDING WELLNESS EDUCATION AND SUPPORT. THE HOSPITAL HAD 12,802 INPATIENT DISCHARGES, 56,217 INPATIENT DAYS, AND 257,486 OUTPATIENT REGISTRATIONS IN 2018. CARSON TAHOE REGIONAL MEDICAL CENTER CONSISTS OF AN ACUTE CARE REGIONAL MEDICAL CENTER WITH 159 LICENSED BEDS, INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES WITH A TOTAL OF 52 LICENSED BEDS, A FREE-STANDING LICENSED EMERGENT CARE CENTER, 2 URGENT CARES, ACCREDITED CANCER CENTER, RETAIL CLINICS, IMAGING CENTERS, PAIN MANAGEMENT CENTER, THERAPY, REHABILITATION AND SEVERAL MEDICAL OFFICE BUILDINGS. 214126573 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 130 0 1866 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 9 0 1 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 1 0 NV X MARLENE HARRIS CPA 7754457902 PO BOX 2168 CARSON CITY NV 89702 GILBERT YANUCK CHAIR 1.00 1.00 X X 0 8400 0 JEFFREY BASA MD VICE CHAIR 1.00 0.00 X X 0 0 0 JAMES MANNING SECRETARY 1.00 0.00 X X 0 0 0 FREEMAN JOHNSON ASSISTANT SECRETARY 1.00 0.00 X X 0 0 0 ELIZABETH DUFFRIN TREASURER 1.00 1.00 X X 0 8400 0 KEVIN HALOW MD DIRECTOR 1.00 0.00 X 0 0 0 PHILIP O'NEILL DIRECTOR 1.00 1.00 X 0 8400 0 BRUCE ROBERTSON DIRECTOR 1.00 1.00 X 0 8400 0 DAVID STRULL MD DIRECTOR 1.00 0.00 X 0 0 0 CHRISTINE SANSOM MSN RN DIRECTOR 1.00 1.00 X 0 8400 0 ED EPPERSON FELLOW ACHE PRESIDENT & CEO 25.00 15.00 X 0 893441 61495 ANN BECK VP, CFO (THROUGH AUG 2018) 10.00 30.00 X 0 740446 49841 WILL MOORE INTERIM CFO 10.00 30.00 X 0 0 0 RICHARD RODRIGUEZ MD CMO 35.00 5.00 X 0 587149 21054 MICHELLE JOY COO 35.00 5.00 X 0 455003 95450 ANNA ANDERS CNO 40.00 0.00 X 0 315266 87946 PAMELA PUCKETT VP CLINICAL INTEGRATION 10.00 30.00 X 0 297124 72014 TRACEY MCCOLLUM DIRECTOR, NURSING 40.00 0.00 X 217558 0 44220 SCOTT MATTES DIRECTOR, ANCILLARY SERVICES 40.00 0.00 X 211701 0 11804 CYNTHIA KUPERUS DIRECTOR, PERI-OPERATIVE SERVICES 40.00 0.00 X 243791 0 55360 WAYNE MITCHELL DIRECTOR, PHARMACY SERVICES 40.00 0.00 X 213745 0 38612 KELLY SCHOTT MANAGER, PHARMACY SERVICES 40.00 0.00 X 181203 0 22300 1067998 3330429 560096 107 0 1 0 NORTH STAR CONSTRUCTION PO BOX 1305 CARSON CITY NV 89703 CONSTRUCTION SERVICES 1558891 BLUEPEAK TECHNOLOGY SOLUTIONS PO BOX 40865 RENO NV 89504 SOFTWARE SERVICES 1544171 QUEST DIAGNOSTICS PO BOX 633545 CINCINNATI OH 45263 LABORATORY SERVICES 1520798 LAKE TAHOE REGIONAL HOSPITALISTS 111 W TELEGRAPH ST 200 CARSON CITY NV 89703 PHYSICIAN SERVICES 1520758 DIVERSIFIED CLINICAL SERVICES INC 28525 NETWORK PLACE CHICAGO IL 60673 PHYSICIAN SERVICES 1290730 28 114887 1280018 18000 1394905 PATIENT SERVICES 621110 314815247 314815247 NONPATIENT SERVICES 621110 2071322 2071322 316886569 4290934 4290934 772018 0 772018 772018 772018 56887072 55006157 1621422 1880915 -1621422 259493 259493 2538 114887 37174 -34636 -34636 33565 275 33290 33290 323602573 316886569 0 5321099 19400000 19400000 259520 259520 90310912 69831333 20231806 247773 3309212 2603289 696549 9374 10677187 7609592 3043350 24245 6479218 5008048 1452838 18332 22154683 14662191 7468483 24009 31980 21000 10980 2547942 1643431 881841 22670 9401560 3837599 5559237 4724 58595 40755 16924 916 8349 5843 2506 6588847 6588847 15019035 6572085 8445895 1055 201535 201535 MEDICAL SUPPLIES 58256280 57664226 592054 SHARED SERVICES 31680811 31680811 BAD DEBT EXPENSE 20288941 20288941 REPAIRS AND MAINTENANCE 7357639 4490376 2867263 3057642 188344 2234055 635243 307089888 214126573 91974974 988341 22588664 19211654 34295795 38972582 6392427 6063672 6296304 11231671 325804006 164150462 169278346 161653544 177310373 179201886 6247916 6247916 0 654987 422409825 423237912 23061398 25090499 139547 29437 161498732 155841537 2150716 650651 3507669 2989172 1344258 0 191702320 184601296 X 230707505 238636616 230707505 238636616 422409825 423237912 16512685 -8583574 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 10056 10056 0 PART II-B, LINE 1: A PORTION OF THE MEMBERSHIP DUES PAID TO THE NEVADA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION WERE USED BY THOSE GROUPS TO LOBBY ON BEHALF OF CARSON TAHOE REGIONAL HEALTHCARE AND OTHER MEMBERS. 21852706 21852706 148077737 53547356 94530381 17363264 10677732 6685532 135187262 99925374 35261888 3323037 3323037 161653544 X 298347348 1658871 1658871 296688477 26914096 26914096 323602573 270088396 37449 37449 270050947 37038941 37038941 307089888 PART X, LINE 2: THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE). HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. UNDER FASB ASC 740, INCOME TAXES, THE HOSPITAL IS REQUIRED TO RECOGNIZE A LIABILITY FOR EACH UNCERTAIN TAX POSITION AT THE AMOUNT ESTIMATED TO BE REQUIRED TO SETTLE THE ISSUES. THERE WERE NO LIABILITIES RECORDED FOR UNCERTAIN TAX POSITIONS FOR THE YEAR ENDED DECEMBER 31, 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: SPECIAL FUNDRAISING EVENT EXPENSES 37,174. CHARITABLE GAMING EXPENSES 275. LOSS ON DISPOSAL OF PROPERTY 1,621,422. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT RETURN 6,175,155. PROVISION FOR BAD DEBTS 20,288,941. CONTRIBUTIONS FOR ACQUISITION OF PROPERTY AND EQUIPMENT 450,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL FUNDRAISING EVENT EXPENSES 37,174. CHARITABLE GAMING EXPENSES 275. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 20,288,941. RELATED PARTY TRANSFERS 16,750,000. HOPEFEST 2018 117425 114887 2538 13855 6789 5700 10830 117425 114887 2538 13855 6789 5700 10830 37174 -34636 33565 275 1 1.00000 33565 275 275 33290 NV 1 0 1 0 1.00000 0.00000 ANGELINA CRAIG PO BOX 2168 CARSON CITY NV 89702 0 KITTY MCKAY 0 EVENT ORGANIZER X 1 33290 1 1 X 1 X 1 X 1 1 1 0 1 1 3682625 3682625 0.01200 37146957 25966000 11180957 0.03640 40829582 25966000 14863582 0.04840 2678182 2678182 0.00870 463471 463471 0.00150 254152 174594 79558 0.00030 148797 148797 0.00050 3544602 174594 3370008 0.01100 44374184 26140594 18233590 0.05940 25125 25125 0.00010 6903 6903 0.00000 32028 32028 0.00010 1 20288941 0 123318775 109546020 13772755 X 1 1 1 1 CARSON TAHOE REGIONAL MEDICAL CENTER 1600 MEDICAL PARKWAY CARSON CITY NV 89703 WWW.CARSONTAHOE.COM 4466HOS-21 X X X CARSON TAHOE REGIONAL HEALTHCARE 0 0 1 X X X X X X X X X 16 1 1 0 1 X SEE PART V, SECTION B, LINE 7D X X 1 16 1 SEE PART V, SECTION B, LINE 7D 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X WWW.CARSONTAHOE.COM/FINANCIALSERVICES.HTML X WWW.CARSONTAHOE.COM/FINANCIALSERVICES.HTML X WWW.CARSONTAHOE.COM/FINANCIALSERVICES.HTML X X X X X 1 X 0 X X X X 1 X 0 0 CARSON TAHOE REGIONAL HEALTHCARE PART V, SECTION B, LINE 5: TO ENSURE THE BEST REPRESENTATION OF THE POPULATION, A TELEPHONE INTERVIEW METHODOLOGY - INCORPORATING BOTH LANDLINE AND CELL PHONE INTERVIEWS - WAS EMPLOYED. A RANDOM SAMPLE OF 800 INDIVIDUALS AGE 18 AND OLDER IN THE PRIMARY SERVICE AREA RESULTED IN 338 SURVEYS IN CARSON CITY, 271 IN DOUGLAS COUNTY, 150 IN LYON COUNTY AND 41 IN OTHER AREAS. TO SOLICIT INPUT FROM KEY INFORMANTS, AN ONLINE KEY INFORMANT SURVEY WAS ALSO IMPLEMENTED. THESE INDIVIDUALS INCLUDED PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HELATH 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 POPULATION WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. IN ALL, 136 COMMUNITY STAKEHOLDERS PARTICIPATED IN THE ONLINE KEY INFORMANT SURVEY. SEE PAGES 13 AND 14 OF THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT FOR A FULL LIST OF ORGANIZATIONS, AGENCIES AND BUSINESSES THAT PARTICIPATED OF THE ONLINE KEY INFORMANT SURVEY PARTICIPANTS. CARSON TAHOE REGIONAL HEALTHCARE PART V, SECTION B, LINE 6A: A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH CARSON TAHOE CONTINUING CARE HOSPITAL, THE OTHER HOSPITAL OWNED BY CARSON-TAHOE HEALTH SYSTEM. CARSON TAHOE REGIONAL HEALTHCARE PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT WWW.CARSONTAHOE.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTML. CARSON TAHOE REGIONAL HEALTHCARE PART V, SECTION B, LINE 11: IN 2018, THE HOSPITAL ADDRESSED SEVEN AREAS IDENTIFIED IN THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT WITH RESOURCES AND PARTNERSHIPS IN THE COMMUNITY. THE AREAS ADDRESSED WERE: ACCESS TO HEALTH SERVICES; DIABETES EDUCATION AND TREATMENT; CANCER SCREENING AND TREATMENT; MENTAL HEALTH AND MENTAL DISORDERS (INCLUDING DEMENTIAS AND ALZHEIMER'S DISEASE); NUTRITION ISSUES; PHYSICAL ACTIVITY AND WEIGHT ISSUES; INFANT HEALTH; AND HEART DISEASE AND STROKE SCREENING AND TREATMENT. THE AREAS IDENTIFIED BUT NOT ADDRESSED BECAUSE THEY WERE OUTSIDE THE HOSPITAL'S CORE SPHERE OF INFLUENCE INCLUDED DISABILITY, INJURY AND VIOLENCE, AND ORAL HEALTH. 17 1 - CARSON TAHOE SIERRA SURGERY CENTER 1400 MEDICAL PARKWAY CARSON CITY NV 89703 INPATIENT AND OUTPATIENT SURGERY 2 - CARSON TAHOE MEDICAL OFFICE BUILDING 1470 MEDICAL PARKWAY STE 140 CARSON CITY NV 89703 CARDIAC REHAB, OP CARDIOLOGY IMAGING, HEALTH CLASSES, COUNSELING & LECTURES 3 - CARSON TAHOE MINDEN MEDICAL CENTER 925 IRONWOOD DRIVE MINDEN NV 89703 EMERGENT CARE, LAB, IMAGING, THERAPY & CARDIOLOGY 4 - CARSON TAHOE CANCER CENTER 1535 MEDICAL PARKWAY CARSON CITY NV 89703 OUTPATIENT AMBULATORY INFUSION CENTER 5 - CARSON TAHOE SPECIALTY MEDICAL CENTER 775 FLEISCHMANN WAY CARSON CITY NV 89703 LAB, IP & OP BEHAVIORAL HEALTH AND EEG 6 - CARSON TAHOE SURGERY CENTER 973 MICA DRIVE CARSON CITY NV 89705 OUTPATIENT SURGERY AND PAIN MANAGEMENT 7 - CARSON TAHOE DAYTON MEDICAL CENTER 901 MEDICAL CENTER DRIVE DAYTON NV 89403 URGENT CARE AND OUTPATIENT LAB 8 - CARSON MALL 1201 S CARSON STREET CARSON CITY NV 89701 URGENT CARE AND THERAPY 9 - CARSON TAHOE CLINIC AT WALMART 3770 US HWY 395 S CARSON CITY NV 89705 CLINIC 10 - CARSON TAHOE CLINIC AT WALMART 3200 MARKET STREET CARSON CITY NV 89706 CLINIC 11 - CARSON TAHOE CLINIC AT WALMART 1511 GRANT STREET GARDNERVILLE NV 89410 CLINIC 12 - CARSON TAHOE BEHAVIORAL HEALTH 1080 N MINNESOTA STREET CARSON CITY NV 89703 INPATIENT BEHAVIORAL HEALTH 13 - CARSON TAHOE MEDICAL GROUP (RENO) 6880 S MCCARRAN BLVD STE 4 RENO NV 89509 CARDIOLOGY 14 - CARSON TAHOE CENTER FOR WOUND HEALING 6630 S MCCARRAN BLVD STE 202 RENO NV 89509 OUTPATIENT WOUND TREATMENT 15 - CARSON TAHOE CARDIOLOGY 276 KINGSBURY GRADE STE 101 STATELINE NV 89449 CARDIOLOGY 16 - CARSON TAHOE CARDIOLOGY 306 SURPRISE STREET YERINGTON NV 89447 CARDIOLOGY 17 - CARSON TAHOE CARDIOLOGY 85 SIERRA PARK ROAD MAMMOTH LAKES CA 93547 CARDIOLOGY PART I, LINE 3C: TO QUALIFY FOR FINANCIAL ASSISTANCE UNDER CARSON TAHOE REGIONAL HEALTHCARE'S FINANCIAL ASSISTANCE PROGRAM, AN INDIVIDUAL MUST:1. LIVE WITHIN CARSON TAHOE'S PRIMARY SERVICE AREA;2. RECEIVE MEDICALLY NECESSARY CARE;3. HAVE HOUSEHOLD GROSS INCOME LESS THAN 400% OF FEDERAL POVERTY LEVELS; 4. APPLY FOR GOVERNMENT ASSISTANCE IF UNINSURED; 5. SUBMIT A BILL FOR INSURANCE COVERAGE IF INSURED; AND5. COMPLETE A FINANCIAL ASSISTANCE APPLICATION.INDIVIDUALS MAY NOT BE REQUIRED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION IF THEY ARE ELIGIBLE FOR STATE ASSISTANCE PROGRAMS (FOOD STAMPS, PHARMACEUTICAL ASSISTANCE PROGRAMS, WELFARE, ETC.) OR ARE CURRENTLY ELIGIBLE FOR MEDICARE BUT WERE NOT ELIGIBLE ON THE DATE THEY RECEIVED MEDICAL CARE. PART I, LINE 7: THE AMOUNTS IN PART I, LINES 7A THROUGH 7C WERE CALCULATED USING THE IRS WORKSHEETS BASED ON A COST-TO-CHARGE RATIO. THE AMOUNTS REPORTED IN PART I, LINES 7E THROUGH 7I ARE ACTUAL COSTS AND REVENUES. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE DIABETES EDUCATION. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES INCLUDED STAFF TIME SPENT IN SUPPORT OF COMMUNITY EMERGENCY PREPAREDNESS AND DISASTER READINESS, AS WELL AS HOSPITAL REPRESENTATION ON COMMUNITY PANELS AND SUPPORT FOR THE COMMUNITY'S SPOOKTACTULAR AND EGGSTRAVAGANZA EVENTS. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 3: THE HOSPITAL CANNOT ESTIMATE WITH REASONABLE ACCURACY THE PORTION OF THE BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT DID NOT COMPLETE AN APPLICATION. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLE" PARAGRAPH IN NOTE 2 ON PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE ALLOWABLE COSTS WERE CALCULATED USING CARSON TAHOE REGIONAL MEDICAL CENTER'S 2018 MEDICARE COST REPORT. PART III, LINE 9B: POLICIES IN EFFECT DURING 2016 ARE THE SAME AS CARSON-TAHOE HEALTH SYSTEM AND CARSON TAHOE CONTINUING CARE HOSPITAL. THE APPLICATION PERIOD FOR COMPLETION OF A FINANCIAL ASSISTANCE APPLICATION IS AVAILABLE FOR A MINIMUM OF 240 DAYS FROM THE TIME OF PATIENT SERVICE. PART VI, LINE 2: THE MOST CURRENT NEEDS ASSESSMENT WAS CONDUCTED IN 2016. NEEDS WERE IDENTIFIED USING DIRECT PATIENT AND PHYSICIAN FEEDBACK, SURVEY RESPONSES AND BEST PRACTICE INFORMATION FROM OTHER ORGANIZATIONS. INFORMATION OBTAINED FROM THE PREVIOUS NEEDS ASSESSMENT CONDUCTED IN 2010 RECOGNIZED THE COMMUNITY'S NEED FOR BETTER ACCESS TO HEALTHCARE. IN RESPONSE, CARSON TAHOE HAS ESTABLISHED CARDIOLOGY CLINICS AND CLINICS AT WALMART IN OUTLYING AREAS. THE HEALTHCARE SYSTEM RELIES ON INTELLIMED SERVICES TO REPORT INFORMATION ON MIGRATION OF SERVICES WITHIN THE PRIMARY AND SECONDARY MARKETS THEN UTILIZES INFORMATION GATHERED TO FORMULATE NEEDS ASSESSMENT. OUR HEALTHCHECK LABORATORY SERVICES OFFER HEALTH SCREENING AT DISCOUNTED RATES AS A RESULT OF FEEDBACK FROM PHYSICIANS AND COMMUNITY REQUESTS. WE WORK WITH NEVADA STATE HEALTH AND HUMAN SERVICES IN IDENTIFYING AREAS OF NEED. CDC AND INFECTION CONTROL MONITOR INDUSTRY TRENDS AND ADVISE POSSIBLE AREAS OF FOCUS. PART VI, LINE 3: INFORMATION IS PROVIDED TO THE PATIENT AT THE TIME OF REGISTRATION, BOTH IN WRITING AND THROUGH DIRECT DISCUSSION WITH PATIENTS. INFORMATION IS PROVIDED IN THE PATIENT'S BILL. ELIGIBILITY REPRESENTATIVES AND FINANCIAL COUNSELORS ARE LOCATED ON SITE. PART VI, LINE 4: THE HOSPITAL'S COMMUNITY CONSISTS OF A SMALL URBAN AREA AND A LARGE RURAL POPULATION IN EXCESS OF 250,000 PEOPLE, COVERING NORTHERN NEVADA AND EASTERN CALIFORNIA, LARGEST DEMOGRAPHIC AGE IS 50 AND ABOVE. PART VI, LINE 5: USE OF SURPLUS FUNDS ALLOWS FACILITY TO UPDATE MEDICAL EQUIPMENT AND TECHNOLOGY WHICH PROVIDE ADVANCEMENTS IN PATIENT CARE. CARSON TAHOE PARTICIPATES WITH CARSON CITY HEALTH AND HUMAN SERVICES IN THE COMMUNITY HEALTH IMPROVEMENHT PLAN 2020. CARSON TAHOE PROVIDES OUTREACH PROGRAMS, HEALTH FAIRS, WELLNESS PROGRAMS, BUSINESS HEALTH PARTNERSHIPS, SEMINARS, LECTURES AND EDUCATIONAL FORUMS TO HELP PROMOTE A HEALTHIER COMMUNITY. THE WOMEN'S HEALTH INSTITUTE PROVIDES FREE HEALTH RESOURCES, CLASSES AND GUIDANCE. CARSON TAHOE IS COMMITTED TO PROVIDING THE BEST HEALTHCARE AVAILABLE TO ALL COMMUNITY MEMBERS REGARDLESS OF THEIR ABILITY TO PAY. PART VI, LINE 6: CARSON TAHOE REGIONAL HEALTHCARE IS A PART OF CARSON-TAHOE HEALTH SYSTEM IN CARSON CITY, NEVADA. THE SYSTEM IS COMPRISED OF THE FOLLOWING ENTITIES:CARSON TAHOE REGIONAL HEALTHCARE OWNS AND OPERATES:- CARSON TAHOE REGIONAL MEDICAL CENTER IS AN ACUTE CARE HOSPITAL LICENSED FOR 144 BEDS WITH A 24-HOUR EMERGENCY ROOM.- SIERRA SURGERY HOSPITAL IS A SURGICAL HOSPITAL CONSISTING OF 15 BEDS, 6 SURGICAL SUITES AND A FULL ARRAY OF IMAGING SERVICES, INCLUDING MRI AND CT SCANNING.- CANCER CENTER PROVIDES FOR EVERY ASPECT OF CANCER CARE FROM A MEDICAL AND RADIATION ONCOLOGY PRACTICE ALONGSIDE A COMPREHENSIVE CANCER RESOURCE CENTER AND INFUSION CENTER.- SPECIALTY MEDICAL CENTER PROVIDES OUTPATIENT LABORATORY, WOUND CARE AND BEHAVIORAL HEALTH SERVICES AND INPATIENT PSYCHIATRICT SERVICES.- MINDEN MEDICAL CENTER INCLUDES PHYSICIAN OFFICES, THE MINDEN EMERGENT AND URGENT CARE CENTER, AND OUTPATIENT LABORATORY AND RADIOLOGY SERVICES.- THREE WALK-IN CLINICS AT WALMARTS- TWO CENTERS FOR WOUND HEALING- TWO URGENT CARE CLINICS- TWO THERAPY CLINICS- ONE CARDIAC REHAB FACILITYCARSON TAHOE CONTINUING CARE HOSPITAL IS A LONG-TERM ACUTE CARE HOSPITAL.CARSON TAHOE PHYSICIAN CLINICS IS A MULTISPECIALTY MEDICAL GROUP THAT EMPLOYS 34 PHYSICIANS AT 13 LOCATIONS WITH SPECIALTIES THAT INCLUDE CARDIOLOGY, ENDOCRINOLOGY, FAMLIY MEDICINE, INTERNAL MEDICINE, ONCOLOGY, PSYCHIATRY, RHEUMATOLOGY, PAIN MANAGEMENT, INTERVENTIONAL CARDIOLOGY AND CARDIOTHORACIC SURGERY.CARSON-TAHOE HEALTH SYSTEM IS THE PARENT ORGANIZATION AND PROVIDES MANAGEMENT AND ADMINISTRATIVE SERVICES TO THE REST OF THE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES NV 1 CARSON-TAHOE HEALTH SYSTEM PO BOX 2168 CARSON CITY NV 89702 880502318 501(C)(3) 16950000 GENERAL OPERATING SUPPORT CARSON TAHOE CONTINUING CARE HOSPITAL 1600 MEDICAL PARKWAY CARSON CITY NV 89703 261635811 501(C)(3) 2450000 GENERAL OPERATING SUPPORT 2 0 PATIENT NON-MEDICAL FINANCIAL ASSISTANCE 62 145680 PATIENT MEDICAL FINANCIAL ASSISTANCE 135 113840 PART I, LINE 2: TRANSFERS TO RELATED ORGANIZATIONS ARE MONITORED THORUGH COMMON MANAGEMENT. GRANTS TO UNRELATED ORGANIZATIONS ARE GIVEN TO QUALIFIED CHARITIES AND GOVERNMENTS, BUT CARSON TAHOE REGIONAL HEALTHCARE DOES NOT MONITOR HOW THE RECIPIENT ORGANIZATION USES THE FUNDS. INDIVIDUAL ASSISTANCE IS GIVEN DIRECTLY TO CREDITORS TO ENSURE THE MONEY IS USED FOR THE APPROPRIATE PURPOSE. 1 1 0 0 0 1 1 0 0 ED EPPERSON FELLOW ACHE PRESIDENT & CEO 0 644800 0 176700 0 71941 0 42500 0 18995 0 954936 0 0 ANN BECK VP, CFO (THROUGH AUG 2018) 0 397634 0 96512 0 246300 0 35912 0 13929 0 790287 0 0 RICHARD RODRIGUEZ MD CMO 0 326176 0 92969 0 168004 0 17662 0 3392 0 608203 0 0 MICHELLE JOY COO 0 370030 0 84973 0 0 0 74294 0 21156 0 550453 0 0 ANNA ANDERS CNO 0 254233 0 61033 0 0 0 68145 0 19801 0 403212 0 0 PAMELA PUCKETT VP CLINICAL INTEGRATION 0 241245 0 55879 0 0 0 62413 0 9601 0 369138 0 0 TRACEY MCCOLLUM DIRECTOR, NURSING 180418 0 37140 0 0 0 24100 0 20120 0 261778 0 0 0 SCOTT MATTES DIRECTOR, ANCILLARY SERVICES 178641 0 33060 0 0 0 11804 0 0 0 223505 0 0 0 CYNTHIA KUPERUS DIRECTOR, PERI-OPERATIVE SERVICES 204799 0 38992 0 0 0 43000 0 12360 0 299151 0 0 0 WAYNE MITCHELL DIRECTOR, PHARMACY SERVICES 177640 0 36105 0 0 0 21090 0 17522 0 252357 0 0 0 KELLY SCHOTT MANAGER, PHARMACY SERVICES 157865 0 23338 0 0 0 9170 0 13130 0 203503 0 0 0 PART I, LINE 3 THE FOLLOWING WERE USED BY CARSON-TAHOE HEALTH SYSTEM TO DETERMINE THE PRESIDENT & CEO'S COMPENSATION. 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. WRITTEN EMPLOYMENT CONTRACT 4. COMPENSATION SURVEY OR STUDY 5. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B CARSON-TAHOE HEALTH SYSTEM PROVIDED THE FOLLOWING DURING 2018: ANN BECK - SEVERANCE, PTO AND MAJOR SICK PAYOUT: $108,557 ANN BECK - 457(F) DISTRIBUTION: $24,470 MICHELLE JOY - 457(F) CONTRIBUTION: $37,294 PAM PUCKETT - 457(F) CONTRIBUTION: $23,358 ANNA ANDERS - 457(F) CONTRIBUTION: $25,145 PART I, LINE 6 NET INCOME IS A TRIGGER FEATURE FOR THE AT-RISK INCENTIVE PLAN FOR CARSON-TAHOE HEALTH SYSTEM. A CARSON CITY NV 886000189 145810CP0 2012-09-06 57151648 REFUND 2002 AND 2003A BONDS 0 0 0 B CARSON CITY NV 886000189 145810DV6 2017-12-18 117356967 RETIRE 2003 AND 2005 BONDS, PROVIDE OPERATING FUNDS, AND FUND FUTURE CONSTRU 0 0 0 A 10985000 62178505 747261 62178505 1 0 0 1 B 2840000 117379647 1509967 1684423 54674680 60265902 1 0 0 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 0 B 0 1 0 0 0 0 0 0 1 A 0 B 1 FORM 990, PART VI, SECTION A, LINE 3 DURING 2018, CONTRACTED INTERIM CFO SERVICES WERE PROVIDED THROUGH A SERVICE AGREEMENT BETWEEN CARSON-TAHOE HEALTH SYSTEM AND SPECTRUM HEALTH PARTNERS. WILL MOORE, THE INTERIM CFO, WAS PAID $190,013 IN 2018 FOR THESE SERVICES. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS CARSON-TAHOE HEALTH SYSTEM, A TAX EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE GOVERNING BODY IS APPOINTED BY CARSON-TAHOE HEALTH SYSTEM, THE PARENT COMPANY. FORM 990, PART VI, SECTION A, LINE 7B THE APPROVAL OF CARSON-TAHOE HEALTH SYSTEM IS REQUIRED FOR EACH OF THE FOLLOWING: (A) ANY AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS; (B) THE ESTABLISHMENT OF ANY NEW CORPORATION, LIMITED LIABILITY COMPANY OR PARTNERSHIP OR THE MERGER, DISSOLUTION OR CONSOLIDATION OF THE ORGANIZATION; (C) ANY MORTGAGE, SALE, LEASE, EXCHANGE OR PLEDGE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION; (D) ANY CHANGE IN LONG-TERM DEBT ARRANGEMENTS OF THE ORGANIZATION OR ANY OF ITS SUBSIDIARIES OR AFFILIATED ORGANIZATIONS THAT WILL AFFECT THE CREDITWORTHINESS OF THE ORGANIZATION; (E) THE STRATEGIC PLAN OF THE ORGANIZATION; (F) THE ESTABLISHMENT OR CHANGE OF THE PHILOSOPHY ACCORDING TO WHICH THE ORGANIZATION OPERATES; (G) APPROVAL OF THE CONTRACT OF EMPLOYMENT OF THE CEO OF THE ORGANIZATION; AND (H) THE DETERMINATION OF THE AMOUNT OF ANY COMPENSATION FOR MEMBERS OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND REVIEW THE 990. THE 990 WAS THEN REVIEWED BY THE ORGANIZATION'S OFFICERS AND THE ACCOUNTING PERSONNEL WITH THE INDEPENDENT ACCOUNTING FIRM. THROUGH THE REVIEW PROCESS, ANY CLARIFICATIONS OR CORRECTIONS THAT NEEDED TO BE MADE WERE MADE. THE FORM 990 WAS THEN REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD WITH THE INDEPENDENT ACCOUNTING FIRM. ANY QUESTIONS OR CONCERNS THE FINANCE COMMITTEE RAISED WERE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEEDED TO BE MADE WERE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES WAS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO ALL VOTING MEMBERS OF THE GOVERNING BOARD AND COMMITTEES WITH BOARD-DESIGNATED POWERS, EXECUTIVE OFFICERS, AND OTHER INDIVIDUALS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE. EACH COVERED INDIVIDUAL IS GIVEN A COPY OF THE POLICY AND COMPLETES A CONFLICT OF DISCLOSURE STATEMENT ANNUALLY. EACH INDIVIDUAL DISCLOSES FULLY AND FRANKLY ANY AND ALL ACTUAL OR POTENTIAL CONFLICTS OF DUALITY OF INTEREST OR RESPONSIBILITY, WHETHER INDIVIDUAL, PERSONAL, OR BUSINESS WHICH EXISTS OR APPEARS TO EXIST. AT ANY TIME THAT AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED, THE REMAINING MEMBERS OF THE BOARD OR COMMITTEE SHALL REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. THE INDIVIDUAL WITH THE POTENTIAL CONFLICT MAY NOT BE PRESENT WHEN THE MATTER IS DISCUSSED AND THE VOTE IS TAKEN. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE DISINTERESTED MEMBERS OF THE GOVERNING BOARD OR COMMITTEE EXERCISE DUE DILIGENCE TO DETERMINE WHETHER THE ORGANIZATION COULD OBTAIN A MORE ADVANTAGEOUS TRANSACTION. AFTER INVESTIGATING ALTERNATIVES, THE BOARD OR COMMITTEE MAY APPROVE THE TRANSACTION ONLY IF THE DISINTESTERED MEMBERS DETERMINE BY MAJORITY VOTE THAT (A) THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION AND (B) THE TRANSACTION IS FAIR AND REASONABLE TO THE ORGANIZATION GIVEN THE IDENTIFIED ALTERNATIVES. IF THE GOVERNING BOARD OR A COMMITTEE HAS REASON BELIEVE AN INDIVIDUAL HAS FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE INDIVIDUAL IS GIVEN A CHANCE TO ADDRESS THE SITUATION. AFTER HEARING THE INDIVIDUAL'S RESPONSE AND CONDUCTING FURTHER INVESTIGATION AS MAY BE WARRANTED, THE BOARD OR COMMITTEE DETERMINES WHETHER THE INDIVIDUAL HAS VIOLATED THE CONFLICT OF INTEREST POLICY. IF AN INDIVIDUAL IS DETERMINED TO HAVE VIOLATED THE POLICY, APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTIONS ARE TAKEN, WHICH MAY INCLUDE REMOVAL FROM THE BOARD OR COMMITTEE OR TERMINATION EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 CARSON-TAHOE HEALTH SYSTEM'S EXECUTIVE COMPENSATION COMMITTEE DETERMINES THE TOTAL COMPENSATION PACKAGE FOR THE CEO BASED ON MARKET SURVEYS POSITIONED SO THAT MIDPOINT WILL TARGET THE 50TH PERCENTILE. INCENTIVES WILL BE POSITIONED TO PROVIDE TOTAL CASH COMPENSATION AT THE 50TH PERCENTILE FOR ON-PLAN PERFORMANCE. ACHIEVING MAXIMUM INCENTIVES MAY RAISE TOTAL COMPENSATION TO APPROXIMATELY THE 65TH PERCENTILE. BENEFITS WILL BE POSITIONED AT MARKET COMPETITIVE LEVELS. THE LAST REVIEW WAS CONDUCTED BY THE HAY GROUP IN 2018. BASE SALARIES FOR OTHER OFFICERS AND KEY EMPLOYEES WILL BE POSITIONED SO THAT MIDPOINTS TARGET THE 50TH PERCENTILE. EXECUTIVE SALARIES WILL BE ADMINISTERED WITHIN RANGES BUILT AROUND THE 50TH PERCENTILE AND BASED ON PERFORMANCE, EXPERIENCE, TENURE, AND OTHER RELEVANT FACTORS AS EVALUATED BY CEO. INCENTIVES WILL BE POSITIONED TO PROVIDE TOTAL CASH COMPENSATION AT THE 50TH PERCENTILE FOR ON-PLAN PERFORMANCE. ACHIEVING MAXIMUM INCENTIVES MAY RAISE TOTAL COMPENSATION TO APPROXIMATELY THE 65TH PERCENTILE. BENEFITS WILL BE POSITIONED AT MARKET COMPETITIVE LEVELS. THE LAST REVIEW WAS CONDUCTED BY THE HAY GROUP IN 2018. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CARSON-TAHOE HEALTH SYSTEM 1600 MEDICAL PARKWAY CARSON CITY NV 89703 880502318 PARENT ORGANIZATION NV 501(C)(3) LINE 12B, II N/A 0 CTRH AUXILIARY 1600 MEDICAL PARKWAY CARSON CITY NV 89703 886007118 SUPPORT CTRH NV 501(C)(3) LINE 12D, III-O CARSON TAHOE REGIONAL HEALTHCARE 0 CARSON TAHOE CONTINUING CARE HOSPITAL 1600 MEDICAL PARKWAY CARSON CITY NV 89703 261635811 LONG-TERM CARE HOSPITAL DE 501(C)(3) LINE 3 CARSON-TAHOE HEALTH SYSTEM 0 CARSON TAHOE PHYSICIAN CLINICS 1600 MEDICAL PARKWAY CARSON CITY NV 89703 020566741 PHYSICIAN GROUP NV N/A C 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 0