2019-07-30T15:22:41-05:00 2018-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 55402 990 2018-01-01 820207116 Bonner General Hospital Inc BONN 2082631441 520 N Third Avenue Sandpoint ID 83864 Sheryl Rickard CEO 2082631441 2019-07-30 1 Kim Hunwardsen P00484560 6122536500 2019-07-30 216.147.181.49 2019-07-30 11:09:18 CD P D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC 2018 2019-02-21 02:37:17Z Bonner General Health Sheryl Rickard 520 N Third Avenue Sandpoint ID 83864 61300431 0 X www.bonnergeneral.org X 1949 ID To provide excellence in healthcare 8 8 511 115 0 0 223790 78144 56852775 60105457 310391 13896 207301 207569 57594257 60405066 31352 35070 0 0 29858630 30607380 0 0 5998 27177789 29226751 57067771 59869201 526486 535865 45040979 46617995 16846631 18050702 28194348 28567293 X To provide excellence in healthcare 0 0 51536953 35070 60124785 Bonner General Hospital (BGH), located in Sandpoint, Idaho, is a full-service critical access hospital licensed for 25 beds. BGH is accredited by the DNV. BGH is the sole provider of inpatient acute care and many other outpatient services in Bonner county. BGH provides services to a largely rural and widely dispersed population of approximately 57,000. Its patient service areas extend to the Canadian border, the western edge of Montana and the eastern border of Washington. BGH provides inpatient and outpatient services regardless of an individual's ability to pay, utilizing moral and ethical principles. Services provided include emergency care, diagnostic and therapeutic services, and prevention programs. BGH also provides educational programs, support groups, counseling and seminars for patients and the general public, as well as professional education programs for high school and college students and its staff. BGH is dedicated to providing quality, patient-focused services that are determined to be both necessary and feasible. Through evaluation and planning by hospital leadership, BGH will continue to identify the existing and future needs of the patients to be served and will strive to continually improve its performance in meeting those needs. During the period of 01/01/18 to 12/31/18, BGH admitted 1,749 patients, serviced 10,357 emergency room visits, delivered 291 babies and performed 3,294 surgical procedures. During that same period, BGH provided 5,079 days of patient care, 6,920 Home Health care visits and 3,542 Hospice visits. BGH provides care to persons covered by government-sponsored health care programs (i.e. Medicare and Medicaid) at below cost, as well as free and/or subsidized care to indigent patients. For the period of 01/01/18 to 12/31/18 BGH provided $26,103,266 in unreimbursed care to government-sponsored health care program (i.e. Medicare and Medicaid), $3,157,942 in uncompensated care to private pay patients, and $666,146 in charity care, based on gross charges. 51536953 1 1 0 0 0 0 0 1 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 101 0 1 511 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 X Sheryl Rickard 2082631441 520 N Third Avenue Sandpoint ID 83864 Ford Elsaesser Chair 1.00 X X 0 0 0 Tim Cochran Vice Chair 1.00 X X 0 0 0 Thomas Lawrence MD Board Member 1.00 X 0 0 0 Scott Burghstaher MD Board Member 1.00 X 0 0 0 Jim Frank Board Member 1.00 X 0 0 0 Bart Casey Board Member 1.00 X 0 0 0 Michelle Anderson Board Member 1.00 X 0 0 0 Shawn Woodward Board Member 1.00 X 0 0 0 Sheryl Rickard CEO 40.00 X 250168 0 33505 John Hennessy CFO 40.00 X 149316 0 8479 Kristin Algoe OB/GYN Physician 40.00 X 270550 0 16753 Jonathan Fisher Wound Care Physician 20.00 X 415002 0 19917 Douglas Cipriano Orthopedic Surgeon 40.00 X 433903 0 12166 Brent Leedle Orthopedic Surgeon 40.00 X 425667 0 12306 Jeffrey Johnson OB/GYN Physician 40.00 X 236840 0 7207 2181446 0 110333 36 0 1 0 Lake Pend Orielle Emergency Medicine 3734 Lakeshore Dr Sagle ID 83860 Emergency Services 1818248 Kootenai Imaging 700 W Ironwood Dr 175 Coeur DAlene ID 83814 Radiology 1449400 Sandpoint Hospitalist Group LLC PO Box 205 Sandpoint ID 83864 Hospitalist 900000 Kootenai Health 2003 Kootenai Health Way Coeur DAlene ID 83814 Software, Lab Services 740900 Focusone Solutions LLC 13609 California St 420 Omaha NE 68154 Temp Staffing & Locums 617391 14 9550 68594 78144 Patient Service Revenue 622110 58412676 58412676 Property Tax Revenue 900099 1314427 1314427 Other Revenue 900099 175743 175743 Cafeteria Revenue 900099 169954 169954 Pinegrove Medical Bldg LLC 900099 32657 32657 60105457 51292 51292 196176 7935 188241 188241 188241 684283 721679 -37396 -37396 -37396 185079 165751 19328 19328 60405066 60124785 0 202137 X 35070 35070 438819 438819 22154831 18795323 3359508 557270 488338 68932 5769262 4330447 1438815 1687198 1387359 299839 42590 42590 77187 77187 6298130 5860136 437994 100247 100247 1021089 781099 234620 5370 1047301 604778 441627 896 643781 643781 226471 199513 26958 411616 411391 225 1372369 770317 602052 763579 758517 5062 Medical Supplies 10180277 10158612 21665 Bad Debt Expense 3158653 3158653 Equipment Lease & Rent 1858681 1607990 250691 Repair & Maintenance 1044100 1040162 3938 980680 505467 475481 -268 59869201 51536953 8326250 5998 9256189 8924147 9506834 10144309 3393181 3239927 111288 475634 37917404 26786750 10216073 11130654 9966945 10299762 2590469 2403562 45040979 46617995 4020048 4932658 9525976 10205404 399408 331635 796746 476552 2104453 2104453 16846631 18050702 X 27292313 28038319 902035 528974 28194348 28567293 45040979 46617995 X 535865 -160969 -1951 X 0 1 X 1 0 X X Public Display 0 2369739 507866 2877605 13463674 10316331 3147343 1042966 198942 844024 18546111 15880235 2665876 1987048 391242 1595806 11130654 Property Taxes Receivable 1147752 Estimated Third-Party Payor Settlements 1255810 2403562 Refundable Advance 2104453 2104453 X 57257179 -160969 -3158653 -3319622 60576801 -171735 -171735 60405066 56884234 173686 173686 56710548 3158653 3158653 59869201 Part III, Line 4: The art contributed to Bonner General Hospital is strictly for display and the benefit of the patients and visitors as part of the healing process. Art benefits patients by aiding their physical, mental and emotional recovery as noted by the Society for the Arts in Healing. As a note, in 1997 the Joint Commission on Accreditation of Healthcare Organizations cited studies in which patients who viewed art recovered more quickly. Part X, Line 2: The Hospital is organized as an Idaho nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from income taxes under Internal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. Management has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Hospital 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 financial statements. The Hospital 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: Bad Debts Reported in Expenses on Form 990 -3,158,653. Part XI, Line 4b - Other Adjustments: Rental Expenses Reported in Expenses on Financial Statements -7,935. Pinegrove Medical Bldg LLC K-1 Income 1,951. Cost of Sales Reported in Expenses on Financial Statements -165,751. Part XII, Line 2d - Other Adjustments: Rental Expenses Reported in Revenues on Form 990 7,935. Cost of Sales Reported in Revenues on Form 990 165,751. Part XII, Line 4b - Other Adjustments: Bad Debts Reported in Revenues on Financial Statements 3,158,653. 1 1 X 1 X 210.000000000000 1 X 1 1 0 0 393000 393000 0.00690 393000 393000 0.00690 52718 52718 0.00090 6983047 4827708 2155339 0.03800 7035765 4827708 2208057 0.03890 7428765 4827708 2601057 0.04580 3 4500 4500 0.00010 3 4500 4500 0.00010 0 3158653 631731 12512228 12571019 -58791 X 1 1 1 Pinegrove Medical Bldg LLC Operation of medical office building 0.50000 0.50000 1 1 Bonner General Hospital Inc 520 N 3rd Avenue Sandpoint ID 83864 www.bonnergeneral.org 22 X X X X 5 Provider Based Clinics Bonner General Hospital Inc 1 0 0 1 X X X X X X X X X 16 1 0 1 1 X See Part V, line 7d X X 1 16 1 See Part V, line 7d 0 1 X 210.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X http://www.bonnergeneral.org/charity-care/ X http://www.bonnergeneral.org/charity-care/ X http://www.bonnergeneral.org/charity-care/ X X X X X X 1 X 0 X X X X 1 X 0 1 Bonner General Hospital, Inc. Part V, Section B, Line 5: We utilized our Advisory Council, a diverse group of business owners and representatives, patients, community leaders, hospital staff, allied health professionals and volunteers. Bonner General Hospital, Inc. Part V, Section B, Line 6b: Panhandle Health District Bonner General Hospital, Inc. Part V, Section B, Line 7d: http://www.bonnergeneral.org/community-health-needs-assessment/ Bonner General Hospital, Inc. Part V, Section B, Line 11: In 2016 the four needs identified in the CHNA were: Obesity, Child Abuse/Neglect, Suicide, Mental Health. All four needs are being addressed by the organization.Obesity (Current Activities):- Providing education & awareness in the hospital & community * Diabetes Education/Nutrition Counseling - Meal planning & carb counting, lifestyle changes to improve health. * Adult Exercise Program - a wellness program designed for anyone who may benefit from regular, supervised exercise in a safe environment. * Intensive Behavioral Therapy (IBT) - is a preventive care program based on behavior modification. Registered dietitians work with IBT patients to create & sustain a healthy lifestyle. Educate patients on the benefits of maintaining a healthy weight. * Sponsor healthy snacks for Lake Pend Oreille School District's Safe Routes to School program for walk and bike to school days. Child Abuse/Neglect: - Sponsor Kinderhaven's fundraisers and community awareness activities. * Participate & sponsor the annual Kinderhaven fundraiser to ensure that abused and/or neglected children have a safe place to live. * Sponsor two free movie at the local Panida Theater in collaboration with Kinderhaven to provide a fun, healthy, free activity for families. - Participating in Food for Our Children * BGH Staff coordinates the food purchase, packing, and delivery of weekend food for three schools in our community (Sandpoint Middle School, Lake Pend Oreille Alternative School, and Sagle Elementary School). - Partnership with Panhandle Alliance for Education through the Books for Babies program. * Each parent and baby will leave with a new book after birth & information on the importance of reading to your children. * Sponsorship of fundraisers to increase educational opportunities for both students and parents. Suicide:- Bonner General Health partnered with Washington Elementary sixth grade's Design for a Change program to educate and create awareness regarding suicide. * BGH provided a 12 session curriculum, Coping and Support Training (CAST) a social & emotional skills based program. Mental Health: - Bonner General Health collaborates with Law Enforcement, the court system, and physicians to improve the mental health hold process. - Bonner General Health has a Behavioral Health clinic staffed by a Psychiatrist and Psychologist to help address the needs in our service area. * 2018 hired the Psychologist to expand services to adolescents. - Bonner General Health leads community support groups. - Bonner General Health collaborates with Sandpoint Community Resource Center. * Sponsors and participates in quarterly SPIN (Service Provider Information Network) providing awareness to community leaders and members regarding current Mental Health resources in Bonner County and throughout the five Northern Counties. Bonner General Hospital, Inc. Part V, Section B, Line 16j: The policy was provided, in writing, to patients for all outpatient and inpatient services upon request. The hospital includes language referencing that we offer assistance to uninsured patients who meet certain financial criteria through the BGH Cares program. We provide this language in the billing invoices, to patients on admissions to the facility and our website. Bonner General Hospital, Inc. Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. 3 1 - Hospice Agency 602 N 3rd Ave Sandpoint ID 83864 Hospice Agency 2 - Immediate Care Physician Clinic 400 Schweitzer Plaza Drive Suite 1 Ponderay ID 83852 Urgent Care Physician Clinic 3 - Home Health Agency 602 N 3rd Ave Sandpoint ID 83864 Home Health Agency Part I, Line 7: Financial assistance was calculated by multiplying the ratio of cost to gross charges by service line for the Hospital by the gross uncompensated charges associated with providing charity care to its patients. Subsidized health services was converted to cost using the cost-to-charge ratio derived from the relevant cost center on the Medicare cost report. Community health improvements is based on actual expenses reported in the general ledger. Part I, Ln 7 Col(f): The amount of bad debt expense removed from the denominator of the calculation was $3,158,653. Part II, Community Building Activities: BGH provides job shadowing opportunities for students interested in health care careers. Part III, Line 2: Bad debt expense on line 2 is reported at charges as presented on the financial statements. Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year. Part III, Line 3: The organization reasonably estimates the portion of bad debt that could have qualified for charity care by identifying the uninsured, unemployed single adult account balances assigned to a collection agency in the current year. An estimated 20% of bad debts in 2018 are attributable to patients potentially eligible for charity care. Part III, Line 4: The financial statement footnote regarding bad debt expense may be found on page 10 of the audited financial statements. Part III, Line 8: Medicare allowable cost is based on the Medicare cost report. The Medicare cost report is completed based on the rules & regulations set forth by Centers for Medicare and Medicaid Services.BGH's position is that the entire Medicare shortfall is a community benefit. Medicare patients are accepted regardless of whether or not a surplus or deficit is realized from providing the services. This basis therefore means providing Medicare services promotes access to healthcare services which is a key community benefit. Part III, Line 9b: If a patient qualifies for financial assistance, Bonner General Hospital will hold all billings and collections until financial assistance is determined. NO extraordinary collection actions will be undertaken during the 120 day notification period and financial assistance applications will be processed when received within 240 days. Part VI, Line 2: Bonner General Hospital's quality service department gives a survey to each patient they discharge to get feedback on the quality of care received and areas of improvement. The Hospital also has internal physician committees that discuss common patient needs and provide feedback to management. Part VI, Line 3: Bonner General Hospital provides information about BGH Cares, its financial assistance policy, during the pre-registration and registration process at admitting and the emergency departments. Business Services includes information in patient statements, and a Patient Financial Advocate assists patients with financial assistance programs and options. Part VI, Line 4: Bonner General Hospital (BGH) is the sole provider of inpatient, acute care and many other outpatient services in Bonner County. BGH provides services to a large rural and widely dispersed population of approximately 57,000. Its patient service areas extend to the Canadian border, the western edge of Montana and the eastern border of Washington. Approximately 20.4% of the population served by BGH is 65 years of age and older. Additionally, 49.8% of the population served by BGH is female. The population of children served by BGH is approximately 25.8%, with 4.7% of these children being under the age of 5. Part VI, Line 5: Bonner General Hospital (BGH) has an ongoing and steadfast commitment to a mission that provides real and tangible benefits for our community. As a community-owned health care provider, our commitment is to improve the health of people in our region. We feel that one way to make improvements is to build partnerships with other agencies and institutions that serve the uninsured and underserved population of the communities we serve. By providing support to our local volunteer health clinic, we help in the delivery of medical care to the people in our community that have no other access to healthcare. BGH aims to prevent disease and injury, promote healthy habits, and improve quality of life in the communities we serve. We do that by offering many free education classes. These classes educate our community members on the health consequences of unhealthy habits, help people to understand their illnesses, encourage compliant behavior through medication, exercise and diet, and support those people that need help dealing with unfortunate circumstances in their lives. We also offer classroom space for others who provide support for community members dealing with problems such as addiction, terminal illnesses, and mental health problems. We are committed to building a strong workforce and ensuring that there continues to be a strong workforce far into the future. We do that by working with educational institutions by providing scholarships, encouraging and supporting our employees to be mentors and proctors, and providing the clinical setting and supervision required in the education of nursing students of all levels, medical laboratory technologists, radiology technologists, pharmacists and pharmacy technologist, therapists, and physicians.The Organization's governing body is comprised of volunteer members who reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are reinvested in facilities to improve patient care. The hospital operates an emergency room that is available to all, regardless of ability to pay. 1 Nursing Education 3 35070 Part I, Line 2: The Bonner General Hospital Board of Directors set up a bank account to be held in trust strictly for nursing education. The Human Resources office maintains a spreadsheet with ongoing information on the Education fund allocations and is responsible for collections on participants that do not comply with the parameters of the policy or fail to sucessfully complete the program. The Nursing Education Fund Committee, Finance and the HR Director monitors the fund availability and the progress of the program. X 1 1 X X X 0 0 0 0 0 0 0 0 0 Sheryl Rickard CEO 240568 0 0 0 9600 0 20133 0 13372 0 283673 0 0 0 John Hennessy CFO 149316 0 0 0 0 0 4423 0 4056 0 157795 0 0 0 Kristin Algoe OB/GYN Physician 270550 0 0 0 0 0 8250 0 8503 0 287303 0 0 0 Jonathan Fisher Wound Care Physician 415002 0 0 0 0 0 8250 0 11667 0 434919 0 0 0 Douglas Cipriano Orthopedic Surgeon 433903 0 0 0 0 0 0 0 12166 0 446069 0 0 0 Brent Leedle Orthopedic Surgeon 425667 0 0 0 0 0 8250 0 4056 0 437973 0 0 0 Jeffrey Johnson OB/GYN Physician 236840 0 0 0 0 0 0 0 7207 0 244047 0 0 0 Part I, Line 1a The determination of the discretionary expense for the CEO is to compensate for travel to meetings in lieu of the mileage reimbursement policy. This determination was made by the Board of Directors and has been in place for many years. A Idaho Health Facilities Authority 826051863 2016-07-07 11275327 Refunded 3/22/07 Note 0 0 0 A 664155 11275327 277467 9487621 1510239 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 1 A 1 Schedule K, Part I, Bond Issues Refunded Revenue Note issued 3/22/07 and Panhandle State Bank Loan relating to the construction, acquisition and renovation of, and equipment for the Hospital. Jack Parker Former Director Loan on Property Purchased X 750000 331635 0 1 1 331635 Form 990, Part VI, Section A, line 1 The Bylaws allow for an Executive Committee. The Executive Committee consists of the Board Chair and three additional Board Members appointed by the Chair. The Chief of Staff will serve as an ex-officio, as needed. It meets and functions solely in an as needed capacity and acts upon those matters of importance. It is required to report its actions to the full governing Board. Form 990, Part VI, Section B, line 11b The draft Form 990 is reviewed by the CFO and CEO prior to filing. A copy of the Form 990 will be provided to the governing body prior to filing. Form 990, Part VI, Section B, line 12c The conflict of interest policy covers board members, officers, committee members or staff members who have a direct or indirect financial interest as defined in the conflict of interest policy, which is reviewed annually. The Compliance Officer is responsible for determining whether a conflict exists once disclosed. Each interested person has a duty to disclose immediately. In addition, annual conflict of interest statements are obtained from all interested persons. Persons with conflicts are restricted from involvement in the review or decision making. Violations of the conflict of interest policy will be investigated and the Board of Directors or Compliance committee shall take appropriate disciplinary or corrective action. Form 990, Part VI, Section B, line 15a Compensation is determined by use of the most recent Idaho Hospital Association CEO compensation survey published. In addition, comparison to the American College of Healthcare Executives compensation is referred to as necessary. The CFO compensation is reviewed by the CEO with the assistance of the HR Director using the Idaho Hospital Association survey and HFMA survey. Compensation is reviewed by independent persons. The organization follows the process described in Part VI, Line 15 on an annual basis. Form 990, Part VI, Section C, line 19 The Organization does not make its governing documents, conflict of interest policy, and financial statements available to the public. The financial statements are attached to the Form 990. Form 990, Part IX, line 11g Professional Fees: Program service expenses 1,644,312. Management and general expenses 87,962. Fundraising expenses 0. Total expenses 1,732,274. Contracted Services: Program service expenses 811,013. Management and general expenses 187,345. Fundraising expenses 0. Total expenses 998,358. Physician Fees: Program service expenses 1,822,758. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,822,758. Other Fees: Program service expenses 1,582,053. Management and general expenses 162,687. Fundraising expenses 0. Total expenses 1,744,740. Form 990, Part XI, line 9: Pinegrove Medical Bldg LLC K-1 Income -1,951.