UINTAH BASIN MEDICAL CENTER: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- UINTAH BASIN MEDICAL CENTER (EIN 87-0276435)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-13
- IRS object ID
- 201941339349307579
- Schema version
- 2017v2.2
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-13T16:16:23-07:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 870514498 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Aycock Miles & Assoc CPAs | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 58 East 100 North 83-13 | AddressLine1Txt |
| City | Roosevelt | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84066 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 870276435 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Uintah Basin Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UINT | BusinessNameControlTxt |
| Phone | 4357224691 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 W 300 N | AddressLine1Txt |
| City | Roosevelt | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84066 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Brent H Hales | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2019-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michael J Miles | PreparerPersonNm |
| PTIN | P00153639 | PTIN |
| Phone | 4357225153 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $81,042,358 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.ubh.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | UT | LegalDomicileStateCd |
| Activity Or Mission | Hospital services, long-term health care, rehabilitation, emergency medical care, inpatient and outpatient pharmaceutical services, and other essential medical services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 862 | TotalEmployeeCnt |
| Total Volunteers | 58 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $75,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $138,758 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $80,608,179 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $80,472,746 | CYProgramServiceRevenueAmt |
| PY Investment Income | $279,831 | PYInvestmentIncomeAmt |
| CY Investment Income | $430,854 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $80,963,010 | PYTotalRevenueAmt |
| CY Total Revenue | $81,042,358 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,948,145 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,197,971 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $49,539,773 | PYOtherExpensesAmt |
| CY Other Expenses | $42,781,075 | CYOtherExpensesAmt |
| PY Total Expenses | $80,487,918 | PYTotalExpensesAmt |
| CY Total Expenses | $76,979,046 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $475,092 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,063,312 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $90,587,657 | TotalAssetsBOYAmt |
| Total Assets EOY | $92,380,120 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $28,072,260 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $24,969,116 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $62,515,397 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $67,411,004 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Hospital services, long-term health care, rehabilitation, emergency medical care, inpatient and outpatient pharmaceutical services, and other essential medical services. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $57,343,170 | ExpenseAmt |
| Revenue | $80,491,315 | RevenueAmt |
| Desc | Hospital services, long-term health care, rehabilitation, emergency medical care, inpatient and outpatient pharmaceutical services, and other essential medical services. The Hospital provided 4,958 patient days, 13,125 home health/hospice visits, 11,198 ER visits, and 2,772 surgeries during the year. | Desc |
| Total Program Service Expenses | $57,343,170 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 93 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 862 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (true) | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | UT | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Brent H Hales CFO | PersonNm |
| Phone | 4357224691 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 W 300 N | AddressLine1Txt |
| City | Roosevelt | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84066 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Bob Gilbert | |||||||||
| 1st Vice Chair | 1.00 | 0.00 | Yes (X) | $3,600 | $0 | $0 | |||
| Tyler Allred | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $3,200 | $0 | $0 | |||
| Dr Sean Paulsen | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $476,100 | $0 | $0 | |||
| Mindi Crowley | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Dr John Blake | |||||||||
| Chief of Staff | 1.00 | 0.00 | Yes (X) | $629,179 | $0 | $0 | |||
| Ryan Snow | |||||||||
| 1st Vice Chair | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Dr John Wells | |||||||||
| Chief of Staff | 1.00 | 0.00 | Yes (X) | $299,471 | $0 | $0 | |||
| Kent Peatross | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $500 | $0 | $0 | |||
| Jenny Adams | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $3,300 | $0 | $0 | |||
| Gregory Todd | |||||||||
| 2nd Vice Chair | 1.00 | 0.00 | Yes (X) | $300 | $0 | $0 | |||
| Tyler Rasmussen | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $2,700 | $0 | $0 | |||
| Jim Marshall | |||||||||
| President & CEO | 50.00 | 0.00 | $395,278 | $0 | $27,000 | Yes (X) | |||
| Brent H Hales | |||||||||
| CFO | 50.00 | 0.00 | $239,806 | $0 | $22,753 | Yes (X) | |||
| Alarik Myrin | |||||||||
| Chairman | 1.00 | 0.00 | $3,000 | $0 | $0 | Yes (X) | |||
| David Decault | |||||||||
| Senior Vice President | 40.00 | 0.00 | $171,495 | $0 | $16,801 | Yes (X) | |||
| Randall Bennett | |||||||||
| Senior Vice President | 40.00 | 0.00 | $203,189 | $0 | $18,931 | Yes (X) | |||
| Bobby Richardson | |||||||||
| Senior VP | 40.00 | 0.00 | $173,242 | $0 | $16,339 | Yes (X) | |||
| Joseph Garcia | |||||||||
| Physician | 40.00 | 0.00 | $441,147 | $0 | $27,000 | Yes (X) | |||
| Kerry Baum | |||||||||
| Physician | 40.00 | 0.00 | $400,101 | $0 | $19,892 | Yes (X) | |||
| Shane Powell | |||||||||
| Physician | 40.00 | 0.00 | $307,044 | $0 | $25,530 | Yes (X) | |||
| Bruce Arnold | |||||||||
| Pathologist | 40.00 | 0.00 | $245,924 | $0 | $24,844 | Yes (X) | |||
| Weston Weaver | |||||||||
| Pharmacy Manager | 40.00 | 0.00 | $178,255 | $0 | $17,818 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,176,831 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $216,908 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Dr M Catten MD PC | |||||
| 250 N 300 W | Roosevelt | UT | 84066 | E.N.T. Surgeon | $978,900 |
| Basin Obstetrics & Gynecology PLLC | |||||
| 250 N 300 W | Roosevelt | UT | 84066 | Obstretrics & Women | $1,289,946 |
| Cerner Corporation | |||||
| 2800 Rock Creek Pkwy | Kansas City | MO | 64117 | Software, IT | $655,067 |
| Colby Duncan MD | |||||
| 250 N 300 W | Roosevelt | UT | 84066 | Physician | $635,628 |
| Jason Larson MD PC | |||||
| 250 N 300 W | Roosevelt | UT | 84066 | E.R. Physician | $651,173 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $138,758 | AllOtherContributionsAmt |
| Total Contributions | $138,758 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net patient services | 621110 | $78,139,609 | $78,139,609 |
| Other medical services | 621110 | $2,333,137 | $2,333,137 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $80,472,746 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $430,854 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $430,854 | RelatedOrExemptFuncIncomeAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $81,042,358 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $80,903,600 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,221,211 | TotalAmt |
| Program Services | $547,927 | ProgramServicesAmt |
| Management And General | $673,284 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,835,439 | TotalAmt |
| Program Services | $17,338,048 | ProgramServicesAmt |
| Management And General | $6,497,391 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,141,321 | TotalAmt |
| Program Services | $5,530,603 | ProgramServicesAmt |
| Management And General | $3,610,718 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,545,788 | TotalAmt |
| Program Services | $11,479,479 | ProgramServicesAmt |
| Management And General | $66,309 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,156,985 | TotalAmt |
| Management And General | $1,156,985 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,206,895 | TotalAmt |
| Program Services | $1,604,060 | ProgramServicesAmt |
| Management And General | $3,602,835 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $391,824 | TotalAmt |
| Program Services | $101,829 | ProgramServicesAmt |
| Management And General | $289,995 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Pharmaceuticals | $7,937,874 | $7,937,678 | $196 |
| Supplies & Materials | $7,588,120 | $6,710,501 | $877,619 |
| Other | $3,216,171 | $2,309,900 | $906,271 |
| Purchased services | $2,993,353 | $1,643,116 | $1,350,237 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,744,065 | TotalAmt |
| Program Services | $2,140,029 | ProgramServicesAmt |
| Management And General | $604,036 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,979,046 | TotalAmt |
| Program Services | $57,343,170 | ProgramServicesAmt |
| Management And General | $19,635,876 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,967,316 | BOYAmt |
| EOY | $2,767,265 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $23,579,736 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,300,491 | BOYAmt |
| EOY | $15,291,705 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,508,525 | BOYAmt |
| EOY | $1,587,486 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,190,077 | BOYAmt |
| EOY | $863,641 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $90,199,638 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $43,677,908 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,695,271 | BOYAmt |
| EOY | $46,521,730 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,647,197 | BOYAmt |
| EOY | $1,647,197 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $278,780 | BOYAmt |
| EOY | $121,360 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,587,657 | BOYAmt |
| EOY | $92,380,120 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,173,024 | BOYAmt |
| EOY | $4,473,344 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,659,097 | BOYAmt |
| EOY | $18,277,729 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,240,139 | BOYAmt |
| EOY | $2,218,043 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,072,260 | BOYAmt |
| EOY | $24,969,116 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,515,397 | BOYAmt |
| EOY | $67,411,004 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,515,397 | BOYAmt |
| EOY | $67,411,004 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,587,657 | BOYAmt |
| EOY | $92,380,120 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,063,312 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $832,272 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $23 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,609,980 | OtherCostOrOtherBasisAmt |
| Book Value | $3,609,980 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $54,375,254 | OtherCostOrOtherBasisAmt |
| Depreciation | $43,677,908 | DepreciationAmt |
| Book Value | $10,697,346 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,214,404 | OtherCostOrOtherBasisAmt |
| Book Value | $32,214,404 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $46,521,730 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Interest rate swap | Desc |
| Amt | $2,218,043 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,218,043 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $81,874,630 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $832,272 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $832,272 | RevenueNotReportedAmt |
| Revenue Subtotal | $81,042,358 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $81,042,358 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $76,979,046 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $76,979,046 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $76,979,046 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X : FIN48 Footnote | FormAndLineReferenceDesc |
| Explanation | The Medical Center is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for income tax is necessary. The Medical Center evaluates uncertain tax positions whereby the effect of the uncertainty would be recorded if the outcome was considered probable and reasonably estimable. As of June 30, 2018 and 2017, the Medical Center had no uncertain tax positions requiring accrual. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| Most Hospitals Policy | Yes (X) | MostHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,628,569 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,628,569 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02120 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,704,205 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,028,630 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $675,575 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00880 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,332,774 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,028,630 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,304,144 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03000 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,921 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $43,921 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,921 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $43,921 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,376,695 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,028,630 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,348,065 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03060 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,096,799 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,096,799 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01420 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,096,799 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,096,799 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01420 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $11,147,224 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $2,037,456 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,327,524 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,233,729 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $93,795 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | false | 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 | Uintah Basin Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 W 300 N | AddressLine1Txt |
| City | Roosevelt | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84066 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.ubh.org | WebsiteAddressTxt |
| State License | 2008-HOSP-180 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Uintah Basin Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.ubh.org/wp-content/uploads | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.ubh.org | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.0000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.0000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.ubh.org | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.ubh.org | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.ubh.org | 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 |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 5 - Account Input from Persons Who Represent the Community | In connection with its most recent CHNA, Uintah Basin Medical Center (Medical Center) took into account input from a variety of persons who represented the broad interest of the community served by the Medical Center (including those with special knowledge of or expertise in public health). Specifically, hospital personnel attended a community health needs meeting at the Medical Center's office in Roosevelt, Utah. The meeting was hosted by the Tri-County Health Department and the Utah Department of Health to discuss the significant health needs and disparities within the Medical Center's community service area. There was also a survey of 800 residents with an 18% response rate in year 2017.At this meeting, the Medical Center disclosed the results of its CHNA Survey, discussed the top health concerns of the surrounding community with representatives of the community, and solicited and gathered input from the meeting attendees regarding possible solutions to the health concerns identified in the Medical Center's CHNA Survey and initial findings. Attendees from local, state or tribal public health organizations included individuals from Indian Health Services, the Ute Indian Tribe,the Tri-County Health Department, the Utah Department of Health (UDOH sent three participants--EPICC LHD liaison, accreditation coordinator, and public health assessment representative), and the Uintah Basin Association of Governments. Attendees from medically undeserved, low-income, uninsured and minority populations included individuals from the Uintah Basin Association of Governments and Community Services Development. There were also attendees from nonprofit and community-based organizations (Rotary Club and Family Support Center), local governmental organizations (Duchesne County and Roosevelt City), local school districts (Duchesne County School District), and a community health center/safety net clinic (Northeastern Counseling Center). |
| Part V, Line 7d - Description of Making Needs Assessment Widely Available | Website complete URL:www.ubh.org/wp-content/uploads/sites/534/2018/04/presentation_chna_dataforwebsite.pdf |
| Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why | Waiting on final assessment of most important needs before we allocate resources to address them. |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Basin Care & Rehabilitation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 260 W 200 N | AddressLine1Txt |
| City | Roosevelt | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84066 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Long-term care and rehabilitation center | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense | Please refer to note disclosure No. 7 of the audited financial statements. |
| Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit | Taxpayer used the "engaged patient model" tool which has a charity predictor to analyze bad debt accounts and estimate bad debt expense that reasonably is attributable to patients who likely would have qualified for financial assistance under the Medical Center's charity care policy but for whom insufficient information was obtained to determine their eligibility. The amount of bad debt expense attributable to the Hospital's charity care policy for year ending June 30, 2018 is $2,037,456. |
| Part III, Line 4 - Bad Debt Expense | Please refer to note disclosure No. 7 of the audited financial statements. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| Bobby Richardson | ||||
| Senior VP | $163,862 | $9,380 | $16,339 | $189,581 |
| Brent H Hales | ||||
| CFO | $227,455 | $12,351 | $22,753 | $262,559 |
| Bruce Arnold | ||||
| Pathologist | $245,924 | $24,844 | $270,768 | |
| David Decault | ||||
| Senior Vice President | $165,078 | $6,417 | $16,801 | $188,296 |
| Dr John Wells | ||||
| Chief of Staff | $299,471 | $299,471 | ||
| Dr Sean Paulsen | ||||
| Director | $476,100 | $476,100 | ||
| Dr John Blake | ||||
| Chief of Staff | $629,179 | $629,179 | ||
| Jim Marshall | ||||
| President & CEO | $339,298 | $55,980 | $27,000 | $422,278 |
| Joseph Garcia | ||||
| Physician | $441,147 | $27,000 | $468,147 | |
| Kerry Baum | ||||
| Physician | $400,101 | $19,892 | $419,993 | |
| Randall Bennett | ||||
| Senior Vice President | $192,874 | $10,315 | $18,931 | $222,120 |
| Shane Powell | ||||
| Physician | $307,044 | $25,530 | $332,574 | |
| Weston Weaver | ||||
| Pharmacy Manager | $178,255 | $17,818 | $196,073 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b: Form 990 Review Process | Review is conducted by the CFO. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Conflict questionnaires are completed by board members annually. If conflicts are present, affected board members are recused from voting. Should an unreported conflict become known, that board member is subject to disciplinary action. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | An independent compensation consultant is hired who uses a survey. Those results are reviewed by our compensation committee and the Board of Directors. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | An independent compensation consultant is hired who uses a survey. Those results are reviewed by our compensation committee and the Board of Directors. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Governing documents, conflict of interest policy, and financial statements are available to the public upon written request to the Board of Directors. |