CLEARWATER VALLEY HOSPITAL & CLINICS INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: CLEARWATER VALLEY HOSPITAL & CLINICS INC (EIN 82-0497771)
Tax period: 2014-07-01 to 2015-06-30
Filed: 2016-04-29
IRS object ID: 201641209349301214
Schema version: 2014v6.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-04-29T14:16:26-05:00	ReturnTs
Tax Period End	2015-06-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	820497771	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Clearwater Valley Hospital and Clinics Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% LENNE BONNER	InCareOfNm
Business Name Control	CLEA	BusinessNameControlTxt
Phone	2084764555	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	301 Cedar Ave	AddressLine1Txt
City	Orofino	CityNm
State Abbreviation	ID	StateAbbreviationCd
ZIP	83544	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	LENNE BONNER	PersonNm
Person Title	President	PersonTitleTxt
Signature	2016-04-21	SignatureDt

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-08-17 19:52:53Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Lenne Bonner	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	301 Cedar Ave	AddressLine1Txt
City	Orofino	CityNm
State Abbreviation	ID	StateAbbreviationCd
ZIP	83544	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$23,226,730	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.smh-cvhc.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1997	FormationYr
Legal Domicile State	ID	LegalDomicileStateCd
Activity Or Mission	WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	227	TotalEmployeeCnt
Total Volunteers	100	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$149,698	PYContributionsGrantsAmt
CY Contributions Grants	$702,444	CYContributionsGrantsAmt
PY Program Service Revenue	$20,716,527	PYProgramServiceRevenueAmt
CY Program Service Revenue	$21,577,820	CYProgramServiceRevenueAmt
PY Investment Income	$120,667	PYInvestmentIncomeAmt
CY Investment Income	$100,122	CYInvestmentIncomeAmt
PY Other Revenue	$24,742	PYOtherRevenueAmt
CY Other Revenue	$846,344	CYOtherRevenueAmt
PY Total Revenue	$21,011,634	PYTotalRevenueAmt
CY Total Revenue	$23,226,730	CYTotalRevenueAmt
PY Grants And Similar Paid	$14,996	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$28,208	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$11,915,122	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$13,307,747	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$38,440	CYTotalFundraisingExpenseAmt
PY Other Expenses	$8,591,352	PYOtherExpensesAmt
CY Other Expenses	$8,454,542	CYOtherExpensesAmt
PY Total Expenses	$20,521,470	PYTotalExpensesAmt
CY Total Expenses	$21,790,497	CYTotalExpensesAmt
PY Revenues Less Expenses	$490,164	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,436,233	CYRevenuesLessExpensesAmt
Total Assets BOY	$12,555,246	TotalAssetsBOYAmt
Total Assets EOY	$16,219,533	TotalAssetsEOYAmt
Total Liabilities BOY	$4,564,811	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$6,845,886	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$7,990,435	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$9,373,647	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$18,077,091	ExpenseAmt
Grant	$28,208	GrantAmt
Revenue	$21,577,820	RevenueAmt
Desc	See schedule O	Desc
Total Program Service Expenses	$18,077,091	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	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	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	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	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
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	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	43	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	227	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
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
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	9	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	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	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	ID	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	LENNE BONNER	PersonNm
Phone	2084768008	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	301 CEDAR ST	AddressLine1Txt
City	Orofino	CityNm
State Abbreviation	ID	StateAbbreviationCd
ZIP	83544	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Larry Coonts
Board VICE CHAIR	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
Maurice Masar MD
Board Director	1.0	1.0	Yes (X)		$0	$0	$0
Gary Rehder
Board Director Thru 9/14	1.0	1.0	Yes (X)		$0	$0	$0
Dan Davis
Board CHAIR	1.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
Sister Mary Rochefort
Board Director	1.0	1.0	Yes (X)		$0	$0	$0
Lee Pippenger
Board SECRETARY/TREASURER	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
Kelly McGrath MD
Board Director	39.0	1.0	Yes (X)		$225,156	$0	$20,474
Alvin SECREST III MD
Board Director	1.0	39.0	Yes (X)		$0	$271,051	$32,179
LONNIE SIMPSON
BOARD DIRECTOR	1.0	1.0	Yes (X)		$0	$0	$0
LENNY HILL
BOARD DIRECTOR	1.0	1.0	Yes (X)		$0	$0	$0
SISTER MARJORIE SCHMIDT
BOARD DIRECTOR	1.0	1.0	Yes (X)		$0	$0	$0
PAUL NUSSER
BOARD DIRECTOR	1.0	1.0	Yes (X)		$0	$0	$0
Lenne Bonner
CAO & CFO Thru 9/14	25.0	25.0		Yes (X)	$189,899	$0	$26,278
PATRICK BRANCO
PRESIDENT	25.0	25.0		Yes (X)	$340,209	$0	$53,222
Leianne Everett
Chief Financial Officer	25.0	25.0		Yes (X)	$135,584	$0	$14,020
Clayton Bunt MD
Physician	40.0	0.0			$196,908	$0	$19,963	Yes (X)
PHILLIP PETERSEN MD
PHYSICIAN	40.0	0.0			$180,493	$0	$19,556	Yes (X)
KIMBERLY CAMPBELL MD
PHYSICIAN	40.0	0.0			$187,321	$0	$30,377	Yes (X)
JOSHUA MORRIS MD
PHYSICIAN	40.0	0.0			$243,664	$0	$21,354	Yes (X)
Cay Berg
Physician	40.0	0.0			$184,112	$0	$9,411	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,883,346	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$271,051	TotReportableCompRltdOrgAmt
Total Other Compensation	$246,834	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	20	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
DMS Imaging Inc
26273 Network Place	CHICAGO	IL	60673	Mobile Radiology	$198,620
GRITMAN MEDICAL CENTER
PO Boc 8007	MOSCOW	ID	83843	Ultrasound	$176,727
Palouse Imaging Consultants
PO BOX 9583	MOSCOW	ID	83843	Radiology Services	$308,523
Wendi Richardson
PO Box 1916	OROFINO	ID	83544	CRNA	$213,563
Walker Construction Inc
PO Box 3901	SPOKANE	WA	99220	General Contractor	$902,233

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	6	CntrctRcvdGreaterThan100KCnt
Related Organizations	$484,510	RelatedOrganizationsAmt
Government Grants	$154,320	GovernmentGrantsAmt
All Other Contributions	$63,614	AllOtherContributionsAmt
Total Contributions	$702,444	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	HOSPITAL & CLINIC SERVICES	Desc
Business	621110	BusinessCd
Total Revenue Column	$21,577,820	TotalRevenueColumnAmt
Related Or Exempt Func Income	$21,577,820	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$21,577,820	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$38,159	TotalRevenueColumnAmt
Exclusion	$38,159	ExclusionAmt

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

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$61,963	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$61,963	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$61,963	TotalRevenueColumnAmt
Exclusion	$61,963	ExclusionAmt

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
GAIN ON LEASE TERMINATION	900099	$822,498	$822,498
VENDING SALES	722514	$14,320	$14,320
FITNESS DUES	713940	$4,864	$4,864

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,662	TotalRevenueColumnAmt
Exclusion	$4,662	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$846,344	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$23,226,730	TotalRevenueColumnAmt
Related Or Exempt Func Income	$21,577,820	RelatedOrExemptFuncIncomeAmt
Exclusion	$946,466	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$28,208	TotalAmt
Program Services	$28,208	ProgramServicesAmt

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	$557,444	TotalAmt
Program Services	$189,665	ProgramServicesAmt
Management And General	$367,779	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	$10,747,504	TotalAmt
Program Services	$9,287,981	ProgramServicesAmt
Management And General	$1,438,081	ManagementAndGeneralAmt
Fundraising	$21,442	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$330,882	TotalAmt
Program Services	$301,755	ProgramServicesAmt
Management And General	$28,033	ManagementAndGeneralAmt
Fundraising	$1,094	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$897,662	TotalAmt
Program Services	$773,473	ProgramServicesAmt
Management And General	$123,205	ManagementAndGeneralAmt
Fundraising	$984	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$774,255	TotalAmt
Program Services	$651,159	ProgramServicesAmt
Management And General	$120,786	ManagementAndGeneralAmt
Fundraising	$2,310	FundraisingAmt

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	$4,299	TotalAmt
Management And General	$4,299	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$15,320	TotalAmt
Management And General	$15,320	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$670	TotalAmt
Management And General	$670	ManagementAndGeneralAmt

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	$8,670	TotalAmt
Management And General	$8,670	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,120,127	TotalAmt
Program Services	$1,938,299	ProgramServicesAmt
Management And General	$176,934	ManagementAndGeneralAmt
Fundraising	$4,894	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$48,594	TotalAmt
Program Services	$3,586	ProgramServicesAmt
Management And General	$45,008	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$873,296	TotalAmt
Program Services	$730,074	ProgramServicesAmt
Management And General	$141,148	ManagementAndGeneralAmt
Fundraising	$2,074	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$127,136	TotalAmt
Program Services	$113,491	ProgramServicesAmt
Management And General	$13,314	ManagementAndGeneralAmt
Fundraising	$331	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$295,808	TotalAmt
Program Services	$222,019	ProgramServicesAmt
Management And General	$72,868	ManagementAndGeneralAmt
Fundraising	$921	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$188,836	TotalAmt
Program Services	$111,321	ProgramServicesAmt
Management And General	$76,940	ManagementAndGeneralAmt
Fundraising	$575	FundraisingAmt

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	$164,555	TotalAmt
Program Services	$102,574	ProgramServicesAmt
Management And General	$61,981	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$18,398	TotalAmt
Program Services	$14,047	ProgramServicesAmt
Management And General	$4,351	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$924,268	TotalAmt
Program Services	$677,691	ProgramServicesAmt
Management And General	$243,257	ManagementAndGeneralAmt
Fundraising	$3,320	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$257,646	TotalAmt
Program Services	$238,875	ProgramServicesAmt
Management And General	$18,771	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$1,426,613	$1,426,613
BAD DEBT EXPENSE	$1,049,370	$1,049,370
DUES & SUBSCRIPTIONS	$444,068	$57,268	$386,305	$495
AFFILIATE SUPPORT FEE	$434,244	$106,998	$327,246

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$52,624	TotalAmt
Program Services	$52,624	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$21,790,497	TotalAmt
Program Services	$18,077,091	ProgramServicesAmt
Management And General	$3,674,966	ManagementAndGeneralAmt
Fundraising	$38,440	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$775	BOYAmt
EOY	$1,150	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,281,558	BOYAmt
EOY	$2,434,689	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$52,793	BOYAmt
EOY	$111,226	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$3,851,134	BOYAmt
EOY	$3,437,553	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$404,587	BOYAmt
EOY	$417,909	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$188,307	BOYAmt
EOY	$122,812	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$13,378,706	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$5,058,083	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$5,032,731	BOYAmt
EOY	$8,320,623	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$1,704,087	BOYAmt
EOY	$1,233,423	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$39,274	BOYAmt
EOY	$140,148	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$12,555,246	BOYAmt
EOY	$16,219,533	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,852,483	BOYAmt
EOY	$1,759,991	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$642,334	BOYAmt
EOY	$600,999	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$462,975	BOYAmt
EOY	$3,402,510	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,607,019	BOYAmt
EOY	$1,082,386	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$4,564,811	BOYAmt
EOY	$6,845,886	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,990,435	BOYAmt
EOY	$9,373,647	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$7,990,435	BOYAmt
EOY	$9,373,647	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$12,555,246	BOYAmt
EOY	$16,219,533	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$1,436,233	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$53,021	NetUnrlzdGainsLossesInvstAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
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)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$670	OtherActivitiesAmt
Total Lobbying Expenditures	$670	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B	FormAndLineReferenceDesc
Explanation	Lobbying Activity Explanation: Clearwater Valley Hospital and Clinics, Inc. pays dues to a certain organization related to the industry which has lobbying expenses. The amount listed is the percentage of the dues paid that were used for lobbying.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$116,169	OtherCostOrOtherBasisAmt
Book Value	$116,169	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,811,377	OtherCostOrOtherBasisAmt
Depreciation	$1,000,444	DepreciationAmt
Book Value	$810,933	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,211	OtherCostOrOtherBasisAmt
Depreciation	$6,211	DepreciationAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,324,056	OtherCostOrOtherBasisAmt
Depreciation	$4,024,101	DepreciationAmt
Book Value	$2,299,955	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,120,893	OtherCostOrOtherBasisAmt
Depreciation	$27,327	DepreciationAmt
Book Value	$5,093,566	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$8,320,623	TotalBookValueLandBuildingsAmt
Financial Derivatives		FinancialDerivativesGrp
Closely Held Equity Interests		CloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	POOLED INVESTMENT FUND	Desc
Book Value	$1,233,423	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$1,233,423	TotalBookValueSecuritiesAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	PAYABLES TO RELATED TAX-EXEMPT ORG	Desc
Amt	$1,082,386	Amt

Field	Value	IRS element (for citing)
Total Liability	$1,082,386	TotalLiabilityAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	160.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	310.	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
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)
Persons Served	393	PersonsServedCnt
Total Community Benefit Expns	$461,940	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$461,940	NetCommunityBenefitExpnsAmt
Total Expense	0.02230	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	2552	PersonsServedCnt
Total Community Benefit Expns	$3,203,644	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,555,073	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$648,571	NetCommunityBenefitExpnsAmt
Total Expense	0.03130	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	2945	PersonsServedCnt
Total Community Benefit Expns	$3,665,584	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,555,073	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,110,511	NetCommunityBenefitExpnsAmt
Total Expense	0.05360	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	1487	PersonsServedCnt
Total Community Benefit Expns	$55,814	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$55,814	NetCommunityBenefitExpnsAmt
Total Expense	0.00270	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	26	PersonsServedCnt
Total Community Benefit Expns	$8,317	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$8,317	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	5	ActivitiesOrProgramsCnt
Persons Served	131	PersonsServedCnt
Total Community Benefit Expns	$6,451	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,451	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	15	ActivitiesOrProgramsCnt
Persons Served	1644	PersonsServedCnt
Total Community Benefit Expns	$70,582	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$70,582	NetCommunityBenefitExpnsAmt
Total Expense	0.00340	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	15	ActivitiesOrProgramsCnt
Persons Served	4589	PersonsServedCnt
Total Community Benefit Expns	$3,736,166	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,555,073	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,181,093	NetCommunityBenefitExpnsAmt
Total Expense	0.05700	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,049,370	BadDebtExpenseAmt
Bad Debt Expense Attributable	$23,400	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$9,945,657	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$9,928,025	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$17,632	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	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	Clearwater Valley Hospital & Clinics	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	301 Cedar Avenue	AddressLine1Txt
City	Orofino	CityNm
State Abbreviation	ID	StateAbbreviationCd
ZIP	83544	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.smh-cvhc.org	WebsiteAddressTxt
State License	01	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Clearwater Valley Hospital & Clinics	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
Information Gaps	Yes (X)	InformationGapsInd
Other	Yes (X)	OtherInd
CHNA Conducted	12	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	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	See Part V, Section C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	12	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	See Part V, Section C	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	160.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	310.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
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
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	See Part V, Section C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See Part V, Section C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See Part V, Section C	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
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (27 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part V, Line 2	Checked "No", so not applicable.
Part V, Line 3j	The Community Health Needs Assessment also includes a Community Health Profile. The profile is based on data from the Behavioral Risk Factors Surveillance System and the University of Wisconsin Population Health Institute County Health Rankings.
Part V, Line 5	A Community/Patient Focus Group was held for community members to identify and prioritize their community health needs. In addition, persons were consulted at Town Hall Meetings, which was designed to address each prioritized health need. During the Town Hall Meeting, intervention options for meeting the health need were presented, and participants selected the option best suited to their community. Individuals from the following organizations attended the Town Hall Meeting (names and titles available upon request): Community/Patient Focus Group, Public Health Idaho North Central District, Business Psychology Associates, Allen Counseling Services, Region II Mental Health Board, and Nimiipuu Health. See the CHNA posted on the website listed in Part V, Line 7a for a list of organizations that were invited to, but did not attend the town hall meetings. An employee of Public Health Idaho North Central District (name and title available upon request) attended the Community/Patient Focus Group and the Town Hall Meeting and provided input on the community health needs and intervention options for addressing the highest priority health need. Two individuals from Nimiipuu Health attended both the Community/Patient Focus Group and the Town Hall Meeting and provided input on the community health needs and intervention options for addressing the highest priority health need. The majority of Clearwater, Idaho, and Lewis Counties are rural according to the 2012 UWPHI County Health Rankings data: 57.3% (Clearwater), 79.1% (Idaho), and 100% (Lewis). Given the known health disparities of rural populations, all attendees of the Community/Patient Focus Group and Town Hall Meetings are representatives and/or members of medically-underserved and low income populations, as well as populations with chronic disease needs. Community/Patient Focus Group participants were specifically instructed to consider themselves as representatives of the community-at-large. Participants at the Town Hall Meetings served more formal leadership or representative roles. The current and former Chairs of Regional Mental Health Boards attended both the Community/Patient Focus Group and the Town Hall Meeting. Elected officials from Clearwater County and Cottonwood City Council (names and titles available upon request) attended the Community/Patient Focus Group. In Clearwater, Idaho, and Lewis Counties, over 88% of individuals are Caucasian. However, as attendees at the Community/Patient Focus Group were instructed to act as representatives of the entire community, and data stratified by race/ethnicity were presented, health needs of minority populations were considered. Additionally, two individuals from Nimiipuu Health attended both the Community/Patient Focus Group and the Town Hall Meeting and provided input on the community health needs and intervention options for addressing the highest priority health need. These individuals provide health education and home visits to the tribal community.
Part V, Line 6a	In the interest of efficiency, cost effectiveness, and alignment with Essentia Health population health strategies, the hospital facilitys CHNA was conducted in a coordinated process with fourteen other Essentia Health hospital facilities. While still allowing for tailoring to each particular hospital facility, procedures were standardized across hospital facilities. The hospital facilities included in this coordinated process are: Essentia Health Ada in Ada, MN; Clearwater Valley Hospital and Clinics, Inc. in Orofino, ID; Essentia Health Deer River in Deer River, MN; Essentia Health Virginia in Virginia, MN; Essentia Health Holy Trinity Hospital in Graceville, MN; Essentia Health West in Fargo, ND; Minnesota Valley Health Center, Inc. in Le Sueur, MN; Essentia Health Northern Pines in Aurora, MN; Essentia Health Sandstone in Sandstone, MN; Essentia Health Duluth in Duluth, MN; Essentia Health St. Josephs Medical Center in Brainerd, MN; Essentia Health St. Marys Hospital-Superior in Superior, WI; St. Marys Hospital, Inc. in Cottonwood, ID; Essentia Health St. Marys Medical Center in Duluth, MN; and Essentia Health St. Marys-Detroit Lakes in Detroit Lakes, MN. Since Essentia Health West joined the collaborative effort on February 1, 2013, not all aspects of the Essentia Health West CHNA are coordinated with those of the other hospital facilities. Clearwater Valley Hospital and Clinics, Inc. did and will collaborate more closely with one of the Essentia Health hospitals in particular St. Marys Hospital, Inc. in Cottonwood, ID by holding joint Community/Patient Focus Groups, Town Hall Meetings, and Intervention Planning Meetings. Additional collaboration between the two hospitals will occur as the interventions progress.
Part V, Line 6b	not applicable
Part V, Line 7a	THE CHNA IS POSTED AT: http://www.smh-cvhc.org/getpage.php?name=community_health&sub=Patient+Info
Part V, Line 7d	This box was not checked, so not applicable.
Part V, Line 10a	The hospital facility's most recently adopted implementation strategy is posted at: http://www.smh-cvhc.org/getpage.php?name=community_health&sub=Patient+Info
Part V, Line 10b	The hospital facility's most recently adopted implementation strategy has not been attached to this return because the link has been provided above.
Part V, Line 11	Seven health needs were identified through the most recently-conducted CHNA. Obesity, physical activity, and nutrition as risk factors for chronic diseases, such as type 2 diabetes was the highest priority health need identified and is addressed as a part of the hospital facilitys implementation strategy. The actions taken by the hospital facility to address this significant health need include implementation of a community wide intervention, National Diabetes Prevention Program (NDPP), as well as preparatory activities for building system-wide population health improvement capacity in FY 2015. The Centers for Disease Control and Prevention-led NDPP is an evidence-based lifestyle change program for type 2 diabetes prevention. The anticipated impact of NDPP is reduced body weight and increased physical activity in participants, which prior research suggests will reduce their type 2 diabetes risk. The hospital facility committed staff time to serve as the Lifestyle Coach, as well as space in the facility to hold the sessions. There are four sessions with participants from the hospital facility service area: Orofino at the hospital conference room, Pierce at the rural clinic, Ahsahka at a private residence, and Kamiah at the local Chamber of Commerce conference room (participants at this site are also from the St. Marys Hospital, Inc. service area). The hospital facility works collaboratively with St. Marys Hospital, Inc. as both facilities share a Lifestyle Coach who conducts 2 additional sessions on St. Marys Hospital, Inc.'s behalf. Other organizations participating in/collaborating on this intervention are the Idaho Department of Health and Welfare (IDHW). Marketing materials, radio public service announcements, banner ads, and assistance with printed materials were provided by IDHW. As of the FY 2015 progress report, 16 participants completed the NDPP program with an average weight loss of 17.50 pounds or a 7.64% loss in body weight. Participants averaged 160 minutes/week of physical activity per week at the completion of the program which is an increase of 40 minutes of physical activity per week. The course continues to see rapid growth and expansion throughout the service area. The true impact of the NDPP in the service area of the hospital has been portrayed by the extraordinary outreach and number of lives touched. The NDPP started from scratch in November 2013 and at present, has been presented in full or in part to over 40 participants in 3 of the communities served by the hospital. Additional opportunities, including teleconferencing for rural communities, are being explored. The hospital continues to work collaboratively with community partners and resources to market NDPP course opportunities. Participants continue to evangelize the value and magnitude this program has on changing lives through referrals to friends and families. One participant referred 18 people to the cohort which began in February 2015. Participants are energized to continue to promote health and wellness to their communities, in one community six participants started gardens to provide produce to their local food bank. The NDPP is fostering a community health movement in the service area of the hospital, demonstrating true success and overwhelming progress. The hospital facility will not directly meet the six unprioritized health needs due to resource constraints. Rather than inadequately addressing all health needs, the hospital facility will focus resources, financial and otherwise, on optimizing the first intervention for the communitys highest priority health need while the Health System collectively builds the necessary resources and capacity for population health improvement in order to foster success in meeting the health need. If the unprioritized health needs remain in the next CHNA cycle, they may be directly addressed at that time. The six unprioritized health needs are as follows: Reduction of excessive/binge drinking Immunizations Preventative care Access to healthcare Tobacco use primary prevention/cessation Secondary prevention/screening Despite not directly meeting the unprioritized needs, interventions addressing the highest prioritized health have partially addressed certain unprioritized health needs that overlap with the prioritized health need. Clearwater Valley Hospital & Clinics, Inc. has done tremendous work to improve access to healthcare in their service area. Accomplishments include achieving recognition as patient-centered medical home, expanding hours of access, offering free and reduced care opportunities, recruiting new providers, nurse case managers and community referral coordinators working collaboratively to eliminate barriers to care, providing access to specialty services through visiting providers and telemedicine, and participating in an active consortium of community members to discuss opportunities to improve access to healthcare. In addition, the hospital facility has updated their website to include a database of community health resources, freely available to the public and also linked on many of their community partners websites. The hospital is also participating in statewide committees for Medicaid innovation, telemedicine, time sensitive emergency care and community health workers. The hospital is conducting extensive outreach for Affordable Care Act insurance enrollment, including partnering with private insurance brokers. The hospital is writing and administering grants focused on improving access to healthcare. The hospital continues to seek to improve access to healthcare and partner with their community partners and community members to meet the needs of their service area. In regards to reduction of excessive/binge drinking, Clearwater Valley Hospital & Clinics, Inc. providers have provided presentations on the dangers and effects of drinking to area high schools. The hospital is also participating in regional public health coalitions focused on reducing alcohol consumption. In regards to immunizations, the hospital is participating in a state-wide IRIS registry system to update immunization records regardless of where the immunization was received. They are also focusing on raising awareness of the need of immunizations through newspaper articles, back to school events and public service announcements. The hospital currently conducts health screening and health education at multiple community locations in regards to preventative care. The hospital is very active in working to reduce childhood obesity; they are an active participant in a childhood obesity learning collaborative which includes offering family-centered activities promoting healthy eating and active living to community members. They are also conducting BMI screenings for elementary school children. In regards to tobacco use primary prevention/cessation, Clearwater Valley Hospital & Clinics, Inc. providers have given presentations to area high schools on the dangers and implications of tobacco use. The hospital also provides tobacco cessation classes and referrals to statewide tobacco cessation aids. The hospital is participating in a regional public health coalition. Internally, they have also focused on process improvement related to meaningful use and medical home measures.
Part V, Line 13b	This box was not checked, so not applicable.
Part V, Line 13h	This box was not checked, so not applicable.
Part V, Line 15c	Subsequent to year end, the policy has been revised to include contact information of hospital facility staff who can provide individuals with information about the FAP and AFAP application process.
Part V, Line 15d	Subsequent to year end, the policy has been revised to include contact information of nonprofit organizations or government agencies that may be sources of assistance with FAP applications.
Part V, Line 15e	This box was not checked, so not applicable.
Part V, Lines 16a, 16b, and 16c	The URL where a patient can find the financial assistance policy, the financial assistance policy application, and the plain language statement of the financial assistance policy can be found at http://www.essentiahealth.org/main/financial-assistance-program.aspx.
Part V, Line 16d	The financial assistance policy (FAP) was made available upon request without charge to the public and available by mail without charge. The FAP was not located in public places, but brochures advertising the FAP were located in such areas. A plan is in place to make the FAP available in public areas of the hospital facility moving forward.
Part V, Line 16e	The financial assistance policy (FAP) application was made available upon request without charge to the public and available by mail without charge. The FAP application was not located in public places, but brochures advertising the FAP were located in such areas. A plan is in place to make the FAP application available in public areas of the hospital facility moving forward.
Part V, Line 16i	This box was not checked, so not applicable.
Part V, Line 18d	This box was not checked, so not applicable.
Part V, Line 19d	This box was not checked, so not applicable.
Part V, Line 20e	This box was not checked, so not applicable.
Part V, Line 21c	This box was not checked, so not applicable.
Part V, Line 21d	This box was not checked, so not applicable.
Part V, Line 22d	For patients known to qualify for the financial assistance program, they are charged the same as the hospital's most common insurance payor.
Part V, Line 23	Checked "No", so not applicable.
Part V, Line 24	Checked "No", so not applicable.

Field	Value	IRS element (for citing)
Facility	4	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Orofino Medical Clinic
301 Cedar Avenue	Orofino	ID	83544	Primary Care Clinic
Kooskia Medical Clinic
201 Thenon Street	Kooskia	ID	83539	PRIMARY CARE CLINIC
Pioneer Medical Clinic
105 Carle Street	Pierce	ID	83546	Primary Care Clinic
OROFINO PHYSICAL THERAPY CLINIC
153 JOHNSON AVE	OROFINO	ID	83544	PHYSICAL THERAPY CLINIC

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part VI, Line 1	Provide the description required for Part I, lines 3c, 6a, 7g, 7, column (f), 7; Part II; Part III, lines 2, 3, 4, 8, 9b: Part I, line 3c Assets will be considered along with the patients income to determine eligibility for the Financial Assistance Program. To be eligible, reportable assets may not exceed $15,000 for a household of one (1), or $25,000 for a household of two (2) or more. Assets may include, but are not limited to, such items as checking and savings accounts, IRAs, 401(k)s; value of additional cars that exceed the number of working members in the household, equity in recreational vehicles and additional property, etc. Part I, line 6a Clearwater Valley Hospital and Clinics, Inc.'s community benefit information is consolidated into the Essentia Health community benefit information which is included in the Essentia Health annual report. The annual report is made available to the public at http://www.essentiahealth.org/Main/Annual-Report.aspx. Essentia Health, headquartered in Duluth, Minn., is an integrated health system serving patients in Minnesota, Wisconsin, North Dakota and Idaho and is Clearwater Valley Hospital and Clinics, Inc.'s parent corporation. Part 1, line 7g Not Applicable. Part I, line 7, column (f) Bad debt expense that was subtracted from total expense to obtain the % of community benefit to total expense amounted to $1,049,370. Part I, line 7 The cost to charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges was used to calculate the costs for the following community benefits: Charity Care and Unreimbursed Medicaid. Actual costs were used for the remainder of the community benefits reported. Part II Not applicable, no community building activities. Part III, Line 2 Discounts, charity care, and bad debt expense are accounted for as reductions to revenue. Bad debt expense on patient accounts would be identified as any balance on the account, less any previous payments and discounts, that has aged and is absent of any payments. If, during the collection process, it becomes known that the patient qualifies for charity care, the amounts included within bad debt expense would be reclassified to charity care. Part III, Line 3 Clearwater Valley Hospital and Clinics, Inc. is a part of a larger organization, Essentia Health. Essentia Health and its member organizations incorporate the cost of bad debt as a community benefit. As a tax exempt hospital, we must provide the necessary services regardless of the patients ability to pay for that care. In doing so, Essentia Health makes quality patient care available to all in our community, regardless of their economic means. Part III, Line 3 Clearwater Valley Hospital and Clinics, Inc. applied a high-level, conservative analytic review by multiplying the ratio of charitable allowances to gross patient revenue against bad debt expense to arrive at an approximation of charity care that resides in bad debt. Part III, Line 4 Page 13 of the audit contains the footnote describing the organizations bad debt expense. Part III, Line 8 The methodology used in determining the reported Medicare Allowable Cost begins with the hospital's general ledger system. The costs are obtained from the general ledger and then adjusted and reported in accordance with Centers for Medicare Services (CMS) "costfinding" guidelines as published in their Provider Reimbursement Manual. Once the Medicare allowable costs are determined from the hospital's cost report, any costs attributed to subsidized health services, and Medical Education, are removed and reported separately. Part III, Line 8 Each Essentia Health hospital is required to file a Medicare cost report 5 months after the close of their fiscal year. The cost report provides Medicare with information that is used to determine utilization and spending trends but also is used to set future payment rates for most Medicare services. If the interim payments paid to a hospital are higher or lower than the filed cost report allowable reimbursement there will be a settlement for that fiscal year. This can be due to changes in utilization or cost of providing services for Critical Access Hospitals (CAH) or differences between interim and final payment factors for Disproportionate Share, Bad Debts, or Indirect Medical Education for non-CAH hospitals. An estimate for these settlements is recorded at the close of the fiscal year. If the estimate varies from the final settlement received 6-7 months after the fiscal year ends then these amounts are recorded as prior year Medicare revenue. Part III, line 8 Clearwater Valley Hospital and Clinics, Inc. is a part of a larger organization, Essentia Health. Essentia Health and its member organizations incorporate the full value of the Medicare shortfall as a community benefit. The rationale for the organization's opinion is providing care for the elderly and serving Medicare patients is an essential part of the community benefit standard. Medicare, like Medicaid, does not pay the full cost of care and it is likely to get worse. Many Medicare beneficiaries are poor and are eligible for Medicaid in addition to Medicare. Medicare underpayment must be shouldered by the hospital in order to continue treating the communitys elderly and poor. These underpayments represent a real cost of serving the community. Part III, line 9b The policies and procedures for internal and external collection practices take into account the extent to which the patient qualifies for the Financial Assistance Policy (FAP) and financial assistance, a patients good faith effort to apply for a governmental program or for financial assistance from Clearwater Valley Hospital and Clinics, Inc. and the patients good faith effort to comply with his/her payment agreements. Clearwater Valley Hospital and Clinics, Inc. offers extended payment plans to eligible patients and will not impose liens on primary residences nor will we report patients to a credit rating agency for outstanding patient bills. Clearwater Valley Hospital and Clinics, Inc. will not charge a patient gross amount of charges for any uninsured treatment. Uninsured discounts will be applied to the gross charges prior to any FAP or other discounts. At any time Clearwater Valley Hospital and Clinics, Inc. recognizes that a patient may be eligible for State or Federal programs, a representative will assist the patient in obtaining information about those programs or provide contact information for those programs. Clearwater Valley Hospital and Clinics, Inc. contracts with an outside patient advocacy agency, which may provide assistance to the uninsured patient in applying to certain State and Federal programs. At any stage of the patient experience and up through the collection process, the patient may express a concern that they are unable to pay their bill in full or meet the payment plan requirements. At that time, the patient will be given every opportunity to complete and submit an application for financial assistance. Clearwater Valley Hospital and Clinics, Inc. trains its outside debt collection agencies and attorneys about the Financial Assistance Policy and how a patient may obtain more information about the FAP or submit an application for financial assistance. Clearwater Valley Hospital and Clinics, Inc. requires its outside collection agencies and attorneys to refer patients who may be eligible for financial assistance to Clearwater Valley Hospital and Clinics, Inc. If a patient has submitted an application for financial assistance after an account has been referred for collection activity, Clearwater Valley Hospital and Clinics, Inc. and its outside debt collection agencies suspend all collection activity until the patients financial assistance application has been processed and Clearwater Valley Hospital and Clinics, Inc. has notified the patient of its decision.
PART VI, LINE 2	NEEDS ASSESSMENT. DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES, IN ADDITION TO ANY NEEDS ASSESSMENTS REPORTED IN PART V, SECTION B: We assess and respond to the health care needs of the communities we serve through many ways including the following: Marketing research Clearwater Valley and St. Mary's Hospitals and Clinics review internal data to better understand the needs and use(s) of our services. This includes access to service areas (e.g. Primary Care), payor information, and overall gaps in services. Assessments have resulted in strategic plans for growing services as well as changes to internal processes for health care access. Population Care Management We regularly compare our health rankings and ratings to state and national data to identify greatest areas of health care needs. We prepare interventions targeted to areas of greatest need, such as uncontrolled diabetes or pre-diabetes. We then measure the effect of interventions compared to overall county rankings. We use this data to assess the implications of expanding pilot programs. Planned interaction with various community health, healthcare and social welfare groups An umbrella coalition of community health, healthcare and social welfare groups meets regularly to share perspectives on community needs and the role Essentia Health can play in addressing those needs as a collaborative partner. Interactions have resulted in successful programs for nurse case management, community referral coordinator, community health worker, and benefits counselor positions. Internal Quality Indicators - They track data that lead to the improved care and treatment of patients with chronic diseases, tobacco use and mental health conditions. This includes patient activity and outcomes, allowing for Essentia Health to better identify the needs of the patients, which can be utilized to assess the overall health of the communities we serve. Health data provided by payor organizations, namely government and commercial health insurers - This health data typically involves medical treatment and outcomes that reflect trends of unhealthy lifestyles and behaviors. Our objective is to understand these relationships and to develop action steps to intervene on the front end to prevent such medical situations from occurring. Examples include management of cardiovascular health and opioid use.
PART VI, LINE 3	Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization's charity care policy: Clearwater Valley Hospital and Clinics, Inc. makes information on its Financial Assistance Policy (FAP) readily available to the patient. Information about financial assistance programs is available on the Essentia Health (parent company) website (www.essentiahealth.org) where the Information and application is easily accessible to be viewed, downloaded and printed at no charge to the patient. Notices on the availability of financial assistance are conspicuously posted in emergency room departments. Financial assistance information is available during the pre-admission financial screening, at the time of registration and prior to a hospital discharge. Information about the FAP is in all collection letters and patient statements. FAP information and/or applications are made available to appropriate community health services agencies and other organizations that assist people in need. Clearwater Valley Hospital and Clinics, Inc. educates staff members who work closely with patients providing direct patient treatment and who work in admissions, billing and collections, about the existence of the FAP and how a patient may obtain more information. Annual education/awareness of the FAP is provided to ensure all employees with patient contact are aware of the program and how patients can obtain additional information. Clinical and hospital staff who provide direct patient care have knowledge of the FAP and know to direct patients to a Registration Interviewer or Business Office Representative. Registration staff have an understanding of the policy, knowledge of where the related documents are located and where to direct the patient for more information on the FAP. Designated employees (Financial Counselors; Patient Accounts Representatives) have a thorough understanding of the FAP and offer the information on the FAP to those patients who make an inquiry about the program or are determined through a financial screening that the patient may be eligible for this program. Patient advocacy services also inform the patient about the availability of assistance. A request for financial assistance may be made by the patient, a patient's guarantor, a family member, close friend, or associate of the patient, subject to applicable privacy laws. Clearwater Valley Hospital and Clinics, Inc. responds to any oral or written requests for more general information on the FAP made by a patient or any interested party.
PART VI, LINE 4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves: Clearwater Valley Hospital and Clinics, Inc. is located in Orofino, ID. Clearwater Valley Hospital and Clinics, Inc. is a part of the larger Essentia Health system, which is defined in Part VI, line 6. Clearwater Valley Hospital and Clinics, Inc. operates 1 hospital and 4 clinics that serve the communities of Idaho, Lewis and Clearwater counties covering 2,400 square miles. The overall community is classified as rural. Clearwater Valley Hospital and Clinics, Inc. covers a service region of approximately 10,000 people. The service region age distribution is 21% under the age of 18; 58% between the ages of 18 and 65; and 21% over the age of 65. The racial makeup of the service region is 99% Caucasian; and other 1%. The gender split ratio is 50% women and 50% men. The average income for the service area is approximately $43,000. Approximately 12.8% of the population falls below the federal poverty guidelines. Clearwater Valley Hospital and Clinics, Inc., along with Essentia Health is committed to serve patients regardless of their ability to pay. 4.8% gross revenue dollars were from self pay patients. In addition, approximately 15.5% of their net revenue dollars were Medicaid recipients. A large portion of the population lacks medical insurance. As mentioned above, Clearwater Valley Hospital and Clinics, Inc. is part of a larger system, Essentia Health. Essentia Health staffs hospitals and clinics in federally-recognized underserved areas and supports the health of its communities through an active outreach program that brings specialists like oncologists, cardiologists, neurologists and others into its smaller communities. This eliminates barriers to care for many patients, particularly those who are elderly, living on low incomes, or are faced with other challenges that make it difficult to travel long distances for care. There are no other hospitals outside of the Essentia Health umbrella that service the community.
PART VI, LINE 5	PROVIDE ANY OTHER INFORMATION IMPORTANT TO DESCRIBING HOW THE ORGANIZATION'S HOSPITALS OR OTHER HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY: Clearwater Valley Hospital and Clinics, Inc.'s Board of Directors is composed of volunteer representatives from the communities it serves. The hospital extends medical staff privileges to all qualified physicians in the community who are properly screened. In addition, the hospital serves as a clinical practice site for many students in x-ray technology, nursing, physician assistant, nurse practitioner, and medical residency programs. This is especially important because Idaho has one of the lowest physician per capita rates in the nation. Clearwater Valley Hospital and Clinics, Inc. regularly reviews facilities and equipment and develops an attrition process to replace aging plant operations & equipment. They also look for opportunities to bring new services to the communities via investing in new skills and technology where appropriate. Clearwater Valley Hospital and Clinics, Inc. engaged communities in coming together and creating social connectivity through support of local events and community programs. These include the formation of community and school gardens, health talks and screening events, sponsorship of races, and participation in county fair activities. We promote better mental health by bringing child and adult psychiatrists to our frontier communities using telemedicine. This model has won state and national awards for innovation in reaching the medically underserved. We are also active participants in national demonstration projects and other collaborations to provide an evidence base for effective processes to promote rural health. Some other projects undertaken by the hospital facility include the following: Each month we have an overall theme targeting a chronic disease state with special programs and outreach to our communities (Feb is heart month, Oct is breast CA awareness, Nov is diabetes, etc.). Doc talks are geared to the monthly theme with screenings and information provided at the events. Our Care Managers, Referral Coordinators, and Quality Director are especially active in coordinating these activities and reaching out to patients who may not be aware of the services offered. Colon cancer awareness and screening has been a major outreach effort at health fairs, local bazaars, some of the Farmer's Market days, and within all of the clinics over the past year. Childhood nutrition was focused on with school gardens and presentations at various locations. Produce from the garden was entered into the county fair and won some awards furthering the effort to get the message into the community about healthier food choices. Asthma education and smoking cessation are ongoing topics of conversation and special events are scheduled around these efforts in collaboration with the local public health department. Collaboration and training with law enforcement agencies (local police, county sheriff offices and tribal police) is ongoing in an effort to facilitate education on the difference between someone presenting with a diabetic episode (high or low) as opposed to substance abuse. The hospital facility is an active participant in attending and sitting on the boards of the local Human Need Councils within the service areas. We have a presence on multiple coalitions throughout northern and north central Idaho. This is often accomplished by phone conferencing in order to participate in the discussions and growth without incurring travel expense. We are also actively engaged in state coalitions on chronic disease (often seen as mentors within these groups for the accomplishments achieved over the past few years). Fundraisers and volunteer efforts are established and ongoing with local food banks, clothing distribution drives, and other volunteers that are geared around the natural disasters within our area (during 2015 devastating forest fires burned large portions of our service area with many homes lost and families in need). The hospital facility was a great supporter of volunteer labor in meeting the needs of not only the residents involved in the loss related to the fires, but also assisted in meeting the needs of firefighting agencies which traveled from all over the country to fight the fires. Food stations and supply stations were manned by our volunteers. Groups were formed for support (emotional and physical) to provide encouragement and shock/grief assistance to those impacted. Animal foster groups were also developed to care for pets and livestock that had been displaced by the fires. Efforts are being made to bring safe walking and bike trails to communities within our service areas. A result of almost every survey and conversation is that the communities want more ways to engage safely in physical activity at little or no expense. Clearwater Valley Hospital and Clinics, Inc. is a part of Essentia Health, a fully integrated health system with facilities in Minnesota, Wisconsin, North Dakota and Idaho. As a non-profit organization, Essentia Health reinvests surplus revenues into medical training, programs and technology that improve patient care. Essentia Health provides services predominantly in rural communities and is committed to eliminating geographic barriers to care. We strive to provide high-quality, patient-centered care close to home for the communities we serve. We continue to upgrade facilities and technology, such as MRIs, CT scanners and surgery suites, to ensure patients in rural communities have nearby access to these services. In addition, we have recently completed several major construction projects, which include a new $50 million wing for our Fargo hospital and several rural community clinics. Essentia Health was one of the first Accountable Care Organizations in the country to receive the highest level of accreditation from the National Committee for Quality Assurance (NCQA). As an ACO, Essentia Health is committed to meeting the Triple Aim of improving care and population health, while reducing the overall costs for patients and society as a whole. The formation of our ACO, along with ongoing management and process improvement, represents a significant investment for Essentia Health. Since a majority of healthcare costs are directly related to caring for patients who have chronic conditions, Essentia Health has developed medical homes, which are designed to improve health outcomes for patients, especially those with chronic diseases. Much of this work is not fully reimbursed by state or federal programs. Essentia Health supports the health of our communities through active research and clinical trials through the Essentia Institute of Rural Health. The Institute conducts clinical, translational and health services research with a primary focus on the needs of rural Americans. Various Essentia Health organizations contributed approximately $4.25 million in support to the Institute during the past year.
PART VI, LINE 6	If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served: Clearwater Valley Hospital and Clinics, Inc. is part of Essentia Health, an integrated health system with 16 hospitals, 68 clinics, eight long-term care facilities, two assisted living facilities, five independent living facilities, five ambulance services and one research institute in four states: Minnesota, Wisconsin, North Dakota and Idaho. The health system serves a predominantly rural population whose median incomes generally fall below averages of the states where they live. The presence of our clinics and hospitals ensures that people with few economic resources dont have to drive an hour or more to receive basic (and in some cases life-saving) medical care. In addition to staffing hospitals and clinics in federally recognized underserved areas, we support the health of our communities through an active outreach program that brings specialists like oncologists, cardiologists, neurologists and others into our smaller communities. This eliminates barriers to care for many patients, particularly those who are elderly, living on low incomes, or faced with other challenges that make it difficult to travel long distances for care. Our size and integrated structure allow us to offer patients services often found only in larger urban settings. Services ranging from chemotherapy to congestive heart failure management and hospice are available to patients in many of the rural communities we serve. Essentia Health also supports the health of our rural communities through active research and clinical trials by the Essentia Institute of Rural Health. The Institute conducts clinical, translational and health services research with a primary focus on the needs of rural Americans. Essentia Health is also serving patients through the use of our electronic health record (EHR). The vast majority of Essentias hospitals and clinics are using a fully-integrated EHR for patient care. Technology like the electronic health record and Essentias telehealth program allows health clinicians to share test results and consult with colleagues in real time across great distances. Medical information is no longer lost in the shuffle of paper records an important consideration in a region where patients must often be transferred to a larger Essentia facility for complex surgeries or medical care. Essentia is also actively working with government agencies and insurers to develop innovative and cost-effective approaches to care that will improve health outcomes while reducing overall costs to patients and insurers. This innovation can be found in our use of remote home monitors for patients with congestive heart failure and our focus on using a team-based approach to helping patients manage chronic diseases. Essentia Health is committed to helping patients and their families lead active and fulfilling lives in the small and large communities where they live. We hope to become a model of healthcare delivery, particularly in rural areas, in the years to come.
PART VI, LINE 7	If applicable, identify all states with which the organization, or a related organization, files a community benefit report: Clearwater Valley Hospital and Clinics, Inc. files a community benefit report in Idaho.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
Essentia Health Foundation
502 E 2nd St	Duluth	MN	55805	271984704	501(c)(3)	$15,848	Program Support
St Mary's Hospital Inc
701 Lewiston	Cottonwood	ID	83522	820226453	501(c)(3)	$8,696	Program support

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule I, Part I, Line 2	FormAndLineReferenceDesc
Explanation	PROCEDURES FOR MONITORING USE OF GRANT FUNDS: CLEARWaTER VALLEY HOSPITAL AND CLINICS, INC.'s MANAGEMENT REVIEWS THE GRANT ACTIVITY BY REVIEWING AND DOCUMENTING EACH EXPENDITURE REQUEST AND APPROVING THE EXPENSE.	ExplanationTxt

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
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Lenne Bonner
CAO & CFO Thru 9/14	$163,474	$0	$26,425	$0	$0	$0	$7,947	$0	$18,331	$0	$216,177	$0	$0	$0
Clayton Bunt MD
Physician	$172,700	$0	$24,208	$0	$0	$0	$7,984	$0	$11,979	$0	$216,871	$0	$0	$0
Kelly McGrath MD
Board Director	$216,428	$0	$8,728	$0	$0	$0	$8,351	$0	$12,123	$0	$245,630	$0	$0	$0
Alvin SECREST III MD
Board Director	$0	$263,952	$0	$7,099	$0	$0	$0	$10,353	$0	$21,826	$0	$303,230	$0	$0
PHILLIP PETERSEN MD
PHYSICIAN	$169,670	$0	$10,823	$0	$0	$0	$7,308	$0	$12,248	$0	$200,049	$0	$0	$0
KIMBERLY CAMPBELL MD
PHYSICIAN	$152,523	$0	$34,798	$0	$0	$0	$8,029	$0	$22,348	$0	$217,698	$0	$0	$0
PATRICK BRANCO
PRESIDENT	$263,929	$0	$76,280	$0	$0	$0	$44,260	$0	$8,962	$0	$393,431	$0	$0	$0
JOSHUA MORRIS MD
PHYSICIAN	$180,129	$0	$63,535	$0	$0	$0	$9,502	$0	$11,852	$0	$265,018	$0	$0	$0
Cay Berg
Physician	$184,082	$0	$30	$0	$0	$0	$1,236	$0	$8,175	$0	$193,523	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule J, Part I, Line 4b	FormAndLineReferenceDesc
Explanation	Supplemental nonqualified retirement plan: Essentia Healths nonqualified retirement plan is offered to designated Essentia Health executives. There is a minimum two year vesting date, or vesting is automatic upon reaching retirement age, death, disability or involuntary termination without cause. Benefits are subject to income taxes upon vesting and payable from Essentia Healths general assets. Reported as Retirement and Other Deferred Compensation in Schedule J, Part II, Column C, Essentia Health made contributions, subject to the vesting terms, during the year into the supplemental nonqualified retirement plan on behalf of the following individuals listed in Form 990, Part VII, Section A, Line 1a: Patrick Branco $40,891	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, Line 4	Program service accomplishments: Clearwater Valley Hospital and Clinics, Inc. is created & organized exclusively for charitable, religious, educational & scientific purposes. Clearwater Valley Hospital and Clinics, Inc. is created & organized to own, maintain, operate & conduct, directly or indirectly, & to assist & coordinate activities of facilities for health care, education, care for the aged & social services. In keeping with its mission, Clearwater Valley Hospital and Clinics, Inc. is committed to serve all members of its communities by providing free care and/or subsidized care, care for the persons covered by governmental programs at below cost, & providing health activities & programs to support the community. During fiscal year 2015, Clearwater Valley Hospital and Clinics, Inc. had 663 admissions involving 2,124 hospital patient days and 38,799 outpatient visits in the hospital, emergency room, & clinics. Charity care is provided through many reduced price services & free programs offered throughout the year based upon activities & services which Clearwater Valley Hospital and Clinics, Inc. believes will serve a bona fide need. These include health fairs, immunizations clinics, health education classes, rural education training, & wellness programs. Clearwater Valley Hospital and Clinics, Inc. provided approximately $462,000 in charity care as well as an additional $649,000 of costs incurred in excess of Medicaid payments received during the fiscal year ended June 30, 2015. Further community benefits provided during the fiscal year include education and workforce development of over $8,000, community services of over $55,000, and cash & in-kind donations of over $6,400.
Form 990, Part V, Line 1c	NO GAMING (GAMBLING) WINNINGS
Form 990, Part VI, Line 6	MEMBERS OF ORGANIZATION: CRITICAL ACCESS GROUP IS THE SOLE MEMBER OF CLEARWATER VALLEY HOSPITAL AND CLINICS, INC. AND MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O PART VI LINE 7A. MEMBER, ESSENTIA HEALTH, HAS RESERVED POWERS WITH RESPECT TO CLEARWATER VALLEY HOSPITAL AND CLINICS, INC. AS DESCRIBED IN SCHEDULE O PART VI LINE 7B.
Form 990, Part VI, Line 7a	MEMBER WITH RIGHT TO ELECT GOVERNING BODY: CRITICAL ACCESS GROUP APPOINTS AND REMOVES CLEARWATER VALLEY HOSPITAL AND CLINICS, INC.'S GOVERNING BODY.
Form 990, Part VI, Line 7b	GOVERNANCE, MANAGEMENT, AND DISCLOSURE: CLEARWATER VALLEY HOSPITAL AND CLINICS, INC. IS A SUBSIDIARY OF ESSENTIA HEALTH, WHOSE BOARD OF DIRECTORS HAS RESERVED POWERS WITH RESPECT TO THIS CORPORATION AND ITS SUBSIDIARIES, AND ALL OF THE OTHER DIRECT AND INDIRECT SUBSIDIARIES OF ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"). ESSENTIA HEALTH'S RESERVED POWERS ARE AS FOLLOWS: STRATEGIC AND BUSINESS PLANS. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S STRATEGIC AND BUSINESS PLANS. MISSION. AUTHORITY TO CREATE, AND TO APPROVE, THE MISSION, PURPOSE AND VISION STATEMENTS FOR ALL ENTITIES IN THE SYSTEM BY THE AFFIRMATIVE VOTE OF AT LEAST 67% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS. DEBT. APPROVAL OF THE INCURRENCE OF DEBT BY, AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE ASSETS OF, ALL ENTITIES IN THE SYSTEM IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS, AND THE AUTHORITY TO CAUSE ALL ENTITIES IN THE SYSTEM TO PARTICIPATE IN SYSTEM BORROWING. GOVERNING INSTRUMENTS. AUTHORITY TO CAUSE, AND TO APPROVE, AMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS OF ALL ENTITIES IN THE SYSTEM. MERGERS AND ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF ALL ENTITIES IN THE SYSTEM. AFFILIATIONS AND JOINT VENTURES. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES WITH THIRD PARTIES OF ALL ENTITIES IN THE SYSTEM. TRANSFER OF ASSETS WITHIN THE SYSTEM. AUTHORITY TO TRANSFER ASSETS, INCLUDING CASH, BETWEEN AND AMONG ENTITIES WITHIN THE SYSTEM; PROVIDED, HOWEVER, THAT ESSENTIA HEALTH SHALL NOT HAVE AUTHORITY TO REQUIRE ANY ENTITY IN THE SYSTEM TO TRANSFER ASSETS (A) THAT WOULD CAUSE SUCH ENTITY TO BE IN DEFAULT OF ITS COVENANTS OR OBLIGATIONS UNDER ANY BOND OR OTHER FINANCING DOCUMENTS; (B) FROM THE CATHOLIC ENTITIES TO THE SECULAR ENTITIES OR FROM THE SECULAR ENTITIES TO THE CATHOLIC ENTITIES IN A MANNER OR TO AN EXTENT THAT WOULD CAUSE THE CATHOLIC ENTITIES TO BE IN VIOLATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS) IN THE JUDGMENT OF THE LOCAL ORDINARY; OR (C) SUCH THAT MONEY GENERATED BY SERVICES AT SECULAR FACILITIES WITHIN THE SYSTEM BY PROCEDURES THAT ARE CONTRARY TO THE ERDS WOULD BE USED AT THE CATHOLIC ENTITIES OR MONEY GENERATED BY CATHOLIC ENTITIES WOULD BE USED IN THE PROVIDING OF SERVICES CONTRARY TO THE ERDS AT SECULAR FACILITIES WITHIN THE SYSTEM. TRANSFER OF ASSETS OUTSIDE THE SYSTEM. AUTHORITY TO CAUSE, AND TO APPROVE, THE SALE, LEASE OR OTHER TRANSFER OF ASSETS OF ALL ENTITIES IN THE SYSTEM TO PARTIES OUTSIDE OF THE SYSTEM WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS. SERVICES. AUTHORITY TO CAUSE, AND TO APPROVE, THE ADDITION OF NEW SERVICES AND SERVICE LOCATIONS AND THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS WITHIN ALL ENTITIES IN THE SYSTEM. BUDGETS. APPROVAL OF CAPITAL AND OPERATING BUDGETS OF ALL ENTITIES IN THE SYSTEM. PROFESSIONAL SERVICES. SELECTION OF THE GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS OF ALL ENTITIES IN THE SYSTEM. ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL ACQUISITIONS BY AND FORMATIONS OF ENTITIES IN THE SYSTEM. MARKETING. AUTHORITY TO IMPLEMENT SYSTEM-WIDE MARKETING AND PROMOTIONAL ACTIVITIES. COMPLIANCE PLANS. AUTHORITY TO CREATE, AND TO APPROVE, CORPORATE COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS FOR ENTITIES WITHIN THE SYSTEM. QUALITY PLAN. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S QUALITY PLAN. NON-BUDGETED PURCHASES. APPROVAL OF NON-BUDGETED CAPITAL PURCHASES AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY ESSENTIA HEALTH FOR ENTITIES WITHIN THE SYSTEM. HUMAN RESOURCES. AUTHORITY TO CREATE HUMAN RESOURCE POLICIES AND PROCEDURES WITHIN THE SYSTEM. RESERVED POWERS. AUTHORITY TO CREATE ADDITIONAL ESSENTIA HEALTH RESERVED POWERS BY THE AFFIRMATIVE VOTE OF AT LEAST 80% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS (EXCLUDING THE ESSENTIA HEALTH CEO); PROVIDED, HOWEVER, THAT ANY ADDITIONAL ESSENTIA HEALTH RESERVED POWERS SHALL NOT CONTRAVENE OR HINDER THE RESERVED POWERS OF BENEDICTINE SISTERS BENEVOLENT ASSOCIATION.
Form 990, Part VI, Line 11a	FORM 990 REVIEW PROCESS: THE 2014 FORM 990, INCLUDING ALL SCHEDULES, WAS REVIEWED BY CLEARWATER VALLEY HOSPITAL AND CLINICS, INC.'S MANAGEMENT AND GOVERNING BODY ON April 26th, 2016 PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. CLEARWATER VALLEY HOSPITAL AND CLINICS, INC.'S PRESIDENT LED THE REVIEW OF THE FORM AND SCHEDULES AND ANY QUESTIONS WERE DISCUSSED. EACH CURRENT DIRECTOR OF THE GOVERNING BODY RECEIVED A FINAL COPY OF THE 2014 FORM 990.
Form 990, Part VI, Line 12c	Monitoring and enforcing Conflict of Interest policy: Essentia Health's comprehensive conflict of interest program prevents, detects and resolves actual conflicts of interests or the actual or potential appearance of such. Fiduciaries, defined as an Essentia Health board member/trustee, officer, board committee member, senior management employee, or any others considered to be in a position of influence, are covered under Essentia's conflict of interest program. Upon initial appointment, each fiduciary must complete an initial conflict of interest statement and disclosure questionnaire. At the conclusion of each fiscal year, each fiduciary must complete an annual conflict of interest statement and disclosure questionnaire. As needed, a fiduciary will update his/her most recently completed questionnaire each time the fiduciary becomes aware of a financial interest, a potential conflict, or change to any information that the fiduciary previously reported. Essentia Health's Chief Compliance Officer will collect the questionnaires and evaluate the disclosures. If a fiduciary has a potential conflict of interest, the Chief Compliance Officer or designee may request additional information from the fiduciary, the management team, and others. During the evaluation process, the Chief Compliance Officer may also consult with Essentia Health's Board and Audit Committee Chairs, senior management, legal department, or appropriate representatives from Essentia Health. The Chief Compliance Officer reports to the Essentia Health Audit Committee and the Essentia Health Board of Directors any actual or potential conflicts of interest disclosed by the fiduciary, along with recommended actions. The Essentia Health Board of Directors (or designee) will then determine whether to approve the situation or to implement special controls to manage the potential conflict of interest. The Chief Compliance Officer will then officially notify the fiduciary in writing of the board's decision. The decision of whether or not the disclosure constitutes a conflict will be at the Essentia Health Board of Director's (or designee) sole discretion, and its concern must be the welfare of Essentia Health and its affiliate(s) and the advancement of its purposes. When the Essentia Health Board of Directors (or designee) considers a Fiduciary's disclosure as a Conflict of Interest, special controls will be identified to manage, eliminate or reduce the likelihood and/or appearance of a conflict arising. Controls may include, but are not limited to: A. If the conflict involves an on-going matter or relationship, the Fiduciary must not participate in Board, Board committee or management discussions related to the conflict and must recuse themselves and if appropriate, withdraw, from any Board meeting or portion thereof where the matter is being discussed and during the vote on the potential Conflict of Interest. The Fiduciary may answer questions at the Board's or the Board Committee's request. B. If the conflict involves a specific transaction or decision, the Fiduciary will fully disclose their interest and all related material facts. The Board or committee of the Board will determine whether the contemplated transaction may be authorized as just, fair, and reasonable to Essentia Health or its affiliate(s). If the Board determines a conflict does not exist, the Fiduciary may proceed with the transaction; however, he or she will not be eligible to vote on related issues should they arise. If the Board determines a conflict does exist, the Fiduciary will be notified of the decision regarding whether the contemplated transaction will be authorized as just, fair, and reasonable.
Form 990, Part VI, Line 15 a & b	PROCESS FOR DETERMINING COMPENSATION: The Essentia Health Clearwater Valley Hospital - St. Mary's Hospital Executive Compensation Committee of the board of directors is authorized to fulfill the board's responsibilities regarding executive compensation consistent with Essentia's mission, values and tax-exempt status, and the Executive Compensation Committee's Charter. The Executive Compensation Committee meets annually to carry out its responsibilities, which include, but are not limited to, establishing, reviewing and modifying, as appropriate, reasonable compensation and benefits for designated Essentia executives who are officers or key employees of Essentia or any of its affiliates which may be paid by related organizations. The Executive Compensation Committee engages qualified independent compensation advisors to provide objective and impartial comparative data and to express opinions on total compensation reasonableness. The Executive Compensation Committee may request its independent advisors to: monitor comparability data and marketplace trends; make appropriate recommendations regarding salary ranges; and periodically review the market competitiveness of Essentia executive compensation packages. Prior to establishing or adjusting executive compensation, the Executive Compensation Committee will obtain and rely upon appropriate data as to comparability of the proposed compensation or adjustments. The Executive Compensation Committee will adequately document the basis for its determination concurrently with making those determinations. The Executive Compensation Committee minutes will include: the terms of the approved compensation and the date approved; the Executive Compensation Committee members present during the review, discussion and approval of the proposed compensation and those who voted on the proposed compensation; identification of the comparability data obtained and relied upon by the Executive Compensation Committee and how the data was obtained; any actions by a member of the Executive Compensation Committee having a conflict of interest; and documentation of the basis for the determination. The year this process was last undertaken for Clearwater Valley Hospital and Clinics, Inc.'s President and Chief Administrative Officer/Chief Financial Officer thru 9/14 was 2014. Clearwater Valley Hospital and Clinics, Inc.'s Chief Financial Officer, starting 9/14, had her compensation subsequently reviewed after June 30, 2015.
Form 990, Part VI, Line 19	Availability of governing documents, conflict of interest policy, & financial statements to the public: Governing documents, conflict of interest policy, and financial statements are made available to the public upon request. The organization is part of Essentia Health's consolidated financial statements which are included in Essentia Health's annual report posted on Essentia Health's web site.
Form 990, Part XII, Line 3	Consolidated A-133: Clearwater Valley Hospital and Clinics, Inc., as part of Essentia Health's consolidated financial statements, was required and underwent a consolidated audit set forth in the Single Audit Act and OMB Circular A-133. The consolidated audit is reviewed by the Essentia Health Audit Committee.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
Brainerd Lakes Integrated Health System
2024 S 6th St	Brainerd	MN	56401	371532145	SUPPORT ORG	MN	501(c)(3)	11 Type II	ESSENTIA	Yes (true)
Brainerd Medical Center Inc
2024 S 6th St	Brainerd	MN	56401	371532148	Clinic	MN	501(c)(3)	3	BLIHS	Yes (true)
Bridges Medical Center
503 E 3rd St Suite 400	Duluth	MN	55805	200479568	Clinic/Hosp	MN	501(c)(3)	3	INNOVIS	Yes (true)
CRITICAL ACCESS GROUP
503 E 3rd ST Suite 400	Duluth	MN	55805	261219624	Support ORG	MN	501(c)(3)	11 Type II	Essentia	Yes (true)
St Joseph's Medical Center
523 N 3rd St	Brainerd	MN	56401	410695602	CLINIC/HOSP	MN	501(c)(3)	3	BLIHS	Yes (true)
St Mary's EMS
1027 Washington Ave	Detroit Lakes	MN	56501	411805811	Emerg SrvCS	MN	501(c)(3)	9	SMRHC	Yes (true)
St Mary's Hospital Inc
PO Box 137	Cottonwood	ID	83522	820226453	Clinic/Hosp	ID	501(c)(3)	3	CAG	Yes (true)
St Mary's Innovis Health
1027 Washington Ave	Detroit Lakes	MN	56501	262861321	Pharmacy	MN	501(c)(3)	3	INNOVIS	Yes (true)
St Mary's Regional Health Center
1027 Washington Ave	Detroit Lakes	MN	56501	411620386	Clinic/Hosp	MN	501(c)(3)	3	INNOVIS	Yes (true)
Essentia Health
502 E 2nd St	Duluth	MN	55805	200360007	Support ORG	MN	501(c)(3)	11TypeIIIFI	NA	false
Innovis Health LLC
3000 32nd Ave S	Fargo	ND	58103	261175213	Clinic/Hosp	DE	501(c)(3)	3	Essentia	Yes (true)
Midwest Medical Equip & Supplies Inc
4418 Haines Rd	Duluth	MN	55811	411674021	Medical Equip	MN	501(c)(3)	9	SMMC	Yes (true)
SMDC Medical Center
502 E 2nd St	Duluth	MN	55805	411878730	Clinic/Hosp	MN	501(c)(3)	3	SMDCHS	Yes (true)
Pine Medical Center
109 Court Ave S	Sandstone	MN	55072	411884597	HOSPITAL/NURS	MN	501(c)(3)	3	SMDCHS	Yes (true)
Polinsky Medical Rehabilitation Center
530 E 2nd St	Duluth	MN	55805	410691275	Rehab Service	MN	501(c)(3)	3	SMMC	Yes (true)
St Mary's Duluth Clinic Health System
407 E 3rd St	Duluth	MN	55805	411836633	SUPPORT ORG	MN	501(c)(3)	11 Type II	Essentia	Yes (true)
St Mary's Hospital of Superior
3500 Tower Ave	Superior	WI	54880	411811073	Clinic/Hosp	MN	501(c)(3)	3	SMMC	Yes (true)
St Mary's Medical Center
407 E 3rd St	Duluth	MN	55805	410695604	HOSPITAL	MN	501(c)(3)	3	SMDCHS	Yes (true)
The Duluth Clinic Ltd
400 E 3rd St	Duluth	MN	55805	410883623	Clinic	MN	501(c)(3)	3	SMDCHS	Yes (true)
First Care Medical Services
900 Hilligoss Blvd SE	Fosston	MN	56542	410706143	Clinic/Hosp	MN	501(c)(3)	3	INNOVIS	Yes (true)
Minnesota Valley Health Center
621 S 4th St	Le Sueur	MN	56058	410837659	Hospital/NURS	MN	501(c)(3)	3	CAG	Yes (true)
Essentia Institute of Rural Health
502 E 2nd St	Duluth	MN	55805	271291124	Research	MN	501(c)(3)	4	DC	Yes (true)
ESSENTIA Health Foundation
502 E 2nd St	Duluth	MN	55805	271984704	Foundation	MN	501(c)(3)	7	ESSENTIA	Yes (true)
NORTHERN PINES MEDICAL CENTER
5211 HWY 110	AURORA	MN	55705	410841441	HOSPITAL/NURS	MN	501(c)(3)	3	SMDCHS	Yes (true)
GRACEVILLE HEALTH CENTER
115 W 2nd ST	GRACEVILLE	MN	56240	410726173	CLINIC/HOSP	MN	501(c)(3)	3	INNOVIS	Yes (true)
DEER RIVER HEALTHCARE CENTER INC
115 10TH AVE NE	DEER RIVER	MN	56636	410844574	Hosp/Clin/NH	MN	501(c)(3)	3	SMDCHS	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	PMC-Gateway Imaging LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	109 Court Ave S	AddressLine1Txt
City	Sandstone	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55072	ZIPCd

Field	Value	IRS element (for citing)
EIN	261634764	EIN
Primary Activities	Imaging Services	PrimaryActivitiesTxt
Legal Domicile State	MN	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	N/A	PredominantIncomeTypeTxt
Share Of Total Income	$0	ShareOfTotalIncomeAmt
Share Of EOY Assets	$0	ShareOfEOYAssetsAmt
UBI Code V	$0	UBICodeVAmt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Controlled OrganizationControlledOrganizationInd	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Legal Domicile StateLegalDomicileStateCd
Essentia Health Insurance Services SPC
PO Box 1159	Grand Cayman	CJ	000000000	Self Indemnity	CJ	NA	Foreign Corp	$0	$0	Yes (true)
East Range Clinics LTD
			410909915	Clinics		NA	C CORP	$0	$0	Yes (true)	910 6th Ave N	Virginia	MN	55792	MN

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Critical Access Group
M	$434,244	Actual Costs
Essentia Health
P	$374,354	Actual Costs
Essentia Health Foundation
C	$415,037	Actual Costs
St Mary's Hospital Inc
C	$69,473	Actual Costs
St Mary's Hospital Inc
O	$2,972,185	ACTUAL COSTS
St Mary's Hospital Inc
P	$1,672,353	ACTUAL COSTS
St Mary's Hospital Inc
Q	$1,095,022	ACTUAL COSTS

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule R, Part II, Column (a)	FormAndLineReferenceDesc
Explanation	Name: The following Essentia Health entities have a doing business as name: Legal Name; Doing Business As Name: Brainerd Lakes Integrated Health System; Essentia Health Central Brainerd Medical Center, Inc.; Essentia Health Brainerd Specialty Clinic Bridges Medical Center; Essentia Health Ada Deer River Healthcare Center, Inc. Essentia Health Deer River First Care Medical Services; Essentia Health Fosston Graceville Health Center; Essentia Health Holy Trinity Hospital Innovis Health, LLC; Essentia Health West Midwest Medical Equipment and Supplies, Inc.; Essentia Health Medical Equipment & Supplies Northern Pines Medical Center; Essentia Health Northern Pines Pine Medical Center; Essentia Health Sandstone Polinsky Medical Rehabilitation Center; Essentia Health Polinsky Medical Rehabilitation Center SMDC Medical Center; Essentia Health Duluth St. Joseph's Medical Center; Essentia Health St. Joseph's Medical Center St. Mary's Duluth Clinic Health System; Essentia Health East St. Mary's EMS; Essentia Health St. Mary's Emergency Medical Services-Detroit Lakes St. Mary's Hospital of Superior; Essentia Health St. Mary's Hospital-Superior St. Mary's Medical Center; Essentia Health St. Mary's Medical Center St. Mary's Regional Health Center; Essentia Health St. Mary's-Detroit Lakes	ExplanationTxt