2025-11-03T12:22:05-06:00 2024-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2024-01-01 946050274 Barton Healthcare System BART 5305413420 PO Box 9578 South Lake Tahoe CA 96158 Kelly Neiger CFO 5305413420 2025-11-03 1 1 Kim Hunwardsen CPA P00484560 6122536500 2025-11-03 2024 2025-03-06 01:10:19Z Clinton Purvance MD PO Box 9578 South Lake Tahoe CA 96158 304539296 0 X www.bartonhealth.org X 1960 CA Barton Health delivers safe, high quality care and engages the community in the improvement of health and wellness. Barton Health is the community health leader known for compassion and chosen for quality. 0 9 1097 100 0 0 730088 813069 233929161 257169695 2611547 7201894 377657 36330 237648453 265220988 532581 683953 0 0 115376212 116653720 0 0 0 108789125 108286830 224697918 225624503 12950535 39596485 360085089 365821141 58720747 43071389 301364342 322749752 X Barton Health delivers safe, high quality care and engages the community in the improvement of health and wellness. Barton Health is the community health leader known for compassion and chosen for quality. 0 0 156826336 683953 249643127 Barton Healthcare System (Barton Health) has been serving Lake Tahoe's health care needs for over 60 years. Barton Health is a nonprofit community health system that includes Barton Memorial Hospital, consisting of 24-hour emergency care services, 63 patient beds, a skilled nursing facility with 48 resident beds, and over 20 ambulatory outpatient clinics. Barton Health is a bi-state health system serving the greater Lake Tahoe region in California and Nevada. Barton Health has approximately 245 credentialed physicians and a team of nearly 1,000 employees providing quality health care services to residents and visitors. Barton Health provides exceptional care, regardless of an individual's ability to pay. 7066066 6966666 The Barton Community Health Center provides primary care to Medicare and Medi-Cal beneficiaries, those with insurance but with very high deductibles, or those who are uninsured. Same day appointments were available, which improved medical outcomes. The Barton Community Health Center combined the efforts of skilled professionals including nurse practitioners, physician assistants, medical assistants, nurses and other medical support staff, and contracted with family and specialty physicians. Patients were seen at this clinic by physicians who specialized in the following areas: family medicine, pediatrics, ADHD treatment, orthopedics and spine care, cardiology, neurology, obstetrics, gynecology, infectious disease (hepatitis C), and a medication-assisted treatment (MAT) program. 7784810 The Financial Assistance Program assists patients of Barton Memorial with their medical bills. It matches the patients' ability to pay according to their unique circumstance. Patients are asked to complete an application and provide financial information about their income to determine their ability to pay. The discount patients receive on their medical bill depends on their adjusted gross income compared with the U.S. Department of Health & Human Services poverty income guidelines. The program is designed for those patients who cannot afford their medical bills. Barton Health provides discounts for those with incomes up to 400 percent of the most recent poverty income guidelines, and/or under special circumstances. During the current year this program provided over $7.7 million of gross charges in charity care. The following programs are community outreach programs that benefit the health of Barton Health Lake Tahoe South Shore Community.Food Insecurity Program: In partnership with Whole Foods and Starbucks Barton picked up and distributed high quality perishable and non-perishable food up to four days a week to our community partners as well as directly to our most vulnerable community members throughout the first half of 2024. In the second half of 2024, we transferred the Starbucks food donation to The Tahoe Coalition for the Homeless and the Whole Foods food donation to the food pantry, Christmas Cheer all Year. Staff also served on the Board of Directors for this pantry that provides food and basic needs to South Lake Tahoe's most vulnerable. Community Health Fair: Barton hosted a successful community health fair at Bijou Elementary School on October 17, 2024. Approximately 220 community members attended and received medical services and education, including blood pressure checks, CPR training, and Covered CA enrollment support, along with community-provided services including flu vaccines. Community Health Improvement Efforts: Barton partnered with ACCEL El Dorado County, a community-wide collaborative of public and private partners working together to improve the health and well-being of El Dorado County's vulnerable populations. Barton Health hosted the Community Health Advisory Committee (CHAC), a collaborative of representatives of various community agencies and community members that meet monthly to address emerging community health needs. Staff members also participated in the Community Behavioral Health Network meetings, community drug education meetings, and the Lake Tahoe Collaborative meetings. Barton staff met with community members at the South Tahoe Family Resource Center to better understand the real and perceived barriers that Latino community members face in receiving care. Staff served on the Board of Directors-of Encompass Youth, working to coordinate collaboration and communication to assure that Transitional Age Youth have the navigational support systems to create a path to stability and independence.Social Determinants of Health: Barton participated in the following community-based programs related to environmental factors that influence our community members' health and wellness.TRANSPORTATION: Barton staff served on the board of the South Shore Transit Management Association, which was a driving force in creating the first ever Microtransit program (LakeLink) that delivered free rides to over 175,000 community members in 2024. BUILT ENVIRONMENT: Hospital staff participated in the Tahoe Chamber of Commerce to address community health and safety issues.SUBSTANCE USE: Staff members participated in community efforts to address substance abuse prevention and education, including the Tahoe Alliance for Safe Kids (TASK) whose mission is to prevent and reduce youth substance use and related harm, and El Dorado Coalition for Overdose Prevention and Education (COPE), whose mission is to build collaboratives to address the overdose epidemic in El Dorado County. A staff member served on the board of Mountain High Recovery Center, a non-profit organization with a mission to strengthen individuals, families, and communities through the education and treatment of substance use disorders.HEALTHCARE DISPARITY: Barton participated in monthly and/or quarterly town hall meetings with a leading Latino/Latina community advocate, The South Tahoe Family Resource Center to educate and inform on important topics of interest related to a myriad of social determinants of health.We have continued our collaboration with The Tahoe Coalition for the Homeless to expedite appropriate care and decrease emergency department visits for those they serve. We also provided staff to assist with the annual Point in Time count and understanding community needs with ride-along activities. 171677212 1 1 0 1 0 0 0 1 0 1 1 0 1 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 222 0 1 1097 1 0 0 0 0 0 0 0 0 0 0 0 0 X 0 9 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 1 1 CA X Kelly Neiger 5305413420 PO Box 9578 South Lake Tahoe CA 96158 Jonathon Cefalu Trustee (As of 5/24) 5.00 1.00 X 0 0 0 Peter DiGrande MD Trustee (As of 5/24) 5.00 1.00 X 0 0 0 Abby Killebrew Chair 5.00 1.00 X X 0 0 0 Patrick Fry Vice Chair 5.00 1.00 X X 0 0 0 Stefan Schunk MD Trustee 5.00 1.00 X 0 0 0 Shawn Anderson Trustee 5.00 1.00 X 0 0 0 Kathryn Biasotti Trustee 5.00 1.00 X 0 0 0 Kirk Ledbetter Trustee 5.00 1.00 X 0 0 0 Sherry Mlynsky Sectretary/Treasurer 5.00 1.00 X 0 0 0 Jeff Rahbeck Trustee 5.00 1.00 X 0 0 0 Scott Weavil Trustee 5.00 1.00 X 0 0 0 Wendy David Trustee (Until 5/24) 5.00 1.00 X 0 0 0 Baghdassar Pat Baghdikian MD Trustee (Until 5/24) 5.00 1.00 X 0 0 0 Clinton Purvance MD CEO 37.00 3.00 X 0 1378212 67732 Kelly Neiger CFO 37.00 3.00 X 0 546460 68061 Polly Birdsong Admin Dir of Surgical Svcs 40.00 0.00 X 260010 0 22141 David Young MD CMO 28.00 2.50 X 11539 569632 37820 Carla Adams CNO 40.00 0.00 X 414657 0 56492 Thomas Davis Director of Medical Imaging 40.00 0.00 X 215442 0 39103 Karen Conant VP of Ambulatory Operations 40.00 0.00 X 241193 0 57031 Richard Belli Admin Director of Facilities 40.00 0.00 X 253620 0 35846 Dana Randall Advanced Practice Provider 40.00 0.00 X 261034 0 14368 Jennifer Whisnant Pulmonary Services Supervisor 40.00 0.00 X 256904 0 63544 Christopher Kiser Director of Foundation 0.00 40.00 X 260756 0 54689 Jason Call Advanced Practice Provider 40.00 0.00 X 260454 0 51085 2435609 2494304 567912 326 0 1 0 BHC MSO LLC 2170 South Ave South Lake Tahoe CA 96150 Management Services 7340000 Lake Tahoe Orthopedic PO Box 11889 Zephyr Cove NV 89448 Physician Services 4604563 Coronis Health RCM LLC 5963 Exchange Dr Suite 114 Sykesville MD 21784 Collection Agency 4483963 Tahoe Orthopedics & Sports PO Box 11889 Zephyr Cove NV 89448 Physician Services 4291877 FocusOne Solutions LLC 13609 California Street Omaha NE 68154 Staff Labor Services 3571662 31 29193 703533 80343 813069 Net Patient Service Revenue 621990 246006437 246006437 Investment in Washoe Barton Medic 621110 8694390 8694390 Supporting Revenue 621990 2237074 2237074 Cafeteria 722514 559902 559902 Investment in ACO Collaborative 621110 -328108 -328108 257169695 3301948 3301948 36330 0 36330 36330 36330 42712500 505754 38910233 408075 3802267 97679 3899946 3899946 265220988 256609793 0 7798126 X 653479 653479 30474 30474 1317607 1317607 476000 465119 10881 85829773 67145847 18683926 3080721 2411417 669304 19409307 15397185 4012122 6540312 5057839 1482473 1470761 26044 1444717 94617 94617 223310 223310 31969926 21053108 10916818 362144 319 361825 7569153 4113442 3455711 6688919 669494 6019425 4761575 1735431 3026144 135027 53639 81388 618461 618461 10603283 10023399 579884 1996033 1996033 Medical Supplies 27638660 27368375 270285 Relief Expense 10523179 9668117 855062 Non-Medical Supplies 2784080 2342288 441792 Bad Debt Expense 847592 847592 110 110 225624503 171677212 53947291 0 10806536 11109726 43598778 42162603 4322297 4500074 3986096 4243463 244847152 136752673 110645424 108094479 96745952 104486358 5024525 5661052 67565928 65723384 17389553 19840002 360085089 365821141 27408629 23735983 7416218 6155224 13100000 0 10795900 13180182 58720747 43071389 X 301364342 322749752 301364342 322749752 360085089 365821141 X 39596485 1645269 -19856344 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 1 25506 25506 0 Part II-B, Line 1: A portion of annual dues paid to trade associations are allocated to lobbying activities. 122999 0 4002933 11223 238739 238739 4014156 3991842 11091 316139 316139 4002933 3969431 22411 3991842 3956933 12798 3969731 3848820 107813 176165 176165 3956633 0.00000 1.00000 0.00000 0 1 1 29045040 6948846 35993886 118843426 69072763 49770663 4908448 2570964 2337484 78368856 61955891 16412965 122999 6609537 3153055 3579481 108094479 Investment in Washoe Barton Medical Clinic 65673611 C ACO Collaborative LLC Stock 5500 C SHC Collaborative LLC Stock 44273 C 65723384 California Hospital Fee Program Receivable 13387308 Right of Use Assets 3397836 Insurance 1800576 Deposits 1254282 19840002 Due to Third Party Payors 907308 Claims Reserve 7499709 Lease Obligations 3397836 457b Plan Payable 1187798 Other Liabilities 200000 Due to/from Related Parties -12469 13180182 X 266642947 1645269 1645269 264997678 223310 223310 265220988 225401193 0 225401193 223310 223310 225624503 Part III, Line 4: Collection consists of general photographs, paintings, etc. Part V, Line 4: Barton Memorial Hospital Foundation, Inc., a related 501(c)(3) entity, holds an endowment fund in which the earnings are used to support Barton Healthcare System. Part X, Line 2: The Hospital believes that they have appropriate support for any tax positions taken affecting their annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Central America and the Caribbean 0 0 Investment 4927747 0 0 0 0 0 0 4927747 0 4927747 0 0 1 1 0 0 Schedule F, Part IV: The organization utilizes a financial advisory firm to manage its investments. International investments are part of its diversification strategy. The organization reviews its direct and indirect investments during the tax period for determining required foreign filings. The Barton Healthcare System makes direct and indirect transfers to a foreign corporation. The Barton Healthcare System would file Form 926 if the transfers met the requirements for filing. In 2024, Barton Healthcare System did not have transfers to foreign corporations. The Barton Healthcare System has ownership interests in a foreign corporation. The Barton Healthcare System would file Form 5471 if the ownership met the requirements for filing. The Barton Healthcare System's ownership in foreign corporations did not require filing Form 5471. The Barton Healthcare System invests in a corporation that holds direct or indirect interests in passive foreign investment companies (PFICs). The Barton Healthcare System would file Form 8621s for underlying investments that generate unrelated business income. The Barton Healthcare System would not file Form 8621s where the investment partnerships have properly filed Form 8621s, or where the underlying investments did not generate any unrelated business income. The Barton Healthcare System did not require filing Form 8621. 1 1 X 1 X 249.000000000000 1 X 1 1 0 1 1 1998602 1998602 0.00890 36107073 35043923 1063150 0.00470 2170431 1505439 664992 0.00300 40276106 36549362 3726744 0.01660 2036483 97925 1938558 0.00860 532682 83595 449087 0.00200 6697209 5086240 1610969 0.00720 295860 295860 0.00130 9562234 5267760 4294474 0.01910 49838340 41817122 8021218 0.03570 3000 3000 0.00000 78485 44460 34025 0.00020 328108 328108 0.00150 409593 44460 365133 0.00170 1 40567163 4369153 23101266 34960018 -11858752 X 1 1 1 1 Barton Memorial Hospital 2170 South Avenue South Lake Tahoe CA 96150 www.bartonhealth.org 030000013 X X X Barton Memorial Hospital 1 0 0 1 X X X X X X X X X 24 1 0 0 1 X See Part V, Page 8 X 1 24 1 See Part V, Page 8 0 1 X 249.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X 1 X 0 X X X X 1 X 0 0 Barton Memorial Hospital Part V, Section B, Line 5: For the CHNA, the hospital took into account input from people in the community served by Barton Health. Sixty-three (63) online Key Informant Surveys were used to gather information and opinions from people who represent the broad interests of the community. Key informants included leaders and/or representatives of medically underserved, low-income, and minority populations, local health or other departments or agencies that have current data or other information relevant to the health needs of the community. Participation included representatives of the following organizations.A Balanced Life, Barton Health, Boys & Girls Club, Catalyst Community, City of South Lake Tahoe, City of South Lake Tahoe PD, El Dorado County, El Dorado County Behavioral Health, El Dorado County Board of Supervisors, El Dorado County Health and Human Services Agency, El Dorado County Public Health, Encompass Youth, First 5 El Dorado, George Whittell High School/ Zephyr Cove Elementary School, Lake Tahoe Community College, Lake Tahoe Unified School District, Live Violence Free, Marcella Foundation, Mount Tallac, Patient and Family Advisory Council, RJ Counseling, Sierra Child and Family Services, SOS Outreach, South Lake Tahoe Family Resource Center, South Lake Tahoe Library, South Lake Tahoe Police Department, South Tahoe Alternative Collaborative Services Outreach, South Tahoe Middle School, Tahoe Alliance for Safe Kids, Tahoe Magic, Tahoe Transportation District, and Tahoe Youth and Family Services. In addition, 400 individuals, ages 18 and older, participated in telephone interviews in El Dorado and Douglas Counties to engage community residents in the Needs Assessment process. Barton Memorial Hospital Part V, Section B, Line 11: In the most recent CHNA, the following significant health needs were identified: 1) Access to care 2) Cancer 3) Heart disease and stroke 4) Infant health and family planning 5) Mental health 6) Nutrition, physical activity and weight 7) Respiratory disease 8) Substance use 9) Tobacco useBarton Health cannot directly address all the health needs present in the community; however, the Implementation Strategy will address the significant health needs identified in the CHNA. Barton Health will endeavor to address any emerging, prevalent or unanticipated issues that may threaten the health and wellbeing of the community. In 2024, Barton Health engaged in activities and programs that addressed the priority health needs identified in the 2022-2024 Implementation Strategy. Barton Health committed to community benefit efforts that addressed: Access to health care services Mental health Substance use Access to Health Care Services 1. Goal: Increase the number of patients assigned to Barton primary care providers by 300 by 12/31/24. Result: The 2023 baseline number of patients with an assigned primary care provider was 18,204. The number increased by 916 to 19,120 by the end of 2024. 2. Goal: Implement two new initiatives by 12/31/2024 that will improve average lead time. Result: Implemented an Open Access Taskforce for Barton Community Health Clinic and a Recall List for Barton Primary Care offices. Implemented provider template changes that allowed for an increased number of preventive care and annual wellness visits by 5% over baseline.Expanded Access to CareBarton welcomed the following providers in 2024, expanding service lines and access to care: one anesthesiologist, one cardiologist, one general surgeon, one family medicine provider, one pediatrician, two critical care providers, two emergency medicine providers, two nurse practitioners, and four physician assistants. Barton Community Health Center The Barton Community Health Center provided primary care to Medicare and Medi-Cal beneficiaries, those with insurance but with very high deductibles, or those who are uninsured. Same day appointments were available, which improved medical outcomes. The Barton Community Health Center combined the efforts of skilled professionals including nurse practitioners, physician assistants, medical assistants, nurses and other medical support staff, and contracted with family and specialty physicians. Patients were seen at this clinic by physicians who specialized in the following areas: family medicine, pediatrics, ADHD treatment, orthopedics and spine care, cardiology, neurology, obstetrics, gynecology, infectious disease (hepatitis C), and a medication-assisted treatment (MAT) program. Community Health FairBarton hosted a successful community health fair at Bijou Elementary School on October 17, 2024. Approximately 220 community members attended and received medical services and education, including blood pressure checks, CPR training, and Covered CA enrollment support, along with community-provided services including flu vaccines.Health EducationIn 2024, Barton hosted 12 wellness webinars by medical experts with topics on substance use disorder, ACL repair, postpartum depression and more.Cardiac Life SupportIn 2024, 7 participants completed Advanced Cardiac Life Support, 44 participants completed Basic Life Support, and 3 participants completed Pediatric Advanced Life Support.Patient-Centered Medical HomeBarton's Population Health team oversees the Patient-Centered Medical Home (PCMH), which is a care delivery model where patient treatments are coordinated through a primary care physician to ensure patients receive the necessary care when and where they need it, in a manner they can understand. This team aims to support the provider-patient relationship by aligning physician practices around system-wide quality, efficiency, and service goals, that will engage providers and patients in improving health and wellness. Below is a summary of our 2024 achievements: *Accepted into the Equity Practice Transformation (EPT) program worth $450,000 over three years. *Achieved an 18% increase in Care Management charges. *Increased Chronic Care Management patient enrollment by 10%. *Supported Waiver Incentive Program (WIP) that produced, among participating providers, a 10% increase in depression screening, 9% improvement in schedule utilization, and 5% improvement in controlling high blood pressure. *Improved quality measures: o Blood pressure control by 4% o Diabetic control by 2% o Depression screening and follow-up by 5% *Provided 280 employee blood pressure check visits for monitoring, education, and follow-up. *Achieved PCMH Recognition Renewal in two Primary Care offices. *Implemented Remote Patient Monitoring (RPM) for hypertension management and resulting in an average decrease in systolic blood pressure of -29.2.Care ManagementThe Barton Care Management Program supported patients transitioning from the hospital to home and managing chronic or persistent medical conditions including diabetes, hypertension or depression. The Care Management RNs partner with patients to develop goals, improve communication with providers, and connect patients with community resources. They worked to support the plan of care, encourage healthy eating, exercise and mental health habits, aid in medication management, educate on disease management, and encourage timely follow up. In 2024, 720 unique patients were engaged in our care management program focusing on the programmatic areas of chronic care management, general care management, and transitional care management.Diabetes and Nutrition CounselingCommunity-based educational programs were offered throughout the year. An annual Community Health Fair reached our most vulnerable community members. For 2024, nutritional counseling was provided to 99 patients with a diagnosis of diabetes mellitus, 10 patients diagnosed with gestational diabetes, and 21 patients with a pre-diabetes diagnosis, 6 pediatric patients with an elevated glucose, and 1 pediatric patient with acanthosis nigricans. Helping Hands Program Financial AssistanceThe Helping Hands program is designed for patients who cannot afford to pay their medical bills. During 2024, the program provided over $7.7 million in free or reduced rates for eligible low-income, uninsured or underinsured patients.Health Care Insurance Enrollment Assistance Barton's certified Covered CA enrollment counselors assisted and enrolled community members in insurance programs.Recruiting Underserved Health ProfessionalsBarton Health facilities are designated as a Health Professional Shortage Area (HPSA). The organization recruited health care providers to work in this underserved area. Barton is a member of the IHCC - Inter Hospital Coordination Council- which is sponsored by Washoe County and the Quad Counties Healthcare Coalition which is sponsored by Douglas County.Trauma Program OutreachBarton Health is designated as a Level III trauma center for El Dorado County. As a trauma center, our hospital is prepared to treat visitors and members of our community suffering from traumatic injury 24 hours a day. Services include access to trauma surgeons, orthopedic surgeons, emergency medicine physicians, trauma nurses, medical imaging, blood product and operating rooms. Our capabilities range from providing an urgent evaluation in the ED, stabilization, life-saving interventions and transferring patients to larger trauma centers when the patient requires additional resources. Our community outreach in FY24 included several educational opportunities. Barton's Trauma Team taught Stop the Bleed to the Lake Tahoe Unified School District nurses. Dr. Daniel Schocket, EMS Medical Director, coordinated a winter injury symposium, that included attendance from our EMS partners and providers from Barton. Dr. Paul Ryan offered an Ortho Primary Care Symposium at the Tahoe Blue Event Center that was open to providers in the community.Emergency Management PreparednessBarton Health is a key stakeholder and participant in several regional health care coalitions. Within these coalitions, exercises, drills, and other emergency preparedness programs were developed and refined in collaboration with representatives from El Dorado County, Douglas County, Area Fire Departments, Law Enforcement, School Districts, (Continued on Part V, Page 8) Barton Memorial Hospital Part V, Section B, Line 13b: In addition to the FPG, the Hospital considers if the patient is uninsured and/or underinsured when determining if they qualify for free care or discounted care. Form 990, Schedule H, Part V, Line 7a and 10a: https://www.bartonhealth.org/about-us/caring-for-our-community/community-health-needs-assessment/ Form 990, Schedule H, Part V, Line 11 Public Utilities and other public and private partners. The breadth of the collaboration and partnerships forged through these coalitions and other outreach efforts was made evident during actual emergencies that included the evacuation of South Lake Tahoe during the Caldor Fire, a significant snow event, which shut down the city for several days, rockslides that shut down a main thoroughfare, and a 6.0 earthquake. Case Management and Social ServicesBarton Case Management and Social Services helped coordinate care for some of our most vulnerable community members. They worked with patients struggling with substance use, depression, navigating complicated discharge planning, eating disorders, PTSD screening, APS and CPS referrals, food and housing insecurity, difficulty paying utility bills, and referrals to financial counselors. In 2024, 1,051 patients were assisted to obtain needed health and social services. Community Health MagazineOur community health magazine, Health & Life, was distributed three times a year. This eight-page health magazine featured a wide range of content on health and wellbeing. Over 54,000 copies were mailed to residents in South Lake Tahoe and Carson City.Childbirth and Lactation Education ClassesOur education department offers a Childbirth Preparation class to expecting mothers and their support partners. In FY24, we served 132 community members (66 expectant mothers and 66 support partners).Sports PhysicalsIn 2024, Barton Health physicians and staff provided free sports physicals to 400 student athletes at Douglas High School and 140 free sports physicals to student athletes at South Tahoe and Whittell High Schools.Wellness Lab DrawsIn 2024, Barton offered discounted Wellness Lab draws for community members, helping improve access to preventive health care screenings and tests. The discounted Wellness Lab Draws were available five days a week at both lab locations.Food InsecurityIn partnership with Whole Foods and Starbucks Barton picked up and distributed high quality perishable and non-perishable food up to four days a week to our community partners as well as directly to our most vulnerable community members throughout the first half of 2024. In the second half of 2024, we transferred the Starbucks food donation to The Tahoe Coalition for the Homeless and the Whole Foods food donation to the food pantry, Christmas Cheer all Year. Staff also served on the Board of Directors for this pantry that provides food and basic needs to South Lake Tahoe's most vulnerable. TransportationBarton staff served on the board of the South Shore Transit Management Association, which was a driving force in creating the first ever Microtransit program (LakeLink) that delivered free rides to over 175,000 community members in 2024. Health Care PartnershipsBarton Health's Emergency Department has a strong partnership with Renown Medical Center, the region's Level II adult and Level II pediatric trauma center. Our trauma team participated in a regional quarterly review with Renown and Tahoe Forest (Level III trauma center). CollaborationBarton partnered with ACCEL El Dorado County, a community-wide collaborative of public and private partners working together to improve the health and well-being of El Dorado County's vulnerable populations.Barton Health hosted the Community Health Advisory Committee (CHAC), a collaborative of representatives of various community agencies and community members that meet monthly to address emerging community health needs. Staff members also participated in the Community Behavioral Health Network meetings, community drug education meetings, and the Lake Tahoe Collaborative meetings. The hospital collaborated with The Tahoe Coalition for the Homeless to expedite appropriate care and decrease emergency department visits for the individuals they serve. Barton staff met with community members at the South Tahoe Family Resource Center to better understand the real and perceived barriers that Latino community members face in receiving care. Staff served on the Board of Directors-of Encompass Youth, working to coordinate collaboration and communication to assure that Transitional Age Youth have the navigational support systems to create a path to stability and independence.Mental Health 1. Goal: Increase depression screenings in primary care offices by 3% by 12/31/24.Result: The 2023 baseline number of patients receiving a depression screening was 76%. By the end of 2024, depression screenings increased by 6% to 77%.2. Goal: Recruit, hire and retain behavioral health providers to increase access to mental health services by 12/31/24.Result: A full-time nurse practitioner and two LCSWs were hired in 2024.Bereavement Camp for YouthHosted by Barton's Hospice team, Camp Sunrise is an annual bereavement camp serving children, ages 7 to 14, who have experienced the death of a loved one or another significant loss. The camp allowed children to meet others their age who experienced similar losses and participate in events involving art, music and recreation. In 2024, 20 children participated in Camp Sunrise and Barton staff contributed time to support Camp activities.Community Grief and Support ServicesIn December 2024 the Barton Hospice team hosted Light up a Life, a community remembrance event honoring loved ones who had passed. Over 150 community members participated.CollaborationStaff members participated in community efforts to address mental and behavioral health, including a monthly Behavioral Health Network meeting, composed of community leaders and health care workers in the mental health field.Substance Use1. Goal: Expand partnership with local substance use counselor to provide counseling to MAT patients via SOR III grant by 12/31/2024. Result: Partnered with substance use counselor at RJ Counseling and counseled 75 MAT Patients. More than double the number we served in 2023 (35).2. Goal: Increase the number of MAT patients by 10% by 12/31/2024.Result: The baseline number of patients in 2023 was 144. By 12/31/2024, the number increased by 17% to 169 patients.3. Goal: Organize two community involvement opportunities related to substance abuse by 12/31/24.Result: Two community presentations were offered in 2024. The first webinar was "Perspective Taking: Reducing Stigma Through Sharing", presented by David Jay, PhD and Kari Herbert, CADCII from Marshall Medical Center. The second was "Update on the Challenges in Treating Community Members Struggling with Alcohol Addiction" presented by Allison Hibbard, LMFT, Executive Director, Mountain High Recovery Center.Medication Assisted Treatment Program (MAT)Barton Medication for Addiction Treatment (MAT) Program offered treatment through the Barton Community Health Center to members of the greater Lake Tahoe community experiencing addiction to opioids and other substances. We offered medication, referrals with an addiction psychologist and peer support coaching services in support of recovery. In 2024, we had 43 medical providers who prescribed Buprenorphine and treated 169 patients in this program. The team also helped distribute 888 Narcan Units in 2024.CollaborationStaff members participated in community efforts to address substance abuse prevention and education, including the Tahoe Alliance for Safe Kids (TASK) whose mission is to prevent and reduce youth substance use and related harm, and El Dorado Coalition for Overdose Prevention and Education (COPE), whose mission is to build collaboratives to address the overdose epidemic in El Dorado County. A staff member served on the board of Mountain High Recovery Center, a non-profit organization with a mission to strengthen individuals, families, and communities through the education and treatment of substance use disorders.Drug Store Project CollaborationA community prevention program designed to educate middle-school youth about the dangers of substance misuse. The 21st Annual Drug Store Project educated 372 6th graders from South Tahoe Middle School, George Whittell High School, and community home-schooled youth. With the help of local agencies and Barton staff, several vignettes were shown to the participants to educate them on the complex nature of substance abuse. Drug Take Back Day On October 26, 2024, Tahoe Alliance for Safe Kids (TASK) and the South Lake Tahoe Police Department hosted a DEA Drug Take Back Day, collecting over 50 pounds of medication from the community. Lock bags, NARCAN, and fentanyl testing strips were distributed, and education was provided on medication safety, disposal and lifesaving methods. Form 990, Schedule H, Part V, Line 16a, FAP Website: https://www.bartonhealth.org/patients-family/billing-financial-services/financial-aid/ Form 990, Schedule H, Part V, Line 16b, FAP Application Website: https://www.bartonhealth.org/patients-family/billing-financial-services/financial-aid/ Form 990, Schedule H, Part V, Line 16c, FAP Plain Language Summary: https://www.bartonhealth.org/patients-family/billing-financial-services/financial-aid/ 20 1 - Barton Center of Orthopedics & Wellness 2170 B South Avenue South Lake Tahoe CA 96150 Orthopedics/Rehab/Performance/Rheumatology 2 - Lake Tahoe Surgery Center 212 Elks Point Road Ste 201 Zephyr Cove NV 89448 Ambulatory Surgery Center 3 - Barton Community Health Center 2201 2209 South Avenue South Lake Tahoe CA 96150 Rural Health Clinic, Primary Care, Pediatrics & Specialty Care 4 - Tahoe Orthopedic & Sports Medicine 935 Mica Drive Bldg C Ste 13 14 Carson City NV 89705 Orthopedic Clinic/OT/Hand Therapy 5 - Barton Obstetrics and Gynecology Clinic 1139 Third Street South Lake Tahoe CA 96150 Telehealth Oncology/Obtetrics/Gynecology 6 - Barton Urgent Care 155 Highway 50 Stateline NV 89449 Urgent Care/Primary Care Clinic 7 - Tahoe Orthopedic & Sports Medicine 165 Highway 50 Stateline NV 89449 Orthopedics 8 - Barton Home HealthHospiceAdvanced Care 2092 Lake Tahoe Blvd Suite 500 South Lake Tahoe CA 96150 Home Health/Hospice Services/Advanced Care 9 - Barton Primary Care at Fourth Street 1108 4th Street South Lake Tahoe CA 96150 Primary Care Clinic 10 - Barton Speciality Clinics 2175 South Avenue South Lake Tahoe CA 96150 General Surgery/Plastic Surgery/Gastroenterology 11 - Barton Ear Nose & Throat 2169 South Ave South Lake Tahoe CA 96150 ENT/Audiology Clinic 12 - Psychiatry & Mental Health 1067 Fourth Street South Lake Tahoe CA 96151 Psychiatry & Mental Health 13 - Barton Urology 2169 South Ave South Lake Tahoe CA 96150 Urology Clinic 14 - Barton Obstetrics & Gynecology 897 Ironwood Dr Minden NV 89423 Obstetrics/Gynecology 15 - Barton Quick Care 2074 Lake Tahoe Blvd Ste 4 South Lake Tahoe CA 96151 Walk-In Quick Care Clinic 16 - Barton Cardiology & Occupational Medicine 155 Highway 50 Ste 203 Stateline NV 89449 Cardiology/Occupational Medicine 17 - Tahoe Orthopedic & Sports Medicine 925 Tahoe Blvd Units 105-106 Incline Village NV 89451 Orthopedic Clinic 18 - Barton Medical Clinic at Kirkwood Mtn 1501 Kirkwood Meadows Drive Kirkwood CA 95646 Seasonal Medical Ski Clinic 19 - Barton Neurology & Concierge Medicine 155 Highway 50 Ste 102 Stateline NV 89450 Neurology Clinic 20 - Barton Home Health & Hospice 155 Highway 50 Stateline NV 89449 Home Health/Hospice Services Care Part I, Line 3c: In addition to FPGs, the Hospital also used the following factors to determine free and discounted care: income level other than FPG, asset level, medical indigency, insurance status, underinsurance status, and residency. Part I, Line 7: The costing methodology used the cost to charge ratio obtained from the cost report for lines 7a, 7b and 7c. Actual operating costs were used to calculate lines 7e, 7f, 7g, and 7i. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 847,592. Part I, Line 6a: The organizations' commnunity benefit report can be found at https://www.bartonhealth.org/about-us/caring-for-our-community/ Part II, Community Building Activities: Economic Development: Barton Health participates in the Chamber of Commerce on issues impacting community health and safety.Coalition Building: The emergency management department develops plans for our Barton Health emergency response and works closely with other local agencies for community emergency planning activities.Advocacy for Community Health Improvement and Safety: Barton Health advocates to improve access to care, care coordination and quality of care. Part III, Line 2: The organziation determines its estimate of implicit price concessions based on its historical collection experience with each class of patients and residents.Includes implicit price concessions estimate of $39,719,571 and bad debt expense of $847,592. Part III, Line 3: Consistent with the Healthcare System's mission, care is provided to patients regardless of their ability to pay. Therefore, the Healthcare System has determined it has provided implicit price concessions to uninsured patients and patients with other uninsured balances (for example, copays and deductibles). The implicit price concessions included in estimating the transaction price represent the difference between amounts billed to patients and the amounts the Healthcare System expects to collect based on its collection history with those patients. The hospital calculated the amount it estimates could be community benefit based on the percentage of applications denied due to lack of information. Part III, Line 4: The footnote to the organization's financial statements that describes implicit price concessions is located on page 13-14 of the attached financial statements. Part III, Line 8: The Organization provides a broad range of services to its Medicare patients without regard to revenue realized from the services provided.The Organization is a rural hospital with the nearest additional hospital approximately 36 miles away. Costs excluded from the organization's Medicare cost report include costs associated with physician clinics, the auxiliary, community relations, and other non-reimbursable costs. The Organization utilizes the cost to charge ratio as provided in its annual cost report.Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall, if any, is considered a community benefit. Part III, Line 9b: Barton Health will not refer accounts for collection where the patient has initially applied for Financial Assistance or other Barton Health sponsored program and Barton Health has not yet notified the patient of its determination (provided the patient has complied with the timeline and information requests delineated by Barton Health during the application process). Barton Health provides a written notice indicating the availability of financial assistance and specifying any deadline, after which a completed application for assistance for the previous care episode will no longer be accepted. This Application period is the later of 30 days after the notice date or 240 days after the first post-discharge billing statement for prior care, whichever is later. Part VI, Line 2: Barton Health is a member of numerous community collaboratives working to address the health needs in our community. Barton participates in the Community Behavioral Health Network Committee which focuses on coordinating mental health services amongst our community providers. We lead the Community Health Advisory Committee, with our top three health priorities determining how funding and resources are utilized. Additionally, we attend the monthly Lake Tahoe collaborative, focusing on collaborations for youth; and we fill the healthcare seat on our community's drug-free community coalition. Part VI, Line 3: Every self-pay patient is screened for eligibility under our financial assistance policy which begins at admission or when otherwise feasible. In addition, reference to our financial assistance program is posted at the emergency room and admitting departments, disclosed on our website, referenced to in the patient handbook, and on patient billing statements. Part VI, Line 4: The primary service area for Barton Memorial Hospital sits within the Sierra Nevada Mountains on the border between California and Nevada. This area encompasses the South Lake Tahoe Basin from Tahoma, CA on the west through Glenbrook, NV on the east. The demographics for this area are as follows: approximately 54% male, 46% female, 20.6% under the age of 18, 11.6% aged 18-24, 30.0% aged 25-44, 28.1% aged 45-64 and 9.8% who were 65 years of age or older; 63.5% are Caucasian and 28% are Hispanic, and 8.5% represent other races, 13% of the community is low income below the 200% federal poverty level. Part VI, Line 5: As described in the Community Benefit section of the 990, Barton Health contributes to our community's health in a variety of ways: our governing body is represented by individuals of our community. Surplus funds are used to maintain a high level of patient care through reinvestment. Barton Health has on open medical staff with privileges available to all qualified physicians in the area. Our laboratory offers discounted lab draws; numerous physicians and employees participate in our free community wellness lectures; our emergency department participates in youth education programs and the drug store project; many of our nurses and practitioners participate in offering medical coverage for special events throughout the community; Barton primary care offer free student sports physicals; Barton Health donates to and sponsors youth programs and local non-profit organizations; staff from various departments like Barton education, family birthing center, Barton rehabilitation participate in community events and have information and educational booths for the community; Barton Memorial Hospital operates an emergency room available to all regardless of ability to pay.The governing board is comprised of members of the communities served, and none of the governing body members are compensated for their board service. A majority of board members reside in the organization's primary service area and are not employees or their family members, or contractors of the organization. The facility maintains an open medical staff except in rare instances when a clinical department is "closed" in accordance with California law for hospital-based services.As a nonprofit organization, any surplus funds are invested back into providing health care services and resources to the community, including but not limited to new patient care locations and equipment, expanded programs and services, and the training of physicians, nurses and other health professionals. Part VI, Line 7, Reports Filed With States CA 1 Lake Tahoe South Shore Chamber of Commerce PO Box 17181 South Lake Tahoe CA 95151 886004359 501(c)(3) 6950 0 Sponsor Tahoe Douglas Visitors Authority PO Box 2332 Stateline NV 89449 880385942 501(c)(3) 89000 0 Sponsor Tahoe Fund PO Box 7124 Tahoe City CA 96145 010974628 501(c)(3) 16800 0 Annual Dinner Sponsor El Dorado County Community Helath Center 4327 Golden Center Drive Placerville CA 95667 421533531 Government 7500 0 ACEL Donation Keep Memory Alive PO Box 931517 Cleveland OH 44193 340714585 501(c)(3) 9500 0 Sponsor Keep Memory Alive 888 W Bonneville Las Vegas NV 89106 880515534 501(c)(3) 27500 0 Sponsor Keep Memory Alive 888 W Bonneville Las Vegas NV 89106 340714585 501(c)(3) 16500 0 Sponsor Barton Memorial Hospital Foundation PO Box 529 Zephyr Cove NV 89448 880268799 501(c)(3) 479729 0 Overhead Funding 8 0 Patient Assistance 705 26474 Athletic Sponsorships 4 4000 Part I, Line 2: The organization provides assistance to various community and other organizations. Based on the relationship with these organizations, the hospital is able to ensure the funds are used for the intended purposes. X 0 1 X X X X X 0 1 0 0 0 0 0 1 0 Clinton Purvance MD CEO 0 1021923 0 352913 0 3376 0 17250 0 50482 0 1445944 0 0 David Young MD CMO 11539 557661 0 9185 0 2786 0 0 0 37820 11539 607452 0 0 Kelly Neiger CFO 0 476058 0 67026 0 3376 0 17250 0 50811 0 614521 0 0 Carla Adams CNO 378665 0 32052 0 3940 0 11771 0 44721 0 471149 0 0 0 Jennifer Whisnant Pulmonary Services Supervisor 251852 0 5052 0 0 0 13285 0 50259 0 320448 0 0 0 Christopher Kiser Director of Foundation 250614 0 7732 0 2410 0 9633 0 45057 0 315446 0 0 0 Jason Call Advanced Practice Provider 254422 0 6032 0 0 0 13265 0 37820 0 311539 0 0 0 Karen Conant VP of Ambulatory Operations 233886 0 4830 0 2477 0 6893 0 50138 0 298224 0 0 0 Richard Belli Admin Director of Facilities 245402 0 5715 0 2503 0 9680 0 26166 0 289466 0 0 0 Polly Birdsong Admin Dir of Surgical Svcs 222796 0 35000 0 2214 0 0 0 22141 0 282151 0 0 0 Dana Randall Advanced Practice Provider 252595 0 8439 0 0 0 0 0 14368 0 275402 0 0 0 Thomas Davis Director of Medical Imaging 209696 0 3586 0 2160 0 10857 0 28246 0 254545 0 0 0 Part I, Line 1a Chartered flight expenses were incurred to enable the CEO to attend two geographically distant, time-sensitive, and critical engagements within a few hours of each other. Commercial travel options were unavailable to meet this essential business schedule. The CEO received the approval from the board Vice Chair to incur the expense. The benefit was not included in taxable income as it was directly business related. Part I, Line 4b Line 4b: Clinton Purvance, MD received payments of $203,998 from a related organization, BHC MSO, LLC, for participation in a 409(a) plan. This is reported on Part II column (ii). Part I, Line 7 Barton gives annual performance-based bonuses for employees if certain criteria are met, including financial performance, quality, and growth set annually per policy. If certain goals are not met due to circumstances beyond the control of the organization, the board may, at its discretion, authorize performance-based payments. A City of South Lake Tahoe 941610868 000000000 2014-06-12 18000000 Equipment 0 0 0 A 11760841 18000000 249697 17750303 2017 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 Michael Neiger Spouse of Officer - Kelly Neiger, CFO 160833 Employee 0 Michael Fry MD Brother of Board Member - Patrick Fry 10881 Independent Contractor 0 Savannah Purvance Daughter of CEO - Clinton Purvance, MD 114540 Employee 0 Janette Goodall Spouce of Board Member - Stefan Schunk MD 189746 Employee 0 Form 990, Part VI, Section A, line 2 Kirk Ledbetter and Jeff Rahbeck have a business relationship. Form 990, Part VI, Section A, line 6 There are two classes of members in the Organization: voting members and associate members. Class I voting members are those who have contributed $200 or more prior to July 11, 1986. Each class I voting member has the right to cast one vote, but not more than five votes for each $200 contribution. Class II voting members are those individuals admitted after July 10, 1986 who have contributed $1,500 or more. Each class II voting member has the right to cast one vote, but not more than five votes, for each $1,500 contribution. Associate members do not have voting rights. Members do not have the right to approve significant decisions nor receive distributions upon dissolution. Form 990, Part VI, Section A, line 7a The Chairman of the organization shall appoint a committee of not more than five or less than three members to serve as a nominating committee in the election of the Board of Directors. Any seven members may also nominate candidates for Director. If more people are nominated for the Board than can be elected, members are permitted to vote and the candidates receiving the highest number of votes shall be elected. Form 990, Part VI, Section A, line 7b Bylaw amendments are subject to approval by the voting members. Form 990, Part VI, Section A, line 8b There are no committees that have the authority to act on behalf of the governing board. Form 990, Part VI, Section B, line 11b Each member of the governing board of directors and officers are provided with an electronic copy of the Form 990 for review prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c The governing board members are required to complete an annual conflict of interest questionnaire pursuant to written policy, the board members are precluded from participating in debate and voting on any issue in which the member(s) (or a family member) may have a personal or business interest. The Board Chair and/or Hospital counsel will determine if there is a conflict. Employees are provided with a copy of the conflict of interest policy that is within ane electronic policy software program that requires employees to mark as read as new hires or as changes are made and monitored by their immediate supervisors. Employees are required to be familiar with the policy at all times. They do not formally review the policy annually but are required to still disclose any potential conflicts that may arise. Form 990, Part VI, Section B, line 15 The CEO is paid by a related management company, BHC MSO, LLC. The organization engaged an independent firm to conduct an executive compensation survey. The independent firm issued a certification of reasonableness upon comparing executive compensation with similar organizations. The compensation committee consisting of board members reviews the CEO compensation and approves changes to the executive team's contracts. The committee substantiates this process in their minutes. The CEO approves the compensation for the remaining executive team using data obtained from annual surveys performed by the California Healthcare Association and/or independent compensation evaluation firms as well as comparisons of specific compensation of executives from similar-sized hospitals both in California and nationwide. Barton Healthcare System is a bi-state healthcare provider that includes a licensed 63-bed full-service hospital with a 24-hour emergency room; designated level III trauma center; 48-bed skilled nursing and long-term care facility; state of the art operating rooms and rehabilitation departments; center of orthopedics and wellness; home health, hospice and palliative care services; Lake Tahoe surgery center; 50% ownership in Carson Valley Health (a full-service hospital located in the Carson Valley); satellite lab facilities; Barton education (providing clinical and community health education); Barton auxiliary; and Barton Memorial Hospital Foundation (a 50l(c)(3) supporting organization). The system further includes over 20 outpatient physician clinics which encompass orthopedic clinics, OB/GYN clinics, pediatrics, internal medicine, performance, multi-specialty general surgery/GI, plastic surgery, rheumatology/wellness, physiatry, palliative care, cardiology, neurology, urology, ENT/audiology, urgent care/occupational health clinics, family care clinics, low-income rural health clinic, behavioral health and seasonal ski clinics. Form 990, Part VI, Section C, line 19 Documents requiring public disclosure are available upon request. Form 990, Part IX, line 11g Consulting: Program service expenses 389,144. Management and general expenses 2,535,179. Fundraising expenses 0. Total expenses 2,924,323. Other Purchased Services: Program service expenses 3,694,989. Management and general expenses 8,039,853. Fundraising expenses 0. Total expenses 11,734,842. Other Medical Services: Program service expenses 0. Management and general expenses 66,178. Fundraising expenses 0. Total expenses 66,178. Medical Fees: Program service expenses 0. Management and general expenses 275,608. Fundraising expenses 0. Total expenses 275,608. Purchased RN Personnel Services: Program service expenses 911,164. Management and general expenses 0. Fundraising expenses 0. Total expenses 911,164. Medical - Physicians and Directorsh: Program service expenses 14,528,276. Management and general expenses 0. Fundraising expenses 0. Total expenses 14,528,276. Other Medical Purchased Services: Program service expenses 1,508,536. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,508,536. Medical - Contracted Education & Tr: Program service expenses 20,999. Management and general expenses 0. Fundraising expenses 0. Total expenses 20,999. Form 990, Part XI, line 9: Paid in capital to Barton Medical Foundation Current Year -9,275,137. Paid in capital to Barton Medical Foundation Prior Year -10,581,207. Accountable Care Collaborative LLC 155 Highway 50 PO Box 5637 Stateline NV 89449 853358643 Operate accountable care organization DE 328108 5500 Barton Healthcare System Barton Memorial Hospital Foundation Inc PO Box 50 Stateline NV 89449 880268799 Supporting Organization NV 501(c)(3) Line 12a, I Barton Healthcare System 1 Barton Medical Foundation PO Box 529 Zephyr Cove NV 89448 853977236 Provides Medical Services CA 501(c)(3) Line 3 Barton Healthcare System 1 BHC MSO LLC PO Box 9578 South Lake Tahoe CA 96158 853297586 Management Services NV Barton Healthcare System C 10214754 4635572 1.00000 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 Barton Memorial Hospital Foundation B 29193 Book Value/Actual Barton Memorial Hospital Foundation C 479729 Book Value/Actual Barton Memorial Hospital Foundation Q 65909 Book Value/Actual Barton Medical Foundation P 14138 Book Value/Actual ACO Collaborative LLC P 328108 Book Value/Actual BHC MSO LLC P 10214754 Book Value/Actual Barton Medical Foundation B 11340369 Book Value/Actual