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Renown Skilled Nursing: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
Renown Skilled Nursing (EIN 20-1347269)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201311359349308601
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-15T16:30:00-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN450250958EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1
CityMinneapolisCity
StateMNState
ZIP Code554027033ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN201347269EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Renown Skilled NursingBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlRENONameControl
Phone7759824404Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11155 Mill Street C/O Tax TreasuryAddressLine1
Address Line2Z-5AddressLine2
CityRenoCity
StateNVState
ZIP Code89502ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDawn D AhnerName
TitleCFOTitle
Phone7759824404Phone
Date Signed2013-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKim Hunwardsen CPAName
PTINP00484560PTIN
Phone6122536500Phone
Date Prepared2013-05-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDawn D AhnerNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11155 Mill Street C/O Tax TreasuryAddressLine1
Address Line2Z-5AddressLine2
CityRenoCity
StateNVState
ZIP Code89502ZIPCode
FieldValueIRS element (for citing)
Gross Receipts10516800GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.renown.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2004YearFormation
State Legal DomicileNVStateLegalDomicile
Activity Or Mission DescriptionA 160 bed long-term acute care nursing facility specializing in rehabilitative care.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers8TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2779730ContributionsGrantsPriorYear
Contributions Grants Current Year2825316ContributionsGrantsCurrentYear
Program Service Revenue Prior Year8795487ProgramServiceRevenuePriorYear
Program Service Revenue CY7689721ProgramServiceRevenueCY
Investment Income Prior Year-145InvestmentIncomePriorYear
Investment Income Current Year-90InvestmentIncomeCurrentYear
Other Revenue Prior Year1475OtherRevenuePriorYear
Other Revenue Current Year1763OtherRevenueCurrentYear
Total Revenue Prior Year11576547TotalRevenuePriorYear
Total Revenue Current Year10516710TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year9018902SalariesEtcPriorYear
Salaries Etc Current Year8019845SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4943347OtherExpensePriorYear
Other Expenses Current Year4082415OtherExpensesCurrentYear
Total Expenses Prior Year13962249TotalExpensesPriorYear
Total Expenses Current Year12102260TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2385702RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1585550RevenuesLessExpensesCY
Total Assets BOY2035397TotalAssetsBOY
Total Assets EOY1633463TotalAssetsEOY
Total Liabilities BOY11928420TotalLiabilitiesBOY
Total Liabilities EOY13112036TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-9893023NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-11478573NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionOur purpose is to make a genuine difference for the many lives we touch by optimizing our patients' healthcare experience.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense9383097Expense
Revenue7691484Revenue
DescriptionSee Schedule ORenown Skilled Nursing is a 160-bed nursing facility designed to serve the healthcare needs of long- and short-term, acute-care patients. Services include physical, occupational and speech rehabilitation and restorative therapy programs. This valuable facility serves a need that otherwise would be unmet in northern Nevada. By accepting the long-term, acute-care patients for rehabilitative services, other hospital beds in the health network are available for higher-acuity, shorter-term care. Renown Skilled Nursing provided 33,862 patient care days for patients transferred from other hospital beds in the health network because they required a level of care delivered most appropriately in a skilled nursing facility. Included in the total patient care days was 35 days of long-term care services that were not funded and were designated for patients awaiting Medicaid qualification. It also includes 733 days of care provided for individuals with no source of payment.Our patients at Renown Skilled Nursing have access to transportation, laundry, a barber and beauty shop, on-site dental and podiatry services, financial advice, and spiritual support - in short, everything patients need to enjoy the best possible quality of life. In an effort to provide patients with the opportunity for social interaction, Renown Skilled Nursing also offered musical performances and pet therapy visits. The facility is proud to have been chosen to be a focus center for the Centers for Medicare & Medicaid Services' Nursing Home Quality Initiative.For the fiscal year ending June 30, 2012, Renown Skilled Nursing, along with its parent, Renown Health and its subsidiaries, provided more than $134 million in benefit to the community (using community benefit numbers gathered by the Nevada Hospital Association using state-approved criteria to ensure consistency). For a full report on the benefit Renown Health provided to our community, as well as our community needs assessment and community benefit plan, go to www.renown.org/communitybenefit.Description
Total Program Service Expense9383097TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Dawn D AhnerBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7759824404TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11155 Mill St Z-6AddressLine1
CityRenoCity
StateNVState
ZIP Code89502ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
James Miller
President/CEO1.00XX01237327350164
Dawn Ahner
CFO1.00XX064881994963
Ellen Kelly
Administrator60.00X11646009859
Barbara Coruna
Supervisor/Clinical Nursin60.00113198019087X
Imelda Decorion-Sayo
Registered Nurse60.00116686023268X
Joseph Moniz
Registered Nurse60.0010150005808X
Virginia Alelis
Registered Nurse60.00100406018941X
FieldValueIRS element (for citing)
Total Reportable Comp From Org548250TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1886146TotalReportableCompFrmRltdOrgs
Total Other Compensation522090TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Talent FrameworkBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15596 Longley Ln Ste AAddressLine1
CityRenoCity
StateNVState
ZIP Code89502ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesTemp LaborDescriptionOfServices
Compensation257366Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Related Organizations2825316RelatedOrganizations
Total Contributions2825316TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUDescription
Business Code623000BusinessCode
Total Revenue Column7689721TotalRevenueColumn
Related Or Exempt Function Income7689721RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue7689721TotalProgramServiceRevenue

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other90Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-90Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-90TotalRevenueColumn
Exclusion-$90ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column1763TotalRevenueColumn
Related Or Exempt Function Income1763RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1763TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column10516710TotalRevenueColumn
Related Or Exempt Function Income7691484RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$90ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6646768Total
Program Services5686137ProgramServices
Management And General960631ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1373077Total
Program Services1152132ProgramServices
Management And General220945ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total12519Total
Management And General12519ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total698720Total
Program Services314732ProgramServices
Management And General383988ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1705696Total
Program Services1649533ProgramServices
Management And General56163ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total848071Total
Program Services708ProgramServices
Management And General847363ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total2985Total
Program Services904ProgramServices
Management And General2081ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total951Total
Program Services734ProgramServices
Management And General217ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total210673Total
Program Services146478ProgramServices
Management And General64195ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total51261Total
Management And General51261ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Licenses & Taxes5597215055822
Management Expense43011043011
Dues & Subscriptions13752102812724
Business Meals/Entertai13102441066

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total437494Total
Program Services430317ProgramServices
Management And General7177ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total12102260Total
Program Services9383097ProgramServices
Management And General2719163ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY36472BOY
EOY19366EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY973768BOY
EOY629331EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY35655BOY
EOY36084EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY24061BOY
EOY9530EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3276183LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2337031LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY965441BOY
EOY939152EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2035397BOY
EOY1633463EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY570581BOY
EOY324654EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY24731BOY
EOY16479EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY11333108BOY
EOY12770903EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY11928420BOY
EOY13112036EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-9893023BOY
EOY-11478573EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-9893023BOY
EOY-11478573EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2035397BOY
EOY1633463EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-1585550ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc1AgentTrusteeEtc
Included On FS1IncludedOnFS

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1443393OtherCostOrOtherBasis
Depreciation970566Depreciation
Book Value472827BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1832790OtherCostOrOtherBasis
Depreciation1366465Depreciation
Book Value466325BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings939152TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue to AffliatesDescription
Amount$12,770,903Amount
FieldValueIRS element (for citing)
Total Of Amounts12770903TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part IV, Line 2b:The organization acts as custodian for the funds of the residents of the skilled nursing facility. These funds are included in cash and custodial liability in the financial statements.
Part X:Renown Skilled Nursing undergoes an annual analysis of its various tax positions, assessing the likelihood of these positions being upheld upon examination with relevant tax authorities, as defined by the accounting principles generally accepted in the United States of America. Renown Skilled Nursing believes that it is compliant with all IRS tax regulations and as of June 30, 2012 has not recorded a tax liability for a tax uncertainty. Renown Skilled Nursing 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. Under normal circumstances, Renown Skilled Nursing is no longer subject to federal tax examinations by tax authorities for years before 2009.Description of Uncertain Tax Positions Under FIN 48:

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
James Miller
0850127037405401314603348300153340158749100
Dawn Ahner
0463146018400001673076431018532074378200

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 4bDawn Ahner is party to a supplemental nonqualified retirement plan. Contribution of $69,000 to Dawn Ahner was included in Schedule J, Part II, Column (C).
Part IIIPart I, Line 3: Renown Skilled Nursing relies on Renown Health, a related organization, to establish compensation for officers and other key employees. Renown Health uses the identified methods to establish compensation. See Schedule O, Form 990, Part VI, Section B, Line 15 for a description of the process utilized by Renown Health.Supplemental Information

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 2James Miller and Dawn Ahner have a business relationship because James Miller serves on the board of an organization where Dawn Ahner is an employee.
Form 990, Part VI, Section A, line 6Renown Health is the sole corporate member of Renown Skilled Nursing.
Form 990, Part VI, Section A, line 7aRenown Health, acting through its Board of Directors, appoints the members of the Board of Governors of Renown Skilled Nursing.
Form 990, Part VI, Section A, line 7bRenown Health must approve any merger, consolidation or dissolution of Renown Skilled Nursing, any borrowing in excess of $1 million in any fiscal year, and encumbrances of assets and certain other actions not in the ordinary course of business.
Form 990, Part VI, Section A, line 8bThere was no committee during the year that had the broad authority to act on behalf of the board.
Form 990, Part VI, Section B, line 11The Form 990 is prepared by the organization's tax department with support from a certified tax preparer. The form is reviewed by the organization's Chief Accounting Officer and/or the Chief Financial Officer prior to the final Form 990 being sent to the board. The IRS Form 990, as filed with the IRS, is sent to each voting member of the Renown Health Board prior to filing. Along with the forms, the Renown Health board is provided with a narrative that explains the various parts of the Form and their content.
Form 990, Part VI, Section B, line 12cOn an annual basis at or prior to the first regular meeting following the election of new board members, the members of the Renown Skilled Nursing Board are given an Annual Disclosure Statement. They are expected to perform a reasonable investigation into their business, financial, family or significant personal relationships to disclose any actual or potential conflicts of interest. If, in connection with a proposed transaction or arrangement involving a Renown Health entity, a board member discovers that an actual or possible conflict of interest has arisen that was not disclosed on the Annual Statement, then the board member must disclose the existence and nature of his or her financial interests to the remaining directors that are considering the proposed transaction or arrangement in a timely manner. If a board member discloses an actual or possible conflict of interest, the board member shall leave the board or committee meeting while the remaining board members discuss the financial interest. The remaining board members shall vote upon and decide whether a conflict of interest actually exists. If the remaining board members determine that a conflict does exist, then appropriate measures are taken to ensure the issue is addressed.
Form 990, Part VI, Section B, line 15Renown Health's executive compensation is set by the Renown Health Compensation Committee. Members of this committee review and approve various employee pay practices and parameters, as well as compensation for the CEO and certain executives. The Compensation Committee is comprised of independent members of the Renown Health Board of Directors unrelated to and not subject to the control or undue influence of executives, with no material financial interest in transactions of the Company or any other perceived or actual conflicts of interest. The Compensation Committee members are appointed by the Chairman of the Renown Health Board of Directors. The Compensation Committee meets approximately five times per year. Meeting minutes are kept documenting the deliberations and decisions regarding the compensation arrangements. Total cash compensation for the organization's executives are targeted at competitive compensation levels, relative to market surveys of comparable healthcare organizations, based upon the level of performance required to achieve the targeted compensation levels. Base compensation and total cash compensation is reviewed at a minimum of every two years in comparison to the surveys for comparable businesses and responsibilities and adjusted as to maintain equity with the survey information. The Compensation Committee undertook the process outlined above for the fiscal year 2012 executive compensation.
Form 990, Part VI, Section C, line 19Renown Skilled Nursing does not make its governing documents, conflict of interest policy, or financial statements available to the general public.
Form 990, Part VII, Column BJim Miller, President & CEO, serves this entity and all related entities a total of 60 hours per week. See Part VII for hours devoted to this entity. Dawn Ahner, CFO, serves this entity and all related entities a total of 60 hours per week. See Part VII for hours devoted to this entity.Average hours per week
Form 990, Part XI, Line 2bRenown Health, the sole member of this entity, has an audit committee that assumes responsibility for the consolidated audit and selection of the independent accountant.Audit Committee
Form 990, Part V, Line 2aRenown Skilled Nursing has its own employees, however, Renown Health, the parent organization, pays all compensation and employee benefit amounts under a common paymaster arrangement. The actual compensation of each employee is directly charged to their assigned entity. Salaries are reported on line 7 of Part IX.Number of employees on W-3

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Renown Health
1155 Mill Street Z-5RenoNV89502942972845Health CareNV501(c)(3)III-FiRenown Health0
Renown Health Foundation
1155 Mill Street Z-5RenoNV89502942972749FoundationNV501(c)(3)7Renown Health0
Renown Regional Medical Center
1155 Mill Street Z-5RenoNV89502880213754HospitalNV501(c)(3)3Renown Health0
Renown South Meadows Medical Center
1155 Mill Street Z-5RenoNV89502460517825HospitalNV501(c)(3)3Renown Health0
Hometown Health Plan
1155 Mill Street Z-5RenoNV89502880231433HMONV501(c)(4)Renown Health0
Renown Network Services
1155 Mill Street Z-5RenoNV89502880231828Outpatient Imaging and Pregnancy CenterNV501(c)(3)3Renown Health0

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
Routt Dialysis LLC
1155 Mill St Z-5RenoNV89502263558729Kidney DialysisNVN/A
Nevada Heart Institute Clinic LLC
1155 Mill St Z-5RenoNV89502453571779CardiologyNVN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntity
Renown Businesses
1155 Mill St Z-5RenoNV89502880228030Health CareNVN/AC
Hometown Health Managment Company
1155 Mill St Z-5RenoNV89502880236758Management ServicesNVN/AC
The Provider Network Inc
1155 Mill St Z-5RenoNV89502880376369Health CareNVN/AC
Remittance Assistance Corporation
1155 Mill St Z-5RenoNV89502880277761CollectionsNVN/AC
Hometown Health Providers Insurance Co
1155 Mill St Z-5RenoNV89502880177026InsuranceNVN/AC
Nevada Heart Institute
1155 Mill St Z-5RenoNV89502880247743CardiologyNVN/AC
NHI-1 Inc
1155 Mill St Z-5RenoNV89502880303924CardiologyNVN/AC
Elko Heart Insititute
1155 Mill St Z-5RenoNV89502452152594CardiologyNVN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Hometown Health Plan IncBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeKTransactionType
Amount Involved584903AmountInvolved
Method Of Amt DeterminationGeneral LedgerMethodOfAmtDetermination