2026-01-30T07:50:00-06:00 2025-03-31 393647910 WIPFLI ADVISORY LLC 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-04-01 880256932 SOUTH LYON HEALTH CENTER INC DBA SOUTH LYON MEDICAL CENTER SOUT 7754632301 PO BOX 940 YERINGTON NV 89447 TONI INSERRA CHIEF EXECUTIVE OFFICER 7754632301 2026-01-28 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2026-01-28 2024 2025-03-06 01:10:19Z TONI INSERRA PO BOX 940 YERINGTON NV 89447 19751601 0 X WWW.SLMCNV.ORG X 1990 NV PROVIDE HEALTHCARE FOR THE RESIDENTS AND VISITORS TO THE CITY OF YERINGTON AND LYON COUNTY, NEVADA. 8 7 178 7 0 0 81291 1302058 17598386 18308028 0 72771 75350 68744 17755027 19751601 0 0 0 0 9149411 10736767 0 0 0 8940141 8903659 18089552 19640426 -334525 111175 10874310 10062300 2426892 1503707 8447418 8558593 TO PROVIDE ACCESS TO QUALITY HEALTH CARE SERVICES NEEDED BY THE COMMUNITY. 0 0 11115668 0 12288905 THE HOSPITAL IS A 14-BED ACUTE HOSPITAL WITH 24 HOUR EMERGENCY ROOM, FULL SERVICE LAB, AND X-RAY DEPARTMENTS. THE E/R SEES APPROXIMATELY 300 PATIENTS A MONTH. CLOSE COMMUNICATIONS WITH LARGER FACILITIES AND SPECIALISTS IN MANY DISCIPLINES ALLOW BOTH HELICOPTER AND AIR AMBULANCE SERVICES TO TAKE PATIENTS TO THOSE HOSPITALS WITHIN A SHORT AMOUNT OF TIME. THE HOSPITAL HAS A SLIDING FEE SCALE AND FINANCIAL ASSISTANCE AVAILABLE FOR PATIENTS COMPLETING APPLICATIONS. THE HOSPITAL PROVIDES THE STANDARD INFLUENZA VACCINE AT A NOMINAL COST. 3338372 0 3690730 THE LONG-TERM CARE PROGRAM IS A MEDICARE APPROVED 49-BED SKILLED NURSING AND LONG-TERM CARE FACILITY WITH IN-HOUSE PHYSICAL THERAPY AVAILABLE. STAFF TO PATIENT RATIO IS ABOVE REQUIRED. A SOCIAL WORKER/RESIDENT ADVOCATE AND AN ENTHUSIASTIC ACTIVITIES PROGRAM MAKE OUR LTC ONE OF THE FINEST ANYWHERE. 2106099 0 2328393 THE CLINICS PROGRAM CONSISTS OF THREE RURAL HEALTH CLINICS. WE HAVE PHYSICIANS, PHYSICIANS ASSISTANTS, AND NURSE PRACTITIONERS THAT WORK OUT OF OUR CLINICS TO SERVE THE NEEDS OF THE COMMUNITY. ONE OF OUR CLINICS IS A WALK-IN CLINIC AVAILABLE AT CONVENIENT HOURS FOR OUR PATIENTS WHO NEED TO SEE A PROVIDER IMMEDIATELY OR WHO DO NOT HAVE A REGULAR DOCTOR. ALL CLINICS OFFER SERVICES AT A REDUCED FEE FOR THOSE WHO NEED IT. A FINANCIAL COUNSELOR IS AVAILABLE FOR ASSISTANCE AT ALL TIMES. 16560139 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 12 0 178 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X DAVID BEZARD 7754636402 213 SOUTH WHITACRE STREET YERINGTON NV 89447 KALEB WARTGOW DIRECTOR/CHIEF OF STAFF 40.00 X 339600 0 36564 JOANNE LAWSON PRESIDENT 1.00 X X 0 0 0 SCOTT HUNTLY VICE PRESIDENT 1.00 X X 0 0 0 EMILY CHRISTENSEN DIRECTOR (THRU 07/2024) 1.00 X 0 0 0 ALYCE REESE DIRECTOR 1.00 X 0 0 0 EMILY TURNER DIRECTOR 1.00 X 0 0 0 RONNIE WEIR-COOLEY DIRECTOR 1.00 X 0 0 0 CARL WILSON DIRECTOR 1.00 X 0 0 0 LEAH WILKINSON DIRECTOR 1.00 X 0 0 0 TONI INSERRA CEO 40.00 X 176250 0 16524 DAVID BEZARD CFO 40.00 X 156269 0 28637 TOM WALSH MD 40.00 X 317563 0 7083 LOREN SIMPSON MD 32.00 X 281212 0 22333 DANA LEWIS MD 40.00 X 174731 0 12470 THOMAS CLIFTEN PHYSICAL THERAPIST 40.00 X 165221 0 27145 THOMAS ARD IT SUPERVISOR 40.00 X 151965 0 15553 1762811 0 166309 19 0 1 0 MEDICAL SOLUTIONS PO BOX 850737 MINNEAPOLIS MN 55485 NURSING LOCUMS SERVICES 2205874 WESTERN HEALTHCARE LLC PO BOX 21228 DEPT 170 TULSA OK 74121 EMERGENCY ROOM LOCUMS SERVICES 1567680 BLUEPEAK TECHNOLOGY SOLUTIONS PO BOX 40865 RENO NV 89504 IT SUPPORT 148400 NV RURAL HOSP PARTNERS 4600 KIETZKE LANE RENO NV 89502 MRI AND CONSORTIUM SERVICES 142808 STABILITY HEALTHCARE INC 87 E GREEN STREET PASADENA CA 91105 NURSING LOCUMS SERVICES 130320 6 1241162 60896 1302058 PROGRAM SERVICE REVENUE-RELATED 621400 15259248 15259248 HOSPITAL DISTRICT REIMBURSEMENT 621400 1127948 1127948 DISTRICT TAX SUBSIDY 900099 1072675 1072675 UPL REVENUE 621400 828337 828337 19820 19820 18308028 72771 72771 1100 0 1100 1100 1100 EMPLOYEE MEALS 900099 33613 33613 34031 34031 67644 19751601 18308028 0 141515 X 787681 378740 408941 8172555 7732646 439909 207755 83390 124365 926241 381488 544753 642535 264208 378327 105922 105922 21 21 4799139 4571179 227960 9064 9064 350084 169388 180696 533571 533571 315167 312190 2977 21591 8085 13506 90261 88093 2168 3530 3145 385 532029 474073 57956 110718 105005 5713 BAD DEBT EXPENSE 1025573 1025573 MEDICAL SUPPLIES 954961 954961 TAXES AND LICENSES 30438 30438 DUES AND SUBSCRIPTIONS 20615 7000 13615 975 975 19640426 16560139 3080287 0 1400 1400 4110707 4168038 2761557 2182540 196281 203556 213429 193680 5489724 2324391 3560805 3165333 30131 147753 10874310 10062300 1022197 1055227 1226612 0 178083 448480 2426892 1503707 X 8447418 8558593 8447418 8558593 10874310 10062300 111175 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 21 21 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF NEVADA HOSPITAL ASSOCIATION AND NATIONAL RURAL HEALTH ASSOCIATION. A PORTION OF MEMBERSHIP DUES TO IS USED FOR LOBBYING. THE ASSOCIATIONS ADVOCATE ON BEHALF OF MEMBERS FOR IMPROVING EFFICIENCY AND ACCESSIBILITY TO THE HEALTHCARE DELIVERY SYSTEMS AND THE HEALTH STATUS OF PATIENTS. 2678001 538252 2139749 2811723 1786139 1025584 3165333 OPERATING LEASE LIABILITY 29719 THIRD PARTY REIMBURSEMENT PAYABLE 300523 FINANCE LEASE LIABILITY 118238 448480 1 1 X 1 X 1 X 1 0 0 251922 251922 0.01350 2389845 778172 1611673 0.08660 2641767 778172 1863595 0.10010 3709351 1274080 2435271 0.13080 3709351 1274080 2435271 0.13080 6351118 2052252 4298866 0.23090 0 809313 380377 3392952 3424076 -31124 X 1 1 1 1 SOUTH LYON MEDICAL CENTER PO BOX 940 YERINGTON NV 89447 WWW.SLMCNV.ORG 660RUH-19 X X X X RURAL SOUTH LYON MEDICAL CENTER 1 0 0 1 X X X X X X X X X 24 1 0 0 1 X SEE PART V, SECTION C, LINE 7D X X 1 24 1 SEE PART V, SECTION C, LINE 7D 0 1 X 100.000000000000 200.000000000000 X X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 SOUTH LYON MEDICAL CENTER PART V, SECTION B, LINE 5: INFORMATION WAS COLLECTED FROM PRIMARY AND SECONDARY DATA SOURCES TO IDENTIFY UNMET HEALTH NEEDS WITHIN THE COMMUNITY. INFORMATION FROM THESE SOURCES WAS SUMMARIZED INTO THEMES THAT REPRESENT THE COMMUNITY'S UNMET HEALTH NEEDS, WHICH SERVE AS THE BASIS OF THE CHNA.PRIMARY DATA:PRIMARY DATA REPRESENTS INFORMATION COLLECTED FIRSTHAND FROM STAKEHOLDERS WITHIN SLMC'S COMMUNITY. THIS DATA WAS COLLECTED TO VALIDATE SECONDARY DATA FINDINGS THAT PERTAIN TO SLMC'S SERVICE AREA, IDENTIFY ISSUES THAT WERE NOT REPRESENTED IN THE SECONDARY DATA, AND UNDERSTAND WHAT SPECIFIC SUBGROUPS OF THE COMMUNITY MAY FACE ADDITIONAL CHALLENGES OR DISPARITIES.INTERVIEWS WERE CONDUCTED WITH COMMUNITY STAKEHOLDERS WHO BEST REPRESENTED THE BROAD INTERESTS, EXPERIENCES, AND NEEDS OF SLMC'S COMMUNITY, PARTICULARLY PEOPLE WHO REPRESENT MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS. A COMMUNITY HEALTH SURVEY WAS ALSO DISTRIBUTED TO ENSURE THAT EACH PERSON HAD THE OPPORTUNITY TO PARTICIPATE AND BE HEARD IN THIS PROCESS. A COMPLETE LIST OF THE COMMUNITY STAKEHOLDERS CAN BE FOUND IN THE REFERENCES AND ACKNOWLEDGMENTS.THE INTERVIEWS AND SURVEYS WERE DESIGNED TO SOLICIT INFORMATION PERTAINING TO THE FOLLOWING TOPICS:- SIGNIFICANT HEALTHCARE ISSUES OR NEEDS- SOCIAL, BEHAVIORAL, AND ENVIRONMENTAL FACTORS THAT CONTRIBUTE TO HEALTH NEEDS- BARRIERS TO CARE WITHIN THE COMMUNITY- VULNERABLE POPULATIONS WHO EXPERIENCE DISPARITIES- SUGGESTIONS OR IDEAS TO ADDRESS THE COMMUNITY'S NEEDS- POTENTIAL RESOURCES OR INFRASTRUCTURE TO SUPPORT HEALTH, SOCIAL, BEHAVIORAL, OR ENVIRONMENTAL NEEDS- AREAS FOR COLLABORATION TO ADDRESS HEALTH NEEDSSECONDARY DATA:SECONDARY DATA WAS COLLECTED FROM STATISTICAL DATA SOURCES AVAILABLE AT THE LOCAL, REGIONAL, STATE, AND NATIONAL LEVEL. THIS DATA PROVIDES A PROFILE OF THE DEMOGRAPHIC, SOCIAL, ECONOMIC, AND HEALTH CHARACTERISTICS OF SLMC'S COMMUNITY. TO THE EXTENT POSSIBLE DATA WAS COLLECTED AT THE LOCAL LEVEL, AND COMPARED TO REGIONAL, STATE, OR NATIONAL BENCHMARKS WHEN DETERMINING HEALTH NEEDS.SOURCES OF SECONDARY DATA INCLUDE:- AMERICAN COMMUNITY SURVEY- BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM- CENTER FOR DISEASE CONTROL AND PREVENTION- COUNTY HEALTH RANKINGS- ESRI BUSINESS INFORMATION SOLUTIONS- HEALTHIEST COMMUNITIES, A COLLABORATION BETWEEN U.S. NEWS AND THE UNIVERSITY OF MISSOURI EXTENSION CENTER FOR APPLIED RESEARCH AND ENGAGEMENT SYSTEMS- U.S. CENSUS BUREAU SOUTH LYON MEDICAL CENTER PART V, SECTION B, LINE 7D: PART V, SECTION B, LINES 7A & 10A:HTTPS://SLMCNV.ORG/COMMUNITY-NEEDS-ASSESSMENT/ SOUTH LYON MEDICAL CENTER PART V, SECTION B, LINE 11: FOLLOWING COMPLETION OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL EVALUATED ALL IDENTIFIED HEALTH PRIORITIES AND DEVELOPED AN IMPLEMENTATION STRATEGY FOCUSED ON AREAS WHERE THE ORGANIZATION CAN HAVE THE STRONGEST AND MOST SUSTAINABLE IMPACT. THE HOSPITAL HAS ALIGNED ITS RESOURCES, PARTNERSHIPS, AND CLINICAL CAPABILITIES TO ADDRESS THE FOLLOWING SIGNIFICANT NEEDS:1. ACCESS TO HEALTH CARE SERVICES- EDUCATION DURING COMMUNITY EVENTS - COMMUNITY OUTREACH PROMOTING AND OFFERING MORE IN-PERSON HEALTH AND WELLNESS EDUCATION CLASSES/PROGRAMSTHE FACILITY WILL WORK WITH OUR DEMENTIA AND COMMUNICATIONS SPECIALIST TO CREATE NEW COMMUNITY FOCUSED PROGRAMS ON TOPICS INCLUDING DEALING WITH DEMENTIA, CAREGIVER BURNOUT, AND DEALING WITH GRIEF. THE FACILITY WILL ENSURE A PRESENCE AT COMMUNITY EVENTS TO PROMOTE WELLNESS AND WELL-BEING. THE FACILITY IS LOOKING AT THE RETURN OF TWO POPULAR COMMUNITY EVENTS THAT WERE ENDED DURING THE COVID19 PANDEMIC INCLUDING A VERSION OF THE HEALTHY EATS PROGRAM WHERE WE SHOWCASE AND EDUCATE THE COMMUNITY ON HEALTHY EATING WHILE MAKING IT FUN.- PROVIDING EASIER ACCESS FOR PATIENTS TO MAKE APPOINTMENTSBEGINNING APRIL 1, 2025, CLINIC STAFF HAVE BEEN REDISTRIBUTED AND ADDITIONAL STAFF TRAINED TO ENSURE PATIENTS ARE ABLE TO BOOK APPOINTMENTS EASILY AT LEAST SIX DAYS PER WEEK.- ENSURING WE HAVE ENOUGH STAFF TO ALLOW OUR CLINICS TO ALWAYS BE OPEN CONSISTENTLY. WE HAVE EMPLOYED A FOURTH PROVIDER FOR OUR RURAL HEALTH CLINIC LOCATED ON OUR CAMPUS. WITH THE ADDITION OF THAT STAFF, THE CLINIC WILL BE AVAILABLE FIVE DAYS A WEEK. WE ARE EXPANDING THE HOURS IN OUR CLINICS TO PROVIDE AN OPPORTUNITY FOR WORKING PATIENTS TO MAKE AN APPOINTMENT AFTER THEIR WORK HOURS. - BUILDING TRUST WITH EXCEPTIONAL CUSTOMER SERVICE SO PATIENTS WANT TO RECEIVE SERVICE IN OUR FACILITY RATHER THAN GOING ELSEWHERE.WE ARE WORKING TO PROVIDE FACILITY WIDE CUSTOMER SERVICE TRAINING WITH FOCUSED TRAINING FOR OUR FRONT LINE STAFF.2. COST OF HEALTHCARE- OFFERING AN EDUCATION CLASS ON HOW TO USE TELEHEALTH SERVICES FOR TECHNOLOGY ILLITERATE PATIENTSWE WILL DEVELOP AND IMPLEMENT A SYSTEM THAT INSTRUCTS AND OR DOES A TEST RUN WITH PATIENTS USING TELEMEDICINE FOR THE FIRST TIME.- DEVELOPING A COMMUNITY HEALTH CARE CENTER TO PROVIDE AFFORDABLE PRIMARY CARE FOR THE UNDERSERVED. WE CURRENTLY ARE PARTNERED WITH UNR SCHOOL OF MEDICINE AND FACILITATE BRINGING MOBILE RURAL OUTREACH CLINICS TO YERINGTON AND SURROUNDING AREAS TO PROVIDE LOW TO NO COST MEDICAL CARE FOR OUR COMMUNITIES. THE FACILITY OFFERS MANY FINANCIAL AID PROGRAMS TO THE PATIENTS INCLUDING A PROMPT PAY DISCOUNT OF 30%, A SLIDING FEE APPLICATION ALLOWING A DISCOUNT UP TO 100% BASED ON INCOME AND A CASH CLINIC FOR THOSE PATIENTS WITH HIGH DEDUCTIBLES OR NO INSURANCE.3. MENTAL ILLNESS- LOOKING AT ESTABLISHING MENTAL AND BEHAVIORAL HEALTH PROFESSIONALS AND INTEGRATING MENTAL HEALTH SERVICES WITH OUR EXISTING PRIMARY CARETHE FACILITY IS EXPLORING A PARTNERSHIP TO PROVIDE ADDITIONAL MENTAL HEALTH SERVICES.- ESTABLISHING PEER SUPPORT PROGRAMS IN OUR FACILITY FACILITATED BY TRAINED SPECIALISTSWE ARE CURRENTLY DEVELOPING AND IMPLEMENTING AND FACILITATING PEER SUPPORT GROUPS WITH COMMUNITY SPECIALISTS - MORE TRAINING FOR OUR PROVIDERS TO UNDERSTAND OUR CULTURAL NUANCES OF A RURAL COMMUNITY 4A. DRUG ABUSE- CREATING ACCESS TO SUBSTANCE ABUSE SERVICESWE WILL CREATE AWARENESS OF THE CURRENT SUBSTANCE ABUSE SERVICES IN OUR COMMUNITY AND PARTNER WITH NA AND AA TO MAKE SURE THE SERVICES ARE WELL PUBLICIZED AND AVAILABLE TO OUR COMMUNITY MEMBERS- OFFERING SMOKING CESSATION PROGRAMS AT OUR FACILITYWE WILL WORK WITH THE AMERICAN CANCER SOCIETY TO SEE HOW WE CAN FACILITATE SMOKING CESSATION PROGRAMS IN OUR FACILITY.- DEVELOP AND IMPLEMENT A MARKETING PLAN TO REDUCE STIGMA.WE WILL WORK WITH OUR SURROUNDING HEALTH PARTNERS TO BRING AWARENESS TO THE STRUGGLES OF DRUG ADDICTION AND EDUCATE OUR COMMUNITY WITH THE SERVICES THAT ARE AVAILABLE.- WORKING WITH OTHER COMMUNITY LEADERS SUCH AS THE SCHOOL TO TARGET TEENS OR THE WOMEN'S LIFE CHOICES CENTER TO TARGET ADDICTED PREGNANT WOMEN. 4B. DIABETES- CONTINUE DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT PROGRAM.WE WILL CONTINUE TO ADVERTISE AND HOLD SELF-MANAGEMENT CLASSES AND ASCERTAIN IF A SUPPORT GROUP IS DESIRED.- UPDATING OUR SOCIAL MEDIA AND WEBSITE, MAKING SURE OUR CONTACT INFORMATION AND SERVICES ARE EASY TO FINDWE HAVE GIVEN ACCESS TO UPDATE AND MODIFY OUR WEBSITE AND SOCIAL MEDIA PLATFORMS TO MORE PEOPLE TO ENSURE THE UPDATES ARE HAPPENING REGULARLY- EDUCATION DURING COMMUNITY EVENTS - COMMUNITY OUTREACHWE ARE SURE TO HAVE AN INFORMATION BOOTH AT COMMUNITY EVENTS WITH EDUCATION OPPORTUNITIES AND MARKETING MATERIALS- TELEHEALTH AND FACE TO FACE INTERVENTIONS WHICH WOULD INCLUDE GOAL SETTING WITH THE PATIENT- WORKING WITH THE SCHOOLS FOR CHILDREN WITH DIABETIC NEEDS. - ALLOWING PRIMARY CARE PROVIDERS TO USE COMMUNITY KNOWLEDGE AND DATA TO REDESIGN EFFECTIVE DIABETES CARE DELIVERY SYSTEMSWE WILL KEEP AN UP-TO-DATE RESOURCE LIST FOR OUR PROVIDERS THAT WILL GIVE THEM EDUCATIONAL OPPORTUNITIES FOR THEIR PATIENTS WITHIN OUR COMMUNITY AND BEYOND. PART V, SECTION B, LINE 16 (A-C): HTTPS://SLMCNV.ORG/FINANCIAL-SERVICES/ 4 1 - LONG TERM CARE 213 S WHITACRE STREET YERINGTON NV 89447 LONG TERM CARE 2 - PHYSICIAN'S CLINIC 311 SURPRISE STREET YERINGTON NV 89447 RURAL HEALTH CLINIC 3 - BARNETT CLINIC 213 S WHITACRE STREET YERINGTON NV 89447 RURAL HEALTH CLINIC 4 - SMITH VALLEY CLINIC 445 STATE HWY 338 WELLINGTON NV 89444 RURAL HEALTH CLINIC PART I, LINE 7: THE COSTING METHODOLOGY IS THE COST TO CHARGES RATIO. THE COST-TO-CHARGES RATIO IS USED FOR ALL PATIENT SEGMENT LINE INPATIENT, OUTPATIENT, AND EMERGENCY ROOM. PART I, LINE 7G: THE ORGANIZATION IS INCLUDING THE THREE RURAL HEALTH CLINICS IN ITS SUBSIDIZED SERVICES CALCULATION. THE YERINGTON CLINIC HAD TOTAL COMMUNITY BENEFIT EXPENSE OF $1,530,569, DIRECT OFFSETTING REVENUE OF $561,577 AND NET COMMUNITY BENEFIT EXPENSE OF $968,992; THE SMITH VALLEY CLINIC HAD TOTAL COMMUNITY BENEFIT EXPENSE OF $1,032,198, DIRECT OFFSETTING REVENUE OF $401,253 AND NET COMMUNITY BENEFIT EXPENSE OF $630,945; AND THE BARNETT CLINIC HAD TOTAL COMMUNITY BENEFIT EXPENSE OF $1,147,564, DIRECT OFFSETTING REVENUE OF $311,251 AND NET COMMUNITY BENEFIT EXPENSE OF $836,313. 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 $ 1,025,573. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL PROVIDED FREE INFLUENZA VACCINATIONS TO ALL COMMUNITY MEMBERS AGED SIX MONTHS AND OLDER AS PART OF ITS ONGOING COMMITMENT TO IMPROVE COMMUNITY HEALTH AND REDUCE PREVENTABLE ILLNESS. THIS INITIATIVE REMOVED FINANCIAL AND ACCESS BARRIERS FOR RESIDENTS IN OUR RURAL SERVICE AREA, INCLUDING UNINSURED AND UNDERINSURED INDIVIDUALS. BY OFFERING NO-COST VACCINES, THE HOSPITAL HELPED DECREASE THE INCIDENCE OF SEASONAL FLU, REDUCED POTENTIAL STRAIN ON LOCAL HEALTHCARE RESOURCES, AND SUPPORTED OVERALL PUBLIC HEALTH PREPAREDNESS. THIS ACTIVITY ALIGNS WITH THE HOSPITAL'S COMMUNITY BENEFIT MISSION AND RESPONDS DIRECTLY TO NEEDS IDENTIFIED THROUGH OUR COMMUNITY HEALTH NEEDS ASSESSMENT. AS PART OF ITS COMMUNITY BENEFIT ACTIVITIES, THE HOSPITAL PROVIDES DISCOUNTED LABORATORY TESTING THROUGH ITS WELLNESS WEDNESDAY PROGRAM TO INCREASE ACCESS TO PREVENTIVE HEALTH SERVICES FOR ALL RESIDENTS, INCLUDING UNINSURED AND UNDERINSURED INDIVIDUALS. THE HOSPITAL ALSO OFFERS FREE, QUARTERLY DIABETES EDUCATION CLASSES TO SUPPORT CHRONIC DISEASE MANAGEMENT AND REDUCE PREVENTABLE COMPLICATIONS. IN ADDITION, THE HOSPITAL HOSTS ANNUAL COMMUNITY HEALTH FAIRS THAT PROVIDE SCREENINGS, HEALTH INFORMATION, AND RESOURCE CONNECTIONS AT NO COST. TO FURTHER ADDRESS ACCESS GAPS IN REMOTE AREAS, THE HOSPITAL CONDUCTS FREE MONTHLY RURAL OUTREACH CLINICS IN PARTNERSHIP WITH REGIONAL HEALTHCARE PROVIDERS. TOGETHER, THESE INITIATIVES ADVANCE THE HOSPITAL'S MISSION TO IMPROVE COMMUNITY HEALTH AND ADDRESS PRIORITY NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. PART III, LINE 2: THIS AMOUNT IS CALCULATED BY MULTIPLYING THE TOTAL CHARGES FOR SERVICES WRITTEN OFF AS BAD DEBT BY THE COST TO CHARGE RATIO. PART III, LINE 3: THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY FINANCIAL ASSISTANCE POLICY IS DETERMINED BY THE ORGANIZATION USING INFORMATION AVAILABLE TO MAKE AN EDUCATED ESTIMATE. PART III, LINE 4: THE ORGANIZATION DOES NOT HAVE A SEPARATE BAD DEBT FOOTNOTE. THE FOOTNOTE INCLUDED HERE IS THE PATIENT AND RESIDENT ACCOUNTS RECEIVABLES AND CREDIT POLICY NOTE.PATIENT AND RESIDENT ACCOUNTS RECEIVABLE ARE REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE ORGANIZATION EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT AND RESIDENT CARE SERVICES. PATIENT AND RESIDENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND IMPLICIT PRICE CONCESSIONS, WHICH REFLECTS MANAGEMENT'S ESTIMATE OF THE TRANSACTION PRICE. THE ORGANIZATION ESTIMATES THE TRANSACTION PRICE BASED ON NEGOTIATED CONTRACTUAL AGREEMENTS, HISTORICAL EXPERIENCE, AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS AND IS RECORDED THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT AND RESIDENT ACCOUNTS RECEIVABLE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT AND RESIDENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE.IN EVALUATING THE COLLECTABILITY OF PATIENT AND RESIDENT ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS AND RESIDENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COST REPORTED IN THE MEDICARE COST REPORT IS THE COST TO CHARGE RATIO. PART III, LINE 9B: EMERGENCY ROOM PATIENTS WITHOUT A PAYMENT SOURCE MAY BE CLASSIFIED AS CHARITY IF THEY DO NOT HAVE A JOB, MAILING ADDRESS, RESIDENCE, OR INSURANCE. CONSIDERATION MUST ALSO BE GIVEN TO CLASSIFYING EMERGENCY ROOM ONLY PATIENTS WHO DO NOT PROVIDE ADEQUATE INFORMATION AS TO THEIR FINANCIAL STATUS. IN MANY INSTANCES, THESE PATIENTS ARE HOMELESS AND HAVE FEW RESOURCES TO COVER THE COST OF THEIR CARE.IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE HOSPITAL'S CHARITY CARE ELIGIBILITY CRITERIA, THEIR PATIENT ACCOUNT MAY BE CONSIDERED CHARITY CARE, EVEN IF THEY WERE ORIGINALLY CLASSIFIED AS A BAD DEBT. COLLECTION AGENCY PATIENT ACCOUNTS MEETING CHARITY CARE CRITERIA SHOULD BE RETURNED TO THE HOSPITAL BILLING OFFICE AND REVIEWED FOR CHARITY CARE ELIGIBILITY. PART VI, LINE 2: SOUTH LYON MEDICAL CENTER (SLMC) CONDUCTS WELLNESS WEDNESDAY WEEKLY OFFERING REDUCED LAB TESTING TO ACCESS PATIENT HEALTH. SLMC WILL MEET WITH LOCAL ORGANIZATIONS (I.E., ROTARY, SOROPTIMISTS, ETC.) UPON REQUEST. SLMC IS ALSO DEVELOPING A COMMUNITY WELLNESS PROGRAM WITH A FOCUS ON DIABETES IN ENGLISH AND SPANISH. THE ORGANIZATION PROVIDES COMMENT BOXES, HCAPHS SURVEYS AND PATIENT COMPLAINT/CONCERNS SURVEYS TO GATHER INFORMATION ON COMMUNITY NEEDS. PART VI, LINE 3: PUBLIC NOTICE OF THE AVAILABILITY OF ASSISTANCE THROUGH THE CHARITY CARE POLICY ARE MADE THROUGH EACH OF THE FOLLOWING MEANS:1. POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMITTING OFFICES, AND HOSPITAL OUTPATIENT SERVICE SETTINGS.2. INCLUDING INFORMATION IN THE BILLS SENT TO UNINSURED PATIENTS STATEMENTS INDICATING:A) IF THE PATIENT MEETS CERTAIN INCOME REQUIREMENTS, THE PATIENT MAY BE ELIGIBLE FOR A GOVERNMENT-SPONSORED PROGRAM OR FOR FINANCIAL ASSISTANCE FROM THE HOSPITAL.B) A HOSPITAL PHONE NUMBER THAT PATIENTS MAY CALL FOR FURTHER INFORMATION.3. POSTING NOTICE OF THE AVAILABILITY OF ASSISTANCE AND A CONTACT PHONE NUMBER ON THE SLMC WEB SITE.4. PROVIDING UNINSURED PATIENTS INFORMATION OUTLINING THE TYPES OF FINANCIAL ASSISTANCE AVAILABLE.POSTED NOTICES (AS LISTED ABOVE) SHALL BE IN THE PRIMARY LANGUAGE(S) OF SLMC'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. POSTED NOTICES SHALL CONTAIN THE FOLLOWING INFORMATION:1. A STATEMENT INDICATING THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS WHO MAY NOT BE ABLE TO PAY THEIR BILL AND THAT THIS POLICY PROVIDES FOR FULL OR PARTIAL CHARITY CARE WRITE-OFF.2. IDENTIFICATION OF A HOSPITAL CONTACT PHONE NUMBER THAT THE PATIENT CAN CALL TO OBTAIN MORE INFORMATION ABOUT THE POLICY AND ABOUT HOW TO APPLY FOR ASSISTANCE. PART VI, LINE 4: AS OF 2021, THE POPULATION OF THE PSA IS 8,897, WITH PROJECTIONS ESTIMATING THAT THE PSA IS ANTICIPATED TO GROW BY 3% OVER THE NEXT FIVE YEARS, OR BY ABOUT 286 PEOPLE.THE AGE DISTRIBUTION OF THE POPULATION ALSO IMPACTS THE NEED FOR HEALTHCARE SERVICES. THE COMMUNITY SERVED BY SLMC TRENDS SIGNIFICANTLY OLDER THAN STATE AND NATIONAL BENCHMARKS, WITH 30% OF THE POPULATION CONSISTING OF PEOPLE OVER THE AGE OF 65. THIS AGE COHORT IS ANTICIPATED TO CONTRIBUTE TO A MAJORITY OF THE GROWTH PROJECTED IN THE PSA OVER THE NEXT FIVE YEARS (321 PEOPLE) SLMC'S PSA IS PREDOMINANTLY WHITE, WITH 64% OF THE POPULATION CONSISTING OF INDIVIDUALS WHO IDENTIFY AS WHITE, NON-HISPANIC. APPROXIMATELY 26% OF THE POPULATION IDENTIFIES AS HISPANIC, HIGHER THAN THE NATIONAL BENCHMARK OF 19%. INCOME IS ONE OF THE MOST IMPORTANT SOCIAL DETERMINANTS OF HEALTH, IMPACTING NOT ONLY EDUCATION AND LIVING CONDITIONS, BUT ALSO PHYSICAL HEALTH, MENTAL HEALTH, AND HEALTH-RELATED BEHAVIORS SUCH AS DIET AND EXERCISE. HOUSEHOLD INCOME IN THE PSA TRENDS SIGNIFICANTLY LOWER THAN COUNTY, STATE, AND NATIONAL BENCHMARKS, WITH 38% OF HOUSEHOLDS IN THE PSA REPORTING A HOUSEHOLD INCOME BELOW $35,000, COMPARED TO 29% OF HOUSEHOLDS IN LYON COUNTY. THIS INDICATES THAT SLMC'S PSA IS SIGNIFICANTLY LESS AFFLUENT. PART VI, LINE 5: SOUTH LYON MEDICAL CENTER HAS A COMMUNITY-BASED BOARD OF DIRECTORS; AN OPEN MEDICAL STAFF AND USES SURPLUS FUNDS TO PAY FOR COMMUNITY SERVICES SUCH AS HEALTH FAIRS, SPACE FOR MEDICAL SPECIALISTS FOR LOCAL VISITS. X X 0 0 0 0 0 0 0 0 0 KALEB WARTGOW DIRECTOR/CHIEF OF STAFF 339600 0 0 0 0 0 13584 0 22980 0 376164 0 0 0 TOM WALSH MD 317563 0 0 0 0 0 7083 0 0 0 324646 0 0 0 LOREN SIMPSON MD 281212 0 0 0 0 0 0 0 22333 0 303545 0 0 0 TONI INSERRA CEO 176250 0 0 0 0 0 7050 0 9474 0 192774 0 0 0 THOMAS CLIFTEN PHYSICAL THERAPIST 165221 0 0 0 0 0 4999 0 22146 0 192366 0 0 0 DANA LEWIS MD 174731 0 0 0 0 0 2895 0 9575 0 187201 0 0 0 DAVID BEZARD CFO 156269 0 0 0 0 0 6491 0 22146 0 184906 0 0 0 THOMAS ARD IT SUPERVISOR 151965 0 0 0 0 0 6079 0 9474 0 167518 0 0 0 REBECCA INSERRA EMPLOYEE OF HOSPITAL 75955 REBECCA INSERRA IS A FAMILY MEMBER OF TONI INSERRA. 0 CATHY WILSON EMPLOYEE OF HOSPITAL 79841 CATHY WILSON IS A FAMILY MEMBER OF CARL WILSON AND RONNIE WEIR-COOLEY 0 JOHSUA INSERRA EMPLOYEE OF HOSPITAL 55770 JOSHUA INSERRA IS A FAMILY MEMBER OF TONI INSERRA. 0 THOMAS K ARD EMPLOYEE OF HOSPITAL 18195 THOMAS K. ARD IS A FAMILY MEMBER OF THOMAS H. ARD. 0 FORM 990, PART VI, SECTION A, LINE 2 CARL WILSON AND RONNIE WEIR-COOLEY HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS 28 MEMBERS. THERE IS ONLY ONE CLASS OF MEMBERS, ALL MEMBERS ARE VOTING MEMBERS. MEMBERSHIP IS LIMITED TO RESIDENTS OF THE SOUTH LYON HOSPITAL DISTRICT. MEMBERS ARE ACCEPTED ANNUALLY UPON COMPLETION OF AN APPLICATION AND PAYMENT OF ANNUAL DUES. MEMBERS MAY HAVE A MOTION CONSIDERED BY THE BOARD OF DIRECTORS. ANY WRITTEN MOTION THAT IS SECONDED WILL BE PRESENTED TO THE BOARD AND THERE WILL BE A DETERMINATION WITHIN 90 DAYS. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS HAVE UNLIMITED TERMS AND ARE ACCEPTED UPON YEARLY COMPLETION OF THE CORPORATION APPLICATION AND PAYMENT DUES. THE MEMBERS ARE REQUIRED TO MEET ANNUALLY AND MUST BE RESIDENTS OF THE SOUTH LYON HOSPITAL DISTRICT. MEMBERSHIP IS NOT TRANSFERABLE OR ASSIGNABLE. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE AUDIT FIRM BASED ON THE INFORMATION PROVIDED BY THE CFO OF THE ORGANIZATION. FORM 990 IS THEN REVIEWED AND APPROVED BY THE CEO PRIOR TO PRESENTING TO THE BOARD OF DIRECTORS. THE FORM IS THEN SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL DIRECTORS, MEMBERS OF THE ADMINISTRATIVE STAFF, AND OTHER PERSONS EMPLOYED BY THE ORGANIZATION. COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. ADMINISTRATION AND RISK MANAGEMENT REVIEW FILES FOR SIGNATURES AND DISCLOSURES. IF A CONFLICT OF INTEREST DOES OCCUR, IT IS ANNOUNCED TO THE ENTIRE BOARD PRESENT. IF NECESSARY, THE BOARD ASKS FOR STAFF INPUT AND LEGAL OPINION TO DETERMINE IF A CONFLICT EXISTS IF THE BOARD CANNOT DO SO INDEPENDENTLY. THE INTERESTED BOARD MEMBER WILL ABSTAIN FROM VOTING ON ITEMS THAT HAVE BEEN IDENTIFIED AS A POTENTIAL CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE CEO, TOP MANAGEMENT AND OFFICERS OF THE ORGANIZATION IS DETERMINED BY USING SURVEYS FROM THE NEVADA HOSPITAL ASSOCIATION, NEVADA RURAL HOSPITAL PARTNERS, MGMA, MERRITT HAWKINS AND OTHER PROFESSIONAL SURVEY INSTRUMENTS. THE CEO'S COMPENSATION IS THEN APPROVED BY THE BOARD OF DIRECTORS ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AND ANNOUNCES SUCH AT BOARD MEETINGS AND THE ANNUAL SOUTH LYON HOSPITAL DISTRICT CORPORATION MEETING. FORM 990, PART IX, LINE 11G MED/SURG SERVICES: PROGRAM SERVICE EXPENSES 1,064,275. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,064,275. ER SERVICES: PROGRAM SERVICE EXPENSES 1,652,585. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,652,585. LTC SERVICES: PROGRAM SERVICE EXPENSES 1,080,564. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,080,564. OTHER SERVICES: PROGRAM SERVICE EXPENSES 500,369. MANAGEMENT AND GENERAL EXPENSES 96,493. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 596,862. MRI SERVICES: PROGRAM SERVICE EXPENSES 126,913. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 126,913. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 146,473. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 146,473. BUSINESS OFFICE PURCHASE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 131,467. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 131,467.