CENTRAL VALLEY MEDICAL CENTER: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL VALLEY MEDICAL CENTER (EIN 87-0419324)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-10
- IRS object ID
- 201231319349301203
- Schema version
- 2010v3.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-10T08:26:18-07:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hansen Barnett & Maxwell PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Triad Center Suite 750 | AddressLine1 |
| City | Salt Lake City | City |
| State | UT | State |
| ZIP Code | 84180 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 870419324 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL VALLEY MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CENT | NameControl |
| Phone | 4356233000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 412 | AddressLine1 |
| City | NEPHI | City |
| State | UT | State |
| ZIP Code | 84648 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Mr Mark Stoddard | Name |
| Title | President & CEO | Title |
| Date Signed | 2012-05-09 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | L MATTHEW EGNEW CPA | Name |
| Phone | 8015322200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Mr Mark Stoddard | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 436 N 800 E | AddressLine1 |
| City | Nephi | City |
| State | UT | State |
| ZIP Code | 84648 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 32903300 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CVMED.NET | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1984 | YearFormation |
| State Legal Domicile | UT | StateLegalDomicile |
| Activity Or Mission Description | HOSPITAL SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 276 | TotalNbrEmployees |
| Total Nbr Volunteers | 6 | TotalNbrVolunteers |
| Total Gross UBI | 2687395 | TotalGrossUBI |
| Contributions Grants Prior Year | 49099 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 68258 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 24591170 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 28213357 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1222053 | InvestmentIncomePriorYear |
| Investment Income Current Year | 836371 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 25862322 | TotalRevenuePriorYear |
| Total Revenue Current Year | 29117986 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 3000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 4000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9315705 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9557037 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 77827 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 14656343 | OtherExpensePriorYear |
| Other Expenses Current Year | 17284991 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 23975048 | TotalExpensesPriorYear |
| Total Expenses Current Year | 26846028 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1887274 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2271958 | RevenuesLessExpensesCY |
| Total Assets BOY | 35650094 | TotalAssetsBOY |
| Total Assets EOY | 39697400 | TotalAssetsEOY |
| Total Liabilities BOY | 14733398 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 16461950 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 20916696 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 23235450 | NetAssetsOrFundBalancesEOY |
| Mission Description | HOSPITAL SERVICES | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 23052228 | Expense |
| Revenue | 28213357 | Revenue |
| Description | CENTRAL VALLEY MEDICAL CENTER OPERATES A HOSPITAL AND TWO MEDICAL CLINICS PROVIDING MEDICAL CARE TO RURAL COMMUNITIES. | Description |
| Total Program Service Expense | 23052228 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 44 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 276 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Central Valley Medical Center | NamePerson |
| Telephone Number | 4356233000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 48 W 1500 N | AddressLine1 |
| City | Nephi | City |
| State | UT | State |
| ZIP Code | 84648 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Highest Compensated EmployeeHighestCompensatedEmployee | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer |
|---|---|---|---|---|---|---|---|
| Steve Breckenridge | |||||||
| PHARMACIST | 40.00 | X | 131952 | 0 | 24650 | ||
| Shauna Archibald | |||||||
| Home Health Dir | 40.00 | X | 110162 | 0 | 13143 | ||
| Randy Allinson | |||||||
| NURSING DIRECTR | 40.00 | X | 107687 | 0 | 7291 | ||
| Mrs Gayle Ludlow | |||||||
| Board Member | 1.00 | 0 | 0 | 0 | X | ||
| Mrs Betty Mikkelsen | |||||||
| Board Member | 1.00 | 0 | 0 | 0 | X | ||
| Mr William D Howard | |||||||
| Board Member | 1.00 | 0 | 0 | 0 | X | ||
| Mr Mark Stoddard | |||||||
| President & CEO | 50.00 | 263135 | 0 | 41226 | X | ||
| Mr Mark Chase | |||||||
| Board Member | 1.00 | 0 | 0 | 0 | X | ||
| Mr John E Gledhill | |||||||
| COO | 40.00 | X | 124568 | 0 | 7766 | X | |
| Mr Duane Crutchfield | |||||||
| Chairman | 1.00 | 0 | 0 | 0 | X | ||
| Mr Brent Davis | |||||||
| Vice President | 50.00 | 101135 | 0 | 23495 | X | ||
| Mr Alan Kennison | |||||||
| Board Member | 1.00 | 0 | 0 | 0 | X | ||
| Kecia White | |||||||
| PHARMACIST | 40.00 | X | 132613 | 0 | 8787 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 967634 | TotalReportableCompFromOrg |
| Total Other Compensation | 126358 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | true | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SW Rehab Inc | |||||
| 887 N 800 E | Nephi | UT | 84648 | Physical Therapy Ser | 788190 |
| Rural Health Management Corporation | |||||
| 48 W 1500 N | Nephi | UT | 84648 | Physician Services | 3090012 |
| Rural Health Group Inc | |||||
| 48 W 1500 N | Nephi | UT | 84648 | Management Services | 1168793 |
| BP CONSULTING INC | |||||
| PO BOX 140095 | BOISE | ID | 83714 | MOBILE MRI | 157811 |
| ARCHITECTURAL NEXUS | |||||
| 595 S RIVERWOODS PARK STE 250 | LOGAN | UT | 84321 | ARCHICTECTURAL | 167510 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Government Grants | 61343 | GovernmentGrants |
| All Other Contributions | 6915 | AllOtherContributions |
| Total Contributions | 68258 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| RETAIL PHARMACY | 446110 | 2662573 | 2662573 | |
| Medical Services | 621110 | 25441255 | 25441255 | |
| Daycare | 624410 | 24822 | 24822 | |
| CAFETERIA/RECORDS/OTHER | 900099 | 84707 | 84707 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 28213357 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 228098 | TotalRevenueColumn |
| Exclusion | $228,098 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4392337 | Securities |
| Other | 1250 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3773600 | Securities |
| Other | 11714 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 618737 | Securities |
| Other | -10464 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 608273 | TotalRevenueColumn |
| Exclusion | $608,273 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 29117986 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25525962 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 2687395 | UnrelatedBusinessRevenue |
| Exclusion | $836,371 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4000 | Total |
| Program Services | 4000 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 557707 | Total |
| Program Services | 308308 | ProgramServices |
| Management And General | 249399 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6812421 | Total |
| Program Services | 6035310 | ProgramServices |
| Management And General | 723881 | ManagementAndGeneral |
| Fundraising | 53230 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 367137 | Total |
| Program Services | 326600 | ProgramServices |
| Management And General | 36615 | ManagementAndGeneral |
| Fundraising | 3922 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1300860 | Total |
| Program Services | 1180484 | ProgramServices |
| Management And General | 105706 | ManagementAndGeneral |
| Fundraising | 14670 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 518912 | Total |
| Program Services | 467143 | ProgramServices |
| Management And General | 48363 | ManagementAndGeneral |
| Fundraising | 3406 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1347512 | Total |
| Management And General | 1347512 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12375 | Total |
| Management And General | 12375 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26585 | Total |
| Management And General | 26585 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4592706 | Total |
| Program Services | 4448430 | ProgramServices |
| Management And General | 144276 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54117 | Total |
| Program Services | 28366 | ProgramServices |
| Management And General | 25751 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 338693 | Total |
| Program Services | 210896 | ProgramServices |
| Management And General | 125370 | ManagementAndGeneral |
| Fundraising | 2427 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 167114 | Total |
| Program Services | 81586 | ProgramServices |
| Management And General | 85528 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 340557 | Total |
| Program Services | 272446 | ProgramServices |
| Management And General | 68111 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 120568 | Total |
| Program Services | 63134 | ProgramServices |
| Management And General | 57323 | ManagementAndGeneral |
| Fundraising | 111 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 758350 | Total |
| Program Services | 758350 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1481575 | Total |
| Program Services | 1331121 | ProgramServices |
| Management And General | 150454 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 373933 | Total |
| Program Services | 223431 | ProgramServices |
| Management And General | 150502 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| SUPPLIES | 4990451 | 4990451 | ||
| PROVISION FOR DOUBTFUL ACCOUNT | 1944540 | 1944540 | ||
| OTHER EXPENSES | 365963 | 31895 | 334068 | |
| MAINTENANCE | 312549 | 300294 | 12194 | 61 |
| EDUCATION | 57403 | 45443 | 11960 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26846028 | Total |
| Program Services | 23052228 | ProgramServices |
| Management And General | 3715973 | ManagementAndGeneral |
| Fundraising | 77827 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1163750 | BOY |
| EOY | 774944 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6515111 | BOY |
| EOY | 6940540 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4118959 | BOY |
| EOY | 4788736 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2101667 | BOY |
| EOY | 2811264 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 926272 | BOY |
| EOY | 1257016 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 242656 | BOY |
| EOY | 337914 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 29841678 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 10404692 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16385362 | BOY |
| EOY | 19436986 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2196317 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2000000 | BOY |
| EOY | 3350000 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35650094 | BOY |
| EOY | 39697400 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1441082 | BOY |
| EOY | 2043711 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13292316 | BOY |
| EOY | 14418239 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14733398 | BOY |
| EOY | 16461950 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20916696 | BOY |
| EOY | 23235450 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20916696 | BOY |
| EOY | 23235450 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35650094 | BOY |
| EOY | 39697400 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2271958 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 46796 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1296178 | OtherCostOrOtherBasis |
| Book Value | 1296178 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18819590 | OtherCostOrOtherBasis |
| Depreciation | 4609073 | Depreciation |
| Book Value | 14210517 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8757059 | OtherCostOrOtherBasis |
| Depreciation | 5245938 | Depreciation |
| Book Value | 3511121 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 968851 | OtherCostOrOtherBasis |
| Depreciation | 549681 | Depreciation |
| Book Value | 419170 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 19436986 | TotalOfBookValueLandBuildings |
| Total Book Value Other Assets | 3350000 | TotalBookValueOtherAssets |
| Total Revenue | 29117986 | TotalRevenue |
| Total Expenses | 26846028 | TotalExpenses |
| Excess Or Deficit For Year | 2271958 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 46796 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 46796 | TotalAdjustments |
| Excess Or Deficit Per FS | 2318754 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 29164782 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 46796 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 46796 | RevenueNotRptdF990 |
| Revenue Subtotal | 29117986 | RevenueSubtotal |
| Total Revenue Per Form990 | 29117986 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 26846028 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 26846028 | ExpensesSubtotal |
| Total Expenses Per Form990 | 26846028 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 597573 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 597573 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02230 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2833686 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2439567 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 394119 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01470 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3431259 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2439567 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 991692 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03700 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 513267 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 241260 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 272007 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01010 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 77727 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 77727 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 590994 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 241260 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 349734 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01300 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 4022253 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2680827 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1341426 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 3000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 3000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,283,397 | BadDebtExpenseAmount |
| Amount Attributable To | 423500 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6299114 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6853849 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -554735 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RURAL HEALTH GROUP INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | MANAGEMENT SERVICES | DescriptionEntPrimaryActivity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 0 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL VALLEY MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 48 W 1500 N | AddressLine1 |
| City | NEPHI | City |
| State | UT | State |
| ZIP Code | 84648 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Critical Access Hospital | X | CriticalAccessHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL VALLEY MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | false | CHNAConducted |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100.0000 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 250.0000 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Other Actions | X | OtherActions |
| Notify Upon Admission | X | NotifyUponAdmission |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 4 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| FOUNTAIN GREEN CLINIC | ||||
| 275 W 300 S | FOUNTAIN GREEN | UT | 84632 | PHYSICIAN CLINIC |
| CENTRAL VALLEY COMMUNITY PHARMACY | ||||
| 152 W 1500 N | NEPHI | UT | 84648 | RETAIL PHARMACY SERVICES |
| CENTRAL VALLEY HOME HEALTH HOSPICE & HME | ||||
| 152 W 1500 N | NEPHI | UT | 84648 | HOME HEALTH, HOSPICE AND HME SERVICES |
| NEPHI MEDICAL CLINIC | ||||
| 48 W 1500 N | NEPHI | UT | 84648 | PHYSICIAN CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part V - Explanation of Number of Facility Type | 1 CRITICAL ACCESS HOSPITAL | |
| Part VI - States Where Community Benefit Report Filed | UT | |
| Part VI - Explanation Of How Organization Furthers Its Exempt Purpose | CVMC PARTICIPATES IN COMMUNITY HEALTH INITIATIVES THROUGH CASH DONATIONS AND EMPLOYEE INVOLVEMENT AND SUPPORT. THE BOARD OF DIRECTORS IS SELECTED FROM THE DIFFERENT COMMUNITIES SERVED BY THE ORGANIZATION TO REPRESENT THE NEEDS OF THESE COMMUNITIES. THE BOARD SERVES AS VOLUNTEERS TO REMOVE FINANCIAL INTEREST CONFLICTS. | |
| Part VI - Community Building Activities | THE ORGANIZATION SUPPORTS AND PARTICIPATES IN COMMUNITY SERVICE AND HEALTH PROMOTION ACTIVITIES THROUGH EMPLOYEE INVOLVEMENT AND CASH DONATIONS. COMMUNITY HEALTH IS OF PRIME IMPORTANCE TO OUR ORGANIZATION AND WE STRIVE TO PROMOTE THAT IN THE COMMUNITIES WE SERVE. | |
| Part VI - Community Information | THE ORGANIZATION SERVES PATIENTS FROM JUAB, SANPETE AND MILLARD COUNTIES IN CENTRAL UTAH. | |
| Part VI - Patient Education of Eligibility for Assistance | SIGNS ARE PLACED AT THE REGISTRATION DESKS THROUGHOUT THE FACILITY INFORMING PATIENTS OF CHARITY ASSISTANCE THAT IS AVAILABLE. OUR REGISTRATION PERSONNEL WORK WITH UNINSURED PATIENTS TO QUALIFY THEM FOR PUBLIC INSURANCE PROGRAMS AND AVAILABLE CHARITY ASSISTANCE. | |
| Part VI - Needs Assessment | COMMUNITY NEEDS ARE ASSESSED THROUGH COMMUNITY AND PHYSICIAN INPUT. | |
| Part V, Line 19d - Other Billing Determination of Individuals Without Insurance | 10 PERCENT DISCOUNT IF PAID WITHIN 30 DAYS - SAME AS AVERAGE PRIVATE INSURANCE DISCOUNT. | Number of Hospital Faciltiy - 0 |
| Part V, Line 16e - Other Collection Actions by Facility or Third Party Engaged | WAGE GARNISHMENTS | Number of Hospital Faciltiy - 0 |
| Part V, Line 15e - Other Collection Actions Against a Patient | WAGE GARNISHMENTS | Number of Hospital Faciltiy - 0 |
| Part V, Line 13g - Other Means Hospital Facility Publicized the Policy | POSTED SIGNS INDICATING HOSPITAL HAD ASSISTANCE PROGRAM | Number of Hospital Faciltiy - 0 |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | ALL PATIENTS ARE GIVEN AN OPPORTUNITY TO APPLY FOR CHARITABLE ASSISTANCE IF THEY DESIRE. APPROPRIATE REDUCTIONS ARE TAKEN IN THEIR PATIENT ACCOUNT BALANCE BASED ON INCOME AND ABILITY TO PAY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | true | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|---|
| Steve Breckenridge | ||||
| 131952 | 7917 | 16733 | 156602 | |
| Mr Mark Stoddard | ||||
| 213864 | 24500 | 16726 | 308308 | 53218 |
| Mr Brent Davis | ||||
| 102652 | 6769 | 16726 | 126147 | |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| RURAL HEALTH MANAGEMENT CORP | |||
| COMMON PRESIDENT | 3090012 | PHYSICIAN SERVICES | false |
| RURAL HEALTH GROUP INC | |||
| COMMON PRESIDENT | 1168793 | MANAGEMENT FEES | false |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990 PART IV LINE 20B | AUDITED FINANCIAL STATEMENTS | |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | AVAILABLE UPON REQUEST | Form 990, Part VI, Line 19 |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | THE ORGANIZATION UTILIZED A COMPENSATION COMMITTEE, COMPARABLE FORM 990S OF OTHER ORGANIZATIONS, COMPENSATION SURVEYS AND STUDIES, AND APPROVAL OF A COMPENSATION COMMITTEE TO ESTABLISH THE REASONABLENESS OF INSIDER COMPENSATION. | Form 990, Part VI, Line 15b |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | VERBAL DISCLOSURE IS MADE ANNUALLY BY BOARD MEMBERS AND OFFICERS. PAPER QUESTIONAIRES WILL BE DISTRIBUTED IN THE FUTURE. | Form 990, Part VI, Line 12c |
| Form 990, Part VI, Line 11: Form 990 Review Process | FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE BEFORE IT IS FILED. | Form 990, Part VI, Line 11 |
| Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company | MANAGEMENT CONTRACT FOR CEO, CFO AND IT SERVICES WITH RURAL HEALTH GROUP, INC. | Form 990, Part VI, Line 3 |
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | CEO IS MAJORITY OWNER OF RURAL HEALTH GROUP, INC. CFO IS A MINORITY OWNER (2%) OF SAME CORPORATION. | Form 990, Part VI, Line 2 |
| Client Note 1 - REASONABLE CAUSE FOR LATE-FILING:FORM 8868, APPLICATION FOR EXTENSION OF TIME TO FILE AN EXEMPT ORGANIZATION RETURN, WAS MAILED VIA CERTIFIED MAIL ON FEBRUARY 10, 2012 (PRIOR TO THE FEBRUARY 15, 2012 DEADLINE) BY OUR CPA FIRM. THE UNITED STATES POST OFFICE ACCEPTED THE ENVELOPE CONTAINING THE EXTENSION AND STAMPED IT AS RECEIVED. HOWEVER, THEY SUBSEQUENTLY DECLINED TO MAIL IT DUE TO INSUFFICIENT POSTAGE BUT DID NOT ALERT THE CPA FIRM OF THE PROBLEM UNTIL THREE WEEKS LATER WHEN THE ENVELOPE WAS RETURNED TO THEM. BY THEN THE DEADLINE FOR FILING THE EXTENSION HAD PASSED. IMMEDIATELY UPON RECEIVING THE RETURNED ENVELOPE FROM THE POST OFFICE, THE CPA FIRM SENT A LETTER TO THE IRS EXPLAINING THE ERROR AND REQUESTED ACCEPTANCE OF THE EXTENSION. HOWEVER, THIS REQUEST WAS DENIED. WE REQUEST THAT THIS FORM 990 BE ACCEPTED AS TIMELY FILED DUE TO REASONABLE CAUSE AS EXPLAINED ABOVE. CENTRAL VALLEY MEDICAL CENTER AND OUR CPA FIRM ACTED IN GOOD FAITH AND WITH DUE DILIGENCE TO OBTAIN AN EXTENSION OF TIME TO FILE. THE POST OFFICE FAILED TO VERIFY PROPER POSTAGE AT THE TIME OF SUBMISSION AND DID NOT RETURN THE ENVELOPE IN A TIMELY MANNER. |