Renown Skilled Nursing: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- Renown Skilled Nursing (EIN 20-1347269)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-13
- IRS object ID
- 201101339349303760
- Schema version
- 2009v1.7
- 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 | 2011-05-13T13:06:39-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5601 Green Valley Drive Ste 700 | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 554371145 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201347269 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Renown Skilled Nursing | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | RENO | NameControl |
| Phone | 7759824404 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1155 Mill Street C/O Tax Treasury | AddressLine1 |
| Address Line2 | Z-5 | AddressLine2 |
| City | Reno | City |
| State | NV | State |
| ZIP Code | 89502 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dawn D Ahner | Name |
| Title | CFO | Title |
| Phone | 7759824404 | Phone |
| Date Signed | 2011-05-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kim Hunwardsen CPA | Name |
| Phone | 9529446166 | Phone |
| Date Prepared | 2011-05-10 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Dawn D Ahner | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1155 Mill Street C/O Tax Treasury | AddressLine1 |
| Address Line2 | Z-5 | AddressLine2 |
| City | Reno | City |
| State | NV | State |
| ZIP Code | 89502 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12895072 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.renown.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2004 | YearFormation |
| State Legal Domicile | NV | StateLegalDomicile |
| Activity Or Mission Description | A 160 bed long-term acute care nursing facility specializing in rehabilitative care. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 3 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 10 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3224655 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2785248 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 10542985 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 10107284 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 6092 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2540 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 13773732 | TotalRevenuePriorYear |
| Total Revenue Current Year | 12895072 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8541197 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8880056 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5644220 | OtherExpensePriorYear |
| Other Expenses Current Year | 5427085 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14185417 | TotalExpensesPriorYear |
| Total Expenses Current Year | 14307141 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -411685 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1412069 | RevenuesLessExpensesCY |
| Total Assets BOY | 1924085 | TotalAssetsBOY |
| Total Assets EOY | 2190530 | TotalAssetsEOY |
| Total Liabilities BOY | 8019335 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9697851 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -6095250 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -7507321 | NetAssetsOrFundBalancesEOY |
| Mission Description | Our purpose is to make a genuine difference for the many lives we touch by optimizing our patients' healthcare experience. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 11150200 | Expense |
| Revenue | 10109824 | Revenue |
| Description | See 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 51,492 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. The facility also provided another 1,206 days of long-term care services that were not funded and were designated for patients awaiting Medicaid qualification.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. | Description |
| Total Program Service Expense | 11150200 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 1 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Nbr Voting Governing Body Members | 3 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAWN D AHNER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7759824404 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1155 MILL STREET Z-6 | AddressLine1 |
| City | RENO | City |
| State | NV | State |
| ZIP Code | 89502 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (4 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| James Miller | |||||||
| President/CEO | 1.00 | X | X | 0 | 787242 | 311466 | |
| Dawn Ahner | |||||||
| CFO | 1.00 | X | X | 0 | 396440 | 84338 | |
| Ellen Kelly | |||||||
| Administrator | 60.00 | X | 0 | 108385 | 11452 | ||
| Barbara Coruna | |||||||
| Supervisor/Clinical Nursing | 60.00 | 0 | 118696 | 20944 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1410763 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 428200 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Related Organizations | 2785248 | RelatedOrganizations |
| Total Contributions | 2785248 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENU | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 10107284 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10107284 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 10107284 | TotalProgramServiceRevenue |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 2540 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2540 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2540 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12895072 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10109824 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7383247 | Total |
| Program Services | 6416299 | ProgramServices |
| Management And General | 966948 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1496809 | Total |
| Program Services | 1296503 | ProgramServices |
| Management And General | 200306 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 412453 | Total |
| Management And General | 412453 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7875 | Total |
| Management And General | 7875 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 495273 | Total |
| Program Services | 290344 | ProgramServices |
| Management And General | 204929 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1755153 | Total |
| Program Services | 1710995 | ProgramServices |
| Management And General | 44158 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1245484 | Total |
| Program Services | 183021 | ProgramServices |
| Management And General | 1062463 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3792 | Total |
| Program Services | 2863 | ProgramServices |
| Management And General | 929 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1552 | Total |
| Management And General | 1552 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 200123 | Total |
| Program Services | 107296 | ProgramServices |
| Management And General | 92827 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93967 | Total |
| Management And General | 93967 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Hospital Provider Tax | 1035762 | 1035762 | |
| Bad Debt Expense | 106321 | 106321 | |
| Other Expenses | 68825 | 796 | 68029 |
| Business Meals/Entertai | 505 | 505 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14307141 | Total |
| Program Services | 11150200 | ProgramServices |
| Management And General | 3156941 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51176 | BOY |
| EOY | 62132 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1187751 | BOY |
| EOY | 1014659 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25728 | BOY |
| EOY | 28047 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23375 | BOY |
| EOY | 107986 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 3771657 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2793951 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 636055 | BOY |
| EOY | 977706 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1924085 | BOY |
| EOY | 2190530 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 572020 | BOY |
| EOY | 639093 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50444 | BOY |
| EOY | 36925 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7396871 | BOY |
| EOY | 9021833 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8019335 | BOY |
| EOY | 9697851 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -6095250 | BOY |
| EOY | -7507321 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -6095250 | BOY |
| EOY | -7507321 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1924085 | BOY |
| EOY | 2190530 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 1 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1355014 | OtherCostOrOtherBasis |
| Depreciation | 867336 | Depreciation |
| Book Value | 487678 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2413204 | OtherCostOrOtherBasis |
| Depreciation | 1926615 | Depreciation |
| Book Value | 486589 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3439 | OtherCostOrOtherBasis |
| Book Value | 3439 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 977706 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Due to Affliates | Description |
| Amount | $9,021,833 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 9021833 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| 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: | The consolidated financial statements did not contain a footnote to report the organization's liability for uncertain tax positions under FIN 48 as there were no uncertain tax positions to be reported. | Description of Uncertain Tax Positions Under FIN 48: |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| James Miller | |||||||||||||
| 0 | 774390 | 0 | 0 | 0 | 12852 | 0 | 296565 | 0 | 16558 | 0 | 1100365 | 0 | 0 |
| Dawn Ahner | |||||||||||||
| 0 | 396440 | 0 | 0 | 0 | 0 | 0 | 65679 | 0 | 18658 | 0 | 480777 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 4a | Dawn Ahner is party to a supplemental nonqualified retirement plan. Contribution of $55,879 to Dawn Ahner was included in Schedule J, Part II, Column (C). | |
| Part III | Part 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 (11 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | Renown Health is the sole corporate member of Renown Skilled Nursing. | |
| Form 990, Part VI, Section A, line 7a | Renown 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 7b | Renown 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 B, line 11 | The 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 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 12c | On 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 15 | Renown 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 2010 executive compensation. | |
| Form 990, Part VI, Section C, line 19 | Renown 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 B | Jim 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 2b | Renown 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 2a | Renown 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 |
| Form 990, Part X | Reclassifications were made to beginning of year amounts in order to provide consistent reporting with end of year amounts. | Balance Sheet Reclassification |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| Renown Health | |||||||||
| 1155 Mill Street Z-5 | Reno | NV | 89502 | 942972845 | Health Care | NV | 501 (c) (3) | III-Fi | N/A |
| Renown Health Foundation | |||||||||
| 1155 Mill Street Z-5 | Reno | NV | 89502 | 942972749 | Foundation | NV | 501 (c) (3) | 7 | N/A |
| Renown Regional Medical Center | |||||||||
| 1155 Mill Street Z-5 | Reno | NV | 89502 | 880213754 | Hospital | NV | 501 (c) (3) | 3 | N/A |
| Renown South Meadows Medical Center | |||||||||
| 1155 Mill Street Z-5 | Reno | NV | 89502 | 460517825 | Hospital | NV | 501 (c) (3) | 3 | N/A |
| Hometown Health Plan | |||||||||
| 1155 Mill Street Z-5 | Reno | NV | 89502 | 880231433 | HMO | NV | 501 (c) (4) | N/A | |
| Renown Network Services | |||||||||
| 1155 Mill Street Z-5 | Reno | NV | 89502 | 880231828 | Outpatient Imaging and Pregnancy Center | NV | 501 (c) (3) | 3 | N/A |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Routt Dialysis LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1155 Mill St Z-5 | AddressLine1 |
| City | Reno | City |
| State | NV | State |
| ZIP Code | 89502 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263558729 | EIN |
| Primary Activity | Kidney Dialysis | PrimaryActivity |
| Legal Domicile State | NV | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| Renown Businesses | ||||||||
| 1155 Mill St Z-5 | Reno | NV | 89502 | 880228030 | Health Care | NV | N/A | C |
| Hometown Health Managment Company | ||||||||
| 1155 Mill St Z-5 | Reno | NV | 89502 | 880236758 | Management Services | NV | N/A | C |
| The Provider Network Inc | ||||||||
| 1155 Mill St Z-5 | Reno | NV | 89502 | 880376369 | Health Care | NV | N/A | C |
| Remittance Assistance Corporation | ||||||||
| 1155 Mill St Z-5 | Reno | NV | 89502 | 880277761 | Collections | NV | N/A | C |
| Hometown Health Providers Insurance Co | ||||||||
| 1155 Mill St Z-5 | Reno | NV | 89502 | 880177026 | Insurance | NV | N/A | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hometown Health Plan Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | L | TransactionType |
| Amount Involved | 414560 | AmountInvolved |