2011-08-15T19:43:39-05:00 2010-09-30 ELGEE REHFELD MERTZ LLC 9309 GLACIER HWY STE B-200 JUNEAU AK 99801 990 2009-10-01 920041488 NORTON SOUND HEALTH CORPORATION NORT 9074433311 PO BOX 966 NOME AK 99762 CRAIG AMBROSIANI 9074433311 2011-08-15 1 Bridget Lujan 9077893178 2011-08-15 2009 2016-02-24 21:20:13Z ROY AGLOINGA PO BOX 966 NOME AK 99762 75225782 0 X NORTONSOUNDHEALTH.ORG X 1970 AK TO PROVIDE QUALITY HEALTH SERVICES AND PROMOTE WELLNESS WITHIN ITS PEOPLE AND ENVIRONMENT. 25 24 689 0 0 0 43049321 43325683 27393206 30565253 396177 318508 1819292 1016338 72657996 75225782 74000 86710 0 33564568 35117637 0 0 27881542 27111519 61520110 62315866 11137886 12909916 75638799 125820991 13900130 50892001 61738669 74928990 TO PROVIDE QUALITY HEALTH SERVICES AND PROMOTE WELLNESS WITHIN ITS PEOPLE AND ENVIRONMENT. 0 0 38315527 24346534 The hospital division of Norton Sound Health Corporation (NSHC) includes a 15 bed acute care hospital and a 19 bed long-term care facility through which medical care is provided to the residents of Nome and 15 villages on the coast and islands of the Bering Sea. In addition to inpatient/outpatient care, NSHC continues to increase its commitment to preventive health care by supporting programs that emphasize health and fitness, including offering numerous screening tests, diet, exercise and fitness counseling, as well as screening procedures for colon and stomach cancer, cardiovascular and diabetes health risks. Quyanna Care Center - the long term care facility, continues to maximize the quality of life for its residents. Staff members strive to maintain a very high level of care by ensuring that patient safety and quality of care come first. A home-like environment is promoted and embraced and the Native culture is woven into every aspect of care. Native foods are prepared often through family and community donations. Celebrations and family gatherings are part of everyday life in the facility.Key hospital statistics for FY10 include:Admissions 637ER Visits 4,211Outpatients 15,042Dental encounters 10,059Radiolgy Exams 6,296 14384965 6625269 NSHC's regional health services provide a wide variety of health care, promotion, screening, and prevention programs to Nome and 15 Bering Sea villages. Such programs include but are not limited to the provision of health aides (certified and in-training) at each village health clinic, a Tribal Healer Program, Infant Learning Programs, Environmental Health Program, Public Health Nursing Program and other services geared specifically to women, infants and children.Key Statistics for FY10 include: Patient visits in village clinics Approximately 30,000 Tribal Healer Patient visits 1,020 Environmental Health 27 Village trips to address environmental health issues Trained 38 water system operators Conducted 38 animal bite/rabies exposure investigations Public Health Nursing 7,792 client contacts 2,048 TB skin tests 138 Well Child exams 8,066 immunizations 33 village trips and 46 population based services 2318537 386015 NSHC's Behavioral Health Services Division provides outpatient individual, couple, family and group mental health therapy, interactive and observational play therapy as well as individual, couple, family and group substance abuse counseling, and Alcohol and Drug Information School. It also provides psychological and neuropsychological testing, psychiatric services including medication assessment and evaluation, case management and referral services and 24/7 crisis intervention in the emergency room and inpatient units. Behavioral Health Services are delivered in the villages through the Village Based Counselors (VBC's) and NSHC operates "Kusqui House" - a facility with capacity of 6 women with up to 8 children at which women may reside while attending intensive outpatient treatment for addictions and mental health concerns. Key Statistics for FY10 include: Substance abuse clients 407 Mental Health services Mental Health Clients 758 Emergency Service Clients 226 Village Based Counselors Client Contacts 2,684 5571618 223773 5571618 223773 60590647 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 92 0 1 689 1 0 0 0 0 0 0 0 0 0 25 24 1 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 1 1 0 AK X CRAIG AMBROSIANI 9074433201 PO BOX 966 NOME AK 99762 JUNE WALUNGA 3.00 X X 15450 0 0 KATHY JOHNSON 3.00 X X 11025 0 0 JOHN HANDELAND 3.00 X X 8415 0 0 BERDA WILLSON 3.00 X X 18765 0 0 MARY KNODEL 3.00 X X 9225 0 0 KARLA NAYOKPUK 1.00 X 3825 0 0 PRESTON ROOKOK 1.00 X 5685 0 0 RUTH OJANEN 1.00 X 8775 0 0 CAROL ABLOWALUK 1.00 X 2700 0 0 LEONARD ADAMS 1.00 X 4725 0 0 CYNTHIA AHWINONA 1.00 X 0 0 0 MARY LOU AMAKTOOLIK 1.00 X 4950 0 0 ALLEN ATCHAK 1.00 X 900 0 0 SIMON BEKOALOK JR 1.00 X 4500 0 0 ELSIE CHEEMUK 1.00 X 2025 0 0 BRIAN JAMES 1.00 X 1800 0 0 KAREN KAZINGNUK 1.00 X 2700 0 0 ROBERT KEITH 1.00 X 3150 0 0 JOANNE KEYES 1.00 X 3375 0 0 MITHCELL KIYUKLOOK 1.00 X 0 0 0 JENNI LEE 1.00 X 0 0 0 FREDERICK MURRAY 1.00 X 4500 0 0 MORRIS NASSUK 1.00 X 3375 0 0 BANTU NICHOLS 1.00 X 0 0 0 BECKY ODINOZOFF 1.00 X 4275 0 0 WESLEY OKBAOK 1.00 X 675 0 0 MICHAEL OLANNA 1.00 X 0 0 0 ROSEMARY OTTEN 1.00 X 675 0 0 FRANK OXEREOK JR 1.00 X 0 0 225 CHRISTINE PERKINS 1.00 X 2025 0 0 JAMES PUSHRUK 1.00 X 0 0 0 ALFRED SAHLIN 1.00 X 9090 0 0 LINCOLN SIMON SR 1.00 X 5625 0 0 REUBEN WEYIOUANNA 1.00 X 0 0 225 EMILY HUGHES 40.00 X 65203 0 9984 CAROL PISCOYA 40.00 X X 150078 0 21674 ROY AGLOINGA 40.00 X 73600 0 128 ANGELA GORN 40.00 X 116182 0 17540 MELISSA BOECKMANN 40.00 X 102959 0 15666 DAVID HEAD 40.00 X X 330777 0 47532 KAREN ONEILL 40.00 X 271991 0 38741 MARK KELSO 40.00 X 266098 0 38504 SAI-LING LIU 40.00 X 263404 0 37070 WILLIAM M COX 40.00 X 163108 0 20802 ROBERT LAWRENCE 40.00 X 162016 0 16730 2107646 0 264821 37 0 1 0 DOWL HKM 4041 B STREET ANCHORAGE AK 99503 CIVIL ENGINEERING SERVICES 1554559 CORE MEDICAL GROUP 2 KEEWAYDIN DRIVE SALEM NH 03079 CONTRACT AND TEMPORARY NURSING STAFF LAB 957040 KUMIN ASSOCIATES 808 E STREET SUITE 200 ANCHORAGE AK 99501 ARCHITECTURAL DESIGN SERVICES 738199 WAINEBRANDT LLC 1755 NORTH BROWN ROAD SUITE 200 LAWRENCEVILLE GA 30043 FINANCIAL MANAGEMENT SERVICES 453751 LOCUM TENENS USA INC 1030 MATHESON WAY ALPHARETTA GA 30022 PHYSICAN STAFFING SERVICES 414790 26 43325683 43325683 NET PATIENT REVENUES 900099 30565253 30565253 30565253 318508 318508 63777 63777 63777 63777 MISCELLANEOUS REVENUES 900099 952561 952561 952561 75225782 31581591 0 318508 86710 86710 729100 252346 476754 26040725 23555287 2485438 1104632 999201 105431 5074754 4533542 541212 2168426 1961462 206964 292190 292190 718588 718588 55910 55910 5263341 4199615 1063726 97342 7333 90009 974474 628317 346157 3413592 2707077 706515 6468142 5974574 493568 49898 49898 2256776 1352051 904725 478860 11215 467645 MATERIALS & OTHER OPERA 4443359 4231254 212105 MAINTENANCE & EQUIPMENT 1847299 1394099 453200 BAD DEBT 316781 316781 ALLOCATION OF INDIRECT 0 8073043 -8073043 434967 200932 234035 62315866 60590647 1725219 0 969908 384011 15095752 50677144 3105469 4670345 7490775 9454377 10124 795364 774895 348236 214305 82869138 34765232 41613626 48103906 5315889 10536241 893656 1005767 75638799 125820991 6395521 6051041 5329275 42517932 868363 1316305 1306971 1006723 13900130 50892001 X 61738669 74928990 61738669 74928990 75638799 125820991 X 0 1 1 X 1 1 X 35355878 31194123 41440464 43049321 43325683 194365469 35355878 31194123 41440464 43049321 43325683 194365469 194365469 378184 403633 489030 446487 382285 2099619 1189777 398579 2664045 1768982 952561 6973944 203439032 148585909 0.95540 0.95900 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1498302 1498302 37043119 23520195 13522924 15880961 11245037 4635924 28446756 28446756 48103906 RESERVE FOR CLAIM PAYMENTS 1006723 1006723 75225782 62315866 12909916 280405 280405 13190321 77706187 280405 2200000 2480405 75225782 0 75225782 64515866 2200000 2200000 62315866 0 62315866 1 1 1 X 1 X 101.000000000000 0 0 0 1 1 2387159 2387159 0.03830 12778266 16143049 -3364783 0.00000 15165425 16143049 -977624 0.03830 4849610 4849610 0.07780 86710 86710 0.00140 356452 356452 0.00570 5292772 5292772 0.08490 20458197 16143049 4315148 0.12320 1341088 0 1341088 0.02150 1341088 1341088 0.02150 0 257543 4545830 2461634 2084196 X 1 0 NORTON SOUND HEALTH CORPORATION

PO BOX 966 NOME AK 99762

X X X X OUTPATIENT PHYSICIAN CLINICS IN THE VILLAGES QUYANNA CARE CENTER

PO BOX 966 NOME AK 99762

LONG TERM CARE FACILITY Part III, Line 4: ESTIMATED UNCOLLECTIBLE REVENUE IS REPORTED AS A PROVISION FOR BAD DEBTS IN THE FINANCIAL STATEMENTS. MANAGMENT'S ESTIMATE OF THE NET REALIZABLE VALUE OF PATIENT ACCOUNTS RECEIVABLE IS BASED ON HISTORICAL COLLECTIONS OF ACCOUNTS RECEIVABLE AND CURRENT ECONOMIC, REGULATORY AND DEMOGRAPHIC INFORMATION. Part III, Line 8: IRS Rev. Rul. 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with government health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. This implies that treating Medicare patients is a community benefit. Costs for Medicare were obtained from the Norton Sound Health Corporation Medicare cost report. Norton Sound Health Corporation (NSHC) prepares an annual written report that describes the organization's programs and services that promote the health of the community or communities served by the organization. This annual report that can found on NSHC's website: www.nortonsoundhealth.org Part VI, Line 2: Norton Sound Health Corporation identifies unmet community health needs by participating in community coalitions, partnerships, boards, committees, commissions and panels. Additionally, each of the 15 villages served by NSHC as well as the Nome region at large are represented on the NSHC Board of Trustees. At each quarterly meeting of the Board, healthcare needs of the various regions are communicated through village reports to the full Board. Part VI, Line 3: Norton Sound Health Corporation is committed to providing access to quality healthcare with compassion, dignity and respect for those we serve, particularly the poor and the underserved in our communities. NSHC effectively communicates with patients regarding patient payment obligations. Financial counseling is provided by our benefit coordinators as well as general patient financial staff. Information on hospital based financial support policies and external programs that provide coverage for services are made available to patients during the registration process and in response to patients seeking financial assistance. Patient accounting staff also support the financial counseling program by providing patients with information and applications while handling customer service calls. AT NSHC we work very closely with patients to ensure that Medicaid coverage is applied for when appropriate. Part VI, Line 4: NORTON SOUND HEALTH CORPORATION, BASED IN NOME, ALASKA, WAS FOUNDED IN 1970 TO SERVE THE HEALTH CARE NEEDS OF THE INUPIAT, SIBERIAN YUPIK, AND YU'PIK PEOPLE OF THE BERING STRAIT REGION OF NORTHWEST ALASKA.A NON-PROFIT CONSORTIUM OF 20 TRIBES, NSHC WAS ONE OF THE FIRST NATIVE HEALTH ORGANIZATIONS IN THE COUNTRY TO ASSUME COMPLEX RESPONSIBILITY FOR MEDICAL CARE OF THE PEOPLE IT SERVES. OUR BOARD OF DIRECTORS IS COMPOSED OF CONSUMERS, MOST CHOSEN BY THE 20 TRIBAL GOVERNMENTS IN THE REGION.THE BERING STRAIT REGION IS A 44,000-SQUARE-MILE AREA THAT EXTENDS TO THE RUSSIAN BORDER IN THE BERING SEA. ABOUT 81 PERCENT OF THE REGIONS 9,200 PEOPLE ARE ALASKA NATIVES.NSHC OPERATES NORTON SOUND REGIONAL HOSPITAL IN NOME, THE HUB CITY OF THE REGION WITH APPROXIMATELY 3,500 RESIDENTS. WE OPERATE CLINICS IN 15 VILLAGES ON THE COAST AND ISLANDS OF THE BERING SEA. Part VI, Line 5: NSHC IS A TRIBAL ORGANIZATION THAT EXISTS TO SERVE OUR PEOPLE. IN ADDITION TO TREATING THE HEALTH PROBLEMS OF THE REGION, NSHC HAS BEEN PUTTING A GROWING EMPHASIS ON WORKING WITH INDIVIDUALS AND OUR COMMUNITIES TO PREVENT HEALTH PROBLEMS. AN ADDITIONAL EFFORT IS PLACED ON "GROWING OUR OWN" FROM BOTH WITHIN THE CORPORATION, AS WELL AS ENCOURAGING OUR PEOPLE WITHIN THE REGION TO FOCUS ON EDUCATION AND/OR TRAINING FOR ALL LEVELS OF POSITIONS WITHIN OUR HEALTH CORPORATION.WE ALSO FOCUS ON PROTECTING OUR ENVIRONMENT, DEVELOPING OUR ORGANIZATION AND ITS FINANCIAL STRENGTH, AND ENCOURAGING THE PEOPLE OF THIS REGION TO BECOME INVOLVED IN HEALTH CAREERS. BECAUSE FEW JOBS ARE AVAILABLE IN THE VILLAGES, MANY PEOPLE CONTINUE TO LEAD A TRADITIONAL SUBSISTENCE LIFESTYLE, SUPPLEMENTING HUNTING, FISHING AND GATHERING WITH SEASONAL OR PART-TIME EMPLOYMENT. AS A RESULT, WE ENCOURAGE OUR VILLAGE PEOPLE TO SEEK CAREERS IN HEALTH FIELDS WHERE WE HAVE MID-LEVEL PRACTITIONERS, HEALTH AIDES, CLINIC TRAVEL CLERKS, DENTAL HEALTH THERAPISTS, VILLAGE BASED COUNSELORS AND PATIENT BENEFIT COORDINATORS POSITIONS IN THE VILLAGES AND CAN CONTINUE TO MAINTAIN A TRADITIONAL SUBSISTENCE LIFESTYLE. "GROWING OUR OWN" THEN BECOMES A REALITY FOR NSHC AND OUR PEOPLE. Part VI, Line 6: AK 1 FINANCIAL ASSISTANCE TO ELIGIBLE STUDENTS WHO ARE PURSUING HIGHER EDUCATION IN A HEALTH RELATED FIELD. 55 86710 CASH Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: SCHOLARSHIP PAYMENTS ARE ISSUED DIRECTLY TO THE EDUCATIONAL INSTITUTION ON BEHALF OF THE ELIGIBLE RECIPIENT. FOR SCHOLARSHIPS, RECIPIENTS MUST PROVIDE EVIDENCE OF SATISFACTORY COMPLETION OF COURSES AND MAINTAIN GPA'S AS MANDATED IN NORTON SOUND POLICY FOR SCHOLARSHIPS. X 0 0 0 0 0 0 0 0 0 CAROL PISCOYA 150078 0 0 0 0 0 10395 0 11279 0 171752 0 0 0 DAVID HEAD 330777 0 0 0 0 0 23116 0 24416 0 378309 0 0 0 KAREN ONEILL 271991 0 0 0 0 0 18929 0 19812 0 310732 0 0 0 MARK KELSO 266098 0 0 0 0 0 18602 0 19902 0 304602 0 0 0 SAI-LING LIU 263404 0 0 0 0 0 18327 0 18743 0 300474 0 0 0 WILLIAM M COX 163108 0 0 0 0 0 9959 0 10843 0 183910 0 0 0 ROBERT LAWRENCE 162016 0 0 0 0 0 7890 0 8840 0 178746 0 0 0 Form 990, Part VI, Section A, line 2 ONE OF THE ORGANIZATIONS DIRECTORS HAS A FAMILY RELATIONSHIP WITH AN OFFICER OF THE ORGANIZATION. Form 990, Part VI, Section A, line 3 NORTON SOUND HEALTH CORPORATION UTILIZED THE SERVICES OF A PUBLIC ACCOUNTING FIRM TO PROVIDE FINANCIAL MANAGEMENT SERVICES. Form 990, Part VI, Section B, line 11 THE ORGANIZATION'S 2009 FORM 990 WILL BE PRESENTED AT A FULL BOARD MEETING IN SEPTEMBER 2011. Form 990, Part VI, Section B, line 15 OFFICER AND KEY EMPLOYEE SALARIES REQUIRE BOARD APPROVAL AND HAVE HISTORICALLY BEEN DETERMINED USING READILY AVAILABLE MARKET DATA FOR COMPARISON. DURING FY10 THE CORPORATION ENGAGED AN OUTSIDE ENTITY TO COMPLETE A COMPENSATION ANALYSIS. THE PLAN WAS FINALIZED IN FY11 AND IS IN THE INITIAL STAGE OF IMPLEMENTATION. Form 990, Part VI, Section C, line 18 THE ORGANIZATION MAKES ITS FORMS 1023 AND 990 AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VI, Section C, line 19 UPON REQUEST, THE ORGANIZATION WILL MAKE ITS GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS AVAILABLE. form 990, part xi, line 2c info reqarding changes to audit oversight or audit selection process there were no changes to the audit oversight or auditor selection process from the prior year.