SOUTH LYON HEALTH CENTER INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- SOUTH LYON HEALTH CENTER INC (EIN 88-0256932)
- Tax period
- 2022-04-01 to 2023-03-31
- Filed
- 2024-02-05
- IRS object ID
- 202440369349300959
- Schema version
- 2022v5.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-02-05T09:43:33-06:00 | ReturnTs |
| Tax Period End | 2023-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 880256932 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH LYON HEALTH CENTER INC | BusinessNameLine1Txt |
| Business Name Line2 | DBA SOUTH LYON MEDICAL CENTER | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 7754632301 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 940 | AddressLine1Txt |
| City | YERINGTON | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89447 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TONI INSERRA | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 7754632301 | PhoneNum |
| Signature | 2024-02-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TONI | PersonFirstNm |
| Person Last | INSERRA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2024-02-02 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TONI INSERRA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 940 | AddressLine1Txt |
| City | YERINGTON | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89447 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,383,758 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SLMCNV.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1990 | FormationYr |
| Legal Domicile State | NV | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HEALTHCARE FOR THE RESIDENTS AND VISITORS TO THE CITY OF YERINGTON AND LYON COUNTY, NEVADA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 198 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,266,641 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,560,041 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,124,772 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,728,448 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | -$6,544 | CYInvestmentIncomeAmt |
| PY Other Revenue | $53,584 | PYOtherRevenueAmt |
| CY Other Revenue | $87,269 | CYOtherRevenueAmt |
| PY Total Revenue | $17,444,997 | PYTotalRevenueAmt |
| CY Total Revenue | $17,369,214 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,523,936 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,816,415 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,698,248 | PYOtherExpensesAmt |
| CY Other Expenses | $8,409,712 | CYOtherExpensesAmt |
| PY Total Expenses | $15,222,184 | PYTotalExpensesAmt |
| CY Total Expenses | $17,226,127 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,222,813 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $143,087 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,479,449 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,003,105 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,840,593 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,221,162 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,638,856 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,781,943 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE ACCESS TO QUALITY HEALTH CARE SERVICES NEEDED BY THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,993,639 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $11,789,539 | RevenueAmt |
| Desc | THE HOSPITAL IS A 14-BED ACUTE HOSPITAL WITH 24 HOUR EMERGENCY ROOM, FULL SERVICE LAB, AND X-RAY DEPARTMENTS. THE E/R SEES APPROXIMATELY 312 PATIENTS A MONTH. CLOSE COMMUNICATIONS WITH LARGER FACILITIES AND SPECIALISTS IN MANY DISCIPLINES ALLOW BOTH HELICOPTER AND AIR AMBULANCE SERVICES TO TAKE PATIENTS TO THOSE HOSPITALS WITHIN A SHORT AMOUNT OF TIME. HOSPITAL HAS A SLIDING FEE SCALE AND FINANCIAL ASSISTANCE AVAILABLE FOR PATIENTS COMPLETING APPLICATIONS. THE HOSPITAL PROVIDES THE STANDARD INFLUENZA VACCINE AT A NOMINAL COST. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,299,280 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,465,739 | RevenueAmt |
| Desc | THE LONG-TERM CARE PROGRAM IS A MEDICARE APPROVED 49-BED SKILLED NURSING AND LONG-TERM CARE FACILITY WITH IN-HOUSE PHYSICAL THERAPY AVAILABLE. STAFF TO PATIENT RATIO IS ABOVE REQUIRED. A SOCIAL WORKER/RESIDENT ADVOCATE AND AN ENTHUSIASTIC ACTIVITIES PROGRAM MAKE OUR LTC ONE OF THE FINEST ANYWHERE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,373,718 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,473,170 | RevenueAmt |
| Desc | THE CLINICS PROGRAM CONSISTS OF THREE RURAL HEALTH CLINICS. WE HAVE PHYSICIANS, PHYSICIANS ASSISTANTS, AND NURSE PRACTITIONERS THAT WORK OUT OF OUR CLINICS TO SERVE THE NEEDS OF THE COMMUNITY. ONE OF OUR CLINICS IS A WALK-IN CLINIC AVAILABLE AT CONVENIENT HOURS FOR OUR PATIENTS WHO NEED TO SEE A PROVIDER IMMEDIATELY OR WHO DO NOT HAVE A REGULAR DOCTOR. ALL CLINICS OFFER SERVICES AT A REDUCED FEE FOR THOSE WHO NEED IT. A FINANCIAL COUNSELOR IS AVAILABLE FOR ASSISTANCE AT ALL TIMES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $14,666,637 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 198 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID BEZARD | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7754636402 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 SOUTH WHITACRE STREET | AddressLine1Txt |
| City | YERINGTON | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89447 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| ROBERT ROWLEY | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOHN DIEKMANN | |||||||
| VICE PRESIDENT (THRU 08/2022) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KALEB WARTGOW | |||||||
| DIRECTOR/CHIEF OF STAFF | 40.00 | Yes (X) | $258,250 | $0 | $29,774 | ||
| JOANNE LAWSON | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| EMILY CHRISTENSEN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT HUNTLY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MYRTLE MCDOWELL | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALYCE REESE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DALE THEISS | |||||||
| DIRECTOR (THRU 07/2022) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RONNIE WEIR-COOLEY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TONI INSERRA | |||||||
| CEO | 40.00 | Yes (X) | $166,050 | $0 | $13,262 | ||
| DAVID BEZARD | |||||||
| CFO | 40.00 | Yes (X) | $143,377 | $0 | $26,630 | ||
| LOREN SIMPSON | |||||||
| MD | 32.00 | $277,721 | $0 | $29,417 | Yes (X) | ||
| DANIEL VILLALOBOS JR | |||||||
| PHYSICIAN ASSISTANT | 40.00 | $125,150 | $0 | $27,111 | Yes (X) | ||
| THOMAS CLIFTEN | |||||||
| PHYSICAL THERAPIST | 40.00 | $156,340 | $0 | $26,798 | Yes (X) | ||
| THOMAS H ARD | |||||||
| IT SUPERVISOR | 40.00 | $151,050 | $0 | $12,962 | Yes (X) | ||
| TOM WALSH | |||||||
| NURSE PRACTIONER | 39.00 | $290,342 | $0 | $5,807 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,568,280 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $171,761 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDICAL SOLUTIONS | |||||
| PO BOX 850737 | MINNEAPOLIS | MN | 55485 | NURSING LOCUMS SERVICES | $1,967,385 |
| WESTERN HEALTHCARE LLC | |||||
| P O BOX 21228 DEPT 170 | TULSA | OK | 74121 | EMERGENCY ROOM LOCUMS SERVICES | $764,640 |
| INTERIM PHYSICIANS LLC | |||||
| PO BOX 679139 | DALLAS | TX | 75267 | EMERGENCY ROOM LOCUMS SERVICES | $685,314 |
| MILES CONSTRUCTION | |||||
| 61 INDUSTRIAL PARKWAY | CARSON CITY | NV | 89706 | CONSTRUCTION GENERAL CONTRACTOR | $283,201 |
| RURAL PHYSICIANS GROUP PANNU | |||||
| 5575 DTC PARKWAY STE 225 | GREENWOOD VILLAGE | CO | 80111 | EMERGENCY ROOM LOCUMS SERVICES | $115,193 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,535,448 | GovernmentGrantsAmt |
| All Other Contributions | $24,593 | AllOtherContributionsAmt |
| Total Contributions | $1,560,041 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PROGRAM SERVICE REVENUE-RELATED | 621400 | $12,816,494 | $12,816,494 |
| UPL REVENUE | 621400 | $1,288,365 | $1,288,365 |
| DISTRICT TAX SUBSIDY | 900099 | $977,277 | $977,277 |
| HOSPITAL DISTRICT REIMBURSEMENT | 621400 | $626,307 | $626,307 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,005 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,005 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,728,448 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,450 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,450 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,450 | TotalRevenueColumnAmt |
| Exclusion | $2,450 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $8,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $14,544 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$6,544 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$6,544 | TotalRevenueColumnAmt |
| Exclusion | -$6,544 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EMPLOYEE MEALS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $30,474 | TotalRevenueColumnAmt |
| Exclusion | $30,474 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,345 | TotalRevenueColumnAmt |
| Exclusion | $54,345 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $84,819 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,369,214 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,728,448 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $80,725 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $657,566 | TotalAmt |
| Program Services | $609,647 | ProgramServicesAmt |
| Management And General | $47,919 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,031,372 | TotalAmt |
| Program Services | $6,212,687 | ProgramServicesAmt |
| Management And General | $818,685 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,527 | TotalAmt |
| Program Services | $48,169 | ProgramServicesAmt |
| Management And General | $57,358 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $475,654 | TotalAmt |
| Program Services | $215,443 | ProgramServicesAmt |
| Management And General | $260,211 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $546,296 | TotalAmt |
| Program Services | $275,418 | ProgramServicesAmt |
| Management And General | $270,878 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,944 | TotalAmt |
| Management And General | $123,944 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125 | TotalAmt |
| Management And General | $125 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,930,185 | TotalAmt |
| Program Services | $4,714,015 | ProgramServicesAmt |
| Management And General | $216,170 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,999 | TotalAmt |
| Management And General | $69,999 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,856 | TotalAmt |
| Program Services | $140,448 | ProgramServicesAmt |
| Management And General | $130,408 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,372 | TotalAmt |
| Management And General | $420,372 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $373,823 | TotalAmt |
| Program Services | $370,627 | ProgramServicesAmt |
| Management And General | $3,196 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,743 | TotalAmt |
| Program Services | $36,892 | ProgramServicesAmt |
| Management And General | $15,851 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,098 | TotalAmt |
| Program Services | $36,314 | ProgramServicesAmt |
| Management And General | $5,784 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,292 | TotalAmt |
| Program Services | $1,151 | ProgramServicesAmt |
| Management And General | $141 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $466,626 | TotalAmt |
| Program Services | $415,795 | ProgramServicesAmt |
| Management And General | $50,831 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,684 | TotalAmt |
| Program Services | $31,293 | ProgramServicesAmt |
| Management And General | $5,391 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $914,929 | $914,929 | |
| BAD DEBT EXPENSE | $636,809 | $636,809 | |
| TAXES AND LICENSES | $32,971 | $32,971 | |
| DUES AND SUBSCRIPTIONS | $23,146 | $7,000 | $16,146 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,110 | TotalAmt |
| Management And General | $13,110 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,226,127 | TotalAmt |
| Program Services | $14,666,637 | ProgramServicesAmt |
| Management And General | $2,559,490 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,400 | BOYAmt |
| EOY | $1,400 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,435,822 | BOYAmt |
| EOY | $3,490,514 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,205,614 | BOYAmt |
| EOY | $3,167,815 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,527 | BOYAmt |
| EOY | $195,240 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $275,016 | BOYAmt |
| EOY | $255,022 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,037,887 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,206,134 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,353,070 | BOYAmt |
| EOY | $3,831,753 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $61,361 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,479,449 | BOYAmt |
| EOY | $11,003,105 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,190,916 | BOYAmt |
| EOY | $946,268 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,588,623 | BOYAmt |
| EOY | $1,226,612 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,054 | BOYAmt |
| EOY | $8,047 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $40,235 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,840,593 | BOYAmt |
| EOY | $2,221,162 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,120,303 | BOYAmt |
| EOY | $8,781,943 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $518,553 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,638,856 | BOYAmt |
| EOY | $8,781,943 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,479,449 | BOYAmt |
| EOY | $11,003,105 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $143,087 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $125 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $125 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS A MEMBER OF NEVADA HOSPITAL ASSOCIATION AND NATIONAL RURAL HEALTH ASSOCIATION. A PORTION OF MEMBERSHIP DUES TO IS USED FOR LOBBYING. THE ASSOCIATIONS ADVOCATE ON BEHALF OF MEMBERS FOR IMPROVING EFFICIENCY AND ACCESSIBILITY TO THE HEALTHCARE DELIVERY SYSTEMS AND THE HEALTH STATUS OF PATIENTS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,678,001 | OtherCostOrOtherBasisAmt |
| Depreciation | $190,322 | DepreciationAmt |
| Book Value | $2,487,679 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,359,886 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,015,812 | DepreciationAmt |
| Book Value | $1,344,074 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,831,753 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE OBLIGATIONS | Desc |
| Amt | $40,235 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $40,235 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $146,982 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $146,982 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00890 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,020,630 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,551,498 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,469,132 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08860 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,167,612 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,551,498 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,616,114 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09750 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,167,612 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,551,498 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,616,114 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09750 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $507,243 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $236,031 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $2,280,817 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,047,255 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$766,438 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH LYON MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 940 | AddressLine1Txt |
| City | YERINGTON | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89447 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SLMCNV.ORG | WebsiteAddressTxt |
| State License | 660RUH-19 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | RURAL | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH LYON MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C, LINE 7D | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C, LINE 7D | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SOUTH LYON MEDICAL CENTER | PART V, SECTION B, LINE 5: INFORMATION WAS COLLECTED FROM PRIMARY AND SECONDARY DATA SOURCES TO IDENTIFY UNMET HEALTH NEEDS WITHIN THE COMMUNITY. INFORMATION FROM THESE SOURCES WAS SUMMARIZED INTO THEMES THAT REPRESENT THE COMMUNITY'S UNMET HEALTH NEEDS, WHICH SERVE AS THE BASIS OF THE CHNA.PRIMARY DATA:PRIMARY DATA REPRESENTS INFORMATION COLLECTED FIRSTHAND FROM STAKEHOLDERS WITHIN SLMC'S COMMUNITY. THIS DATA WAS COLLECTED TO VALIDATE SECONDARY DATA FINDINGS THAT PERTAIN TO SLMC'S SERVICE AREA, IDENTIFY ISSUES THAT WERE NOT REPRESENTED IN THE SECONDARY DATA, AND UNDERSTAND WHAT SPECIFIC SUBGROUPS OF THE COMMUNITY MAY FACE ADDITIONAL CHALLENGES OR DISPARITIES.INTERVIEWS WERE CONDUCTED WITH COMMUNITY STAKEHOLDERS WHO BEST REPRESENTED THE BROAD INTERESTS, EXPERIENCES, AND NEEDS OF SLMC'S COMMUNITY, PARTICULARLY PEOPLE WHO REPRESENT MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS. A COMMUNITY HEALTH SURVEY WAS ALSO DISTRIBUTED TO ENSURE THAT EACH PERSON HAD THE OPPORTUNITY TO PARTICIPATE AND BE HEARD IN THIS PROCESS. A COMPLETE LIST OF THE COMMUNITY STAKEHOLDERS CAN BE FOUND IN THE REFERENCES AND ACKNOWLEDGMENTS.THE INTERVIEWS AND SURVEYS WERE DESIGNED TO SOLICIT INFORMATION PERTAINING TO THE FOLLOWING TOPICS:- SIGNIFICANT HEALTHCARE ISSUES OR NEEDS- SOCIAL, BEHAVIORAL, AND ENVIRONMENTAL FACTORS THAT CONTRIBUTE TO HEALTH NEEDS- BARRIERS TO CARE WITHIN THE COMMUNITY- VULNERABLE POPULATIONS WHO EXPERIENCE DISPARITIES- SUGGESTIONS OR IDEAS TO ADDRESS THE COMMUNITY'S NEEDS- POTENTIAL RESOURCES OR INFRASTRUCTURE TO SUPPORT HEALTH, SOCIAL, BEHAVIORAL, OR ENVIRONMENTAL NEEDS- AREAS FOR COLLABORATION TO ADDRESS HEALTH NEEDSSECONDARY DATA:SECONDARY DATA WAS COLLECTED FROM STATISTICAL DATA SOURCES AVAILABLE AT THE LOCAL, REGIONAL, STATE, AND NATIONAL LEVEL. THIS DATA PROVIDES A PROFILE OF THE DEMOGRAPHIC, SOCIAL, ECONOMIC, AND HEALTH CHARACTERISTICS OF SLMC'S COMMUNITY. TO THE EXTENT POSSIBLE DATA WAS COLLECTED AT THE LOCAL LEVEL, AND COMPARED TO REGIONAL, STATE, OR NATIONAL BENCHMARKS WHEN DETERMINING HEALTH NEEDS.SOURCES OF SECONDARY DATA INCLUDE:- AMERICAN COMMUNITY SURVEY- BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM- CENTER FOR DISEASE CONTROL AND PREVENTION- COUNTY HEALTH RANKINGS- ESRI BUSINESS INFORMATION SOLUTIONS- HEALTHIEST COMMUNITIES, A COLLABORATION BETWEEN U.S. NEWS AND THE UNIVERSITY OF MISSOURI EXTENSION CENTER FOR APPLIED RESEARCH AND ENGAGEMENT SYSTEMS- U.S. CENSUS BUREAU |
| SOUTH LYON MEDICAL CENTER | PART V, SECTION B, LINE 7D: PART V, SECTION B, LINES 7A & 10A:HTTPS://SLMCNV.ORG/COMMUNITY-NEEDS-ASSESSMENT/ |
| SOUTH LYON MEDICAL CENTER | PART V, SECTION B, LINE 11: CHNA IMPLEMENTATION PLAN:IN COLLABORATION WITH WIPFLI AND THE ADVISORY COMMITTEE, SLMC DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THE PRIORITIZED HEALTH NEEDS. SLMC WILL EXPLORE THE FOLLOWING STRATEGIC OBJECTIVES AND TACTICS TO ADDRESS THE PRIORITIZED HEALTH NEEDS:ACCESS TO PRIMARY CAREACCESS TO SPECIALTY CARESTRATEGIC OBJECTIVES:- REDUCE APPOINTMENT WAIT TIMES TO CREATE BETTER ACCESSIBILITY FOR PATIENTS- IMPROVE PROVIDER PRODUCTIVITY TO CREATE BETTER ACCESSIBILITY FOR PATIENTS- IMPROVE ACCESSIBILITY FOR SPANISH-SPEAKING PATIENTS- RIGHT-SIZE NUMBER OF PROVIDERS EMPLOYED BY SLMC TO ALIGN SUPPLY WITH DEMANDTACTICS:- IMPLEMENT AND ADVERTISE A TWO-WEEK APPOINTMENT GUARANTEE WITHIN THE COMMUNITY- DEVELOP AN ADVERTISEMENT STRATEGY TO REACH THE HISPANIC POPULATION AND INCREASE RECRUITMENT OF BI-LINGUAL EMPLOYEES- CONDUCT A CLINICAL OPERATIONAL ASSESSMENT TO ANALYZE PROVIDER THROUGHPUT AND PRODUCTIVITY AND OTHER FACTORS IMPACTING THE PATIENT EXPERIENCE AT SLMC- EXPLORE IMPLEMENTING PRODUCTIVITY-BASED COMPENSATION AGREEMENTS TO IMPROVE PROVIDER PRODUCTIVITY- CONDUCT AN ASSESSMENT TO DETERMINE NUMBER OF PRIMARY CARE PROVIDERS NEEDED TO SUPPORT COMMUNITY DEMAND- CONTINUE SUPPORTING PARTNERSHIPS/AFFILIATIONS WITH RURAL RESIDENT TRAINING PROGRAMS TO RECRUIT MORE PRIMARY CARE PROVIDERS COMMITTED TO RURAL HEALTH TO SLMCSTRATEGIC OBJECTIVES:- EXPLORE FEASIBILITY OF OFFERING NEW SPECIALTY SERVICES AT SLMC- RIGHT-SIZE NUMBER OF PROVIDERS EMPLOYED OR CONTRACTED BY SLMC TO ALIGN SUPPLY WITH DEMAND- IMPROVE ADVERTISEMENT OF SERVICES AVAILABLE AT SLMC, INCLUDING DIAGNOSTIC AND OUTREACH/VISITING SPECIALTY SERVICES- REDUCE TRANSPORTATION BARRIERS FOR PATIENTS WHO NEED TO ACCESS SPECIALTY SERVICESTACTICS:- EXPLORE FEASIBILITY OF IMPLEMENTING A CARDIAC ECHO PROGRAM TO SUPPORT PATIENTS WITH HEART DISEASE- IMPLEMENT PROVIDER EDUCATION FOR TELEHEALTH SPECIALTY REFERRALS- HIRE A SOCIAL MEDIA COORDINATOR TO IMPROVE SOCIAL MEDIA PRESENCE AND IMPROVE ADVERTISEMENT OF SERVICES WITHIN THE COMMUNITY, INCLUDING THE HISPANIC POPULATION- EXPLORE COLLABORATION WITH HELPING HANDS TO PROVIDE FINANCIAL/OPERATIONAL SUPPORTMENTAL HEALTH AND SUBSTANCE USE:STRATEGIC OBJECTIVES:- IMPROVE ACCESSIBILITY TO MENTAL HEALTH AND SUBSTANCE USE SERVICES AT SLMC- RECRUIT OR CONTRACT WITH MORE BEHAVIORAL HEALTH PROVIDERS TO IMPROVE OUTPATIENT AND EMERGENCY RESPONSE SERVICES- IMPROVE ADVERTISEMENT OF BEHAVIORAL HEALTH SERVICES AVAILABLE AT SLMCTACTICS:- CONTINUE PROVIDING ACCESSIBILITY TO TELE-MENTAL HEALTH SERVICES WITH RENOWN, AND EXPLORE VIRTUAL PRESCRIBING CAPABILITIES FOR MEDICATION-ASSISTED TREATMENT- EXPLORE NEED FOR AND BARRIERS TO TELE-MENTAL HEALTH ADOPTION AND UTILIZATION IN SLMC PATIENTS- EXPLORE CONTRACTING WITH BEHAVIORAL HEALTH SOLUTIONS TO PROVIDE BEHAVIORAL HEALTH SERVICES TO PATIENTS- EXPLORE CONTRACTING WITH A LICENSED CLINICAL SOCIAL WORKER TO PROVIDE EMERGENCY BEHAVIORAL HEALTH CASE MANAGEMENT SERVICES |
| PART V, SECTION B, LINE 16 (A-C): | HTTPS://SLMCNV.ORG/FINANCIAL-SERVICES/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - LONG TERM CARE | ||||
| 213 S WHITACRE STREET | YERINGTON | NV | 89447 | LONG TERM CARE |
| 2 - PHYSICIAN'S CLINIC | ||||
| 311 SURPRISE STREET | YERINGTON | NV | 89447 | RURAL HEALTH CLINIC |
| 3 - BARNETT CLINIC | ||||
| 213 S WHITACRE STREET | YERINGTON | NV | 89447 | RURAL HEALTH CLINIC |
| 4 - SMITH VALLEY CLINIC | ||||
| 445 STATE HWY 338 | WELLINGTON | NV | 89444 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COSTING METHODOLOGY IS THE COST TO CHARGES RATIO. THE COST-TO-CHARGES RATIO IS USED FOR ALL PATIENT SEGMENT LINE INPATIENT, OUTPATIENT, AND EMERGENCY ROOM. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 636,809. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THERE ARE A VARIETY OF ACTIVITIES THAT SLMC DOES TO SUPPORT AND PROMOTE HEALTH AND WELLNESS IN THE COMMUNITY. THESE ACTIVITIES INCLUDE WELLNESS WEDNESDAY (OFFERING REDUCED COST FOR SERVICES), PROVIDING SPACE FOR SPECIALISTS FOR LOCAL VISITS, PROVIDING FREE MEETING ACCESS TO COMMUNITY SUPPORT ORGANIZATIONS, PROVIDING DIABETIC EDUCATION TO PATIENTS, THEIR FAMILIES, AND THE COMMUNITY. SLMC ALSO PROVIDES TRAVELING FLU VACCINATION CLINICS TO AREA BUSINESSES. MANY OF THESE PROGRAMS ARE NOT EASY OR COST EFFECTIVE TO TRACK IN OUR ACCOUNTING SYSTEM AND THEREFORE ARE NOT REPORTED. |
| PART III, LINE 2: | THIS AMOUNT IS CALCULATED BY MULTIPLYING THE TOTAL CHARGES FOR SERVICES WRITTEN OFF AS BAD DEBT BY THE COST TO CHARGE RATIO. |
| PART III, LINE 3: | THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY FINANCIAL ASSISTANCE POLICY IS DETERMINED BY THE ORGANIZATION USING INFORMATION AVAILABLE TO MAKE AN EDUCATED ESTIMATE. |
| PART III, LINE 4: | THE ORGANIZATION DOES NOT HAVE A SEPARATE BAD DEBT FOOTNOTE. THE FOOTNOTE INCLUDED HERE IS THE PATIENT AND RESIDENT ACCOUNTS RECEIVABLES AND CREDIT POLICY NOTE.PATIENT AND RESIDENT ACCOUNTS RECEIVABLE ARE REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE ORGANIZATION EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT AND RESIDENT CARE SERVICES. PATIENT AND RESIDENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND IMPLICIT PRICE CONCESSIONS, WHICH REFLECTS MANAGEMENT'S ESTIMATE OF THE TRANSACTION PRICE. THE ORGANIZATION ESTIMATES THE TRANSACTION PRICE BASED ON NEGOTIATED CONTRACTUAL AGREEMENTS, HISTORICAL EXPERIENCE, AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS AND IS RECORDED THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT AND RESIDENT ACCOUNTS RECEIVABLE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT AND RESIDENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE.IN EVALUATING THE COLLECTABILITY OF PATIENT AND RESIDENT ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS AND RESIDENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. |
| PART III, LINE 8: | THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COST REPORTED IN THE MEDICARE COST REPORT IS THE COST TO CHARGE RATIO. |
| PART III, LINE 9B: | EMERGENCY ROOM PATIENTS WITHOUT A PAYMENT SOURCE MAY BE CLASSIFIED AS CHARITY IF THEY DO NOT HAVE A JOB, MAILING ADDRESS, RESIDENCE, OR INSURANCE. CONSIDERATION MUST ALSO BE GIVEN TO CLASSIFYING EMERGENCY ROOM ONLY PATIENTS WHO DO NOT PROVIDE ADEQUATE INFORMATION AS TO THEIR FINANCIAL STATUS. IN MANY INSTANCES, THESE PATIENTS ARE HOMELESS AND HAVE FEW RESOURCES TO COVER THE COST OF THEIR CARE.IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE HOSPITAL'S CHARITY CARE ELIGIBILITY CRITERIA, THEIR PATIENT ACCOUNT MAY BE CONSIDERED CHARITY CARE, EVEN IF THEY WERE ORIGINALLY CLASSIFIED AS A BAD DEBT. COLLECTION AGENCY PATIENT ACCOUNTS MEETING CHARITY CARE CRITERIA SHOULD BE RETURNED TO THE HOSPITAL BILLING OFFICE AND REVIEWED FOR CHARITY CARE ELIGIBILITY. |
| PART VI, LINE 2: | SOUTH LYON MEDICAL CENTER (SLMC) CONDUCTS WELLNESS WEDNESDAY WEEKLY OFFERING REDUCED LAB TESTING TO ACCESS PATIENT HEALTH. SLMC WILL MEET WITH LOCAL ORGANIZATIONS (I.E., ROTARY, SOROPTIMISTS, ETC.) UPON REQUEST. SLMC IS ALSO DEVELOPING A COMMUNITY WELLNESS PROGRAM WITH A FOCUS ON DIABETES IN ENGLISH AND SPANISH. THE ORGANIZATION PROVIDES COMMENT BOXES, HCAPHS SURVEYS AND PATIENT COMPLAINT/CONCERNS SURVEYS TO GATHER INFORMATION ON COMMUNITY NEEDS. |
| PART VI, LINE 3: | PUBLIC NOTICE OF THE AVAILABILITY OF ASSISTANCE THROUGH THE CHARITY CARE POLICY ARE MADE THROUGH EACH OF THE FOLLOWING MEANS:1. POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMITTING OFFICES, AND HOSPITAL OUTPATIENT SERVICE SETTINGS.2. INCLUDING INFORMATION IN THE BILLS SENT TO UNINSURED PATIENTS STATEMENTS INDICATING:A) IF THE PATIENT MEETS CERTAIN INCOME REQUIREMENTS, THE PATIENT MAY BE ELIGIBLE FOR A GOVERNMENT-SPONSORED PROGRAM OR FOR FINANCIAL ASSISTANCE FROM THE HOSPITAL.B) A HOSPITAL PHONE NUMBER THAT PATIENTS MAY CALL FOR FURTHER INFORMATION.3. POSTING NOTICE OF THE AVAILABILITY OF ASSISTANCE AND A CONTACT PHONE NUMBER ON THE SLMC WEB SITE.4. PROVIDING UNINSURED PATIENTS INFORMATION OUTLINING THE TYPES OF FINANCIAL ASSISTANCE AVAILABLE.POSTED NOTICES (AS LISTED ABOVE) SHALL BE IN THE PRIMARY LANGUAGE(S) OF SLMC'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. POSTED NOTICES SHALL CONTAIN THE FOLLOWING INFORMATION:1. A STATEMENT INDICATING THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS WHO MAY NOT BE ABLE TO PAY THEIR BILL AND THAT THIS POLICY PROVIDES FOR FULL OR PARTIAL CHARITY CARE WRITE-OFF.2. IDENTIFICATION OF A HOSPITAL CONTACT PHONE NUMBER THAT THE PATIENT CAN CALL TO OBTAIN MORE INFORMATION ABOUT THE POLICY AND ABOUT HOW TO APPLY FOR ASSISTANCE. |
| PART VI, LINE 4: | AS OF 2021, THE POPULATION OF THE PSA IS 8,897, WITH PROJECTIONS ESTIMATING THAT THE PSA IS ANTICIPATED TO GROW BY 3% OVER THE NEXT FIVE YEARS, OR BY ABOUT 286 PEOPLE.THE AGE DISTRIBUTION OF THE POPULATION ALSO IMPACTS THE NEED FOR HEALTHCARE SERVICES. THE COMMUNITY SERVED BY SLMC TRENDS SIGNIFICANTLY OLDER THAN STATE AND NATIONAL BENCHMARKS, WITH 30% OF THE POPULATION CONSISTING OF PEOPLE OVER THE AGE OF 65. THIS AGE COHORT IS ANTICIPATED TO CONTRIBUTE TO A MAJORITY OF THE GROWTH PROJECTED IN THE PSA OVER THE NEXT FIVE YEARS (321 PEOPLE) SLMC'S PSA IS PREDOMINANTLY WHITE, WITH 64% OF THE POPULATION CONSISTING OF INDIVIDUALS WHO IDENTIFY AS WHITE, NON-HISPANIC. APPROXIMATELY 26% OF THE POPULATION IDENTIFIES AS HISPANIC, HIGHER THAN THE NATIONAL BENCHMARK OF 19%. INCOME IS ONE OF THE MOST IMPORTANT SOCIAL DETERMINANTS OF HEALTH, IMPACTING NOT ONLY EDUCATION AND LIVING CONDITIONS, BUT ALSO PHYSICAL HEALTH, MENTAL HEALTH, AND HEALTH-RELATED BEHAVIORS SUCH AS DIET AND EXERCISE. HOUSEHOLD INCOME IN THE PSA TRENDS SIGNIFICANTLY LOWER THAN COUNTY, STATE, AND NATIONAL BENCHMARKS, WITH 38% OF HOUSEHOLDS IN THE PSA REPORTING A HOUSEHOLD INCOME BELOW $35,000, COMPARED TO 29% OF HOUSEHOLDS IN LYON COUNTY. THIS INDICATES THAT SLMC'S PSA IS SIGNIFICANTLY LESS AFFLUENT. |
| PART VI, LINE 5: | SOUTH LYON MEDICAL CENTER HAS A COMMUNITY-BASED BOARD OF DIRECTORS; AN OPEN MEDICAL STAFF AND USES SURPLUS FUNDS TO PAY FOR COMMUNITY SERVICES SUCH AS HEALTH FAIRS, SPACE FOR MEDICAL SPECIALISTS FOR LOCAL VISITS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LOREN SIMPSON | ||||||||||||||
| MD | $277,721 | $0 | $0 | $0 | $0 | $0 | $5,554 | $0 | $23,863 | $0 | $307,138 | $0 | $0 | $0 |
| TOM WALSH | ||||||||||||||
| NURSE PRACTIONER | $290,342 | $0 | $0 | $0 | $0 | $0 | $5,807 | $0 | $0 | $0 | $296,149 | $0 | $0 | $0 |
| KALEB WARTGOW | ||||||||||||||
| DIRECTOR/CHIEF OF STAFF | $258,250 | $0 | $0 | $0 | $0 | $0 | $5,165 | $0 | $24,609 | $0 | $288,024 | $0 | $0 | $0 |
| THOMAS CLIFTEN | ||||||||||||||
| PHYSICAL THERAPIST | $156,340 | $0 | $0 | $0 | $0 | $0 | $3,155 | $0 | $23,643 | $0 | $183,138 | $0 | $0 | $0 |
| TONI INSERRA | ||||||||||||||
| CEO | $166,050 | $0 | $0 | $0 | $0 | $0 | $3,321 | $0 | $9,941 | $0 | $179,312 | $0 | $0 | $0 |
| DAVID BEZARD | ||||||||||||||
| CFO | $143,377 | $0 | $0 | $0 | $0 | $0 | $2,987 | $0 | $23,643 | $0 | $170,007 | $0 | $0 | $0 |
| THOMAS H ARD | ||||||||||||||
| IT SUPERVISOR | $151,050 | $0 | $0 | $0 | $0 | $0 | $3,021 | $0 | $9,941 | $0 | $164,012 | $0 | $0 | $0 |
| DANIEL VILLALOBOS JR | ||||||||||||||
| PHYSICIAN ASSISTANT | $125,150 | $0 | $0 | $0 | $0 | $0 | $2,503 | $0 | $24,608 | $0 | $152,261 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| REBECCA INSERRA | |||
| EMPLOYEE OF HOSPITAL | $63,808 | REBECCA INSERRA IS A FAMILY MEMBER OF TONI INSERRA. | 0 |
| TAMMY MCCONNELL | |||
| EMPLOYEE OF HOSPITAL | $55,146 | TAMMY MCCONNELL IS A FAMILY MEMBER OF MYRTLE MCDOWELL. | 0 |
| JOHSUA INSERRA | |||
| EMPLOYEE OF HOSPITAL | $17,886 | JOSHUA INSERRA IS A FAMILY MEMBER OF TONI INSERRA. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS 48 MEMBERS. THERE IS ONLY ONE CLASS OF MEMBERS, ALL MEMBERS ARE VOTING MEMBERS. MEMBERSHIP IS LIMITED TO RESIDENTS OF THE SOUTH LYON HOSPITAL DISTRICT. MEMBERS ARE ACCEPTED ANNUALLY UPON COMPLETION OF AN APPLICATION AND PAYMENT OF ANNUAL DUES. MEMBERS MAY HAVE A MOTION CONSIDERED BY THE BOARD OF DIRECTORS. ANY WRITTEN MOTION THAT IS SECONDED WILL BE PRESENTED TO THE BOARD AND THERE WILL BE A DETERMINATION WITHIN 90 DAYS. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS HAVE UNLIMITED TERMS AND ARE ACCEPTED UPON YEARLY COMPLETION OF THE CORPORATION APPLICATION AND PAYMENT DUES. THE MEMBERS ARE REQUIRED TO MEET ANNUALLY AND MUST BE RESIDENTS OF THE SOUTH LYON HOSPITAL DISTRICT. MEMBERSHIP IS NOT TRANSFERABLE OR ASSIGNABLE. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY THE AUDIT FIRM BASED ON THE INFORMATION PROVIDED BY THE CFO OF THE ORGANIZATION. FORM 990 IS THEN REVIEWED AND APPROVED BY THE CEO PRIOR TO PRESENTING TO THE BOARD OF DIRECTORS. THE FORM IS THEN SUBMITTED TO THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL DIRECTORS, MEMBERS OF THE ADMINISTRATIVE STAFF, AND OTHER PERSONS EMPLOYED BY THE ORGANIZATION. COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. ADMINISTRATION AND RISK MANAGEMENT REVIEW FILES FOR SIGNATURES AND DISCLOSURES. IF A CONFLICT OF INTEREST DOES OCCUR, IT IS ANNOUNCED TO THE ENTIRE BOARD PRESENT. IF NECESSARY, THE BOARD ASKS FOR STAFF INPUT AND LEGAL OPINION TO DETERMINE IF A CONFLICT EXISTS IF THE BOARD CANNOT DO SO INDEPENDENTLY. THE INTERESTED BOARD MEMBER WILL ABSTAIN FROM VOTING ON ITEMS THAT HAVE BEEN IDENTIFIED AS A POTENTIAL CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF THE CEO, TOP MANAGEMENT AND OFFICERS OF THE ORGANIZATION IS DETERMINED BY USING SURVEYS FROM THE NEVADA HOSPITAL ASSOCIATION, NEVADA RURAL HOSPITAL PARTNERS, MGMA, MERRITT HAWKINS AND OTHER PROFESSIONAL SURVEY INSTRUMENTS. THE CEO'S COMPENSATION IS THEN APPROVED BY THE BOARD OF DIRECTORS ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AND ANNOUNCES SUCH AT BOARD MEETINGS AND THE ANNUAL SOUTH LYON HOSPITAL DISTRICT CORPORATION MEETING. |
| FORM 990, PART IX, LINE 11G | MED/SURG SERVICES: PROGRAM SERVICE EXPENSES 1,620,215. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,620,215. ER SERVICES: PROGRAM SERVICE EXPENSES 1,816,042. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,816,042. LTC SERVICES: PROGRAM SERVICE EXPENSES 585,578. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 585,578. OTHER SERVICES: PROGRAM SERVICE EXPENSES 350,863. MANAGEMENT AND GENERAL EXPENSES 101,838. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 452,701. MRI SERVICES: PROGRAM SERVICE EXPENSES 185,509. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 185,509. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 155,808. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 155,808. BUSINESS OFFICE PURCHASE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 114,332. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 114,332. |
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