2021-11-14T12:31:59-06:00 2020-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2020-01-01 880405927 Washoe Barton Medical Clinic WASH 7757821500 1107 Hwy 395 Gardnerville NV 89410 Colleen Reid CFO 7757821500 2021-11-12 1 Colleen Reid 999009999 Kim Hunwardsen CPA P00484560 6122536500 2021-11-10 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Carson Valley Medical Center Colleen Reid 1107 Hwy 395 Gardnerville NV 89410 71296756 0 X carsonvalleymedicalcenter.org X 1999 NV Nevada non-profit corporation which operates as the sole hospital in the county. 6 6 564 17 0 0 171543 650698 67220850 69378525 955002 1011501 268744 256032 68616139 71296756 0 0 0 0 28250977 30603122 0 0 80568 32423768 33782014 60674745 64385136 7941394 6911620 78608203 104905968 13113203 31687959 65495000 73218009 X Our mission is to care for your health and wellness. Our vision is to strengthen our community by providing accessible, affordable, high quality healthcare to all. 0 0 40898028 38890191 Washoe Barton Medical Clinic dba Carson Valley Medical Center:Carson Valley Medical Center covers a service area that includes approximately 50,000 residents. A focus on patient centered care and quality have resulted in Carson Valley Medical Center consistently ranking high in patient satisfaction on both inpatient and outpatient consumer satisfaction surveys. Carson Valley Medical Center facilities include a full-service hospital, Emergency Room, Infusion, Lab, Medical Imaging, Physical and Respiratory Therapy, Mental Health, Sleep & Neurodiagnostic Lab, Wound Care and Telemedicine. Clinics include Carson Valley Medical Center Senior Care (a provider-based clinic (Continued on SCH O)servicing patients over 65), Job's Peak Internal Medicine & Family Practice, Topaz Ranch Medical Clinic, Minden Family Medicine and Complete Care, Ironwood Primary Care, Ironwood Urgent Care and Occupational Health Clinics. 8110825 22103779 Pharmacy:Program expenses are used in the provision of health care services to the community. Carson Valley Medical Center provides inpatient and outpatient pharmaceutical services for the hospital and outpatient clinics. In 2020, there were higher patient acuities and more chemotherapy patients than the previous year. In 2020, 150,825 pharmacy orders were processed. 7381111 8384555 Surgery:Program expenses are used in the provision of surgical services to the community. Carson Valley Medical Center provides inpatient and outpatient surgery services. Emergency and elective surgeries are performed by general and specialty surgeons. In 2020, 1,433 surgeries were performed at Carson Valley Medical Center. 56389964 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 133 0 1 564 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 X Colleen Reid 7757821649 1107 Highway 395 N Gardnerville NV 89410 Jeff Prater CEO 40.00 X 266649 0 26152 Colleen Reid CFO 40.00 X 227619 0 32174 Brandon Battis Pharmacist 40.00 X 169279 0 31818 James Gocke Nurse Practitioner 40.00 X 149369 0 33828 Greg Ponsness Pharmacy Manager 40.00 X 162650 0 16598 Valerie Harrell Medical Imaging Supervisor 40.00 X 154579 0 23203 Shannon Albert Director of Operations 40.00 X 148404 0 23940 Dr Paul Fry III Board Member 0.50 X 7250 0 0 Clint Purvance Chair 0.50 X X 0 0 0 Kelly Neiger Secretary 0.50 X X 0 0 0 Dawn Ahner Board Member 0.50 X 0 0 0 Sy Johnson Board Member 0.50 X 0 0 0 Ann Beck Board Member 0.50 X 0 0 0 1285799 0 187713 37 0 1 0 Renown Health Medical Group 780 Kuenzli St Ste 202 Reno NV 89502 Physician Salary, IT, Physician Read Fee 2584339 Leman Medical Corporation 1122 Monterra Dr Minden NV 89423 ER Physician Group 2105199 Renown Health 1155 Mill Street - Z5 Reno NV 89502 EMR Support 804285 AYA Healthcare Inc PO Box 123519 Dallas TX 753123519 Contract Staffing 776505 Rural Physicians Group 5575 DTC Parkway Ste Greenwood Village CO 80111 Hospitalists Physician Group 737764 25 48220 602478 650698 Net Patient Services 621400 68468338 68468338 Other Supporting Revenue 900099 910187 910187 69378525 323113 323113 256032 0 256032 256032 256032 688388 0 688388 688388 688388 71296756 69378525 0 1267533 X 556074 556074 23474136 20023441 3381348 69347 401148 332178 68970 4441703 3686916 754356 431 1730061 1459137 265761 5163 17950 17950 44652 9963 34689 73356 73356 2055 2055 16451 16451 13923393 12304286 1619000 107 508518 489217 18284 1017 867274 787386 76457 3431 268089 56585 211455 49 659999 510297 149165 537 26573 7746 18827 191883 103010 88698 175 273060 235646 37414 2647519 2544659 102860 251565 139634 111931 Medical Supplies 13412830 13334980 77850 Equipment Rental/Lease 190450 128387 62063 406397 234441 171645 311 64385136 56389964 7914604 80568 15024168 35796002 9321148 10236374 1704310 2167913 511759 384905 57286783 29834772 27978158 27452011 22662660 24370763 1406000 4498000 78608203 104905968 5432538 7427237 5131753 5160539 4599983 2061247 2219748 5240142 458879 7069096 13113203 31687959 X 65433824 73218009 61176 0 65495000 73218009 78608203 104905968 X 6911620 816018 -4629 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2055 2055 0 Part II-B, Line 1: Dues paid to associations that are required to report lobby activities. Total dues paid was $222,379. The portion attributable to lobbying activities as reported by the associations was $2,055. 187000 3428979 3615979 37962214 19024832 18937382 13867591 10074299 3793292 1840999 735641 1105358 27452011 Due from Medicare 7069096 7069096 X 72160238 816018 76213 892231 71268007 16451 12298 28749 71296756 64438459 69774 69774 64368685 16451 16451 64385136 Part X, Line 2: The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Eliminate Foundation Activity for Separately Filed Form 990 76,213. Part XI, Line 4b - Other Adjustments: Gain Included in Expenses on Financial Statements 12,298. Part XII, Line 2d - Other Adjustments: Eliminate Foundation Activity for Separately Filed Form 990 82,072. Gain Included in Revenue on Form 990 -12,298. 1 1 X 1 X 250.000000000000 1 X 1 1 0 0 658000 658000 0.01020 5422375 3158411 2263964 0.03520 6080375 3158411 2921964 0.04540 620610 61913 558697 0.00870 19413284 11023229 8390055 0.13030 52549 52549 0.00080 20086443 11085142 9001301 0.13980 26166818 14243553 11923265 0.18520 5 420 420 0.00000 5 420 420 0.00000 1 4021304 42738 24601997 24425592 176405 X 1 1 1 1 Washoe Barton Medical Center 1107 Hwy 395 Gardnerville NV 89410 www.cvmchospital.org 3986RUH-14 X X X X 2 provider based clinics Carson Valley Medical Center 1 0 0 1 X X X X X X X X X 19 1 0 1 1 X See Section C, line 7d X 1 19 1 See Section C, line 7d 0 1 X 250.000000000000 350.000000000000 X X X 1 1 X X X X 1 X https://www.cvmchospital.org/patients-visitors/financial-assistance/ X https://www.cvmchospital.org/patients-visitors/financial-assistance/ X https://www.cvmchospital.org/patients-visitors/financial-assistance/ X X X X X X X 1 X 0 X X X X 1 X 0 0 Carson Valley Medical Center Part V, Section B, Line 5: In 2019, A Community Health Needs Assessment was conducted on behalf of Carson Valley Medical Center by Professional Research Consultants, Inc. (PRC). Methodology: This assessment incorporates data from both quantitative and qualitative sources. Quantitative data input includes secondary research (vital statistics and other existing health related data) that allows for comparison to benchmark data at the state and national levels. Qualitative data input includes primary research gathered through the Online Key Informant Survey. The study area for this effort is Douglas County, Nevada. This community definition was determined based on the areas of residence of most recent patients of Carson Valley Medical Center.To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey was implemented as part of this process. A list of recommended participants was provided by Carson Valley Medical Center; this list included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall.Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. In all, 33 community stakeholders took part in the Online Key Informant Survey.Through this process, input was gathered from several individuals whose organizations work with low-income, minority, or other medically underserved populations. In the online survey, key informants were asked to rate the degree to which various health issues are a problem in their own community. Follow-up questions asked them to describe why they identify problem areas as such, and how these might better be addressed. Results of their ratings, as well as their verbatim comments, are included throughout this report as they relate to the various other data presented. NOTE: The Online Key Informant Survey was designed to gather input regarding participants' opinions and perceptions of the health needs of the residents in the area. Thus, these findings are based on perceptions, not facts. Carson Valley Medical Center Part V, Section B, Line 6b: Final participation included representatives of the organizations: Carson Valley Medical Center/ Minden Family Medicine, Carson Valley Chamber of Commerce, Douglas County School District, Douglas County Sheriff's Office, DP Consulting, East Fork Fire Protection District, Me for Incredible Youth (MEFIYI), Minden Family Medicine, Rural Health Clinic (CVMC), REMSA/Care Flight, Renown Health, Senior Care, Sierra Nevada ENT and Hearing Aid Center, Tahoe Fracture and Orthopedics, The RecordCourier Newspaper. Carson Valley Medical Center Part V, Section B, Line 7d: http://cvmchospital.org/about_us/health_needs_assessment.aspx Carson Valley Medical Center Part V, Section B, Line 11: For the 2019 Community Health Needs Assessment - the following were the community needs identified and addressed in the 2019 - 2020 implementation plan as well as actions that CVMC has taken to address these areas.The Areas of Opportunity were determined after consideration of various criteria, including: standing in comparison with benchmark data; the preponderance of significant findings within topic areas; the magnitude of the issue in terms of the number of persons affected; and the potential health impact of a given issue. These also take into account those issues of greatest concern to the community stakeholders (key informants) giving input to this process.1) Access to Health Services - lack of health insurance for children and adults and the primary care physician ratio2) Heart Disease & Stroke - high blood cholesterol3) Infant Health & Family Planning - low-weight births4) Injury & Violence - unintentional injury deaths5) Mental Health - suicide deaths *ranked as a top concern in the Online Key Informant Survey 6) Nutrition, Physical Activity & Weight - low food access *ranked as a top concern in the Online Key Informant Survey7) Substance Abuse - excessive drinking *ranked as a top concern in the Online Key Informant Survey 8) Tobacco Use - cigarette smoking prevalenceCVMC did not address infant health and family planning as that is covered in our community by the community health department, who we work closely with. Specifically, actions taken to address the top three areas of need for the year 2020 include:1) Mental Health- Suicide Deaths: CVMC continued to grow our outpatient behavioral health clinic, growing to 4253 visits in 2020. Our Vitality for Life behavioral health program for seniors had 4811 visits, a 2.25% increase from the prior year. Continued support/partnership with Suicide Prevention Network.2) Nutrition, Physical Activity and Weight - Low Food Access: Continued free and discounted education sessions with CVMC Dietitian. Included virtual cooking sessions and shopping tips from our healthcare experts. Continued Weight loss support group (limited in 2020 due to COVID-19). Support at monthly Food Closet distribution days.3) Substance Abuse - Excessive Drinking: Continued support/partnership with Partnership of Community Resources. Carson Valley Medical Center Part V, Section B, Line 16j: English and Spanish are readily available and if another language is needed, then the FAP is translated into that language. 6 1 - Ironwood Primary Care 897 Ironwood Dr Minden NV 89423 Medical Clinic 2 - Occupational Medicine 897 Ironwood Drive Minden NV 89243 Medical Clinic 3 - Ironwood Urgent Care 897 Ironwood Dr Minden NV 89423 Medical Clinic 4 - Job's Peak Internal Medicine & Family 1520 Virginia Ranch Rd Unit B Gardnerville NV 89410 Medical Clinic 5 - Minden Family Medicine 1649 Lucerne St Unites A B Minden NV 89423 Medical Clinic 6 - Topaz Ranch Medical Center 3919 Carter Wellington NV 89444 Medical Clinic Part I, Line 7: Part I, line 7a:Financial Assistance was calculated by multiplying the ratio of cost to gross charges for the Organization by the gross uncompensated charges associated with providing charity care to its patients.Part I, Line 7b and 7g:Unreimbursed Medicaid and Subsidized Health Services are calculated using the cost report and analyzing the Medicare ratio of cost to charge for the respective cost centers. Part I, line 7e:Community health improvement services are actual costs reported in the general ledger. Part I, line 7i:Cash and in-kind donations are actual costs reported in the general ledger. Part I, Line 7g: Carson Valley Medical Center runs seven physician clinics to treat patients in the community. The clinics need to be subsidized by the hospital to meet their payroll and other monthly expense needs. The subsidized health services amount includes $3,049,284 associated with two rural health clinics and $3,882,009 from physician clinics. Part II, Community Building Activities: Community Support includes support groups provided to the community by CVMC. These include "coping with change," grief, Alzheimer's caregiver, diabetes, and weight management support groups. Due to the COVID-19 pandemic, all support groups were cancelled after March 2020 for the remainder of the year. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Part III, Line 3: The Hospital estimated the amount of implicit price concessions attributable to patients eligible under the organization's financial assistance policy by applying the percentage of charity care to total patient gross charges to the implicit price concessions. Part III, Line 4: The financial statement footnote regarding implicit price concessions may be found on page 12 and 13 of the attached financial statements. Part III, Line 8: Total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: The general billings and collections policy applies to all patients, including any application under the charity care policy. The Hospital does not send patient accounts to collections before 120 days of the date of the first invoice. The Hospital will pull back patient accounts from collections if a patient submits a financial assistance application within 240 days of the date of the first invoice. Part VI, Line 2: In addition to the community health needs assessment, CVMC regularly assesses data trends and utilization data from internal sources as well as secondary sources (state and local agencies, Nevada Rural Hospital Partners, Nevada Hospital Association, etc.) to assess community need. CVMC partners with local development authority, Chambers of Commerce, and government committees to ensure CVMC is responding to the needs of the community. Part VI, Line 3: Communication is via website, brochures, telephone and in person. Website is www.cvmchospital.org/patients_visitors/financial_assistance.aspx Part VI, Line 4: Carson Valley Medical Center (CVMC), serves Douglas County which is an area spanning 710 square miles and includes eight ZIP codes: 89705 (south Carson City), 89460 (Gardnerville Ranchos), 89411 (Genoa), 89423 (Minden), 89448 (Zephyr Cove), 89449 (Stateline), 89444 (Topaz Ranch) and 89410 (Gardnerville). It also includes outlying areas that include Wellington NV, Markleeville, CA and Coleville, CA. This broad area encompasses various neighborhood settings, including both rural and suburban areas. CVMC is in Douglas County, NV, which has a population of 49,463 (80% white, 14% Hispanic, 2% Native American). Median household income is $61,176, with 9.8 percent of population in poverty. (Data from Carson City Health & Human Services: Primary & Secondary Data Sets, 2019). Part VI, Line 5: The majority of the organization's board of directors is comprised of persons serving in the medical community of the greater Northern Nevada area. The organization extends medical staff privileges to credentialed and approved practitioners in its community. The organization's mission is to promote the health and wellness of the Carson Valley and its visitors. Surplus funds are used to acquire equipment and resources that improve patient care.CVMC Emergency Room available to all patients, regardless of ability to pay.CVMC is committed - as the community hospital - to promote the health of the members of the community. We do so through community outreach and wellness programs, including reaching out to local employers in our workplace wellness programs and offering low cost and free screenings to detect and prevent illness and disease. The hospital operates a 24 hour emergency room for medically necessary care to all regardless of ability to pay. The hospital participates in education and training of healthcare professionals. The hospital participates in government-sponsored health programs such as all Medicaid, Medicare, Tricare, all Veterans Administration healthcare and Indian Health Services. The organization is the sole community hospital in Douglas County. The organization currently has 17 active volunteers. The organization has numerous employees involved in local and state community programs including Douglas County Business Council, Minden Rotary, Carson Valley Chamber of Commerce, Nevada Rural Hospital Partners, National Association for Healthcare Quality, American Hospital Association, MGMA, Boy Scouts of America, Family Support Council of Douglas County, Partnership of Community Resources, Tahoe Youth and Family Services, and the Douglas County Community and Senior Center.Community outreach and education are provided to our community members to increase awareness of prevalent health issues and promote healthy behaviors and lifestyles. Programs include workplace wellness, health fairs, career days, and services provided at large-scale community events. The organization is responsive to the community needs such as opportunities for community involvement in governance and advisory groups. The organization serves as a vehicle for attracting and effectively uses donated funds. Part VI, Line 6: Although this hospital is not in an affiliated health system, it does have two members, each about 45 miles away serving different communities. X X 0 0 0 0 0 0 0 0 0 Jeff Prater CEO 235667 0 29974 0 1008 0 7739 0 18413 0 292801 0 0 0 Colleen Reid CFO 198858 0 26000 0 2761 0 7177 0 24997 0 259793 0 0 0 Brandon Battis Pharmacist 169279 0 0 0 0 0 3326 0 28492 0 201097 0 0 0 James Gocke Nurse Practitioner 133144 0 14500 0 1725 0 5335 0 28492 0 183196 0 0 0 Greg Ponsness Pharmacy Manager 162200 0 0 0 450 0 13553 0 3045 0 179248 0 0 0 Valerie Harrell Medical Imaging Supervisor 154579 0 0 0 0 0 2090 0 21113 0 177782 0 0 0 Shannon Albert Director of Operations 146104 0 2000 0 300 0 4842 0 19098 0 172344 0 0 0 A Douglas County Nevada 886000031 2013-04-17 8700000 Refinance 2003 bond issued 04/15/2003; purchase & build urgent care center 0 0 0 A 3988153 8700000 174000 2621962 5904038 2013 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 0 0 0 1 A 0 Date Rebate Computation Performed Issuer Name: Douglas County, Nevada Date the Rebate Computation was Performed: 10/08/2018 Form 990, Part VI, Section A, line 2 Clint Purvance and Kelly Neiger have a business relationship. Ann Beck, Sy Johnson and Dawn Ahner have a business relationship. Form 990, Part VI, Section A, line 6 The Corporation shall have two (2) Members, which shall be Renown Health and Barton Healthcare System. Form 990, Part VI, Section A, line 7a Each member shall have the right to appoint 50% of the board members. Each member has the right to remove any or all of its designated directors at any time and from time to time. Form 990, Part VI, Section A, line 7b The following actions or items will require the approval of the Members prior to implementation or becoming effective: (a) Adoption and amendment of a strategic plan; (b) Development and adoption of investment policies; (c) Amendment, restatement or repeal of the Articles or these Bylaws; (d) Purchase, sale, transfer, conveyance, assignment, pledge, hypothcatio, encumbrance, gift or lease of any asset of the Corporation, which involves the receipt or payment of $1,000,000 or more; (e) Incurrence of debt or equity financing for any prupose in the amount of $1,000,000 or more; (f) Purchase or acquistion of another orgranization; (g) Joint venture with any other organization, entity or person; (h) Merger, consolidation, or dissolution of the Corporation. (i) The sale, lease, conveyance or other transfer of all or substantially all of the Corporation's assets; and (j) Admission of additional members. Form 990, Part VI, Section A, line 8b The organization does not have any committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b A draft copy of the Form 990 is reviewed in detail by the organization's Chief Finance Officer. An electronic copy of the Form 990 is sent to all voting members of the board of directors for their review and comments prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c The conflict of interest policy covers directors, officers and managing employees of Carson Valley Medical Center. According to established policies there is an on-going review of contracts and enforcement is handled by the Corporate Compliance Officer. If a potential conflict is disclosed the interested person is required to leave the Board or committee meeting while the matter is discussed and voted upon. The remaining Board or committee members determine if a conflict does exist. Form 990, Part VI, Section B, line 15a The CEO, CFO, and key employees' compensation are determined using a regionally recognized market survey and competitor comparisons. The CEO's compensation is also reviewed and approved by the board of directors. The compensation is reviewed annually. The CEO and Human Resources review the compensation of the CFO. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Repairs and Maintenance: Program service expenses 822,255. Management and general expenses 118,172. Fundraising expenses 106. Total expenses 940,533. Consulting: Program service expenses 145,719. Management and general expenses 461,671. Fundraising expenses 0. Total expenses 607,390. Other: Program service expenses 1,189,214. Management and general expenses 772,426. Fundraising expenses 1. Total expenses 1,961,641. Purchased Services: Program service expenses 455,196. Management and general expenses 110,351. Fundraising expenses 0. Total expenses 565,547. Contract: Program service expenses 955,755. Management and general expenses 0. Fundraising expenses 0. Total expenses 955,755. Consulting-401K: Program service expenses 0. Management and general expenses 9,200. Fundraising expenses 0. Total expenses 9,200. Medical Purchased Services: Program service expenses 8,736,147. Management and general expenses 147,180. Fundraising expenses 0. Total expenses 8,883,327. Form 990, Part XI, line 9: Other Change in Net Assets -4,629. Carson Valley Medical Center Rural Health Clinic LLC 1107 Highway 395 Gardnerville NV 89410 261513495 Rural health and senior care clinic NV 0 0 Washoe Barton Medical Clinic Carson Valley Medical Center Foundation Inc 1107 Highway 395 Gardnerville NV 89410 364649725 Charitable Foundation NV 501(c)(3) Line 7 Washoe Barton Medical Clinic 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0 Carson Valley Medical Center Foundation Inc C 78948 General Ledger