2020-11-16T07:22:14-06:00 2019-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2019-01-01 880405927 Washoe Barton Medical Clinic WASH 7757821500 1107 Hwy 395 Gardnerville NV 89410 Colleen Reid CFO 7757821500 2020-11-13 1 Kim Hunwardsen CPA P00484560 6122536500 2020-11-13 64.83.233.163 2020-11-13 12:09:25 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 818E7D27379BF4EE6921138ED2990C81DED2D31F 2019 2021-01-29 14:40:06Z Carson Valley Medical Center Colleen Reid 1107 Hwy 395 Gardnerville NV 89410 85516569 0 X carsonvalleymedicalcenter.org X 1999 NV Nevada non-profit corporation which operates as the sole hospital in the county. 5 5 553 27 0 0 61417 171543 61778124 67220850 232575 955002 106056 268744 62178172 68616139 0 0 0 0 25868556 28250977 0 0 130227 31933298 32423768 57801854 60674745 4376318 7941394 69734332 78608203 12723713 13113203 57010619 65495000 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 38031183 39608653 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, Senior 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. 7978412 19530794 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 2019, there were higher patient acuities and more chemotherapy patients than the previous year. In 2019, 149,362 pharmacy orders were processed. 6740456 8081403 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 2019, 1,529 surgeries were performed at Carson Valley Medical Center. 52750051 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 1 108 0 1 553 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 1 1 X Jeff Prater 7757821500 1107 Highway 395 N Gardnerville NV 89410 Jeff Prater CEO 40.00 0.00 X 238472 0 18983 Colleen Reid CFO 40.00 0.00 X 190531 0 29315 Brandon Battis Pharmacist 40.00 0.00 X 165545 0 35211 Greg Ponsness Pharmacy Manager 40.00 0.00 X 162518 0 35089 Aaron Teachout Director of Finance 40.00 0.00 X 165096 0 11696 Kathryn Cocking Chief Nursing Officer 40.00 0.00 X 154688 0 17239 Shannon Albert Director of Operations 40.00 0.00 X 148023 0 24006 Dr Paul Fry III Board Member 0.50 0.00 X 5500 0 0 Dawn Ahner Chair 0.50 0.00 X X 0 0 0 Clint Purvance-Board MemberJan- May,Oct-Dec)/Secretary(June-Sep) 0.50 0.00 X X 0 0 0 Kelly Neiger Secretary (Oct-Dec) 0.50 0.00 X X 0 0 0 Preston Becker Board Member (Jan-Jul) 0.50 0.00 X X 0 0 0 Sy Johnson Board Member 0.50 0.00 X 0 0 0 Hakeem Olanrewaju Board Member (Jan-Oct) 0.50 0.00 X 0 0 0 1230373 0 171539 32 0 1 0 Renown Health Medical Group 780 Kuenzli St Ste 202 Reno NV 89502 Physician Salary, IT, Physician Read Fee 2146537 Leman Medical Corporation 1122 Monterra Dr Minden NV 89423 ER Physician Group 2132732 The Neenan Company LLLP 3325 South Timberline Road Suite 10 Fort Collins CO 80525 Constructions/Design 1776456 Barton Healthcare Systems 2170 South Ave South Lake Tahoe CA 96150 IT, Lab, Pathology 962014 AYA Healthcare Inc PO Box 123519 Dallas TX 753123519 Contract Staffing 939855 25 113672 57871 171543 Net Patient Services 621400 66566493 66566493 Other Supporting Revenue 900099 654357 654357 67220850 482931 482931 268744 0 268744 268744 268744 17372501 16893228 7202 479273 -7202 472071 472071 68616139 67220850 0 1223746 X 487258 487258 21407376 18009300 3325810 72266 392633 315073 77560 4365648 3597596 767597 455 1598062 1333929 258729 5404 92415 6729 85686 76033 76033 3629 3629 11759 11759 12854505 11182515 1667299 4691 295161 263548 20408 11205 1237294 1124928 81760 30606 220249 100071 120178 477480 340060 136689 731 59966 24149 34677 1140 203286 126847 73659 2780 300883 259656 41227 2492257 2409443 82814 288308 27821 260487 Medical Supplies 12912350 12909846 2504 Equipment Rental/Lease 231560 203000 28560 666633 511911 153773 949 60674745 52750051 7794467 130227 15869145 15024168 8746177 9321148 1531019 1704310 497358 511759 55289168 27311010 26417671 27978158 16257258 22662660 415704 1406000 69734332 78608203 4315663 5432538 5703816 5160539 2249000 2061247 455234 458879 12723713 13113203 X 56974970 65433824 35649 61176 57010619 65495000 69734332 78608203 X 7941394 548113 -5126 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3629 3629 0 Part II-B, Line 1: Dues paid to associations that are required to report lobby activities. Total dues paid was $118,974. The portion attributable to lobbying activities as reported by the associations was $3,629. 187000 3428979 3615979 37331237 17022975 20308262 13213832 9412185 3801647 1128120 875850 252270 27978158 Other Liabilities 458879 458879 X 69259005 548113 99310 647423 68611582 11759 -7202 4557 68616139 60808234 145248 145248 60662986 11759 11759 60674745 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: Foundation Revenue Included in Consolidated Financial 99,310. Part XI, Line 4b - Other Adjustments: Loss Included in Expenses on Financial Statements -7,202. Part XII, Line 2d - Other Adjustments: Foundation Expenses Included in Consolidated Financial Statements 138,046. Loss Included in Revenue on Form 990 7,202. 1 1 X 1 X 250.000000000000 1 X 1 1 0 1 1 622000 622000 0.01030 4755674 2694448 2061226 0.03400 5377674 2694448 2683226 0.04430 605748 49621 556127 0.00920 7745757 3967712 3778045 0.06230 72403 72403 0.00120 8423908 4017333 4406575 0.07270 13801582 6711781 7089801 0.11700 1 3607436 0 25594318 25590511 3807 X 1 1 1 1 Washoe Barton Medical Center 1107 Hwy 395 Gardnerville NV 89410 www.cvmchospital.org 3986RUH-14 X X X X 1 provider based clinic 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 400.000000000000 X X X X 1 1 X X X X 1 X www.cvmchospital.org/patients_visitors/financial_assistance.aspx X www.cvmchospital.org/patients_visitors/financial_assistance.aspx X www.cvmchospital.org/patients_visitors/financial_assistance.aspx 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 - unitentional 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. In 2019, for substance abuse and tobacco use, CVMC continued to partner and support the area's non-profit whose mission is substance abuse and tobacco use - the Partnership of Community Resources. We host a fundraiser for them annually and our leadership sits on their governing board to ensure full support of their efforts. For access to healthcare, in 2019 we extended primary care and physical therapy hours; as well as supporting and partnering with DART the regional transportation service to ensure patients can get to their medical appointments. In 2019 CVMC also added 2 new primary care providers. For mental health services, CVMC opened the area's first behavioral health clinic to serve the community. We offer intensive individual and group outpatient sessions to meet this community need. To address nutrition and obesity, CVMC hired a dietitian intern in 2019 to offer more nutritional seminars and outreach services. To address heart disease and stroke, CVMC purchased a new CT machine in 2019 that enabled us to perform cardiac calcium screenings for our community. 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 6a: The organization's community benefit report is available upon request and is posted at www.cvcmhospital.org/about_us/ Part I, Line 7: Part I, Line 7a:Financial Assistance was calculated using the cost-to-charge ratio. All patient segments are addressed using this method. The methodology used is to be in compliance with laws and regulations set forth by Medicare and the filing of the annual cost report. Part I, Line 7b and 7g:Unreimbursed Medicaid and Subsidized Health Services was 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 8 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 $3,020,492 associated with two rural health clinics and $3,572,961 from physician clinics. 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 reported bad debt in accordance with HFMA Statement 15, and therefore, bad debt expense does not include charity care. Part III, Line 4: The financial statement footnote regarding implicit price concessions may be found on page 11 and 12 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.Carson Valley Medical Center Emergency Room is 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 21 active volunteers. The organization has numerous employees involved in local and state community programs including Kiwanis, 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. Carson Valley Medical Center offers a series of community support groups provided as a free service to engage our community members in education, guidance, and support to improve their health and their quality of life. The support groups include weight management, Alzheimer's support, coping with change, grief, and diabetes. Part VI, Line 6: Although this hospital is not in an affiliated health system, it does have two parent companies each about 45 miles away serving different communities. X X 0 0 0 0 0 0 0 0 0 Jeff Prater CEO 220444 0 16942 0 1086 0 4662 0 14321 0 257455 0 0 0 Colleen Reid CFO 185456 0 3737 0 1338 0 6694 0 22621 0 219846 0 0 0 Brandon Battis Pharmacist 163134 0 2411 0 0 0 5962 0 29249 0 200756 0 0 0 Greg Ponsness Pharmacy Manager 157211 0 4857 0 450 0 5840 0 29249 0 197607 0 0 0 Aaron Teachout Director of Finance 164832 0 0 0 264 0 0 0 11696 0 176792 0 0 0 Kathryn Cocking Chief Nursing Officer 150003 0 2647 0 2038 0 5450 0 11789 0 171927 0 0 0 Shannon Albert Director of Operations 147727 0 0 0 296 0 4909 0 19097 0 172029 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 3412167 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, Kelly Neiger and Preston Becker have a business relationship. Hakeem Olanrewaju has a business relationship with Sy Johnson and Dawn Ahner. 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) Approval of long-term or material agreements involving more than two hundred fifty thousand dollars, including but not limited to borrowings, equity financings or capitalized leases, and agreements involving the sale or disposition of assets which involve the receipt or payment of more than two hundred fifty thousand dollars; (b) Approval of the Corporation's strategic plan and selection or approval of the manager or senior executives of the Corporation; (c) Any amendment or modification of the Corporation's Articles of Incorporation or the Bylaws; (d) Approval of the Corporation's operating and capital budgets (e) Admit any additional members; (f) Approval of any capital or other investment (including real property) or purchase in excess of the amount approved in the annual budget and any revisions thereto; (g) A sale, lease, conveyance or other transfer of all or substantially all of the assets of the Corporation; and (h) A merger, consolidation, reorganization or dissolution of the Corporation. 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 876,451. Management and general expenses 143,376. Fundraising expenses 6. Total expenses 1,019,833. Consulting: Program service expenses 84,761. Management and general expenses 612,812. Fundraising expenses 0. Total expenses 697,573. Other: Program service expenses 1,365,309. Management and general expenses 664,165. Fundraising expenses 4,685. Total expenses 2,034,159. Purchased Services: Program service expenses 432,407. Management and general expenses 94,618. Fundraising expenses 0. Total expenses 527,025. Contract: Program service expenses 1,026,602. Management and general expenses 529. Fundraising expenses 0. Total expenses 1,027,131. Consulting-401K: Program service expenses 0. Management and general expenses 19,352. Fundraising expenses 0. Total expenses 19,352. Medical Purchased Services: Program service expenses 7,396,985. Management and general expenses 132,447. Fundraising expenses 0. Total expenses 7,529,432. Form 990, Part XI, line 9: Net Assets Adjustment -5,126. 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 1 1 0 0 Carson Valley Medical Center Foundation Inc C 113672 General Ledger