2020-11-05T08:25:48-06:00 2019-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2019-01-01 880065829 Boulder City Hospital Inc BOUL 7022934111 901 Adams Blvd Boulder City NV 89005 Thomas Maher CEO 7022934111 2020-11-04 1 Kim Hunwardsen CPA P00484560 6122536500 2020-11-04 69.180.150.71 2020-11-04 16:38:44 CS P A9F393D044C6B02927C29CDABEE7CBE310A8D2B0 F4E1B545B5A64400ED95821F5295FDCB6EE8A6F8 2019 2021-01-29 14:40:06Z Thomas Maher 901 Adams Blvd Boulder City NV 89005 28151339 0 X www.bchcares.org X 1954 NV Provide health care services to residents of Clark County and surrounding areas in southern Nevada. 13 13 328 122 0 0 254448 495529 28533964 27642288 2541 22 494 -5821 28791447 28132018 0 0 0 0 16059079 16514128 0 0 0 13148618 11203580 29207697 27717708 -416250 414310 24426025 24321162 27026173 26506335 -2600148 -2185173 X Boulder City Hospital seeks to continually improve the quality of the care and service to our patients, guests, and physicians. We Promote effective and efficient utilization of available resources to ensure long-term financial viability. Boulder City Hospital seeks to earn the Trust of the residents of Boulder City, neighboring communities and area visitors by meeting their health care needs with compassion, integrity, and sincerity without regard to one's ability to pay. 0 0 22957638 27642288 Boulder City Hospital operates a 25-bed critical access hospital (CAH), a 47-bed long-term care facility, and a 10-bed geriatric behavioral medicine center. Boulder City Hospital provides emergency services, a behavioral medicine center, a long-term care facility and a skilled nursing unit. 22957638 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 9 0 1 328 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Frey Belete 7022934111 901 Adams Blvd Boulder City NV 89005 Thomas Maher CEO 40.00 X 249922 0 13295 Stephanie West Pharmacy Manager 40.00 X 145318 0 9272 Doug Lewis CFO 40.00 X 143376 0 0 Rae Cummings COO 40.00 X 125460 0 11147 Andre Pastian CNO 40.00 X 124449 0 5383 Elizabeth Flores ER Nurse 40.00 X 119007 0 462 Jeanne Solakiewicz Case Manager 40.00 X 117046 0 4926 Peggy Caspar President 0.50 X X 0 0 0 Robert Kenney Vice President 0.50 X X 0 0 0 Cindy Anderson Secretary 0.50 X X 0 0 0 Ross Johnson Treasurer 0.50 X X 0 0 0 Scott Hinson Director 0.50 X 0 0 0 Derek Meeks Director 0.50 X 0 0 0 Bruce Woodberry Director 0.50 X 0 0 0 Alan Bowman Director 0.50 X 0 0 0 Linda Faiss Director (Jan-Jun) 0.50 X 0 0 0 Sue Manteris Director 0.50 X 0 0 0 Bret Runion Director 0.50 X 0 0 0 Wendell Whitman Director 0.50 X 0 0 0 Alfonso Noyola Director 0.50 X 0 0 0 Barbara Muphey Framke Director (Mar-Dec) 0.50 X 0 0 0 1024578 0 44485 19 0 1 0 Horizon Health PO Box 840839 Dallas TX 752840839 Contracted Management Service 3075676 The Health Plan 1110 Main St Wheeling WV 260032704 Employee Health Administration 1335293 Medsmart Inc 3185 St Rose Pkwy Ste 330 Henderson NV 890523511 X-Ray Tech Purchased Service 1131640 Emcare Inc 7032 Collections Ctr Dr Chicago IL 60693 ER Doctors Service 1018079 Cerner Corporations PO Box 959156 St Louis MO 631959156 IT Purchased Service 781151 6 495529 79700 495529 Net Patient Service Revenue 621500 27153394 27153394 EHR Revenue 621500 312028 312028 176866 176866 27642288 22 22 13500 19321 -5821 -5821 -5821 28132018 27642288 0 -5799 X 408256 408256 12406782 10943016 1463766 2762048 2448150 313898 937042 796658 140384 400 400 37000 37000 4926207 4117879 808328 1988529 1944457 44072 427233 259292 167941 1030504 616181 414323 1407168 880965 526203 162661 117780 44881 Registry 505147 496767 8380 Equipment rental 151821 107710 44111 Repairs 148743 148226 517 Licenses and Taxes 80352 50410 29942 337815 30147 307668 27717708 22957638 4760070 0 952302 1185324 2536317 649957 4238656 6010397 326184 351349 120767 120145 35924051 20798222 14420431 15125829 1831368 878161 24426025 24321162 3924356 4261853 416037 104009 7934 9914 22592612 21398736 85234 547129 0 184694 27026173 26506335 X -2600148 -2185173 -2600148 -2185173 24426025 24321162 X 414310 665 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 652289 652289 21750513 10328837 11421676 385399 351285 34114 12604480 10118100 2486380 531370 531370 15125829 Estimated Third-Party Payor 184694 184694 X 28132683 665 665 28132018 0 28132018 27717708 0 27717708 0 27717708 Part IV, Line 2b: The organization holds funds on behalf of its residents. Part X, Line 2: The Hospital 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 financial statements. The Hospital 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: Change in Investment in Foundation in Revenue on Financial Statements 323. Change in Investment in Auxiliary in Revenue on Financial Statements 342. 1 1 X 1 X 1 X 1 1 0 0 36311 36311 0.00130 1928625 477014 1451611 0.05240 1964936 477014 1487922 0.05370 1964936 477014 1487922 0.05370 1 3052363 305236 10828122 10994334 -166212 X 1 1 1 1 Boulder City Hospital Inc 901 Adams Blvd Boulder City NV 89005 www.bchcares.org 633RUH-27 X X X Geriatric behavior medical center Boulder City Hospital Inc 1 0 0 1 X X X X X X 18 1 0 0 1 X http://bchcares.org/community/ X 1 18 1 http://bchcares.org/community/ 0 1 X 100.000000000000 200.000000000000 X X X X X X 1 1 X X X X 1 X bchcares.org/insurance/ X bchcares.org/insurance/ X bchcares.org/insurance/ X X X X 1 0 X X X X 1 X 0 0 Boulder City Hospital, Inc. Part V, Section B, Line 5: A survey was conducted from October to December 2018 via paper surveys and online surveys. 98% of the respondents reside in Boulder City. Boulder City Hospital, Inc. Part V, Section B, Line 11: The 2018 Community Health Needs Assessment (CHNA) identified the following needs:1) Access to Health Services2) Cost of Health Care3) Access to Medicaid/Medicare providers4) Mental Illness5) Drug AbuseIn 2019, the hospital recruited and hired and third full time provider for the clinic. This provider has experience in women's services to fill a need in the community. The hospital added telemedical infrastructure and capabilities to realize its vision as a real and virtual multispecialty clinic in the future. The hospital added a general surgeon to its medical staff who committed to perform outpatient procedures for patients from Boulder City at Boulder City Hospital.The hospital integrated operations with the PHP (Partial Hospital Program for outpatient mental health) to increase access for mental health and dual diagnosis services.The Hospital will not address mental illness or drug abuse due to lack of funds. Other organizations in the community are better suited to assist the community with these needs. Boulder City Hospital, Inc. Part V, Section B, Line 13h: Boulder City Hospital, Inc. ('The Hospital') uses 200% of the Federal Poverty Guidelines ('FPG') to qualify patients for discounted patient care. Once qualified, the Hospital uses a sliding scale based on income and number of dependents to determine the amount of discount they receive. Patients not falling within the FPG may qualify for charity care after being considered by the Administrative Council. Factors considered by the Council may include medical indigence, deceased status, bankruptcy, homelessness. In addition, a patient's assets may also be considered. 2 1 - Boulder City Primary Care 999 Adams Blvd Ste 102 Boulder City NV 89005 Rural Health Clinic 2 - Boulder City Long Term Care Facility 901 Adams Blvd Boulder City NV 89005 Long Term Care Facility Part I, Line 3c: Boulder City Hospital, Inc. uses 200% of the Federal Poverty Guidelines (FPG) to qualify patients for discounted patient care. Once qualified, the Hospital uses a sliding scale based on income and number of dependents to determine the amount of discount they receive. Patients not falling within the FPG may qualify for charity care after being considered by the Administrative Council. Factors considered by the Council may include medical indigence, deceased status, bankruptcy, homelessness. In addition, a patient's assets may also be considered. Part I, Line 7: Line 7f is calculated based on actual expenses.Lines 7g was converted to cost based on an average ratio of costs to gross charges according to costs allocated to the relevant costs centers on the Medicare Cost Report. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients. Part III, Line 3: It is estimated that 10% of implicit price concessions patients would have been charity care if applicants would have applied. Part III, Line 4: The footnote to the organization's financial statements addressing implicit price concessions may be found on page 12 and 13 of the attached audited financial statements. Part III, Line 8: One hundred percent of any shortfall should be treated as community benefit. A facility must be able to recover its costs in order to continue to provide quality care to Medicare patients and the community as a whole.Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. Providing these services is essential to these patients and the community and increase their access to healthcare services. Therefore, the entire Medicare shortfall is considered a community benefit.Medicare allowable costs of care are based on 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: BCH provides a plain language summary of the FAP within 30 days after need identified.BCH provides a 120 Day notification period to individuals to obtain a completed FAP application from the date first post discharge billing statement is provided. During the 120 Day-notification period BCH will make all reasonable efforts to notify the individual about FAP eligibility prior to initiating EAC's.When an individual has submitted a FAP application, BCH will provide a 240-day application period beginning from post discharge statement to consider FAP eligibility for care. In circumstances where an incomplete FAP application was submitted during the 240-day application period BCH notifies the individual and will give additional time to complete the FAP application. Part VI, Line 2: The Hospital identifies needs of the community through interaction and feedback from board members, physicians, staff, and patients. Part VI, Line 3: Admitting staff hand out pamphlets explaining the charity policy to patients. The patient is instructed to read the pamphlet and complete if necessary. Business office staff contact patients after the first bill is sent. The patient is instructed to apply for charity care at that time if needed.If at any time a patient indicates they cannot afford to pay for a service, the staff bring in a financial consultant immediately to discuss applying for financial assistance. The financial consultant assists the patient with completing the financial assistance application. Part VI, Line 4: Boulder City Hospital, Inc. serves Boulder City, Nevada and the western portion of Henderson, Nevada. Nearly half of the area's residents rely on Medicare subsidies to pay for health care. Part VI, Line 5: The Hospital's governing body is comprised of persons who reside in the Organization's primary service area. The Hospital applies any surplus funds to improve the Facility and equipment to improve patient care. The Hospital also extends medical staff privileges to other qualified physicians in the community.Boulder City Hospital, Inc. maintains a 24 hour emergency room that is available to residents in its community without regard to ability to pay. The Hospital is designated a critical access hospital, and therefore, the hospital provides health care to residents who would not otherwise have access to readily available health care. X X X 0 0 0 0 0 0 0 0 0 Thomas Maher CEO 249922 0 0 0 0 0 0 0 14215 0 264137 0 0 0 Stephanie West Pharmacy Manager 145318 0 0 0 0 0 0 0 10166 0 155484 0 0 0 X Solar Light Bulbs 1 79700 Cost 0 0 1 0 Part I, Column (b): The number in column (b) represents the number of contributions. Form 990, Part VI, Section A, line 1 The Executive Committee can act on behalf of the Board of Trustees on items of an emergency nature between meetings of the Board of Trustees. The Executive Committee shall be composed of the elected officers of the Board of Trustees and the immediate Past President. The President of the Board of Trustees shall serve as Chairman and the Vice President shall serve as Vice Chairman of the committee. The Administrator/CEO shall be an ex-officio of this committee. Form 990, Part VI, Section B, line 11b Prior to Form 990 being signed, a copy is forwarded to all board members. Additionally, the Finance Committee reviews the 990 at a committee meeting. Form 990, Part VI, Section B, line 12c On an annual basis, all officers, directors, and key employees complete the conflict of interest disclosure statement. The board of directors review for any potential conflicts, as well as determine if one exists. If an individual has a potential conflict, that individual will abstain from the deliberation and voting of that situation. Form 990, Part VI, Section B, line 15a The CEO's compensation is determined and approved by an independent compensation committee. Compensation of other individuals is determined annually by the human resources department (HR). HR uses a salary survey from the Nevada Hospital Association to determine the appropriate compensation amounts. Persons involved in this process are independent and the conclusions are documented. Form 990, Part VI, Section C, line 19 Boulder City Hospital makes its governing documents, conflict of interest policy, and financial statements available to the public through the hospital's administration department. Form 990, Part IX, line 11g Medical Director Fees: Program service expenses 280,404. Management and general expenses 0. Fundraising expenses 0. Total expenses 280,404. Purchased Services: Program service expenses 3,837,475. Management and general expenses 808,328. Fundraising expenses 0. Total expenses 4,645,803. Form 990, Part XI, line 9: Change in Interest in Foundation 323. Change in Interest in Auxiliary 342.