2019-11-15T06:55:22-06:00 2018-12-31 450250958 EIDE BAILLY LLP 877 W MAIN ST STE 800 BOISE ID 83702 990 2018-01-01 880065829 Boulder City Hospital Inc BOUL 7022934111 901 Adams Blvd Boulder City NV 89005 Thomas Maher CEO 7022934111 2019-11-14 1 Kim Hunwardsen CPA P00484560 2083447150 2019-11-14 216.147.181.48 2019-11-14 15:22:05 MS P 51153E6FE133A46BE9F60C7A8748BC609ADBB28A A9F393D044C6B02927C29CDABEE7CBE310A8D2B0 2018 2020-03-31 21:24:44Z Thomas Maher 901 Adams Blvd Boulder City NV 89005 28805728 0 X www.bchcares.org X 1954 NV Provide health care services to residents of Clark County and surrounding areas in southern Nevada. 12 12 321 122 0 0 214717 254448 27576479 28533964 399 2541 314255 494 28105850 28791447 0 0 0 0 15138981 16059079 0 0 0 13767919 13148618 28906900 29207697 -801050 -416250 21239883 24426025 23454909 27026173 -2215026 -2600148 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. 1 1 24146057 28533964 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. 24146057 1 1 0 0 0 0 0 0 1 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 14 0 1 321 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 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 Peggy Casper President 0.50 X X 0 0 0 Scott Henson Vice President 0.50 X X 0 0 0 Ross Johnson Treasurer 0.50 X X 0 0 0 Cindy Anderson Secretary 0.50 X X 0 0 0 Alan Bowman Director 0.50 X 0 0 0 Linda Faiss Director 0.50 X 0 0 0 Christine Milburn Director 0.50 X 0 0 0 Windell Whitman Director 0.50 X 0 0 0 Robert Kenney 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 Bret Runion Director 0.50 X 0 0 0 Thomas Maher CEO 40.00 X 247665 0 9043 Doug Lewis CFO 40.00 X 139810 0 2600 Stephanie West Pharmacy Manager 40.00 X 147728 0 11524 Nancy Carlson Nursing Director of Acute Services 40.00 X 114747 0 7866 Andre Pastian CNO 40.00 X 122787 0 4516 Linda Burdno Home Health Manager 40.00 X 113558 0 803 Catherine Litsiba Charge Nurse 40.00 X 104240 0 10687 990535 0 47039 7 0 1 0 Horizon Health PO Box 840839 Dallas TX 752840839 TRU & Pysch Unit Mgmt 1385680 The Health Plan 1110 Main St Wheeling WV 260032704 Employee Health Administration 636923 Medsmart Inc 3185 St Rose Pkwy Ste 330 Henderson NV 890523511 X-Ray Tech Purchased Service 568393 Emcare Inc 7032 Collections Ctr Dr Chicago IL 60693 ER Doctors Service 490998 Cerner Corporations PO Box 959156 St Louis MO 631959156 IT Purchased Service 310937 5 254448 254448 Net Patient Service Revenue 621500 28051077 28051077 482887 482887 28533964 16 16 14700 14206 494 494 494 2600 75 2525 2525 2525 28791447 28533964 0 3035 X 408527 408527 11938976 10460155 1478821 2810892 2429749 381143 900684 771585 129099 10755 10755 80000 80000 4733366 3853285 880081 1790503 1756571 33932 466052 259292 206760 942786 524526 418260 1330574 740275 590299 153617 99691 53926 Bad Debt 2528174 2528174 Registry 420325 405812 14513 Equipment rental 128739 118775 9964 Repairs 118340 118230 110 445387 79937 365450 29207697 24146057 5061640 0 870079 952302 10363 2536317 3847079 4238656 275682 326184 55871 120767 33825711 19405280 15344475 14420431 836334 1831368 21239883 24426025 3564339 3924356 732755 416037 7934 19157815 22592612 85234 23454909 27026173 X -2236091 -2600148 21065 0 -2215026 -2600148 21239883 24426025 X -416250 31128 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 652289 652289 21559603 9674187 11885416 11053580 9385822 1667758 560239 345271 214968 14420431 Estimated Third Paty Payor Settlements 1747700 Interest in Net Assets of Foundation 37185 Interest in Net Assets of Auxiliary 46483 1831368 X 26294401 -2497046 -2497046 28791447 0 28791447 26679523 0 26679523 2528174 2528174 29207697 Part IV, Line 2b: The organization holds funds on behalf of its residents. Part X, Line 2: Boulder City Hospital, Inc. is organized as a Nevada nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. Management has determined that the Hospital is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990]T) with the IRS. 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: Bad Debt Expenses in Expenses for Tax Purposes -2,528,174. Change in Foundation and Auxiliary in Revenue on Financial Statements 31,128. Part XII, Line 4b - Other Adjustments: Bad Debt Expenses in Expense for Tax Purposes 2,528,174. 1 1 X 1 X 1 X 1 1 0 0 5293412 5000634 292778 0.01100 5293412 5000634 292778 0.01100 35675 35675 0.00130 327870 80973 246897 0.00930 363545 80973 282572 0.01060 5656957 5081607 575350 0.02160 1 2528174 252817 13170228 13255752 -85524 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 1 X http://bchcares.org X http://bchcares.org X 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 2018 the Hospital addressed the needs first three needs with the following actions:1) Expansion of Boulder City Primary Care clinic (BCPC): in order to provide improved access to health services and Medicaid/Medicare providers BCPC was built and became fully operational in December 2018. We also expanded clinic hours and continued to recruit more specialty physicians.2) Fostering relationship with Universal Health Services: Universal Health Services is a larger health system that will continue to assist in the needs identified. The relationship will assist with specialty physician recruitment.3) The Hospital is advocating to bring full cost reimbursement for long term care, which was identified as a key service in the CHNA. In late 2018 the Hospital created a consortium of Nevada Critical Access Hospitals to advocate that these services are underpaid. This initiation resulted in increased payments starting in 2018. 4) Implemented the 340B drug program to reduce costs of health care to patients, especially Medicaid patients.5) Cost of Health Care was addressed by finding ways to save money in the Hospital operations. We secured a USDA loan to refinance debt, allowing the Hospital to pursue the new Rural Health Clinic. Leadership also lobbied to create a Provider Fee program that allows the state of Nevada to negotiate provider fees with defined hospital groups. 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. Boulder City Hospital, Inc. Part V, Section B, Line 16j: At December 31, 2018 a plain language summary was not posted, but it is currently posted on the organization's website. 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. ('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. Part I, Line 7: Lines 7b and 7g were 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.Line 7f is calculated based on actual expenses. 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 $ 2,528,174. Part III, Line 2: Bad debt expense is based on charges. Part III, Line 3: It is estimated that 10% of bad debt patients would have been charity care if applicants would have applied. Part III, Line 4: The footnote to the Organization's financial statements can be found on page 8 and page 9 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 makes reasonable efforts to determine whether an individual is eligible for assistance under the hospital organization's financial assistance policy (FAP) before engaging in extraordinary collection actions (ECAs) against that individual. Individuals are given 3 statements which will encourage them to apply for financial assistance. After 90 days they are automatically place in collection status and referred to a collection agency. 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 first bill is sent. 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: 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 247665 0 0 0 0 0 0 0 9963 0 257628 0 0 0 Stephanie West Pharmacy Manager 147728 0 0 0 0 0 0 0 12418 0 160146 0 0 0 Form 990, Part III, line 2 The organization opened a Medicare/Medicaid Rural Health Clinic in December 16, 2018 which was certified to provide much needed primary care services to Boulder County which is an underserved area. Form 990, Part III, line 3 In 2018 the organization discontinued home health agency services. 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 247,881. Management and general expenses 0. Fundraising expenses 0. Total expenses 247,881. Purchased Services: Program service expenses 3,605,404. Management and general expenses 880,081. Fundraising expenses 0. Total expenses 4,485,485. Form 990, Part XI, line 9: Change in Interest in Auxiliary 1,927. Change in Interest in Foundation 29,201.