SOUTH LYON HEALTH CENTER INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- SOUTH LYON HEALTH CENTER INC (EIN 88-0256932)
- Tax period
- 2016-04-01 to 2017-03-31
- Filed
- 2018-02-13
- IRS object ID
- 201840449349300039
- Schema version
- 2016v3.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-02-13T12:30:23-06:00 | ReturnTs |
| Tax Period End | 2017-03-31 | 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 | 7601 France Avenue South Suite 400 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55435 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-04-01 | 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 dba | BusinessNameLine1Txt |
| Business Name Line2 | 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 | 2018-02-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Tim A Ritter CPA | PreparerPersonNm |
| PTIN | P00732856 | PTIN |
| Phone | 9525483400 | PhoneNum |
| Preparation | 2018-02-08 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 50.249.107.123 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-02-08 | IPDt |
| IP Tm | 13:43:02 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BB3069DA9F6047B5836CE2952E0AE234800C2778 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | 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 | $12,347,589 | 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 | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 236 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $34,726 | PYContributionsGrantsAmt |
| CY Contributions Grants | $33,312 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,252,402 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,112,640 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,006 | CYInvestmentIncomeAmt |
| PY Other Revenue | $436,356 | PYOtherRevenueAmt |
| CY Other Revenue | $196,631 | CYOtherRevenueAmt |
| PY Total Revenue | $11,723,484 | PYTotalRevenueAmt |
| CY Total Revenue | $12,347,589 | 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 | $7,669,845 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,303,224 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,581,850 | PYOtherExpensesAmt |
| CY Other Expenses | $4,794,314 | CYOtherExpensesAmt |
| PY Total Expenses | $12,251,695 | PYTotalExpensesAmt |
| CY Total Expenses | $12,097,538 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$528,211 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $250,051 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,168,817 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,209,720 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,382,530 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,173,382 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,786,287 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,036,338 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of South Lyon Medical Center is to provide access to quality health care services needed by the community. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,156,407 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $7,289,344 | 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 300 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 assistance available for 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 | $2,705,043 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,202,840 | 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 | $1,492,780 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,767,490 | 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 | $10,354,230 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 236 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | 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 (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Myrtle McDowell | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Robert Rowley | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Ted Rudolph | |||||||
| Director (Thru Jan) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Dale Theiss | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Robin L Titus | |||||||
| Director/Chief of Staff (Thru Jan) | 40.00 | Yes (X) | $191,454 | $0 | $24,105 | ||
| Jeffrey Westin | |||||||
| Director/Chief of Staff | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| Matt Christenson | |||||||
| President | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| John Diekmann | |||||||
| Vice President | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| David Bezard | |||||||
| CFO | 40.00 | $93,432 | $0 | $21,322 | Yes (X) | ||
| Toni Inserra | |||||||
| CEO | 40.00 | $115,100 | $0 | $11,267 | Yes (X) | ||
| Thomas Ard | |||||||
| IT Director | 40.00 | $110,497 | $0 | $11,175 | Yes (X) | ||
| Thomas Cliften | |||||||
| Physical Therapist | 40.00 | $138,792 | $0 | $23,052 | Yes (X) | ||
| Patricia Wise | |||||||
| Physician Assistant | 40.00 | $100,100 | $0 | $10,967 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $749,375 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $101,888 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Jeffrey Westin MD | |||||
| 2851 Friar Rock Court | Sparks | NV | 89436 | Physican Services | $527,475 |
| Robert T Floyd MD LLC | |||||
| 180 Ox-Yoke Lane | Reno | NV | 89521 | Physican Services | $411,850 |
| RN Network | |||||
| PO Box 974088 | Dallas | TX | 75397 | Nursing Locums Services | $158,238 |
| NV Rural Hospital Partners | |||||
| 4600 Kietzke Lane | Reno | NV | 89502 | MRI and Technical Services | $112,772 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $33,312 | AllOtherContributionsAmt |
| Total Contributions | $33,312 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Program Service Revenue-Related | 621400 | $9,911,720 | $9,911,720 |
| Hospital District Reimbursement | 621400 | $846,229 | $846,229 |
| District Tax Subsidy | 900099 | $738,184 | $738,184 |
| UPL Revenue | 621400 | $589,441 | $589,441 |
| Patient Lab Testing | 621400 | $26,000 | $26,000 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,066 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,066 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,112,640 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $5,200 | 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 | $5,200 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,200 | TotalRevenueColumnAmt |
| Exclusion | $5,200 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,006 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,006 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,006 | TotalRevenueColumnAmt |
| Exclusion | $5,006 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| EHR Incentive | 900099 | $147,034 | $147,034 | |
| Employee Meals | 900099 | $8,685 | $8,685 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,712 | TotalRevenueColumnAmt |
| Exclusion | $35,712 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $191,431 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,347,589 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,259,674 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $54,603 | 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 | $453,666 | TotalAmt |
| Program Services | $275,729 | ProgramServicesAmt |
| Management And General | $177,937 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,761,960 | TotalAmt |
| Program Services | $5,019,205 | ProgramServicesAmt |
| Management And General | $742,755 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,006 | TotalAmt |
| Program Services | $73,160 | ProgramServicesAmt |
| Management And General | $10,846 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $476,838 | TotalAmt |
| Program Services | $421,523 | ProgramServicesAmt |
| Management And General | $55,315 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $526,754 | TotalAmt |
| Program Services | $447,319 | ProgramServicesAmt |
| Management And General | $79,435 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,087 | TotalAmt |
| Management And General | $98,087 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,482,695 | TotalAmt |
| Program Services | $2,319,618 | ProgramServicesAmt |
| Management And General | $163,077 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,127 | TotalAmt |
| Management And General | $2,127 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,318 | TotalAmt |
| Program Services | $155,596 | ProgramServicesAmt |
| Management And General | $193,722 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,813 | TotalAmt |
| Management And General | $171,813 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,695 | TotalAmt |
| Program Services | $270,350 | ProgramServicesAmt |
| Management And General | $345 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,601 | TotalAmt |
| Program Services | $4,144 | ProgramServicesAmt |
| Management And General | $15,457 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,902 | TotalAmt |
| Program Services | $58,405 | ProgramServicesAmt |
| Management And General | $5,497 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,600 | TotalAmt |
| Management And General | $6,600 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,682 | TotalAmt |
| Program Services | $27,682 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,138 | TotalAmt |
| Program Services | $121,696 | ProgramServicesAmt |
| Management And General | $3,442 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $863,382 | $863,382 | |
| PROVISION FOR BAD DEBTS | $289,012 | $289,012 | |
| Dues and Subscriptions | $24,049 | $7,200 | $16,849 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $213 | TotalAmt |
| Program Services | $209 | ProgramServicesAmt |
| Management And General | $4 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,097,538 | TotalAmt |
| Program Services | $10,354,230 | ProgramServicesAmt |
| Management And General | $1,743,308 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,554,779 | BOYAmt |
| EOY | $1,676,923 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,563 | BOYAmt |
| EOY | $18,223 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,378,886 | BOYAmt |
| EOY | $2,126,202 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,271 | BOYAmt |
| EOY | $115,415 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,021 | BOYAmt |
| EOY | $96,563 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $280,812 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $104,418 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,297 | BOYAmt |
| EOY | $176,394 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,168,817 | BOYAmt |
| EOY | $4,209,720 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,052,255 | BOYAmt |
| EOY | $843,107 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $330,275 | BOYAmt |
| EOY | $330,275 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,382,530 | BOYAmt |
| EOY | $1,173,382 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,786,287 | BOYAmt |
| EOY | $3,036,338 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,786,287 | BOYAmt |
| EOY | $3,036,338 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,168,817 | BOYAmt |
| EOY | $4,209,720 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $250,051 | 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 | $95 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $95 | 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. A portion of membership dues to Nevada Hospital Association is used for Lobbying. The Nevada Hospital Association advocates on behalf of its members for improving efficiency and accessibility of the healthcare delivery systems and the health status of Nevada's Population. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $90,670 | OtherCostOrOtherBasisAmt |
| Depreciation | $54,665 | DepreciationAmt |
| Book Value | $36,005 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $190,142 | OtherCostOrOtherBasisAmt |
| Depreciation | $49,753 | DepreciationAmt |
| Book Value | $140,389 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $176,394 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $11,320,393 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,320,393 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,027,196 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,027,196 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $12,347,589 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,808,526 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $11,808,526 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $289,012 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $289,012 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,097,538 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 4b - Other Adjustments: | Provision for bad debts 289,012. Nonoperating Gains - District Tax Subsidy 738,184. |
| Part XII, Line 4b - Other Adjustments: | Provision for bad debts 289,012. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | 0 | FPGReferenceFreeCareInd |
| 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 | $31,525 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,525 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,717,105 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $705,083 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,012,022 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08570 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,748,630 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $705,083 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,043,547 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08840 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,748,630 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $705,083 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,043,547 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08840 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $184,043 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $61,348 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,143,031 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,939,521 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $203,510 | 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 | 15 | 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 Supplemental Information | 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 | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Supplemental Information | 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 | 0.000000000000 | 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Page 7 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Page 7 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Page 7 | 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 |
| 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 Private | Yes (X) | LookBackMedicarePrivateInd |
| 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: 1,750 surveys were distributed to local community businesses and groups, including Yerington and Smith Valley Schools. 480 Spanish surveys were provided to Yerington Elementary school in an attempt to reach out to nonEnglish speaking community members. An online version of the survey with identical questions was made available on the South Lyon Medical Center website and Facebook page using Survey Monkey. 302 completed paper surveys were returned to Nevada State Office of Rural Health (8 in Spanish) and 52 additional surveys were completed online. The University of Nevada Institutional Review Board did not require approval of this pilot project because the information was collected for a community health needs assessment rather than research purposes. |
| South Lyon Medical Center | Part V, Section B, Line 7d: https://slmcnv.org/community-needs-assessment/ |
| South Lyon Medical Center | Part V, Section B, Line 11: South Lyon Medical Center (SLMC) completed the most recent CHNA in March 2016 and has begun addressing the following identified needs: 1)Access to Healthcare - Wellness Wednesdays are held weekly to provide reduced cost screenings, Telemedicine education is being provided to our clinic providers to increase utilization for specialists, coordinate mobile screening vans providing mammography and diabetic retinopathy and working to integrate reporting from EHR to state health registries. Due to the lack of available services in the area, South Lyon Medical Center added a staff Behavioral Health provider in 2017. This individual helps primary care providers and patients bridge the gaps to ensure care is provided. South Lyon Medical Center also extended the hours and days its walk-in clinic is available. We have added Telepsych and Telestroke to our ER which will provide Emergent Psychiatric and stroke evaluations. We also have access to a website for our Spanish speaking community members to get free help with diabetes, smoking cessation and other health improving strategies.2)Quality of Care - We have moved forward with the Dialysis project, added 4 Emergency room doctors Certified in ER care, we have added 3 new clinic practitioners, we have begun to accept VA patients in our Long Term care facility and are moving forward with developing and implementing a community wellness program with the main focus on diabetes. We now have a Certified Diabetes Educator and offer public courses every quarter. South Lyon Medical Center participates in the CMS Quality Reporting for hospital compare and has a very vigorous quality assurance committee. 3) Cost of Care - The facility has added a cash clinic offering patients with no insurance an option to see a physician for a reduced fee at all three clinics, a prompt pay discount was instituted which allows patients a 30% discount on outpatient and inpatient services, we have revised our sliding fee discounts to be more generous and less restrictive and a certified enrollment counselor position was created to help individuals obtain coverage through the Insurance Exchange. We now have a representative from The American Cancer Society that comes twice a month to meet with the public and help them navigate the available resources at no charge.4) More Specialty Services Needed - We are educating all our providers on the availability of telemedicine services for specialty providers, we increased the advertising for our current visiting providers including a better internet presence/social media and we hope to increase the types of specialties offered. We have added Surgeons from CVMC that also provide wound care and added a Podiatrist who comes out monthly. |
| Part V, Section B, Line 16 (a-c): | https://slmcnv.org/wp-content/uploads/2017/04/FAP-CHARITY-CARE-LOW-INCOME-UNINSURED-web-2017.pdf |
| 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 $ 289,012. |
| 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 RECEIVABLES AND CREDIT POLICY NOTE.PATIENT AND RESIDENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND AN ALLOWANCE FOR DOUBTFUL ACCOUNTS, WHICH REFLECT MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT PROVIDES FOR CONTRACTUAL ADJUSTMENTS UNDER TERMS OF THIRD-PARTY REIMBURSEMENT AGREEMENTS THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT AND RESIDENT ACCOUNTS RECEIVABLE.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, Soroptomists, 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: | The primary medical service area for South Lyon Medical Center consists of three zip code tabulation areas: 89430 (Smith Valley), 89444 (Wellington) and 89447 (Yerington). This is a large rural area consisting 1,098 square miles in size and has a population of 11,098 according to the Census 2010 data. 25 percent of the population (or 2,750 individuals) are age 65 years and older which is about twice the percentage of this age group in the national or state population. The Hispanic population is 17% and is much younger on average than the non-Hispanic population. |
| 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. SLMC provides access to medical information via the Cares Cottage, providing diabetic education to community members and via outreach programs with the local schools. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Robin L Titus | ||||||||||||||
| Director/Chief of Staff (Thru Jan) | $191,454 | $0 | $0 | $0 | $0 | $0 | $3,829 | $0 | $20,276 | $0 | $215,559 | $0 | $0 | $0 |
| Thomas Cliften | ||||||||||||||
| Physical Therapist | $138,792 | $0 | $0 | $0 | $0 | $0 | $2,776 | $0 | $20,276 | $0 | $161,844 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Rebecca Inserra | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Employee of hospital | RelationshipDescriptionTxt |
| Transaction | $35,071 | TransactionAmt |
| Transaction | Rebecca Inserra is a family member of Toni Inserra and is an employee of the hospital. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
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 42 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 of 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. The 990 is then reviewed and approved by the CEO prior to sharing with the board of directors. The Form is then submited 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 | Other Services: Program service expenses 303,423. Management and general expenses 50,181. Fundraising expenses 0. Total expenses 353,604. Laboratory Services: Program service expenses 165,669. Management and general expenses 0. Fundraising expenses 0. Total expenses 165,669. MRI Services: Program service expenses 158,628. Management and general expenses 0. Fundraising expenses 0. Total expenses 158,628. Business Office Purchase Services: Program service expenses 0. Management and general expenses 112,896. Fundraising expenses 0. Total expenses 112,896. Med/Surg Services: Program service expenses 302,536. Management and general expenses 0. Fundraising expenses 0. Total expenses 302,536. LTC Services: Program service expenses 125,544. Management and general expenses 0. Fundraising expenses 0. Total expenses 125,544. ER Services: Program service expenses 1,263,818. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,263,818. |
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