FURP.ORG / PUBLIC DATA EXPLORER

BOULDER CITY HOSPITAL INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
BOULDER CITY HOSPITAL INC (EIN 88-0065829)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-09-20
IRS object ID
201632649349300118
Schema version
2015v2.1
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

FieldValueIRS element (for citing)
Return2016-09-20T10:36:30-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN880150455PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BRADSHAW SMITH AND CO LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15851 W CHARLESTON BLVDAddressLine1Txt
CityLAS VEGASCityNm
State AbbreviationNVStateAbbreviationCd
ZIP89146ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN880065829EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BOULDER CITY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBOULBusinessNameControlTxt
Phone7022934111PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1901 ADAMS BLVDAddressLine1Txt
CityBOULDER CITYCityNm
State AbbreviationNVStateAbbreviationCd
ZIP89005ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS MAHERPersonNm
Person TitleCEOPersonTitleTxt
Phone7022934111PhoneNum
Signature2016-09-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHEATHER R GRECHPreparerPersonNm
PTINP00165182PTIN
Phone7028789788PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTHOMAS MAHERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1901 ADAMS BLVDAddressLine1Txt
CityBOULDER CITYCityNm
State AbbreviationNVStateAbbreviationCd
ZIP89005ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$24,719,053GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BCHCARES.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1954FormationYr
Legal Domicile StateNVLegalDomicileStateCd
Activity Or MissionBOULDER CITY HOSPITAL, INC. IS A NONPROFIT, NONSTOCK CORPORATION WHICH OPERATES A 25-BED ACUTE CARE FACILITY, A 47-BED LONG TERM CARE FACILITY, A 10-BED GERIATRIC BEHAVIORAL MEDICINE CENTER AND A HOME HEALTH AGENCY. THE HOSPITAL PROVIDES COMPREHENSIVE MEDICAL, SURGICAL, EMERGENCY, OUTPATIENT, SKILLED NURSING AND HOME HEALTH SERVICES TO THE RESIDENTS OF CLARK COUNTY.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee332TotalEmployeeCnt
Total Volunteers68TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$34,498PYContributionsGrantsAmt
CY Contributions Grants$246,578CYContributionsGrantsAmt
PY Program Service Revenue$21,868,242PYProgramServiceRevenueAmt
CY Program Service Revenue$24,454,012CYProgramServiceRevenueAmt
PY Investment Income$4,184PYInvestmentIncomeAmt
CY Investment Income$1,263CYInvestmentIncomeAmt
PY Other Revenue$5,272PYOtherRevenueAmt
CY Other Revenue-$1,084CYOtherRevenueAmt
PY Total Revenue$21,912,196PYTotalRevenueAmt
CY Total Revenue$24,700,769CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,825,280PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$12,633,735CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$10,087,879PYOtherExpensesAmt
CY Other Expenses$11,699,640CYOtherExpensesAmt
PY Total Expenses$21,913,159PYTotalExpensesAmt
CY Total Expenses$24,333,375CYTotalExpensesAmt
PY Revenues Less Expenses-$963PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$367,394CYRevenuesLessExpensesAmt
Total Assets BOY$26,005,451TotalAssetsBOYAmt
Total Assets EOY$27,411,093TotalAssetsEOYAmt
Total Liabilities BOY$24,396,535TotalLiabilitiesBOYAmt
Total Liabilities EOY$25,268,329TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,608,916NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,142,764NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionBOULDER 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$20,916,179ExpenseAmt
Revenue$24,404,754RevenueAmt
DescBOULDER CITY HOSPITAL OPERATES AN ACUTE CARE HOSPITAL WITH EMERGENCY SERVICES, A BEHAVIORAL MEDICINE CENTER, A LONG TERM CARE FACILITY AND A SKILLED NURSING UNIT.Desc
Total Program Service Expenses$20,916,179TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document25IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee332EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FREY BELETE CONTROLLERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7022934111PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1901 ADAMS BLVDAddressLine1Txt
CityBOULDER CITYCityNm
State AbbreviationNVStateAbbreviationCd
ZIP89005ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
WENDELL WHITMAN
DIRECTOR0.50Yes (X)$0$0$0
LINDA FAISS
VICE PRESIDENT0.50Yes (X)$0$0$0Yes (X)
ALAN BOWMAN
PRESIDENT0.50Yes (X)$0$0$0Yes (X)
ROBERT KENNEY
DIRECTOR0.50Yes (X)$0$0$0
MICHAEL RAVITCH MD
DIRECTOR0.50Yes (X)$0$0$0
CHRISTINE A MILBURN
SECRETARY0.50Yes (X)$0$0$0Yes (X)
VERNON BURK
DIRECTOR0.50Yes (X)$0$0$0
DEREK MEEKS DO
CHIEF OF STAFF0.50Yes (X)$0$0$0
BRUCE WOODBURY
DIRECTOR0.50Yes (X)$0$0$0
PEGGY CASPAR
DIRECTOR0.50Yes (X)$0$0$0
ROSS JOHNSON
TREASURER0.50Yes (X)$0$0$0Yes (X)
SUE MANTERIS
DIRECTOR0.50Yes (X)$0$0$0
THOMAS MAHER
CEO40.00$203,836$0$8,591Yes (X)
DOUGLAS LEWIS
CFO40.00$122,200$0$0Yes (X)
ANDRE PASTIAN
CNO40.00$105,010$0$7,850Yes (X)
RAE CUMMINGS
COO (THROUGH MID YEAR)40.00$109,400$0$6,540Yes (X)
LINDA BURDNO
HOME HEALTH DIRECTOR40.00$133,930$0$0Yes (X)
FREZEWED BELETE
CONTROLLER40.00$101,758$0$7,850Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$776,134TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$30,831TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HORIZON HEALTH
PO BOX 840839DALLASTX752840839TECHNICIANS AND HEALTH CARE MANAGEMENT$1,043,285
MEDSMART INC
1701 N GREEN VALLEY PARKWAY 2AHENDERSONNV89074TECHNICIANS AND ON-CALL MEDICAL$517,915
EMCARE
7032 COLLECTION CENTER DRIVECHICAGOIL60693ER PHYSICIANS$491,895
BUILDING HOPE NEVADA
1050 INDIGO DRIVE SUITE 140LAS VEGASNV89145DEVELOPMENT CONSULTANT$178,000
FIRST SOURCE SOLUTIONS
6455 RELIABLE PARKWAYCHICAGOIL60686REVENUE CYCLE MANAGEMENT$172,731
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Government Grants$189,256GovernmentGrantsAmt
All Other Contributions$57,322AllOtherContributionsAmt
Total Contributions$246,578TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
NET PATIENT SERVICE FEES900099$24,359,205$24,359,205
CAFETERIA SALES722210$49,258$49,258

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$45,549TotalRevenueColumnAmt
Related Or Exempt Func Income$45,549RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$24,454,012TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$208TotalRevenueColumnAmt
Exclusion$208ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$17,200RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$18,284RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$1,084RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,084TotalRevenueColumnAmt
Exclusion-$1,084ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$1,055OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$1,055OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,055TotalRevenueColumnAmt
Exclusion$1,055ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$24,700,769TotalRevenueColumnAmt
Related Or Exempt Func Income$24,404,754RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$49,437ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$540,446TotalAmt
Program Services$214,410ProgramServicesAmt
Management And General$326,036ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,594,415TotalAmt
Program Services$8,260,497ProgramServicesAmt
Management And General$1,333,918ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,764,980TotalAmt
Program Services$1,498,733ProgramServicesAmt
Management And General$266,247ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$733,894TotalAmt
Program Services$620,235ProgramServicesAmt
Management And General$113,659ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$8,919TotalAmt
Management And General$8,919ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$78,476TotalAmt
Management And General$78,476ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,813,480TotalAmt
Program Services$3,285,324ProgramServicesAmt
Management And General$528,156ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$25,019TotalAmt
Program Services$25,019ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$256,131TotalAmt
Program Services$47,294ProgramServicesAmt
Management And General$208,837ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$256,107TotalAmt
Program Services$217,691ProgramServicesAmt
Management And General$38,416ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$322,249TotalAmt
Program Services$273,912ProgramServicesAmt
Management And General$48,337ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$948,927TotalAmt
Program Services$806,588ProgramServicesAmt
Management And General$142,339ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,348,424TotalAmt
Program Services$1,146,160ProgramServicesAmt
Management And General$202,264ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$187,896TotalAmt
Program Services$159,712ProgramServicesAmt
Management And General$28,184ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$2,139,555$2,110,239$29,316
EQUIPMENT RENTAL & MTN$1,579,200$1,579,200
REGISTRY$735,257$671,165$64,092

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$24,333,375TotalAmt
Program Services$20,916,179ProgramServicesAmt
Management And General$3,417,196ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,498,777BOYAmt
EOY$777,157EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$870,057BOYAmt
EOY$9,043EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,449,494BOYAmt
EOY$8,385,610EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$320,377BOYAmt
EOY$305,288EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$60,663BOYAmt
EOY$70,516EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$33,038,761LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,379,479LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$16,250,013BOYAmt
EOY$17,659,282EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$404BOYAmt
EOY$411EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,555,666BOYAmt
EOY$203,786EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$26,005,451BOYAmt
EOY$27,411,093EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,176,226BOYAmt
EOY$5,509,968EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$19,037,337BOYAmt
EOY$17,528,045EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$182,972BOYAmt
EOY$2,230,316EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$24,396,535BOYAmt
EOY$25,268,329EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,587,851BOYAmt
EOY$2,121,699EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$21,065BOYAmt
EOY$21,065EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,608,916BOYAmt
EOY$2,142,764EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$26,005,451BOYAmt
EOY$27,411,093EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$367,394ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$166,454OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$652,289OtherCostOrOtherBasisAmt
Book Value$652,289BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,237,136OtherCostOrOtherBasisAmt
Depreciation$7,636,658DepreciationAmt
Book Value$13,600,478BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$385,399OtherCostOrOtherBasisAmt
Depreciation$320,011DepreciationAmt
Book Value$65,388BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,639,341OtherCostOrOtherBasisAmt
Depreciation$7,298,214DepreciationAmt
Book Value$3,341,127BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$124,596OtherCostOrOtherBasisAmt
Depreciation$124,596DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$17,659,282TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
CAPITAL LEASES$2,142,654
DUE FROM FOUNDATION$87,662
FieldValueIRS element (for citing)
Total Liability$2,230,316TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$24,867,223TotalRevEtcAuditedFinclStmtAmt
Other Revenue$166,454OtherRevenueAmt
Revenue Not Reported$166,454RevenueNotReportedAmt
Revenue Subtotal$24,700,769RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$24,700,769TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$24,333,375TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$24,333,375ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$24,333,375TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN INCOME TAX POSITIONS, THE HOSPITAL DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE HOSPITAL RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS IN 2015.
PART XI, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION AND AUXILLIARY 166,454.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$28,888TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$28,888NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,292,386TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,694,986DirectOffsettingRevenueAmt
Net Community Benefit Expns-$402,600NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,321,274TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,694,986DirectOffsettingRevenueAmt
Net Community Benefit Expns-$373,712NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,321,274TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,694,986DirectOffsettingRevenueAmt
Net Community Benefit Expns-$373,712NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,241,780BadDebtExpenseAmt
Reimbursed By Medicare$13,974,205ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$14,411,856CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$437,651MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BOULDER CITY HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1901 ADAMS BLVDAddressLine1Txt
CityBOULDER CITYCityNm
State AbbreviationNVStateAbbreviationCd
ZIP89005ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1BOULDER CITY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
BOULDER CITY HOSPITAL, INCPART V, SECTION B, LINE 5: THE HOSPITAL INVOLVED A COMMUNITY FOCUS GROUP AND ENGAGED THE ASSISTANCE OF THE OFFICE OF STATEWIDE INITIATIVES AND THE UNIVERSITY OF NEVADA SCHOOL OF MEDICINE. THE PRIMARY FACILITATOR WAS JOHN PACKHAM, PHD. A SURVEY, OF PRIMARILY RESIDENCES OF BOULDER CITY, NEVADA, WAS CONDUCTED FROM SEPTEMBER 21, 2015 TO NOVEMBER 16, 2015.
BOULDER CITY HOSPITAL, INCPART V, SECTION B, LINE 22D: BOULDER CITY HOSPITAL FOLLOWS ITS FINANCIAL ASSISTANCE POLICY TO DETERMINE WHAT THEY EXPECT TO RECEIVE FROM FAP ELIGIBLE PATIENTS. FAP ELIGIBLE INDIVIDUALS WITH INCOME UP TO 100% FPG ARE NOT CHARGED ANYTHING AND INDIVIDUALS UP TO 200% OF FPG ARE CHARGED ON A SLIDING DISCOUNT SCALE.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - BOULDER CITY HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1901 ADAMS BLVDAddressLine1Txt
CityBOULDER CITY NVCityNm
State AbbreviationNVStateAbbreviationCd
ZIP89005ZIPCd
FieldValueIRS element (for citing)
FacilitySKILLED NURSINGFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:BOULDER CITY HOSPITAL ("THE HOSPITAL') USES 200% OF THE FEDERAL POVERTY GUIDELINES ("FPG") TO QUALIFY PATIENTS FOR CHARITY CARE. ONCE QUALIFIED, THE HOSPITAL USES A SLIDING SCALE BASED ON INCOME AND NUMBER OF DEPENDENTS TO DETERMINE THE AMOUNT A PATIENT IS REQUIRED TO PAY IN FULL SATISFACTION OF THEIR HOSPITAL LIABILITY. PATIENTS NOT FALLING WITHIN THE FPG MAY QUALIFY FOR CHARITY CARE AFTER BEING CONSIDERED BY THE CHARITY CARE COMMITTEE.
PART I, LINE 7:BOULDER CITY HOSPITAL, INC. USES A COST TO CHARGE RATIO FOR DETERMINING THE AMOUNT REPORTED IN PART I, LINE 7A. THE COST TO CHARGE RATIO USED TO REPORT LINE 7A WAS CALCULATED USING THE TOTAL COST FOR THE ENTIRE HOSPITAL ORGANIZATION TO THE TOTAL PATIENT CHARGES FOR THE ENTIRE HOSPITAL. A SEPERATE COST TO CHARGE RATIO WAS USED TO CALCULATE THE UNREIMBURSED MEDICAID TO SHOW A MORE ACCURATE REPRESENTATION OF THE COMMUNITY BENEFIT EXPENSE.LINE 7B USES A COST TO CHARGE RATIO DETERMINED FROM THE MEDICARE COST REPORT TO MORE ACCURATELY REPRESENT THE COMMUNITY BENEFIT EXPENSE FROM MEDICAID.
PART I, LN 7 COL(F):BAD DEBT EXPENSE FOR THE YEAR WAS $3,241,780. THIS AMOUNT WAS OMITTED FROM TOTAL EXPENSES WHEN CALCULATING COMMUNITY BENEFIT EXPENSE FOR SCHEDULE H.
PART III, LINE 4:TO DETERMINE THE COST OF BAD DEBT EXPENSE, THE HOSPITAL USES A COST-TO-CHARGE RATIO.FINANCIAL STATEMENT FOOTNOTE REGARDING BAD DEBTS - ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND ALLOWANCES 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 DEBIT AGAINST GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. IN ADDITION, MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY FROM UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A DEBIT AGAINST GROSS REVENUE AND A CREDIT TO A VALUATION ALLOWANCE.IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL 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 WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL 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. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. BECAUSE OF THE INHERENT NATURE OF THE ALLOWANCE, IT IS AT LEAST REASONABLE POSSIBLE THAT THE ESTIMATES WILL CHANGE WITHIN THE NEAR TERM.THE HOSPITAL IS IN COMPLIANCE WITH HEALTHCARE MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND THEREFORE WOULD NOT REPORT ANY BAD DEBT ATTRIBUTABLE TO CHARITY CARE.
PART III, LINE 8:THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE SIGNIFICANT PORTIONS OF LABORATORY, RADIOLOGY, AND REHABILITATION SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANESTHESIA PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON THE FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COST OF CARING FOR PATIENTS. EMERGENCY AND SURGICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD BE CONSIDERED AS A BENEFIT THAT BOULDER CITY HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR THE IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED DECEMBER 31, 2015 AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICES REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSEMENT ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING THE SERVICES TO ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY.
PART III, LINE 9B:WITHIN BOULDER CITY HOSPITAL'S COLLECTION POLICY, PROVISIONS ARE MADE FOR COLLECTION PRACTICES FOR THOSE WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. THE PATIENT MUST REQUEST OR THE COLLECTION COORDINATOR MAY RECOMMEND A PATIENT FOR CHARITY CARE ASSISTANCE. PATIENTS MUST ALSO EXHAUST OTHER ASSISTANCE PROGRAMS AVAILABLE, SUCH AS ASSISTANCE FROM CLARK COUNTY OR THE STATE OF NEVADA. PATIENTS WHO QUALIFY FOR COUNTY AND STATE ASSISTANCE ARE SUBJECT TO TRADITIONAL COLLECTION PRACTICES TO THE EXTENT OF THE PATIENTS LIABILITY FOR CARE PROVIDED. PATIENTS ON FINANCIAL ASSISTANCE CAN ALSO BE PLACED ON PAYMENT PLANS TO HELP THEM PAY DOWN AMOUNTS OWED TO THE HOSPITAL.
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.
PART VI, LINE 4:BOULDER CITY HOSPITAL SERVES BOULDER CITY, NV AND THE WESTERN PORTION OF HENDERSON, NV. NEARLY HALF OF THE AREA'S RESIDENTS RELY ON MEDICARE SUBSIDIES TO PAY FOR HEALTH CARE. FOR 2015, 58% OF GROSS PATIENT REVENUE WAS ATTRIBUTABLE TO MEDICARE PATIENT SERVICES.
PART VI, LINE 5:BOULDER CITY HOSPITAL 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.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonTHOMAS MAHERPersonNm
TitleCEOTitleTxt
Base Compensation Filing Org$203,836BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$8,591NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$212,427TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11PRIOR TO FORM 990 BEING SIGNED BY THE CEO, THOMAS MAHER, 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 12CON AN ANNUAL BASIS, ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES COMPLETE THE CONFLICT OF INTEREST DISCLOSURE STATEMENT.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION OF THESE INDIVIDUALS IS DETERMINED 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. THE CEO'S COMPENSATION IS DETERMINED AND APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19BOULDER CITY HOSPITAL MAKES ITS DOCUMENTS AVAILABLE TO THE PUBLIC THROUGH THE HOSPITAL'S ADMINISTRATION DEPARTMENT.
FORM 990, PART IX, LINE 11GER AND SPECIALITY MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 3,285,324. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,285,324. CONSULTANTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 528,156. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 528,156.
FORM 990, PART XI, LINE 9:CHANGE IN INTEREST OF NET ASSETS OF AUXILLIARY -9,535. CHANGE IN INTEREST OF NET ASSETS OF FOUNDATION 175,989.
FORM 990, PART XII, LINE 2C:THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationInd
BOULDER CITY HOSPITAL FOUNDATION
901 ADAMS BOULEVARDBOULDER CITYNV89005943141555FINANCIAL SUPPORT OF BOULDER CITY HOSPITAL, INC.NV501(C)(3)LINE 11C, III-FI0
BOULDER CITY HOSPITAL AUXILIARY
901 ADAMS BOULEVARDBOULDER CITYNV89005886001696SUPPORT THE WELFARE OF BOULDER CITY HOSPITAL, INC.NV501(C)(3)LINE 70
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
BOULDER CITY HOSPITAL FOUNDATION
C$171,251CASH RECEIVED
BOULDER CITY HOSPITAL FOUNDATION
N$0BCH ABSORBED
BOULDER CITY HOSPITAL FOUNDATION
O$0BCH ABSORBED
BOULDER CITY HOSPITAL FOUNDATION
Q$2,744COST BASIS
BOULDER CITY HOSPITAL FOUNDATION
E$87,662COST BASIS
BOULDER CITY HOSPITAL FOUNDATION
D$3,852COST BASIS
BOULDER CITY HOSPITAL AUXILLIARY
C$13,204CASH RECEIVED