2016-05-16T14:52:27-05:00 2015-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2014-07-01 942972845 Renown Health RENO 7759824404 1155 Mill St C/O Tax Treasury Z-4 Reno NV 89502 Dawn D Ahner EVP & Chief Administrative Officer 7759824404 2016-05-16 1 Kim Hunwardsen CPA P00484560 6122536500 2016-05-12 2014 2016-08-17 19:52:53Z Dawn D Ahner 1155 Mill St C/O Tax Treasury Z-4 Reno NV 89502 89561229 0 X www.renown.org X 1985 NV To establish, equip and maintain one or more general acute care hospitals and medical centers. 13 12 6757 0 8481477 -79490 0 0 72561558 79421166 -52266 -18275 7661904 8832175 80171196 88235066 268900 1780223 0 0 41834009 46643086 0 0 0 44176416 51092653 86279325 99515962 -6108129 -11280896 468310283 356326239 342002688 190834116 126307595 165492123 X Renown Health makes a genuine difference in the health and well-being of the people and communities we serve. 0 0 88768544 1780223 79421166 See Schedule ORenown Health is the parent company of northern Nevada's largest, private, not-for-profit healthcare network. As a local not-for-profit health network, Renown Health's income stays right here in the community to provide many programs and services that would otherwise be unavailable. Renown is dedicated to this region and governed by local community leaders and physicians. We are proud to provide the health, education and social welfare that our friends, neighbors and family members expect and deserve.Renown Health provides various services to all affiliates including Renown Regional Medical Center, a 808-bed full service regional hospital, Renown South Meadows Medical Center, a 76-bed acute care community hospital, and Renown Rehabilitation Hospital, a 62-bed rehabilitation hospital. This furthers the tax-exempt status of the supported Renown entities that provide quality healthcare for Renown's primary service area, Washoe County and the secondary service areas of northern Nevada and northern California. Renown Health has more than 5,500 employees and serves a 17-county region with a total population in excess of 1.9 million. It comprises two medical centers, a rehabilitation hospital, a skilled-nursing facility, a children's hospital, numerous medical-group, urgent-care and outpatient imaging practices, and a health-insurance provider. Renown Health offers advanced care for patients and embraces its role in improving the health and well-being of the people in the communities we serve.Besides our commitment to meeting the healthcare needs of the region, Renown Health gives back to communities by contributing funds, services, facilities and the time and expertise of employees. These benefits to the community flow from Renown Health as a whole and from the individual hospitals, facilities and departments that make up our health network.In FY 15, Renown Health provided a one-time grant to Northern Nevada HOPES, a local Federally Qualified Health Center (FQHC) that provides primary medical care, chronic disease management, behavioral health and counseling services, social services and an onsite pharmacy. Northern Nevada HOPES is an important partner to support in our efforts to increase access to primary and behavioral healthcare for Medicaid and uninsured populations. For the fiscal year ending June 30, 2015, Renown Health and its subsidiaries, provided more than $78 million in benefit to the community (using community benefit numbers gathered by the Nevada Hospital Association using state-approved criteria to ensure consistency). For a full report on the benefit Renown Health provided to our community, as well as our community needs assessment and community benefit plan, go to www.renown.org/communitybenefit. 88768544 1 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 0 1 1237 0 1 6757 1 1 1 0 0 0 0 0 0 0 0 0 X 13 12 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Dawn D Ahner 7759824404 1155 Mill St Z-4 Reno NV 89502 David Line Pres (Jul)/Director (Jul-Jun) 3.00 18.00 X X 58370 0 0 Tracy Mimno-Wirshing Secretary (Jul-Dec) 3.00 0.00 X X 29900 0 0 James DeVolld Treasurer 3.00 0.00 X X 36394 0 0 Kimberly Cooney Dir (Jul-Dec)/Sec (Jan-Jun) 3.00 3.00 X X 0 0 0 Bernie Carter Director 3.00 0.00 X 39814 0 0 Michael Alonso Director (Jul-Dec) 3.00 0.00 X 16250 0 0 Rob Winkel Director 3.00 0.00 X 33463 0 0 Leslie Smith Director (Jul-Dec) 3.00 0.00 X 14000 0 0 G Blake Smith Director 3.00 0.00 X 35653 0 0 Michael Peterson Director 3.00 0.00 X 92966 0 0 Jeff Resnik Director 3.00 0.00 X 2000 0 0 Joanne Olsen Director 3.00 0.00 X 21500 0 0 Alvaro Devia Director 3.00 0.00 X 24219 0 0 Christi Matteoni Director (Jan-Jun) 3.00 0.00 X 12204 0 0 William Newberg Dir (Jan-Jun) 3.00 0.00 X 4500 0 0 Anthony Slonim President/CEO (Jul-Jun) 4.00 56.00 X X 369367 0 62216 Dawn Ahner EVP & CAO 9.00 51.00 X 713516 0 105113 Donald Sibery Interim CEO (Jul) 4.00 56.00 X 0 0 0 Larry Trilops III SVP and CEO Network Development 32.00 12.00 X 448988 0 66790 Michelle Sanchez-Bickley VP Human Resources 60.00 0.00 X 374188 0 63996 Max Jackson Chief Medical Officer 60.00 0.00 X 513366 0 21686 Allan Hanssen VP Strategic Initiatives 14.00 46.00 X 350447 0 44745 Phyllis Freyer VP Marketing & Communicati 60.00 0.00 X 385237 0 70518 James I Miller Former President/CEO 0.00 0.00 X 935610 0 24299 4511952 0 459363 49 1 1 0 Bryan Cave LLP PO Box 503089 St Louis MO 63150 Legal Services 3465538 Optima Healthcare Insurance 9229 Sierra College Blvd Roseville CA 95661 Insurance Services 3124942 EPIC Systems Corp PO Box 88314 Milwaukee WI 53288 Software Maintenance 2161658 Hims Consulting Group Inc 2155 Resort Drive Suite 220 Steamboat Springs CO 80487 Consulting Services 1032967 Sagacious Consultants LLC 26528 Network Place Chicago IL 60673 Consulting Services 797547 33 Program Svc Rev 622110 78196006 78196006 Child Care Center 624410 1225160 1225160 79421166 1100 1100 2133563 1306788 826775 826775 476077 350698 19375 -19375 -19375 -19375 Management Fees 541610 8005400 8005400 8005400 88235066 79421166 8481477 332423 1780223 1780223 1082882 1082882 37567071 33810364 3756707 7993133 7193820 799313 8297223 7467501 829722 950111 855100 95011 68750 61875 6875 7086215 6377594 708621 3721321 3349189 372132 3109503 2798553 310950 7887147 7098432 788715 708126 637313 70813 655741 590167 65574 413281 371953 41328 476858 429172 47686 9621488 8659339 962149 2417230 2175507 241723 Recruitment 1473742 1326368 147374 Licenses & Property Tax 229853 206867 22986 Dues & Subscription 223799 201419 22380 Events 24686 22217 2469 3727579 3355571 372008 99515962 88768544 10747418 0 20781 12272 31641 8119 60924 26059 2162412 3408153 152798164 58086856 81340360 94711308 141316097 180027492 243378068 78132836 468310283 356326239 21006285 24001512 4238114 189729 316758289 166642875 342002688 190834116 X 126307595 165492123 126307595 165492123 468310283 356326239 X -11280896 50465424 X X 0 1 X 1 0 X X 6 Renown Health Foundation 942972749 7 1 0 1007133 Renown Regional Medical Center 880213754 3 1 0 56540991 Hometown Health Plan Inc 880231433 9 0 0 2406913 Renown Network Services 880231828 3 0 0 918156 Renown South Meadows Medical Center 460517825 3 0 0 9762837 Renown Skilled Nursing 201347269 9 0 0 298103 6 0 70934133 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 Schedule A, Part I, Line 11g, Column vi: Renown Health provides centralized management, control, oversight, and other support services for the supported organizations. Amounts reported here are for the allocation of the following services: Administration and payroll for all employees, information resource systems & support, purchasing and procurement of supplies, marketing and communication services, accounting, billing and collection services, insurance and legal services. Schedule A, Part IV, Section A, Line 1: Two of the six supported organizations are listed by name in the governing documents: Renown Health Foundation and Renown Regional Medical Center. The remaining supported organizations have a historic and continuing relationship with Renown Health. Renown Health is the parent organization within the health system and provides centralized management, control, oversight, and other support services for the system. As the health system has grown, additional entities have been formed to carry out the overall tax-exempt purpose of making a genuine difference in the health and well-being of the people and communities the system serves. Renown Health controls all supported organizations through its power as the sole member to appoint and remove members of the governing body of each supported organization. Schedule A, Part IV, Section A, Line 3b: Hometown Health Plan is tax-exempt under IRC Section 501(c)(4) and operates a health maintenance organization and health insurance services to commercial enrollees and to those eligible for Medicare through its Medicare Advantage plan Senior Care Plus. Hometown Health Plan has more than 15,000 members in its commercial HMO and more than 17,000 in its Medicare Advantage HMO. Hometown Health Plan satisfies the public support test under section 509(a)(2) by receiving payments for services from its tens-of-thousands of members and by keeping its overall investment income within the required limit. As such, Hometown Health Plan is reported as a 509(a)(2) tax-exempt organization in Schedule A, Part I, Line 11g, column (iii). Schedule A, Part IV, Section A, Line 3c: Renown Health provides centralized management, control, oversight, and other support services to Hometown Health Plan. Renown Health is the sole member of Hometown Health Plan and through its power as the sole member it appoints and removes members of the governing body of Hometown Health Plan. Through this control and relationship, Renown Health ensures all support provided is used exclusively for charitable purposes. Schedule A, Part IV, Section A, Line 6: Renown Health also provides centralized management, control, oversight, and other support services to various related for-profit subsidiaries within the health system. Provision of these services furthers the overall tax-exempt purpose of making a genuine difference in the health and well-being of the people and communities the system serves. Schedule A, Part IV, Section D, Line 3: Renown Health is responsive to the needs and demands of its supported organizations. Each supported organization has officers and directors who also serve as officers and directors of Renown Health. Due to this close and continuous working relationship, the officers and directors of the supported organizations have the ability to influence Renown Health's decisions regarding the use of its income and assets. Schedule A, Part IV, Section E, Line 3a: Renown Health controls all supported organizations through its power as the sole member to appoint and remove members of the governing body of each supported organization. Schedule A, Part IV, Section E, Line 3b: Through its power as the sole member and through the continuous working relationship between the organizations, Renown Health exercises substantial direction over the policies, programs, and activities of each of its supported organizations. In addition, Renown Health reserves the authority to approve certain governance decisions of the supported organizations. 0 0 0 0 0 0 1 68750 0 0 68750 0 Schedule C Part II-B, line 1g Payments are made to a consultant for two purposes: 1) Inform management and staff of pertinent activities of the legislative and regulatory bodies. 2) Represent the interest of the hospitals before the legislative and executive branches of Nevada, other Nevada political subdivisions, and other political jurisdictions in which Renown Health does businesses. 42080130 42080130 41290149 12451812 28838337 181067 45568 135499 65581015 45589476 19991539 3665803 3665803 94711308 Inv in Hometown Health Management 142078050 F Inv in Carson Valley Medical 21180944 F Inv in California Health 429930 F Inv in Renown Businesses 16338568 F 180027492 Other Receivables 502250 Deposits - Freight 35000 Cash Surrender Value 1305474 Capital Accumulation Account 8275233 Due From Affiliates 62506910 Supplemental Retirement Plan 4453129 Deposits - Plan CD 250000 Long Term Prepayments 804840 78132836 Due To Affiliates 135191414 Retirement Liability Accrual 835374 Other Liabilities 83480 Malpractice Reserve 7755955 Capital Accumulation Account 8258907 Supplemental Retirement Plan 4453129 Serp Contribution Payable 334269 Retirement Plan Accrual 2131233 Renown Business Loan 5840909 Microsoft Licensing Assurance 1404539 ACA TRP Fees 186846 IBNP 166820 166642875 X Part X, Line 2: Renown Health is organized as a Nevada nonprofit entity and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). In addition, Renown Health is subject to income tax on net income derived from business activities that are unrelated to its tax exempt purpose. Renown Health files an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report any unrelated business taxable income. Renown Health believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the combined financial statements. Renown Health would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Renown Health's Federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2012. 1 Northern Nevada Hopes 467 Ralston St Reno NV 89503 860865357 501(c)(3) 501000 Community Event Sponsorship Community Health Alliance 680 S Rock Blvd Reno NV 89502 880293149 501(c)(3) 500000 Community Event Sponsorship Care Chest Inc 7910 N Virginia St Reno NV 89506 943118373 501(c)(3) 251000 Community Event Sponsorship Committee to Aid Abused Women 1735 Vassar Street Reno NV 89502 942605396 501(c)(3) 51000 Community Event Sponsorship Nevada Discovery Museum 490 S Center St Reno NV 89501 611474845 501(c)(3) 50000 Community Event Sponsorship American Heart Association 155 Country Estates Circle Ste 200 Reno NV 89511 135613797 501(c)(3) 33250 Community Event Sponsorship Renown Health Foundation 1155 Mill Street Reno NV 89502 942972749 501(c)(3) 30200 Community Event Sponsorship Nevada Womens Fund 770 Smithridge Park Reno NV 89502 942860375 501(c)(3) 30000 Community Event Sponsorship Edawn 5190 Neil Rd Ste 110 Reno NV 89502 880183034 501(c)(3) 29167 Community Event Sponsorship High Fives Non-Profit Foundation 10775 Pioneer Trail 108 Truckee CA 96161 264275773 501(c)(3) 20000 Community Event Sponsorship American Cancer Society 400 Edison Way Reno NV 89502 841316555 501(c)(3) 15500 Community Event Sponsorship Western Industrial Nevada PO Box 1841 Reno NV 89505 880218440 501(c)(6) 14380 Community Event Sponsorship Childrens Cabinet Inc 1090 S Rock Blvd Reno NV 89502 770097156 501(c)(3) 13750 Community Event Sponsorship Unr Foundation UNR Mail stop 162 Reno NV 89557 942781749 501(c)(3) 12500 Community Event Sponsorship Catholic Charities of Northern PO Box 5099 Reno NV 89513 880339754 501(c)(3) 11500 Community Event Sponsorship Food Bank of Northern Nevada 550 Italy Drive Sparks NV 89434 942924979 501(c)(3) 11000 Community Event Sponsorship Reno Sparkschamber of Commerce 449 S Virginia St Suite 200 Reno NV 89501 880041905 501(c)(6) 10935 Community Event Sponsorship Reno Bike Project Inc 541 E 4th Street Reno NV 89512 141988800 501(c)(3) 10000 Community Event Sponsorship Nevada Business Group on Health 1755 E Plum Lane Ste 107 Reno NV 89502 880348643 501(c)(6) 10000 Community Event Sponsorship Ronald Mcdonald House 323 Maine Street Reno NV 89502 942863819 501(c)(3) 8750 Community Event Sponsorship Immunize Nevada 427 Ridge St Suite C Reno NV 89501 462266350 501(c)(3) 8000 Community Event Sponsorship Reno Philharmonic 925 Riverside Dr Ste3 Reno NV 89503 942762076 501(c)(3) 7500 Community Event Sponsorship United Way of Northern Nevada 639 Isbell Road Suite 460 Reno NV 89509 880059327 501(c)(3) 6000 Community Event Sponsorship 20 3 Part I, Line 2 The organization's grants are given directly to the recipient to cover a need that was identified during the granting process. There is no ongoing monitoring necessary for these grants. X X X X X 1 1 0 0 0 0 0 0 0 Anthony Slonim President/CEO (Jul-Jun) 368578 0 0 0 789 0 60000 0 2425 0 431792 0 0 0 Dawn Ahner EVP & CAO 514191 0 190546 0 8779 0 86618 0 18494 0 818628 0 0 0 Larry Trilops III SVP and CEO Network Development 340133 0 102645 0 6210 0 59673 0 7117 0 515778 0 0 0 Michelle Sanchez-Bickley VP Human Resources 295944 0 76796 0 1448 0 54706 0 9290 0 438184 0 0 0 Max Jackson Chief Medical Officer 241894 0 109984 0 161488 0 9821 0 12045 0 535232 0 0 0 Allan Hanssen VP Strategic Initiatives 240748 0 101459 0 8240 0 40000 0 5165 0 395612 0 0 0 Phyllis Freyer VP Marketing & Communicati 292095 0 87856 0 5286 0 54328 0 16190 0 455755 0 0 0 James I Miller Former President/CEO 7436 0 0 0 928174 0 10000 0 14299 0 959909 0 0 0 Part I, Lines 4a-b James Miller received a severance payment. A payment of $916,432 to James Miller is included in Schedule J, Part II, Column (B)(iii). Anthony Slonim, Dawn Ahner, Allan Hanssen, Larry Trilops III, Phyllis Freyer and Michelle Sanchez-Bickley are parties to a supplemental nonqualified retirement plan. Contributions of $60,000 to Anthony Slonim, $76,218 to Dawn Ahner, $31,149 to Allan Hanssen, $50,698 to Larry Trilops III, $43,928 to Phyllis Freyer, and $44,306 to Michelle Sanchez-Bickley were included in Schedule J, Part II, Column (C). Decisive Consulting Solutions LLC Interim CEO is the President/Managing Partner of Decisive Consulting 412000 Management Services to Renown 0 Form 990, Part VI, Section A, line 1 The governing documents allow for an Executive Committee. The Executive Committee consists of the President and CEO of the Corporation, Chairman, Vice Chair, Secretary, and Treasurer and up to 2 "at-large" members of the Board of Directors who are appointed by the Chairman. The Executive Committee shall act in the interval between meetings of the board in emergency or time-sensitive situations. All decisions are submitted for final ratification at the next scheduled board meeting. Form 990, Part VI, Section A, line 2 Bernard Carter had a business relationship with David Line. Rob Winkel and G. Blake Smith had a business relationship. Anthony Slonim, David Line, Dawn Ahner, Donald Sibery and Allan Hanssen have a business relationship. Form 990, Part VI, Section A, line 3 Renown Health paid Decisive Consulting Solutions, LLC for Donald Sibery's services as the Interim CEO for all the Renown entities. Renown Health paid $412,000 for fiscal year ending June 30, 2015 for the Interim CEO services and reimbursed travel and business expenses. Form 990, Part VI, Section B, line 11 The Form 990 is prepared by the organization's tax department with support from a certified tax preparer. The form is reviewed by the organization's current CFO and current EVP and Chief Administrative Officer prior to the final Form 990 being sent to the board. The IRS Form 990, as filed with the IRS, is sent to each voting member of the Renown Health Board prior to filing. Along with the forms, the Renown Health board is provided with a narrative that explains the various parts of the Form and their content. Form 990, Part VI, Section B, line 12c On an annual basis at or prior to the first regular meeting following the election of new board members, the members of the Renown Health Board are given an Annual Disclosure Statement. They are expected to perform a reasonable investigation into their business, financial, family or significant personal relationships to disclose any actual or potential conflicts of interest. If, in connection with a proposed transaction or arrangement involving a Renown Health entity, a board member discovers that an actual or possible conflict of interest has arisen that was not disclosed on the Annual Statement, then the board member must disclose the existence and nature of his or her financial interests to the remaining directors that are considering the proposed transaction or arrangement in a timely manner. If a board member discloses an actual or possible conflict of interest, the board member shall leave the board or committee meeting while the remaining board members discuss the financial interest. The remaining board members shall vote upon and decide whether a conflict of interest actually exists. If the remaining board members determine that a conflict does exist, then appropriate measures are taken to ensure the issue is addressed. Form 990, Part VI, Section B, line 15a Renown Health's executive compensation, including compensation for the CEO and certain executives, is reviewed and approved by the Renown Health Executive Committee. All decisions are submitted for final ratification at the next scheduled board meeting. The discussion is documented in the Executive Committee minutes and Board minutes. The Executive Committee is comprised of members of the Renown Health Board of Directors unrelated to and not subject to the control or undue influence of executives, with no material financial interest in transactions of the Company or any other perceived or actual conflicts of interest. Total cash compensation for the organization's executives is targeted at competitive compensation levels, relative to market surveys of comparable healthcare organizations, based upon the level of performance required to achieve the targeted compensation levels. Base compensation and total cash compensation is reviewed at a minimum of every two years in comparison to the surveys for comparable businesses and responsibilities and adjusted as to maintain equity with the survey information. The Executive Committee undertook the process outlined above for the fiscal year 2015 executive compensation. Form 990, Part VI, Section C, line 19 Renown Health does not make its governing documents, conflict of interest policy, or financial statements available to the general public. Form 990, Part XI, line 9: Changes in Post Retirement Obligation -1,463,352. Change in Market Value of NSDC Investment 2,748,848. Investment in Subsidiaries 12,802. Intercompany Settlements 89,107,514. NHI Dissolution -39,940,388. Form 990, Part XII, Line 2B, Audit Committee Renown Health has an audit committee that assumes responsibility for the consolidated audit and selection of the independent accountant. Renown Accountable Care LLC 1155 Mill St Z-4 Reno NV 89502 462005545 Accountable-Care Organization NV 0 0 Renown Health Hometown Health Plan 1155 Mill St Z-4 Reno NV 89502 880231433 HMO NV 501 (c) (4) Renown Health 1 Renown Health Foundation 1155 Mill St Z-4 Reno NV 89502 942972749 Foundation NV 501 (c) (3) 3 Renown Health 1 Renown Regional Medical Center 1155 Mill St Z-4 Reno NV 89502 880213754 Hospital NV 501 (c) (3) 3 Renown Health 1 Renown Skilled Nursing 1155 Mill St Z-4 Reno NV 89502 201347269 Nursing Facility NV 501 (c) (3) 9 Renown Health 1 Renown South Meadows Medical Center 1155 Mill St Z-4 Reno NV 89502 460517825 Hospital NV 501 (c) (3) 3 Renown Health 1 Renown Network Services 1155 Mill St Z-4 Reno NV 89502 880231828 Outpatient Imaging and Pregnancy Center NV 501 (c) (3) 3 Renown Health 1 Routt Dialysis LLC 1155 Mill St Z-4 Reno NV 89502 263558729 Kidney Dialysis NV N/A Renown Businesses 1155 Mill St Z-4 Reno NV 89502 880228030 Health Care NV Renown Health C 14105304 76041412 1.00000 1 Hometown Health Management Company 1155 Mill St Z-4 Reno NV 89502 880236758 Management Services NV Renown Health C 123565035 55707343 1.00000 1 Hometown Health Providers Insurance Company Inc 1155 Mill St Z-4 Reno NV 89502 880177026 Insurance NV Hometown Health Management C 63955144 44525996 1.00000 1 The Provider Network Inc 1155 Mill St Z-4 Reno NV 89502 880376369 Health Care NV Hometown Health Management C 1.00000 1 Remittance Assistance Corporation 1155 Mill St Z-4 Reno NV 89502 880277761 Collections NV Renown Business C 7259709 1.00000 1 Nevada Heart Institute 1155 Mill St Z-4 Reno NV 89502 880247743 Cardiology NV Renown Health C 14940153 1.00000 1 NHI-1 Inc 1155 Mill St Z-4 Reno NV 89502 880303924 Cardiology NV Renown Health C 1.00000 1 Elko Heart Institute 1155 Mill St Z-4 Reno NV 89502 452152594 Cardiology NV Renown Health C 1.00000 1 1 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 0 1 0 Hometown Health Management Company A 978604 General Ledger Renown Network Services A 593263 General Ledger Renown South Meadows Medical Center L 9762837 General Ledger Hometown Health Management Company L 7428770 General Ledger Renown Skilled Nursing L 298103 General Ledger Renown Businesses L 74526 General Ledger Nevada Heart Institute L 502104 General Ledger Renown Network Services L 918156 General Ledger Renown Regional Medical Center L 56540991 General Ledger Renown Skilled Nursing A 406019 General Ledger