2012-08-15T15:19:02-05:00 2011-09-30 BKD LLP 6120 S Yale 1400 Tulsa OK 741364223 990 2010-10-01 730630359 VALLEY VIEW REGIONAL HOSPITAL VALL 5804211412 430 N MONTE VISTA ADA OK 74820 MARY GARBER 5804211412 2012-08-15 true Anne M Adams 9185842900 2010 2016-02-24 21:20:13Z W KENT ROGERS CEO 430 N MONTE VISTA ADA OK 74820 71827061 false X WWW.VALLEYVIEWREGIONAL.COM X 1935 OK THROUGH QUALITY HEALTH CARE, VALLEY VIEW REGIONAL HOSPITAL WILL EXCEED THE EXPECTATIONS OF THOSE WE SERVE. 13 10 816 100 0 0 8645080 202539 68097923 70607609 -116553 -259149 1179544 888252 77805994 71439251 28795 47033 0 0 31464573 34458999 0 0 0 32998050 32195002 64491418 66701034 13314576 4738217 40587483 46714771 6483402 7872473 34104081 38842298 X THE ORGANIZATION'S MISSION IS TO PROVIDE A CULTURE OF SAFETY THAT CREATES A PATIENT SAFETY COMMITMENT FROM ALL EMPLOYEES IN WHICH PATIENT CARE PROCESSES ARE DEVELOPED AND IMPROVED. THE HEALTH CARE TEAM CARES FOR THOSE WHO NEED IT REGARDLESS OF THEIR ABILITY TO PAY. SERVICES ARE MATCHED TO PATIENTS NEEDS AND IT INSPIRES AND EMPOWERS THE HEALTH CARE TEAM TO SEEK OUT THE OPPORTUNITIES FOR PERFORMANCE IMPROVEMENT. THE ORGANIZATION ENCOURAGES PREVENTION, WELLNESS, AND IMPROVEMENT IN PATIENT'S QUALITY OF LIFE AND REMAINS AWARE OF OUR FISCAL RESPONSIBILITY TO THE COMMUNITY. false false 53230641 47033 70818722 VALLEY VIEW REGIONAL HOSPITAL IS A 157 BED ACUTE CARE HOSPITAL PROVIDING HEALTH CARE TO THE GENERAL PUBLIC REGARDLESS OF RACE, RELIGION, OR ABILITY TO PAY. 53230641 true true false false false false false false false true false false true false false false true false false false false false false false false true true true false true false false false false false false true true false false false false true true true true false false true 75 0 true 816 true false false false false false false false false false false X 13 10 true true false false false true false true true false false true true true true true true false false OK X MARY GALLUP CFO 5804211412 430 N MONTE VISTA ADA OK 74820 BILL G LANCE JR 1.0 X 0 0 0 DALE BOATWRIGHT 1.0 X X 0 0 0 THOMAS C BOLITHO 1.0 X 0 0 0 CC BUXTON III 1.0 X 0 0 0 JO ANN CARPENTER MD 1.0 X 0 0 0 JIM E DICUS 1.0 X 0 0 0 FRANK CARTMELL MD 1.0 X 0 0 0 DAN NORTHCUTT 1.0 X 0 0 0 DEAN PETERSON 1.0 X 0 0 0 CARLTON TILLEY 1.0 X 0 0 0 BART MCCORTNEY 1.0 X 0 0 0 MARK WEEMS DDS 1.0 X 0 0 0 CHARLES R METTRY DO 1.0 X 0 0 0 MARY E GARBER 40.0 X 0 0 0 W KENT ROGERS 40.0 X 0 0 0 DR KIMBALL PRATT 32.0 X 693427 0 11476 DR CHARLES VEST 40.0 X 355820 0 9080 STEVEN FILLMORE 27.0 X 338266 0 6191 DR LEWIS WALLACE 40.0 X 333721 0 4900 DR IMTIAZ AHMED 40.0 X 186466 0 0 1907700 0 31647 16 false true true REHABCARE GROUP INC 733 FORSYTH BLVD STE 2300 ST LOUIS MO 63150 REHAB MANAGEMENT 914747 MID-AMERICA PHYSICIAN SERVICES 430 N MONTE VISTA ADA OK 74820 ER PHYSICIAN MGMT 1528944 MERCY HEALTH SYSTEMS OF OK 4300 W MEMORIAL RD OKLAHOMA CITY OK 73120 MANAGEMENT SVCS 821514 ADA ANESTHESIA ASSOCIATES PLLC 1621 CRADDUCK RD ADA OK 74820 ANESTHESIA SERVICES 599562 DIVERSIFIED CLINICAL SERVICES PO BOX 636981 CINCINNATTI OH 452636981 WOUND CARE MGMT 562893 21 187615 14924 202539 Net Patient Service Revenue 621300 70607609 70607609 70607609 121114 121114 0 0 43850 43850 43850 43850 7547 385909 1901 -385909 5646 -380263 -380263 0 0 0 Cafeteria Income 722210 633289 633289 Gift Shop 453220 115468 115468 Purchase Discounts 900099 7709 7709 87936 87936 844402 71439251 70818722 417990 47033 47033 0 0 0 0 139967 104975 34992 27593373 20695030 6898343 0 1028392 771294 257098 3668846 2751634 917212 2028421 1521316 507105 584927 438695 146232 0 0 0 0 0 0 120092 90069 30023 142904 107178 35726 0 0 831714 623786 207928 171292 128469 42823 0 0 166646 124984 41662 0 3197022 2397767 799255 1294014 970510 323504 PURCHASED SERVICES 7532035 7532035 PHARMACY 3031505 3031505 SUPPLIES 7969890 5977418 1992472 EQUIPMENT RENTAL & MAINTENANCE 2301260 1725945 575315 NEUROSCIENCE EXPENSE 1127000 1127000 3724701 3063998 660703 66701034 53230641 13470393 0 1143454 6385171 3406580 6176026 8504756 8676719 145080 228525 2233405 2169939 706999 647658 74905357 57439488 19366152 17465869 1086716 1346562 938278 961250 3056063 2657052 40587483 46714771 3222780 5771943 3260622 2100530 6483402 7872473 X 17868062 23454007 16236019 15388291 34104081 38842298 40587483 46714771 4738217 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 30619135 24318389 6300746 117579 15250 102329 42939317 32688426 10250891 1229326 417423 811903 17465869 NET PENSION ASSET 2379010 CSV OF LIFE INSURANCE 198042 DUE FROM MEDICARE 80000 2657052 true true true X true X true true true false false 781018 781018 0.01170 9733290 9800209 10514308 9800209 781018 0.01170 36323 0.00050 22200 0.00030 58523 0.00080 10572831 9800209 781018 0.01250 27175 0.00040 3169 30344 0.00040 false 5268425 24906780 17028799 7877981 X true false 1 1 VALLEY VIEW REGIONAL HOSPITAL

430 N MONTE VISTA ADA OK 74820

X X X SOLE COMMUNITY HOSP VALLEY VIEW REGIONAL HOSPITAL 1 1 SCHEDULE H, PART III, LINE 3 & 4 LINE 3: THE HOSPITAL ELECTED NOT TO ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE AT COST. LINE 4: THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PATERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. 2 SCHEDULE H, PART III, LINE 8 & 9B THE COST TO CHARGE RATIO WAS APPLIED TO BAD DEBT EXPENSE TO CALCULATE BAD DEBT EXPENSE AT COST. THE ORGANIZATION HAS A CHARITY CARE POLICY AND A WRITTEN COLLECTION POLICY. THE WRITTEN COLLECTION POLICY DOES NOT CONTAIN PROVISIONS ON PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE. THE CHARITY CARE POLICY IS DESIGNED TO PROVIDE A PROCESS TO EFFECTIVELY EVALUATE CANDIDATES THAT MAY QUALIFY FOR CHARITY CARE. THE PROGRAM IS DESIGNED TO AID THE ORGANIZATION IN DISTINGUISHING TRUE BAD DEBT EXPENSE FROM CHARITY CARE, AND TO INCREASE THE PUBLIC'S AWARENESS OF THE CHARITY CARE PROVIDED TO THE COMMUNITY. THE DETERMINATION FOR CHARITY CARE REQUIRES PARTICIPATION AND COOPERATION FROM THE PATIENT/GUARANTOR TO PROVIDE NECESSARY DOCUMENTATION, AND PATIENTS THAT FAIL TO PAY ANY REMAINING BALANCE AFTER THE CHARITY CARE DEDUCTION IS MADE BECOMES SUBJECT TO NORMAL COLLECTION PROCEDURES. 3 SCHEDULE H, PART VI, LINE 2 VVRH IN CONJUNCTION WITH MERCY HEALTH SYSTEMS HOSTS ANNUALLY A COMMUNITY ROUNDTABLE DISCUSSION. IN THIS VENUE COMMUNITY MEMBERS ARE INVITED TO PARTICIPATE IN PLANNING FUTURE HEALTH NEEDS OF THE COMMUNITY. THEY ARE ALSO INVITED TO SHARE THEIR CONCERNS AND OFFER THEIR OPINIONS. 4 SCHEDULE H, PART VI, LINE 3 WE HAVE AN ONSITE REPRESENTATIVE FROM HCFS THAT SCREENS ALL OF OUR INPATIENT, ONE DAY SURGERY, AND ER SELF PAY PATIENTS, AS WELL AS ANY OTHER OUTPATIENTS THAT ARE REFERRED, FOR ANY TYPE OF ASSISTANCE PROGRAMS FOR WHICH THE PATIENT MIGHT QUALIFY. IF NO ASSISTANCE IS AVAILABLE, THEY ARE GIVEN AN APPLICATION OR INFORMED OF OUR FINANCIAL ASSISTANCE/CHARITY CARE PROGRAM. OUR PATIENT FINANCIAL COUNSELORS ALSO INFORM THE PATIENTS OF THESE POLICIES DURING THE PRE-REGISTRATION PROCESS. 5 SCHEDULE H, PART VI, LINE 4 VVRH, IS LOCATED IN ADA OKLAHOMA , AND IS THE COUNTY SEAT FOR PONTOTOC COUNTY. VALLEY VIEW SERVES A NINE COUNTY AREA IN SOUTH CENTRAL OKLAHOMA. IN ADDITION THE HOSPITAL OWNS A RURAL HEALTH CLINIC IN STRATFORD, OK, A ECONOMICALLY DISADVANTAGE COMMUNITY OF APPROXIMATELY 1,200 PEOPLE, WHO ARE OVER THE AGE OF 65. 6 SCHEDULE H, PART VI, LINE 5 VALLEY VIEW REGIONAL HOSPITAL PARTICIPATES IN COMMUNITY EVENTS SPONSORED BY THE ADA REGIONAL UNITED WAY, BY PROVIDING NUTRITIONAL SNACKS AND EXERCISES DURING THEIR KIDS FAIR THAT IS HELD ANNUALLY AT WINTERSMITH PARK. THE AUDIENCE AGES RANGE FROM INFANTS UP TO ADULTS. WE PARTNER WITH THE BOY SCOUTS OF AMERICA AND PROVIDE PHYSICALS ANNUALLY TO THE BOY SCOUTS. WE ALSO PROVIDE MEDICAL SUPPLIES TO AREA SCHOOLS, BOY SCOUT SUMMER CAMP, AND ADA BOYS AND GIRLS CLUB. THE DIRECTOR OF EDUCATIONAL SERVICES SERVES ON THE PONTOTOC COUNTY BOARD OF THE AMERICAN CANCER SOCIETY AND HAS BEEN SURVIVOR CHAIR OF THE RELAY FOR LIFE EVENT FOR 12 YEARS. THE HOSPITAL HAS PROVIDED CANCER INFORMATION AND BROCHURES, AS WELL AS GOODIE BAGS FOR OVER 300 SURVIVORS FOR MANY YEARS, AS WELL AS DONATING THE COST OF POSTAGE TO SEND RELAY INFORMATION TO OVER 600 CANCER SURVIVORS. THE EDUCATIONAL SERVICES DEPARTMENT ALSO DONATES DIAPERS AND SUPPLIES FROM PRE-NATAL CLASSES TO THE LOCAL WOMEN'S CRISIS CENTER UPON RECEIVING A NEW SHIPMENT OF MATERIALS. true ADA REGIONAL UNITED WAY 314 S BROADWAY STE 204 ADA OK 74820 730941532 501(C)(3) 6000 HLTH/HUMAN SRV PRGM MARCH OF DIMES FOUNDATION 1275 MAMARONECK AVE WHITE PLAINS NY 10605 131846366 501(C)(3) 7500 NURSE OF YEAR PRGM AMERICAN CANCER SOCIETY 250 WILLIAMS STREET ATLANTA GA 30303 131788491 501(C)(3) 5973 CANCER RESEARCH 3 0 1 SCHEDULE I, PART I, LINE 2 THE ORGANIZATION GRANTS MONEY TO OTHER 501(C)(3) ORGANIZATIONS THAT ARE PUBLIC CHARITIES. THE ORGANIZATION RECEIVES DOCUMENTATION FROM THE CHARITIES ON HOW THE FUNDS WILL BE USED AND AN ACKNOWLEDGEMENT OF THE AMOUNT THE ORGANIZATION GAVE TO THE CHARITIES. false false false false false false false false false DR KIMBALL PRATT 693427 0 0 0 0 0 4900 0 6576 0 704903 0 0 0 DR CHARLES VEST 355820 0 0 0 0 0 4900 0 4180 0 364900 0 0 0 STEVEN FILLMORE 338266 0 0 0 0 0 4900 0 1291 0 344457 0 0 0 DR LEWIS WALLACE 333721 0 0 0 0 0 4900 0 0 0 338621 0 0 0 DR IMTIAZ AHMED 186466 0 0 0 0 0 0 0 0 0 186466 0 0 0 1 FORM 990, SCHEDULE J, PART 1 THE FOLLOWING INVIDUALS RECEIVED COMPENSATION FROM AN UNRELATED ORGANIZATION (MERCY HEALTH SYSTEM) FOR SERVICES RENDERED TO THE ORGANIZATION. THE ORGANIZATION IS NOT AWARE OF THE TERMS OF THE AGREEMENT BETWEEN THE IDVIDUALS AND MERCY HEALTH SYSTEM. MARY GALLUP W. KENT ROGERS CHERYL FAMILY MEMBER OF MARK WEEMS WEEMS, BOARD MEMBER 76514 EMPLOYMENT false BRADEN FAMILY MEMBER OF DEAN PETERSON PETERSON, BOARD MEMBER 43563 EMPLOYMENT false JACQUELINE FAMILY MEMBER OF CHARLES VEST R. VEST, BOARD MEMBER 19890 INDEPENDENT CONTRACTOR false 1 FORM 990, PART VI, LINE 2 JOANN CARPENTER, M.D. AND CHARLES R. METTRY, D.O. HAVE A BUSINESS RELATIONSHIP. 2 FORM 990, PART VI, LINE 3 VALLEY VIEW REGIONAL HOSPITAL IS MANAGED BY MERCY HEALTH SYSTEMS. 3 FORM 990, PART VI, LINE 7A THE TOTAL NUMBER OF MEMBERS OF THE BOARD IS THE SAME AS THE TOTAL NUMBER OF MEMBERS OF THE VALLEY VIEW HOSPITAL AUTHORITY BOARD. MEMBERS OF THE BOARD OF THE AUTHORITY ARE MEMBERS OF VALLEY VIEW REGIONAL HOSPITAL'S BOARD. SHOULD ANY MEMBER OF THE AUTHORITY BOARD DECLINE OR FAIL TO QUALIFY AS A MEMBER OF THE HOSPITAL BOARD, THE HOSPITAL BOARD SHALL HAVE THE POWER TO ELECT A PERSON TO FILL THE VACANCY. 4 FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. THE RETURN IS REVIEWED INTERNALLY AND THEN IS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE OF THE BOARD BEFORE FILING WITH THE IRS. THE REVIEW AND APPROVAL IS DOCUMENTED IN THE MINUTES OF THE FINANCE COMMITTEE. A COPY OF THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD BEFORE IT IS FILED WITH THE IRS. 5 FORM 990, PART VI, LINE 12C EACH DIRECTOR, PRINCIPAL OFFICER, SENIOR MANAGEMENT STAFF, AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. 6 FORM 990, PART VI, LINE 15A THE ORGANIZATION DOES NOT COMPENSATE THE CEO OR OTHER OFFICERS OR KEY EMPLOYEES. THE CEO AND OTHER OFFICERS RECIEVE COMPENSATION FROM AN UNRELATED ORGANIZATION FOR SERVICES RENDERED TO THE ORGANIZATION. 7 FORM 990, PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. MEDICAL CENTER OF STRATFORD 217 W SMITH STRATFORD OK 74872 731327488 CLINIC OK 436286 234679 NA VALLEY VIEW FOUNDATION INC 430 N MONTE VISTA ADA OK 74820 201964563 SUPPORT ORG OK 501(C)(3) 11A NA VALLEY VIEW HOSPITAL AUTHORITY INC 430 N MONTE VISTA ADA OK 74820 730759362 SUPPORT VVRH OK GOV'T NA VALLEY VIEW MANAGEMENT GROUP INC 430 N MONTE VISTA ST ADA OK 74820 731481379 PHYSICIAN PRACT OK NA C CORPORATION 1629592 460091 1.00000 false true true false false false false false false false false false true false false false false false VALLEY VIEW MANAGEMENT GROUP INC B 2069183 VALLEY VIEW MANAGEMENT GROUP INC C 1350000