BOULDER CITY HOSPITAL INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- BOULDER CITY HOSPITAL INC (EIN 88-0065829)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-15
- IRS object ID
- 201133199349306238
- Schema version
- 2010v3.4
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-15T13:57:36-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8010 | AddressLine1 |
| City | WAUSAU | City |
| State | WI | State |
| ZIP Code | 544028010 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 880065829 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOULDER CITY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BOUL | NameControl |
| Phone | 7022934111 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 ADAMS BOULEVARD | AddressLine1 |
| City | BOULDER CITY | City |
| State | NV | State |
| ZIP Code | 89005 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | FREY BELETE | Name |
| Title | CONTROLLER | Title |
| Phone | 7022934111 | Phone |
| Date Signed | 2011-11-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KATHLEEN J LABRAKE CPA | Name |
| Phone | 7158453111 | Phone |
| Date Prepared | 2011-11-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | FREY BELETE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 ADAMS BOULEVARD | AddressLine1 |
| City | BOULDER CITY | City |
| State | NV | State |
| ZIP Code | 89005 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 19653073 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.BOULDERCITYHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1954 | YearFormation |
| State Legal Domicile | NV | StateLegalDomicile |
| Activity Or Mission Description | BOULDER CITY HOSPITAL, INC. IS A NONPROFIT, NONSTOCK CORPORATION WHICH OPERATES A 20-BED ACUTE CARE FACILITY, A 47-BED SKILLED NURSING FACILITY, 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 259 | TotalNbrEmployees |
| Total Nbr Volunteers | 669 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 46210 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 64514 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 19172014 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 18963342 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -64194 | InvestmentIncomePriorYear |
| Investment Income Current Year | 16575 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 36757 | OtherRevenuePriorYear |
| Other Revenue Current Year | 40855 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 19190787 | TotalRevenuePriorYear |
| Total Revenue Current Year | 19085286 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 10174453 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10023340 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9638507 | OtherExpensePriorYear |
| Other Expenses Current Year | 9810388 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 19812960 | TotalExpensesPriorYear |
| Total Expenses Current Year | 19833728 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -622173 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -748442 | RevenuesLessExpensesCY |
| Total Assets BOY | 11912478 | TotalAssetsBOY |
| Total Assets EOY | 11946754 | TotalAssetsEOY |
| Total Liabilities BOY | 8422159 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 8156154 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3490319 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3790600 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | BOULDER CITY HOSPITAL SEEKS TO CONTINUALLY IMPROVE THE QUALITY OF THE CARE AND SERVICE TO OUR PATIENTS, GUESTS, AND PHYSICIANS. WE PROMOTE EFFECTIVE AND EFFICIENT UTILIZATION OF AVAILABLE RESOURCES TO ENSURE LONG-TERM FINANCIAL VIABILITY. BOULDER CITY HOSPITAL SEEKS TO EARN THE TRUST OF THE RESIDENTS OF BOULDER CITY, NEIGHBORING COMMUNITIES AND AREA VISITORS BY MEETING THEIR HEALTH CARE, SAFETY AND RELATED EDUCATIONAL NEEDS WITH COMPASSION, INTEGRITY, AND SINCERITY WITHOUT REGARD TO ONE'S ABILITY TO PAY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 16945688 | Expense |
| Revenue | 18920193 | Revenue |
| Description | BOULDER CITY HOSPTIAL OPERATES AN ACUTE CARE HOSPITAL WITH EMERGENCY SERVICES AND SKILLED NURSING UNIT. ADMISSIONS FOR THE HOSPTIAL AND SKILLED NURSING FACILITY WERE 517 AND 150, RESPECTIVELY. TOTAL PATIENT DAYS WERE 1,887 AND 13,587, RESPECTIVLEY. THERE WERE 5,183 EMERGENCY ROOM VISITS. | Description |
| Total Program Service Expense | 16945688 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 0 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 31 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 259 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NV | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREY BELETE CONTROLLER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7022934111 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 ADAMS BLVD | AddressLine1 |
| City | BOULDER CITY | City |
| State | NV | State |
| ZIP Code | 89005 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| KATHY CALHOUN 2012 | ||||||
| TRUSTEE | 0.50 | X | 0 | 0 | 0 | |
| GOLDIE BEGLEY 2010 | ||||||
| SECRETARY | 0.50 | X | 0 | 0 | 0 | X |
| DEREK MEEKS DO 2012 | ||||||
| TRUSTEE | 0.50 | X | 0 | 0 | 0 | |
| MICHAEL RAVITCH MD 2012 | ||||||
| TRUSTEE | 0.50 | X | 0 | 0 | 0 | |
| JOE HARDY MD 2010 | ||||||
| TRUSTEE | 0.50 | X | 0 | 0 | 0 | |
| VERNON BURK 2012 | ||||||
| TRUSTEE | 0.50 | X | 0 | 0 | 0 | |
| SCOTT LIEN 2012 | ||||||
| VICE-PRESIDENT | 0.50 | X | 0 | 0 | 0 | X |
| CHRISTINE A MILBURN 2011 | ||||||
| PRESIDENT | 0.50 | X | 0 | 0 | 0 | X |
| BOB KENNEY 2011 | ||||||
| TREASURER | 0.50 | X | 0 | 0 | 0 | X |
| LINDA FAISS 2011 | ||||||
| TRUSTEE | 0.50 | X | 0 | 0 | 0 | |
| ANDREA ANDERSON 2011 | ||||||
| TRUSTEE | 0.50 | X | 0 | 0 | 0 | |
| WENDELL WHITMANN 2012 | ||||||
| TRUSTEE | 0.50 | X | 0 | 0 | 0 | |
| BRUCE WOODBURY 2012 | ||||||
| TRUSTEE | 0.50 | X | 0 | 0 | 0 | |
| THOMAS E MAHER | ||||||
| CEO | 40.00 | 171776 | 0 | 15355 | X | |
| DEBRA K BALIDO | ||||||
| CNO | 40.00 | 122219 | 0 | 4350 | X | |
| FREY BELETE | ||||||
| CONTROLLER | 40.00 | 76912 | 0 | 3781 | X | |
| JACKSON C BAILEY | ||||||
| COO | 40.00 | 101750 | 0 | 10799 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 472657 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 34285 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EPIPHANY SURGICAL | |||||
| 2110 E FLAMINGO 109 | LAS VEGAS | NV | 89119 | OP SURGICAL COMPANY | 414517 |
| DANIEL ROLLINS MD | |||||
| PO BOX 91930 | HENDERSON | NV | 89009 | ER PHYSICIAN | 216330 |
| DEREK MEEKS DO PC | |||||
| 1885 HILLSBORO DRIVE | HENDERSON | NV | 89074 | ER PHYSICIAN | 184142 |
| GREEN VALLEY MEDICAL IMAGING | |||||
| 743 DESCARTES AVENUE | HENDERSON | NV | 89002 | EKG & ULTRASOUND IMAGING | 145345 |
| WILLIAM HARRINGTON | |||||
| 2020 HOMEVIEW CT | LAS VEGAS | NV | 89117 | ER PHYSICIAN | 110154 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| All Other Contributions | 64514 | AllOtherContributions |
| Total Contributions | 64514 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| NET PATIENT SERVICE RE | 900099 | 18853257 | 18853257 | |
| OTHER OPERATING REVENU | 900099 | 66936 | 66936 | |
| CAFETERIA SALES | 900099 | 43149 | $43,149 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 18963342 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6829 | TotalRevenueColumn |
| Exclusion | $6,829 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 60354 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 19499 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 40855 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 40855 | TotalRevenueColumn |
| Exclusion | $40,855 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 558034 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 548288 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 9746 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9746 | TotalRevenueColumn |
| Exclusion | $9,746 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19085286 | TotalRevenueColumn |
| Related Or Exempt Function Income | 18920193 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $100,579 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 506942 | Total |
| Management And General | 506942 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7773134 | Total |
| Program Services | 7038065 | ProgramServices |
| Management And General | 735069 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43569 | Total |
| Program Services | 37034 | ProgramServices |
| Management And General | 6535 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1089120 | Total |
| Program Services | 925752 | ProgramServices |
| Management And General | 163368 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 610575 | Total |
| Program Services | 518989 | ProgramServices |
| Management And General | 91586 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5632 | Total |
| Management And General | 5632 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54500 | Total |
| Management And General | 54500 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2321922 | Total |
| Program Services | 1653703 | ProgramServices |
| Management And General | 668219 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27458 | Total |
| Management And General | 27458 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 347783 | Total |
| Program Services | 262122 | ProgramServices |
| Management And General | 85661 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 365167 | Total |
| Program Services | 318738 | ProgramServices |
| Management And General | 46429 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 926432 | Total |
| Program Services | 886218 | ProgramServices |
| Management And General | 40214 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 216647 | Total |
| Program Services | 184150 | ProgramServices |
| Management And General | 32497 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PROVISION FOR BAD DEBTS | 2403000 | 2403000 | |
| PATIENT CARE SUPPLIES | 2195245 | 2085483 | 109762 |
| EQUIPMENT RENTAL AND MA | 569863 | 341918 | 227945 |
| OTHER | 234986 | 173890 | 61096 |
| REGISTRY EXPENSE | 141753 | 116626 | 25127 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19833728 | Total |
| Program Services | 16945688 | ProgramServices |
| Management And General | 2888040 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 286881 | BOY |
| EOY | 366028 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3065782 | BOY |
| EOY | 2570919 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1891492 | BOY |
| EOY | 1919275 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119555 | BOY |
| EOY | 568066 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 517785 | BOY |
| EOY | 323360 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104679 | BOY |
| EOY | 220227 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 19545874 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 13719780 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5775978 | BOY |
| EOY | 5826094 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 150326 | BOY |
| EOY | 152785 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11912478 | BOY |
| EOY | 11946754 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1946913 | BOY |
| EOY | 2193240 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5304232 | BOY |
| EOY | 5021237 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1171014 | BOY |
| EOY | 941677 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8422159 | BOY |
| EOY | 8156154 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3324813 | BOY |
| EOY | 3622957 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 165506 | BOY |
| EOY | 167643 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3490319 | BOY |
| EOY | 3790600 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11912478 | BOY |
| EOY | 11946754 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -748442 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 1048723 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $49 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 49 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | DUES TO NEVADA HOSPITAL ASSOCIATION THAT ARE ALLOCATED TO LOBBYING ON BEHALF OF MEMBERS. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 287987 | OtherCostOrOtherBasis |
| Book Value | 287987 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8430896 | OtherCostOrOtherBasis |
| Depreciation | 5612158 | Depreciation |
| Book Value | 2818738 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 351099 | OtherCostOrOtherBasis |
| Depreciation | 279574 | Depreciation |
| Book Value | 71525 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9617836 | OtherCostOrOtherBasis |
| Depreciation | 7828048 | Depreciation |
| Book Value | 1789788 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 858056 | OtherCostOrOtherBasis |
| Book Value | 858056 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5826094 | TotalOfBookValueLandBuildings |
| Total Revenue | 19085286 | TotalRevenue |
| Total Expenses | 19833728 | TotalExpenses |
| Excess Or Deficit For Year | -748442 | ExcessOrDeficitForYear |
| Other | $1,048,723 | OtherAmount |
| Total Adjustments | 1048723 | TotalAdjustments |
| Excess Or Deficit Per FS | 300281 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 19196336 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 111050 | OtherRevenues |
| Revenue Not Rptd F990 | 111050 | RevenueNotRptdF990 |
| Revenue Subtotal | 19085286 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 19085286 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 19833728 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 19833728 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 19833728 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | BOULDER CITY HOSPITAL IS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAX. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN INCOME TAX POSITIONS, ASC TOPIC 740-10, ACCOUNT FOR UNCERTAINTY IN INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS 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 2010. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CONTRIBUTIONS FOR CAPITAL ACQUISITION 928,887. CHANGE IN INTEREST IN NET ASSETS OF AUXILIARY 5,923. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 113,913. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION AND AUXILLIARY 111,050. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 150.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 34575 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 34575 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1674888 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1674888 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09610 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 94796 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 94796 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00540 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1804259 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1804259 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10350 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1804259 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1804259 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10350 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,377,822 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5667345 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6373409 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -706064 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOULDER CITY HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 ADAMS BLVD | AddressLine1 |
| City | BOULDER CITY | City |
| State | NV | State |
| ZIP Code | 89005 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOULDER CITY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOULDER CITY HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 ADAMS BLVD | AddressLine1 |
| City | BOULDER CITY | City |
| State | NV | State |
| ZIP Code | 89005 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | SKILLED NURSING | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 3C: BOULDER CITY HOSPITAL ("THE HOSPITAL") USES 150% 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: A COST-TO-CHARGE RATIO WAS DETERMINED USING WORKSHEET 2. |
| PART I, L7 COL(F): BAD DEBT EXPENSE FOR THE YEAR WAS $2,403,000. THIS AMOUNT WAS OMITTED FROM TOTAL EXPENSES WHEN CALCULATING COMMUNITY BENEFIT EXPENSE FOR SCHEDULE H. |
| PART II: NEW PROGRAMS AND EQUIPMENT ARE PAID FROM FUNDS GENERATED INTERNALLY THROUGH OPERATIONS. |
| PART III, LINE 4: TO DETERMINE THE COST OF BAD DEBT EXPENSE, THE HOSPITAL USES A COST-TO-CHARGE RATIO CALCULATED ON WORKSHEET 2.FINANCIAL STATMENT FOOTNOTE REGARDING BAD DEBTS - THE CARRYING AMOUNTS OF ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES THAT 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 CHARGE TO GROSS REVENUE AND A CREDIT TO ACCOUNTS RECEIVABLE. IN ADDITION, MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY FROM UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE.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: A COST-TO-CHARGE RATIO IS USED TO PREPARE THE MEDICARE COST REPORT. THE DATA REPORTED ABOVE WAS TAKEN FROM THE MEDICARE COST REPORT. |
| 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 HANDS PAMPHLET EXPLAINING CHARITY POLICY TO PATIENT. THE PATIENT IS INSTRUCTED TO READ PAMPHLET AND COMPLETE IF NECESSARY. BUSINESS OFFICE STAFF CONTACTS PATIENT 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 AREAS RESIDENTS RELY ON MEDICARE SUBSIDIES TO PAY FOR HEALTH CARE. FOR 2009, 49% OF GROSS PATIENT REVENUE WAS ATTRIBUTABLE TO MEDICARE PATIENT SERVICES. |
| PART VI, LINE 6: 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 ALSO THE SOLE COMMUNITY PROVIDER OF HEALTH CARE, AS IT IS DESIGNATED A CRITICAL ACCESS HOSPITAL. THE HOSPITAL PROVIDES HEALTH CARE TO RESIDENTS WHO WOULD NOT OTHERWISE HAVE ACCESS TO READILY AVAILABLE HEALTH CARE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | THOMAS E MAHER | NamePerson |
| Base Compensation Filing Org | 171776 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 15355 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 187131 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DEREK MEEKS DO PC | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | DR. MEEKS IS A CONTRACTED ER PHYSICIAN WITH BOULDER CITY HOSPITAL, INC. | Relationship |
| Amount Of Transaction | 184142 | AmountOfTransaction |
| Description Of Transaction | DR. MEEKS IS CONTRACTED ER PHYSICIAN WITH BOULDER CITY HOSPITAL, INC. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS. THE RETURN IS REVIEWED BY THE BOARD AT THEIR MONTHLY MEETING. | |
| ON AN ANNUAL BASIS, ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES COMPLETE THE CONFLICT OF INTEREST DISCLOSURE STATEMENT. | FORM 990, PART VI, SECTION B, LINE 12C | |
| COMPENSATION OF THESE INDIVIDUALS IS DETERMINED BY THE HUMAN RESOURCES DEPARTMENT. 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 WERE PROPERLY DOCUMENTED. THE CEO COMPENSATION IS DETERMINED AND APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE. | FORM 990, PART VI, SECTION B, LINE 15 | |
| BOULDER CITY HOSPITAL MAKES ITS DOCUMENTS AVAILABLE TO THE PUBLIC THROUGH THE HOSPITAL'S ADMINISTRATION DEPARTMENT. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | CONTRIBUTIONS FOR CAPITAL ACQUISITION 928,887. CHANGE IN INTEREST IN NET ASSETS OF AUXILIARY 5,923. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 113,913. TOTAL TO FORM 990, PART XI, LINE 5: 1,048,723. | FORM 990, PART XI, LINE 5: |
| THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. | FORM 990, PART XI, LINE 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| BOULDER CITY HOSPITAL FOUNDATION | ||||||||||
| 901 ADAMS BOULEVARD | BOULDER CITY | NV | 89005 | 943141555 | FINANCIAL SUPPORT OF BOULDER CITY HOSPITAL, INC. | NV | 501 C (3) | LINE 11C, III-FI | N/A | 0 |
| AUXILIARY OF THE BOULDER CITY HOSPITAL INC | ||||||||||
| 901 ADAMS BOULEVARD | BOULDER CITY | NV | 89005 | 886001696 | SUPPORT THE WELFARE OF BOULDER CITY HOSPITAL, INC. | NV | 501 C (3) | 509 (A) (1) | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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