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        </ContributorBusinessName>
        <ContributorUSAddress>
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          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
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        <ExplanationTxt>Payments are made to American Hospital Association and Nevada Hospital Association to provide unified, regulatory advocacy for member hospitals.</ExplanationTxt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Third Party Settlement</Desc>
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      <FootnoteTextInd>X</FootnoteTextInd>
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        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Renown South Meadows Medical Center 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). This entity must annually file Returns of Organizations Exempt from Income Tax (Form 990) with the IRS. In addition, Renown South Meadows Medical Center is subject to income tax on net income derived from business activities that are unrelated to its tax exempt purpose. Renown South Meadows Medical Center files an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS to report any unrelated business taxable income. Renown South Meadows Medical Center 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 South Meadows Medical Center 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.</ExplanationTxt>
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      <WrittenPolicyInd>1</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
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        <ExplanationTxt>Part V, Section B, Line 5: Renown used validated and reliable data sources, results from an online survey of 1,400 residents, input from local subject matter experts and feedback from over 80 leaders and stakeholders who participated in a community workshop.</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 5: Renown used validated and reliable data sources, results from an online survey of 1,400 residents, input from local subject matter experts and feedback from over 80 leaders and stakeholders who participated in a community workshop.</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 6a: Renown Regional Medical Center and Renown Rehabilitation Hospital</ExplanationTxt>
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        <FormAndLineReferenceDesc>Renown Rehabilitation Hospital</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 6a: Renown Regional Medical Center and Renown South Meadows Medical Center</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 6b: Truckee Meadows Tomorrow</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 6b: Truckee Meadows Tomorrow</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 11: The prioritized health needs identified in its 2020 CHNA include: Priority 1: Healthy Behaviors (Health Literacy and System Navigation);Priority 2: Immunizations and Infectious Diseases; andPriority 3: Behavioral, Youth, and Adolescent Health (Mental Health, Substance Abuse, and Youth/Adolescent Health).PRIORITY 1: HEALTHY BEHAVIORS (HEALTH LITERACY AND SYSTEM NAVIGATION) Overarching Goal Statement: Early and Equitable Access to Genetic Screening and Application.Collaboration Partners include Tier 1 Genomics, Healthy Nevada Project (HNP) and the Renown Health Communication Team.Three inherited autosomal dominant conditions-BRCA related hereditary breast and ovarian cancer (HBOC), Lynch syndrome (LS) and familial hypercholesterolemia (FH)-have been termed the Centers for Disease Control and Prevention Tier 1 (CDCT1) genetic conditions, for which early identification and intervention have a meaningful potential for clinical actionability and a positive impact on public health. In typical medical practice, genetic testing for these conditions is based on personal or family history, ethnic background or other demographic characteristics. In a study of a cohort of 26,906 participants in the HNP, it was evaluated whether population screening could efficiently identify carriers of these genetic conditions and, second, the impact of genetic risk on health outcomes for these participants. It was found a 1.33% combined carrier rate for pathogenic and likely pathogenic (P/LP) genetic variants for HBOC, LS and FH. Of these carriers, 21.9% of participants had clinically relevant disease, among whom 70% had been diagnosed with relevant disease before age 65. Moreover, 90% of the risk carriers had not been previously identified, and less than 19.8% of these had documentation in their medical records of inherited genetic disease risk, including family history. In a direct follow-up survey with all carriers, only 25.2% of individuals reported a family history of relevant disease. Our experience with the HNP suggests that genetic screening in patients could identify at-risk carriers, who would not be otherwise identified in routine care.In 2023, Renown worked with the HNP to increase marketing efforts and community engagement around genetic testing. From those efforts, 17 unique materials were developed and distributed among patients, providers and public health practitioners. In addition to physical materials, the HNP team attended 12 community events to build strong partnerships toward mutual goals, which include healthcare payers, healthcare providers, advocacy groups and other key stakeholders. Enrollment numbers increased by 3,216 in 2023, for a total of 54,994 participants in the project.PRIORITY 2: IMMUNIZATIONS &amp; INFECTIOUS DISEASES Overarching Goal Statement: Create equity and improve vaccine and immunization access within our communities through structural and systems level changes that are sustainable and culturally reflective.Target Populations include socially vulnerable populations, those without vehicles/transportation opportunities, people with disabilities, older adults, and those with limited English proficiency. Collaboration partners include Immunize Nevada, Nevada Vaccine Equity Collaborative and Community Health Alliance (CHA).From the most recent report dated February 2022, the pharmacy department at CHA has given 10,633 vaccines during vaccine events, pop-up events, and walk-ins at one of three pharmacy locations. Of this total, 48% have been to the pediatric population between the ages of 5 and 18. The pharmacy department has conducted 55 off site vaccine clinics and pop-up events. 81.8% of these events have targeted the pediatric population. CHA has collaborated with the Washoe County School District, the Washoe County Health Department, the Boys and Girls Club, Our Place, the Reno Sparks Gospel Mission, Catholic Charities, Immunize Nevada and many other community partners to help host and support these events. Vaccinations have included flu, COVID primary series and boosters, and routine immunizations. Specifically, the newest CHA Pharmacy, funded with support from Renown Health has provided 92 pediatric vaccines and 191 adult vaccine clinics. In 2023, 76% of the allocated efforts were in support of these socially vulnerable populations. In addition to this, five communications campaigns were posted and got 336,549 unique views to meet the cultural and linguistic needs of communities highly impacted by COVID-19. Immunize Nevada had 5,232 attendees during vaccine clinic events and 3,858 attendees at vaccine outreach events to give a total of 1,900 vaccines.PRIORITY 3: BEHAVIORAL, YOUTH, AND ADOLESCENT HEALTH Overarching Goal Statement: Systemic approach to supporting the behavioral health needs of Washoe County by building a foundation for a healthier community.Target Populations include providers with first line of sight, teachers, childhood educators, childcare and care providers, young adults, foster care population, students and families (parents and guardians). Collaboration Partners include The Children's Cabinet, Washoe County School District (WCSD), Renown Health, and the Nevada Office of Suicide Prevention which came together to create Connect Washoe County (CWC).CWC continues to provide feedback to WCSD regarding their Suicide Response Policy and held a planning discussion for a student peer support model, including a meeting with the Student Advisory Council. CWC is host to a multi-agency Consultation Supervision team consortium, which includes mental health supervisors from Children's Cabinet, Quest Counseling, WCSD, and CHA. This group published a Washoe County Children's Mental Health Consortium (WCCMHC) annual report community snapshot. The Signs of Suicide education and screening occurred at 21 schools including all WCSD 7th graders. 3,289 students were screened with 34.5% scoring at risk or at high risk for mental health or suicide concern.The WCSD Suicide Response Policy has been revised and finalized, with the help of CWC. CWC hosted the 2nd annual Washoe County Youth Mental Health Summit in 2023, which had 400 attendees present. The Children's Cabinet was a prominent partner of Renown Health that aimed to strengthen networks of care for teens and adolescents and their families. The number of support programs increased from 8 programs in 2022 to 12 programs in 2023. Renown partnered with several other organizations to provide support to youth populations which helped to reduce the suicides of people 18 or younger in Washoe County from 6 in 2022 to 5 in 2023. These partners include Amplify Life, Boys &amp; Girls Club of Truckee Meadows, Child Assault Prevention, The City of Reno, Communities in Schools, Education Alliance of Washoe County, Food Bank of Northern Nevada, Forever14, High Fives, Hope Means Nevada, Make-A-Wish Northeastern &amp; Central California and Northern Nevada, Northern Nevada Children's Cancer Foundation, Quest Counseling &amp; Consulting, ReDirect Youth Outreach, Ronald McDonald House Charities Northern Nevada, Safe Kids Washoe County, Safe Talk For Teens, and Step2.Although the majority of the overarching goals, objectives, and efforts will focus on the top three priority areas, Renown Health remains committed to supporting positive advancements in addressing Maternal and Child Health, and other identified focus areas through partnerships, collaborations, and stakeholder alignment. There are several identified health focus areas remaining: Economy; Women's Health; Built Environment &amp; Infrastructure; Domestic Violence; Older Adults &amp; Aging; Access to Health Services; Maternal, Fetal, &amp; Infant Health; Exercise, Nutrition, and Weight. Although these remaining health needs are significant, other groups in Washoe County have made this their focus, so they are not directly targeted in the 2021 Implementation Strategy &amp; Plan. However, they will continue to be interwoven through both existing and proposed Renown Health strategic plans.</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 11: The prioritized health needs identified in its 2020 CHNA include: Priority 1: Healthy Behaviors (Health Literacy and System Navigation);Priority 2: Immunizations and Infectious Diseases; andPriority 3: Behavioral, Youth, and Adolescent Health (Mental Health, Substance Abuse, and Youth/Adolescent Health).PRIORITY 1: HEALTHY BEHAVIORS (HEALTH LITERACY AND SYSTEM NAVIGATION) Overarching Goal Statement: Early and Equitable Access to Genetic Screening and Application.Collaboration Partners include Tier 1 Genomics, Healthy Nevada Project (HNP) and the Renown Health Communication Team.Three inherited autosomal dominant conditions-BRCA related hereditary breast and ovarian cancer (HBOC), Lynch syndrome (LS) and familial hypercholesterolemia (FH)-have been termed the Centers for Disease Control and Prevention Tier 1 (CDCT1) genetic conditions, for which early identification and intervention have a meaningful potential for clinical actionability and a positive impact on public health. In typical medical practice, genetic testing for these conditions is based on personal or family history, ethnic background or other demographic characteristics. In a study of a cohort of 26,906 participants in the HNP, it was evaluated whether population screening could efficiently identify carriers of these genetic conditions and, second, the impact of genetic risk on health outcomes for these participants. It was found a 1.33% combined carrier rate for pathogenic and likely pathogenic (P/LP) genetic variants for HBOC, LS and FH. Of these carriers, 21.9% of participants had clinically relevant disease, among whom 70% had been diagnosed with relevant disease before age 65. Moreover, 90% of the risk carriers had not been previously identified, and less than 19.8% of these had documentation in their medical records of inherited genetic disease risk, including family history. In a direct follow-up survey with all carriers, only 25.2% of individuals reported a family history of relevant disease. Our experience with the HNP suggests that genetic screening in patients could identify at-risk carriers, who would not be otherwise identified in routine care.In 2023, Renown worked with the HNP to increase marketing efforts and community engagement around genetic testing. From those efforts, 17 unique materials were developed and distributed among patients, providers and public health practitioners. In addition to physical materials, the HNP team attended 12 community events to build strong partnerships toward mutual goals, which include healthcare payers, healthcare providers, advocacy groups and other key stakeholders. Enrollment numbers increased by 3,216 in 2023, for a total of 54,994 participants in the project.PRIORITY 2: IMMUNIZATIONS &amp; INFECTIOUS DISEASES Overarching Goal Statement: Create equity and improve vaccine and immunization access within our communities through structural and systems level changes that are sustainable and culturally reflective.Target Populations include socially vulnerable populations, those without vehicles/transportation opportunities, people with disabilities, older adults, and those with limited English proficiency. Collaboration partners include Immunize Nevada, Nevada Vaccine Equity Collaborative and Community Health Alliance (CHA).From the most recent report dated February 2022, the pharmacy department at CHA has given 10,633 vaccines during vaccine events, pop-up events, and walk-ins at one of three pharmacy locations. Of this total, 48% have been to the pediatric population between the ages of 5 and 18. The pharmacy department has conducted 55 off site vaccine clinics and pop-up events. 81.8% of these events have targeted the pediatric population. CHA has collaborated with the Washoe County School District, the Washoe County Health Department, the Boys and Girls Club, Our Place, the Reno Sparks Gospel Mission, Catholic Charities, Immunize Nevada and many other community partners to help host and support these events. Vaccinations have included flu, COVID primary series and boosters, and routine immunizations. Specifically, the newest CHA Pharmacy, funded with support from Renown Health has provided 92 pediatric vaccines and 191 adult vaccine clinics. In 2023, 76% of the allocated efforts were in support of these socially vulnerable populations. In addition to this, five communications campaigns were posted and got 336,549 unique views to meet the cultural and linguistic needs of communities highly impacted by COVID-19. Immunize Nevada had 5,232 attendees during vaccine clinic events and 3,858 attendees at vaccine outreach events to give a total of 1,900 vaccines.PRIORITY 3: BEHAVIORAL, YOUTH, AND ADOLESCENT HEALTH Overarching Goal Statement: Systemic approach to supporting the behavioral health needs of Washoe County by building a foundation for a healthier community.Target Populations include providers with first line of sight, teachers, childhood educators, childcare and care providers, young adults, foster care population, students and families (parents and guardians). Collaboration Partners include The Children's Cabinet, Washoe County School District (WCSD), Renown Health, and the Nevada Office of Suicide Prevention which came together to create Connect Washoe County (CWC).CWC continues to provide feedback to WCSD regarding their Suicide Response Policy and held a planning discussion for a student peer support model, including a meeting with the Student Advisory Council. CWC is host to a multi-agency Consultation Supervision team consortium, which includes mental health supervisors from Children's Cabinet, Quest Counseling, WCSD, and CHA. This group published a Washoe County Children's Mental Health Consortium (WCCMHC) annual report community snapshot. The Signs of Suicide education and screening occurred at 21 schools including all WCSD 7th graders. 3,289 students were screened with 34.5% scoring at risk or at high risk for mental health or suicide concern.The WCSD Suicide Response Policy has been revised and finalized, with the help of CWC. CWC hosted the 2nd annual Washoe County Youth Mental Health Summit in 2023, which had 400 attendees present. The Children's Cabinet was a prominent partner of Renown Health that aimed to strengthen networks of care for teens and adolescents and their families. The number of support programs increased from 8 programs in 2022 to 12 programs in 2023. Renown partnered with several other organizations to provide support to youth populations which helped to reduce the suicides of people 18 or younger in Washoe County from 6 in 2022 to 5 in 2023. These partners include Amplify Life, Boys &amp; Girls Club of Truckee Meadows, Child Assault Prevention, The City of Reno, Communities in Schools, Education Alliance of Washoe County, Food Bank of Northern Nevada, Forever14, High Fives, Hope Means Nevada, Make-A-Wish Northeastern &amp; Central California and Northern Nevada, Northern Nevada Children's Cancer Foundation, Quest Counseling &amp; Consulting, ReDirect Youth Outreach, Ronald McDonald House Charities Northern Nevada, Safe Kids Washoe County, Safe Talk For Teens, and Step2.Although the majority of the overarching goals, objectives, and efforts will focus on the top three priority areas, Renown Health remains committed to supporting positive advancements in addressing Maternal and Child Health, and other identified focus areas through partnerships, collaborations, and stakeholder alignment. There are several identified health focus areas remaining: Economy; Women's Health; Built Environment &amp; Infrastructure; Domestic Violence; Older Adults &amp; Aging; Access to Health Services; Maternal, Fetal, &amp; Infant Health; Exercise, Nutrition, and Weight. Although these remaining health needs are significant, other groups in Washoe County have made this their focus, so they are not directly targeted in the 2021 Implementation Strategy &amp; Plan. However, they will continue to be interwoven through both existing and proposed Renown Health strategic plans.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Renown South Meadows Medical Center</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 13h: In addition to the federal poverty guidelines, we also consider eligibility for state assistance programs and homelessness or no documentation to establish indigence as factors in determining eligibility. Guarantors who are above 400% FPG but have large medical bills due to catastrophic illness, may be considered for financial assistance.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Renown Rehabilitation Hospital</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 13h: In addition to the federal poverty guidelines, we also consider eligibility for state assistance programs and homelessness or no documentation to establish indigence as factors in determining eligibility. Guarantors who are above 400% FPG but have large medical bills due to catastrophic illness, may be considered for financial assistance.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Renown South Meadows Medical Center</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 16j: On every itemized bill and statement sent to the patient is a number they can call to get help with financial assistance. A financial counselor is made available to all self-pay patients upon admission. In addition, Patient Financial Assistance counselors proactively work with self-pay patients to aid in applying for financial assistance. The organization's website lists the phone number a patient can call to speak to a financial counselor.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Renown Rehabilitation Hospital</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 16j: On every itemized bill and statement sent to the patient is a number they can call to get help with financial assistance. A financial counselor is made available to all self-pay patients upon admission. In addition, Patient Financial Assistance counselors proactively work with self-pay patients to aid in applying for financial assistance. The organization's website lists the phone number a patient can call to speak to a financial counselor.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Renown South Meadows Medical Center</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 20e: On every itemized bill and statement sent to the patient is a number they can call to get help with financial assistance. A financial counselor is made available to all self-pay patients upon admission. In addition, Patient Financial Assistance counselors proactively work with self-pay patients to aid in applying for financial assistance. The organization's website lists the phone number a patient can call to speak to a financial counselor.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Renown Rehabilitation Hospital</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 20e: On every itemized bill and statement sent to the patient is a number they can call to get help with financial assistance. A financial counselor is made available to all self-pay patients upon admission. In addition, Patient Financial Assistance counselors proactively work with self-pay patients to aid in applying for financial assistance. The organization's website lists the phone number a patient can call to speak to a financial counselor.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Renown South Meadows Medical Center</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 24: Per our Financial Assistance Policy, no assistance is provided for non-medically necessary procedures regardless of eligibility.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Renown Rehabilitation Hospital</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 24: Per our Financial Assistance Policy, no assistance is provided for non-medically necessary procedures regardless of eligibility.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Lines 7a, 10a:</FormAndLineReferenceDesc>
        <ExplanationTxt>https://www.renown.org/en/about/community-commitment/community-health-needs-assessment/</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Line 7b:</FormAndLineReferenceDesc>
        <ExplanationTxt>https://www.renown.org/en/about/community-commitment/community-health-needs-assessment/</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Lines 16a, 16b &amp; 16c:</FormAndLineReferenceDesc>
        <ExplanationTxt>https://www.renown.org/patients-and-visitors/billing/financial-assistance/</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3c:</FormAndLineReferenceDesc>
        <ExplanationTxt>In addition to the federal poverty guidelines, we also consider eligibility for state assistance programs and homelessness or no documentation to establish indigence as factors in determining eligibility. Guarantors who are above 400% FPG but have large medical bills due to catastrophic illness, may be considered for financial assistance.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 6a:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's community benefit report is contained in a report prepared by its parent corporation, Renown Health.Part I, Line 5c: The organization budgets the amount of charity care expected in the next year but does not use that estimate as a constraint on the amount of charity care provided.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>Charity care expense was converted to cost on line 7a using the cost-to-charge ratio derived from Worksheet 2. Unreimbursed Medicaid and other unreimbursed costs on line 7b was calculated using the cost-to-charge ratio derived from Worksheet 2. Community health improvement, health professions education, subsidized health services, research and cash and in-kind contributions on lines 7e and 7i are reported from the organization's records.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Ln 7 Col(f):</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount of bad debt expense removed from total expenses to determine the percentage was $5,529,126.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount included on Line 2 reflects the amount at charges reported in the financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>The footnote to the audited financial statements that addresses bad debt is on page 18 of the attached audit financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>The costing methodology for Line 7 uses the cost accounting system in year ended December 31, 2023, as filed in the Medicare cost report.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b:</FormAndLineReferenceDesc>
        <ExplanationTxt>Patients in the process of qualifying for state or local indigent programs or the organization's charity program are indicated with a particular payor class/status in the patient accounting system. The patient is not subject to collection efforts while in those classes/statuses.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization reviews the current demographic information of the population it serves and the impact those demographics have on the health needs of the community. See explanation 4 for a description of the community. While the demographics start to tell the story of community health needs, Renown Health also consults with community partners and draws from state and local government, non-profits, and school district data sources to assess healthcare needs in the community. Renown Health also used data from the Washoe County Health District to identify health care needs and barriers in its service area. Renown Health's Community Benefit Committee spearheads the development of an annual community needs assessment and corresponding community benefit plan, and oversees the tracking and reporting of community benefit activities. The committee oversees the development or updating of a community needs assessment, and from that assessment develops a community benefit plan that prioritizes and identifies community needs that the organization can support with its finite resources. The needs assessment and community benefit plan then go before the Renown Health Board for review and approval on behalf of all Renown organizations. The needs assessment and the community benefit plan are posted to the organization's website at www.renown.org/en/about/community-commitment/.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization educates patients on assistance eligibility by posting information on its website regarding its financial assistance program and whenever situations indicate that the patient may be unable to pay for services. The organization has a dedicated Patient Financial Assistance department that works with uninsured patients to establish eligibility for a state or local program. For those that do not qualify for a state or local program, they will refer the patient to the organization's charity care process.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>Washoe County is located in the northwest corner of Nevada and has a population of 498,022 as of July 2023 according to the US Census Bureau. According to the US Census Bureau, the population in the Washoe County area is 50.9% male and 49.1% female. A fifth (20.5%) of the population is under the age of 18 and 17.7% of the population is 65 and over. Washoe County's population was estimated to have the following breakdown: 60.2% Caucasian/White, 3.0% African American/Black, 7.1% Asian/Hawaiian or Pacific Islander, 2.3% American Indian and Alaska Native and 26.2% Hispanic/Latino.The Washoe County median household income was estimated to be $81,531 according to the US Census Bureau and 10.3% of Washoe County residents are under the federal poverty guidelines. Reno-Sparks unemployment currently is estimated to be at 3.9% as of December 2023, below the state of Nevada at 5.3%.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>See Schedule O, Part III, Line 4a for a description of how the organization furthers its exempt purpose by promoting the health of the community.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>Renown South Meadows Medical Center is a 115-bed hospital that offers the latest in medical and surgical care, intensive care, telemetry, a 24-hour emergency room, inpatient and outpatient surgical and lab services. Renown South Meadows Medical Center provides a wide range of healthcare services to the south Reno and Washoe Valley communities regardless of race, creed, sex, national origin, handicap, age or ability to pay. Renown South Meadows Medical Center has approximately 540 physicians on its medical staff and extends admitting privileges to all eligible and qualified physicians.Since it opened as an acute care hospital in 2002, Renown South Meadows Medical Center has tripled its bed capacity by expanding the intensive care, surgical and telemetry units. Renown South Meadows Medical Center is also the local home of endoscopic ultrasound. This technology, applied with skillful hands, has helped diagnose and treat digestive diseases in thousands of patients. Renown South Meadows Medical Center is ranked in the top one percent nationwide for quality care based on measures for heart attack, heart failure, pneumonia and surgical care. They have the region's only certified pulmonary rehab and interventional pulmonary program, in addition to specializing in joint replacement and upper extremity procedures.Renown South Meadows Medical Center is engaged in a large facility expansion that will include interventional radiology, diagnostic and interventional catheterization, a retail pharmacy, and a 121,000 square foot medical office building with a hospital outpatient department and six new operating rooms and a state-of-the-art Breast Center - inclusive of Medical/Surgical Oncology, Breast Imaging, Infusion, and Wellness Center.Renown Rehabilitation Hospital is a 62-bed, inpatient rehabilitation environment, and the only CARF (Commission on Accreditation of Rehabilitation Facilities) accredited facility in the region, focusing on care that prepares patients to live as independently as possible after experiencing a disabling injury or illness. Renown Rehabilitation offers physical, occupational, speech, recreational and cognitive therapies, highly specialized Physical Medicine &amp; Rehabilitation physicians board certified in Spinal Cord Injury Medicine and Traumatic Brain Injury as well as housing an interventional pain management program.Renown Rehabilitation Hospital has the highest concentration of Certified Rehabilitation Registered Nurses in Northern Nevada. Rehabilitation nurses provide comfort, therapy and education, promote health-conducive adjustments, support adaptive capabilities and promote achievable independence. During 2023, there was only one other inpatient acute rehabilitation facility in Northern Nevada.Renown South Meadows Medical Center and Renown Rehabilitation Hospital further their not-for-profit status by providing quality healthcare for Renown's primary service area, Washoe County and the secondary service areas of northern Nevada and northern California. There is a long tradition and commitment to improve the care and the health of our community. In addition to our commitment to meet the healthcare needs of the region, we give 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.For the year ended December 31, 2023, Renown South Meadows Medical Center, along with its parent, Renown Health and its subsidiaries, provided approximately $274 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 needs assessment and community benefit plan go to: https://www.renown.org/en/about/community-commitment/.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 7, Reports Filed With States</FormAndLineReferenceDesc>
        <ExplanationTxt>NV</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part I, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Renown South Meadows Medical Center (RSMMC) provides transportation for patients with a lower level of care that would not typically be covered by insurance. There are no specific eligibility requirements other than the need of the service. It is in the best interest of the patient and the hospital to provide these services. No formal monitoring is required because the service is provided directly to the individual. RSMMC provides medical equipment, medical supplies or reimbursement of expenses to patients in need. There are no specific eligibility requirements other than the need of the assistance. Members of the operational team follow a standard process to request patient assistance. The request and supporting documentation, if an expense reimbursement, are reviewed and assistance is awarded if approved. No formal monitoring is required as each request goes through a formal review and approval process.</ExplanationTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kevin Desmond</PersonNm>
        <TitleTxt>Pharmacy Manager South Meadows</TitleTxt>
        <BaseCompensationFilingOrgAmt>191442</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jennifer Fleiner</PersonNm>
        <TitleTxt>Chief Nurse and Operations Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>181902</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Carter Roth</PersonNm>
        <TitleTxt>Nuclear Medicine Technologist</TitleTxt>
        <BaseCompensationFilingOrgAmt>161036</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>5000</BonusFilingOrganizationAmount>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>Tax Indemnification and Gross-up Payments: Sam Weller and Carter Roth - included in taxable compensation</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Renown South Meadows Medical Center relied on Renown Health, a related organization to establish compensation for its top management official. Renown Health used the following methods to establish compensation: compensation committee, independent compensation consultant, compensation survey or study, and approval by the board or compensation committee. See Renown Health's Form 990, Schedule O, narrative for Part VI, Section B, Line 15 for a description of the process utilized by Renown Health.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Lines 4a-b</FormAndLineReferenceDesc>
        <ExplanationTxt>Thomas Graf, Josiah Johnson, and Susan Lee received severance payments of $573,471, $749,539, and $254,998, respectively. These amounts are included in Schedule J, Part II, Column (B)(iii). Brian Erling, Ann Beck, and Sam Weller are parties to a supplemental nonqualified retirement plan. Contributions of $184,068 to Brian Erling, $88,989 to Ann Beck, and $25,000 to Sam Weller were included in Schedule J, Part II, Column (C). Dawn Ahner received a distribution of $1,781,034 from a 457(f) retirement plan. This amount is included in Schedule J, Part II, Column (C).</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part V, Line 1a, Number reported in Box 3 of Form 1096:</FormAndLineReferenceDesc>
        <ExplanationTxt>Renown South Meadows Medical Center has independent contractors, however, Renown Health, the parent organization, pays all the independent contractors directly. The actual expense of each independent contractor is directly charged to the assigned entity. The highest compensated independent contractors are reported on Part VII, Section B.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part V, Line 2a, Number of employees on W-3:</FormAndLineReferenceDesc>
        <ExplanationTxt>Renown South Meadows Medical Center has its own employees, however, Renown Health, the parent organization, pays all compensation and employee benefit amounts under a common paymaster arrangement. The actual compensation of each employee is directly charged to their assigned entity. Salaries and benefits are reported on lines 7 through 10 of Part IX.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>All the directors of the filing organization are also directors of the related tax-exempt organization, Renown Health. The directors have a business relationship with individuals reported on Part VII that are employed by Renown Health.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Renown Health is the sole corporate member of Renown South Meadows Medical Center.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Renown Health, acting through its board of directors, appoints the members of the board of governors of Renown South Meadows Medical Center.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>Renown Health must approve: 1) any changes of a strategic plan 2) selection of independent auditors, employee benefit consultants, legal counsel, and investment advisors 3) insurance and risk management programs 4) annual operating or capital budgets 5) material changes to the budget 6) investment policies 7) contracts among Renown entities 8) changes to governing documents 9) encumbrances of assets in excess of $1 million or real property 10) any borrowing in excess of $1 million in any fiscal year 11) merger, purchase or acquisition of another organization 12) joint venture with any other organization, entity or persons 13) any other material action take outside of ordinary course of business</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 8b</FormAndLineReferenceDesc>
        <ExplanationTxt>There was no committee during the year that had the broad authority to act on behalf of the board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is prepared by an independent public accounting firm with support from the organization's tax department. The Form 990 is reviewed by the organization's current Corporate Controller and current Chief Financial Officer prior to the final version being sent to the Board. The Form 990, as filed with the IRS, is sent to each voting member of the Renown Health Board prior to filing. Along with the Form 990 and Schedules, the Renown Health Board is provided with a narrative that explains the contents of the various parts of the return.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>On an annual basis at or prior to the first regular meeting following the election of new board members, the members of the Renown South Meadows Medical Center 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>Renown Health's executive compensation, including compensation for the CEO and certain executives, is reviewed and approved by the Renown Health executive committee. As a member of the executive committee, the CEO abstains from any decisions or discussions related to their own compensation. 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. 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 year ended December 31, 2023 executive compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Renown South Meadows Medical Center doesn't make its governing documents or conflict of interest policy available to the public. A copy of the audited financial statements is part of the Form 990 which is made available to the public.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Overhead Allocation: Program service expenses 0. Management and general expenses 25,987,363. Fundraising expenses 0. Total expenses 25,987,363. Ambulance Charges: Program service expenses 3,633. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,633. Billing Services: Program service expenses 0. Management and general expenses 79,893. Fundraising expenses 0. Total expenses 79,893. Cleaning Services: Program service expenses 1,592,215. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,592,215. Construction Services: Program service expenses 122,496. Management and general expenses 250,124. Fundraising expenses 0. Total expenses 372,620. Consulting Services: Program service expenses 0. Management and general expenses 21,615. Fundraising expenses 0. Total expenses 21,615. Document Destruction: Program service expenses 0. Management and general expenses 22,032. Fundraising expenses 0. Total expenses 22,032. Laundry Services: Program service expenses 1,809,104. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,809,104. Medical Services: Program service expenses 5,578,607. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,578,607. Medical Waste: Program service expenses 48,837. Management and general expenses 0. Fundraising expenses 0. Total expenses 48,837. Other Misc Services: Program service expenses 2,677,642. Management and general expenses 485,567. Fundraising expenses 0. Total expenses 3,163,209. Medical Equipment Service Agreements: Program service expenses 1,137,255. Management and general expenses 15,818. Fundraising expenses 0. Total expenses 1,153,073. Transportation Services: Program service expenses 8,185. Management and general expenses 33,906. Fundraising expenses 0. Total expenses 42,091.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Intercompany Settlements 34,317,315.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part X, Line 20:</FormAndLineReferenceDesc>
        <ExplanationTxt>The issue price includes the filing organization's share of the entire bond issue, which was issued to Renown Regional Medical Center on behalf of the Renown Obligated Group. The Renown Obligated Group consists of Renown Regional Medical Center, Renown South Meadows Medical Center, and Renown Transitional Care Services, but amounts are only listed on the financials of Renown Regional Medical Center and Renown South Meadows Medical Center as they specifically relate to those entities. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Renown Regional Medical Center's tax return (EIN 88-0213754). Renown Health, the sole member of this entity, has an audit committee that assumes responsibility for the consolidated audit and selection of the independent accountant.</ExplanationTxt>
      </SupplementalInformationDetail>
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          <BusinessNameLine1Txt>Hometown Health Plan</BusinessNameLine1Txt>
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          <AddressLine1Txt>1155 Mill St Z-4</AddressLine1Txt>
          <CityNm>Reno</CityNm>
          <StateAbbreviationCd>NV</StateAbbreviationCd>
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          <AddressLine1Txt>1155 Mill St Z-4</AddressLine1Txt>
          <CityNm>Reno</CityNm>
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</Return>