2024-07-17T11:15:09-04:00 2023-09-30 200079326 DINGUS ZARECOR & ASSOCIATES PLLC 12015 E MAIN AVE SPOKANE VALLEY WA 99206 990 2022-10-01 261938641 NORTH CANYON MEDICAL CENTER INC NORT 2089348765 267 NORTH CANYON DRIVE GOODING ID 83330 J'DEE ADAMS TRUSTEE/CEO 2089348765 2024-07-08 true JDEE ADAMS 999009999 true THOMAS DINGUS P00951009 5092420874 2024-07-17 2022 2023-04-26 12:10:37Z J'DEE ADAMS 267 NORTH CANYON DRIVE GOODING ID 83330 62501377 false X WWW.NORTHCANYON.ORG X 2007 ID POWERED BY EXCELLENCE, WE ARE GROWING A MEDICAL ORGANIZATION THAT SERVES OUR COMMUNITIES. 10 8 412 25 42802 1683210 720684 51717622 60612865 -125216 571630 498009 556103 53773625 62461282 2480 14975 0 27036834 31415062 0 13228 24382349 27430206 51421663 58860243 2351962 3601039 60658693 66319456 45801936 47728324 14856757 18591132 X POWERED BY EXCELLENCE, WE ARE GROWING A MEDICAL ORGANIZATION THAT SERVES OUR COMMUNITIES. false false 9911000 20983000 NORTH CANYON MEDICAL CENTER (NCMC) OPERATES AN 18-BED CRITICAL ACCESS HOSPITAL THAT PROVIDES SERVICES THAT INCLUDE: ACUTE CARE, SWING BED CARE, DIAGNOSTIC IMAGING, DIABETIC EDUCATION, EMERGENCY CARE, LABORATORY SERVICES, REHABILITATION SERVICES, RESPIRATORY THERAPY, ADDICTION MEDICINE, BEHAVORIAL HEALTH, DERMATOLOGY, SLEEP STUDIES, ORTHOPEDICS, SPINE, FOOT AND ANKLE, HAND AND WRIST, PAIN MANAGEMENT, UROLGY, GENERAL SURGERY, SURGICAL SERVICES, AND FAMILY MEDICINE. NCMC'S SURGICAL DEPARTMENT PERFORMS SURGICAL AND ENDOSCOPIC PROCEDURES. NCMC EMPLOYS A SPINE SURGEON, TWO ORTHOPEDIC SURGEONS, A HAND/WRIST SURGEON, A GENERAL SURGEON, A PODIATRIST, A UROLOGIST, AS WELL AS WELCOMING VISITING SPECIALISTS. IN 2023, THE SURGICAL DEPARTMENT PERFORMED 1,962 CASES. 3176000 3233000 NORTH CANYON MEDICAL CENTER'S MEDICAL-SURGICAL DEPARTMENT HANDLES ACUTE CARE, SWING BED CARE, OBSERVATION, AND POST SURGICAL CARE. SWING BED CARE IS FOR THOSE PATIENTS DISCHARGED FROM ACUTE CARE BUT REQUIRE ADDITIONAL SKILLED CARE. NCMC HAD 348 ADMISSIONS IN 2023, OF WHICH 40% WERE MEDICARE. THE AVERAGE DAILY CENSUS FOR THE YEAR WAS 3.5. THE ACUTE AVERAGE LENGTH OF STAY WAS 3.3 DAYS. 2646000 4495000 NCMC OFFERS A FULL-SERVICE LABORATORY DEPARTMENT STAFFED BY A TEAM OF SPECIALISTS WHO ARE COMMITTED TO PROVIDING HIGH-QUALITY DIAGNOSTIC SERVICES FOR HEALTH CARE PROVIDERS AND PATIENTS. THE LABORATORY UTILIZES CUTTING- EDGE ANALYZERS AND EQUIPMENT TO ENSURE QUALITY AND ACCURACY. LABORATORY STAFF IS AVAILABLE 24 HOURS A DAY. OUR LABORATORY PERFORMS THE FOLLOWING AREAS OF TESTING: HEMATOLOGY, CLINICAL CHEMISTRY, IMMUNOASSAY, SEROLOGY, COAGULATION, MOLECULAR TESTING, MICROBIOLOGY, URINALYSIS, AND BLOOD BANK. THE LAB PERFORMED AND PROCESSED 128,380 TESTS IN 2023. 34551824 14975 31901865 NCMC PROVIDES A WIDE RANGE OF HEALTHCARE SERVICES IN TECHNOLOGICALLY ADVANCED FACILITIES. SERVICES INCLUDE ORTHOPEDICS, SPINE CARE, FOOT AND ANKLE, HAND AND WRIST, GENERAL SURGERY, PAIN MANAGEMENT, UROLOGY, BEHAVIORAL HEALTH, CARDIOLOGY, DERMATOLOGY, SLEEP STUDIES, AND REHABILITATION SERVICES. OUR REHABILITATION SERVICES ARE PROVIDED BY TRAINED, LICENSED PROFESSIONALS WHO SPECIALIZE IN PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. WE PROVIDE INPATIENT AND OUTPATIENT THERAPY AT NCMC. ADDITIONAL SERVICES PROVIDED BY NCMC INCLUDE DIAGNOSTIC IMAGING, ADDICTION MEDICINE, NUTRITION SERVICES, A SPECIALTY CLINIC, FAMILY PRACTICE CLINICS, AND WOUND CARE. NCMC OFFERS STATE OF THE ART RADIOLOGY EQUIPMENT NOT NORMALLY FOUND IN A RURAL SETTING. NCMC EMPLOYS ONLY CERTIFIED RADIOLOGIC TECHNOLOGISTS TO PERFORM EXAMS, EACH HAVING SPECIALIZED TRAINING IN THE TYPE OF EXAM BEING GIVEN. NCMC EMPLOYS A RADIOLOGIST WHO READS EXAMS ON SITE. ALSO, NCMC RECEIVED DONATIONS FROM THE TOUGH ENOUGH TO WEAR PINK ORGANIZATION THAT WAS USED TO FURTHER BREAST CANCER AWARENESS BY AIDING IN PURCHASING A NEW ULTRASOUND. NCMC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 268,192 FOR CHARITY CARE, 15,806,462 FOR MEDICARE, 9,729,425 FOR MEDICAID, AND 25,420,649 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR. 34551824 14975 31901865 50284824 true true false true false false false false true false true false false false true true true false false false false false false false false false true true true false true true false false false false false false false false false false false false false false false false false false false true 59 0 true 412 true true true false false false false false false false false false false false X 10 8 false false false false false false false true true false false true true true true true true true true false X RYAN WILSON 2089348765 267 NORTH CANYON DRIVE GOODING ID 83330 TOBY ANDERTON TRUSTEE/PHYS 40.00 X 988261 0 9150 GUY GROOMS PHYSICIAN 40.00 X 689532 0 9150 KYLE GROOMS PHYSICIAN 40.00 X 528205 0 5772 RICHARD KENT SANDERS PHYSICIAN 40.00 X 459790 0 10845 CORY BATES PHYSICIAN 40.00 X 386113 0 6300 DAVID VERST PHYSICIAN 40.00 X 385597 0 4368 J'DEE ADAMS TRUSTEE/CEO 40.00 X X 180980 0 17218 RYAN WILSON CFO 40.00 X 127690 0 3448 ELAINE BRYANT CHAIR 1.00 X X 0 0 0 JJ MCBRIDE VICE CHAIR 1.00 X X 0 0 0 BONNIE MARSHALL TREASURER 1.00 X X 0 0 0 HELEN EDWARDS SECRETARY 1.00 X X 0 0 0 JIM MCCAUGHEY TRUSTEE 1.00 X 0 0 0 LUCY OSBORNE TRUSTEE 1.00 X 0 0 0 PAT HAMILTON TRUSTEE 1.00 X 0 0 0 LEO SANCHEZ TRUSTEE 1.00 X 0 0 0 3746168 66251 35 false true false CENTRAL IDAHO ANESTHESIA 85 HORSESHOE CIRCLE JEROME ID 83338 ANESTHESIA SVS 1112968 EMERGENCY MEDICINE PHYSICIAN ASSIST PO BOX 476 GOODING ID 83330 ER PAS 949141 HEALTHCARE WORKFORCE LOGISTICS HOLD 3452 LAKE LYNDA DR STE 200 ORLANDO FL 32817 CONTRACTED RNS 842340 PHYSICIANS IMMEDIATE CARE CENTER 243 CHENEY DR W STE 200 TWIN FALLS ID 83301 PHYSICIAN ASSIS 314400 BOISE RADIOLOGY GROUP LLC 115 W MAIN STREET 202 BOISE ID 83702 DIAGNOSTIC IMAG 273009 7 552940 167744 720684 PATIENT SERVICE REVENUE, NET 624100 60537724 60537724 COSMETIC CLINIC REVENUE 812900 42802 42802 RENTAL INCOME 621110 32339 32339 60612865 454470 454470 157255 40095 117160 117160 117160 CAFETERIA 900099 306532 306532 REBATES 900099 219130 219130 OTHER REVENUE 900099 30441 30441 556103 62461282 60570063 42802 1127733 X 14975 14975 1486598 1061434 425164 23477752 20544319 2929152 4281 251970 248723 3198 49 4605294 4000728 603773 793 1593448 1381512 211662 274 6380 6380 79941 79941 26539 26539 9575292 7239975 2335311 6 92472 92472 970558 599313 367825 3420 81062 81062 1952973 1604237 348736 159420 112134 47229 57 226034 109294 116685 55 38526 27971 10555 3819922 3225357 594565 401258 316148 85110 MEDICAL SUPPLIES & DRUGS 9257522 9257522 TAXES & LICENSES 310093 293870 16223 DUES & SUBSCRIPTIONS 158947 84905 72555 1487 273267 162407 108054 2806 58860243 50284824 8562191 13228 8706807 1173053 5744298 14746942 7695719 9591477 1067863 936044 676103 565632 71852522 37908204 33605748 33944318 2071599 2221397 1090556 3140593 60658693 66319456 7059110 7907258 105315 14170000 13875000 23526517 23201419 940994 2744647 45801936 47728324 X 14856757 18591132 14856757 18591132 60658693 66319456 X 3601039 132945 391 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5920 5920 false SCHEDULE C, PART II-B, LINE 1 NCMC DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. NCMC PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. true 46782 53056 66895 32943 false 3750757 3750757 42835063 21182781 21652282 22885695 16725423 6160272 2381007 2381007 33944318 OPERATING LEASE LIABILITIES 1279647 INDEMNITY AND EXPENSE RESERVE 1100000 ESTIMATED 3RD-PARTY PAYOR SETTLEMENT 365000 2744647 X 62568079 132945 391 133336 62434743 26539 26539 62461282 58833704 58833704 26539 26539 58860243 SCHEDULE D, PAGE 2, PART IV, LINE 1B NCMC HAS AN AUXILIARY THAT OPERATES USING THE EIN OF NCMC. THE INCOME AND EXPENSES OF THE AUXILIARY ARE EXCLUDED FROM THE 990, PART VIII AND IX. THE ASSETS, LIABILITIES, AND EQUITIES ARE ALSO EXCLUDED FROM THE 990, PART X. SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE HOSPITAL EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF SEPTEMBER 30, 2023 AND 2022, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. SCHEDULE D, PAGE 4, PART XI, LINE 2D CHANGE IN CASH VALUE LIFE INSURANCE 391 true true true X true X 1.750000000000 true true false true true 136778 136778 0.00230 9171356 8253625 917731 0.01560 9308134 8253625 1054509 0.01790 314032 44055 269977 0.00460 3730276 2253257 1477019 0.02510 1421 1421 4045729 2297312 1748417 0.02970 13353863 10550937 2802926 0.04760 3971 3971 0.00010 25925 25925 0.00040 29896 29896 0.00050 true 769236 131414 11223873 11309429 -85556 X true true 1 1 NORTH CANYON MEDICAL CENTER INC 267 NORTH CANYON DRIVE GOODING ID 83330 X X X X NORTH CANYON MEDICAL CENTER INC 1 false false true X X X X X X X X X X 22 true false false true X WWW.NORTHCANYON.ORG X true 22 true WWW.NORTHCANYON.ORG false true X 100.000000000000 175.000000000000 true true X X X X true X WWW.NORTHCANYON.ORG X WWW.NORTHCANYON.ORG X WWW.NORTHCANYON.ORG X X X X true X false true X false true FACILITY 1, NORTH CANYON MEDICAL CENTER, INC. - PART V, LINE 3E IDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS BEGIN ON PAGE 21 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. FACILITY 1, NORTH CANYON MEDICAL CENTER, INC. - PART V, LINE 5 TO ENSURE INPUT FROM PERSONS WITH BROAD KNOWLEDGE OF THE COMMUNITY, A COMMUNITY SURVEY WAS ADMINISTERED IN MARCH 2022 THROUGH LOCAL NEWS MEDIA, EMAIL TO CHAMBERS OF COMMERCE AND AREA CIVIC GROUPS ALONG WITH INVITATIONS AND LINKS THROUGH HOSPITAL SOCIAL MEDIA AND WEBSITE WITH OVER 230 RESPONDENTS PRIMARILY FROM THE GOODING AND TWIN FALLS COUNTIES. TWO FOCUS GROUPS WERE THEN HELD IN APRIL WITH COMMUNITY STAKEHOLDERS TO FACILITATE DISCUSSION AND GET INPUT AROUND THE HEALTH NEEDS AND RESOURCES IN THE COMMUNITY. INVITATIONS WERE SENT TO INDIVIDUALS REPRESENTING VARIOUS COMMUNITY, BUSINESS, AND EDUCATIONAL ORGANIZATIONS. REPRESENTATIVES FROM LOCAL HEALTH CARE PROVIDERS AND THE COMMUNITY HEALTH DEPARTMENTS WERE INCLUDED TO BRING IN ADDITIONAL PROFESSIONAL PERSPECTIVE. FOR INVITEES UNABLE TO ATTEND THE FOCUS GROUP SESSIONS, INPUT WAS GATHERED BY EMAIL VIA THE COMMUNITY SURVEY. THE INDIVIDUALS IDENTIFIED TO PARTICIPATE IN THE PROCESS HAVE DIRECT ACCESS TO INDIVIDUALS ACROSS ALL SUBSECTIONS OF THE COMMUNITY AND THEREFORE CAN ADDRESS NEEDS THAT MAY IMPACT THOSE POPULATIONS THAT ARE MEDICALLY UNDERSERVED OR MOST IN NEED. COMMUNITY PARTICIPANTS REPRESENTED THE FOLLOWING COMMUNITY ORGANIZATIONS: NORTH CANYON MEDICAL CENTER GOODING SCHOOL DISTRICT (SOCIAL SERVICES, HOMELESS LIAISON) UNITED WAY JEROME SCHOOL DISTRICT ST. LUKE'S COMMUNITY HEALTH GOODING COUNTY COMMISSIONER JEROME 2020 FACILITY 1, NORTH CANYON MEDICAL CENTER, INC. - PART V, LINE 11 THE NCMC CHNA ADVISORY COMMITTEE IS MADE UP OF SELECTED INDIVIDUALS WITH A WIDE RANGE OF BACKGROUNDS IN HEALTH RELATED AGENCIES AND WITH HEALTH RELATED QUALIFICATIONS. COLLECTIVELY, THESE INDIVIDUALS ADVOCATE ON BEHALF OF THE MEDICALLY UNDERSERVED, LOW INCOME AND MINORITY POPULATIONS WITHIN THE COMMUNITY THROUGH THEIR ORGANIZATIONS. IN ORDER TO GATHER FEEDBACK FROM INDIVIDUALS NOT PARTICIPATING IN THE COMMUNITY ADVISORY COMMITTEE, A SURVEY TOOL WAS DEVELOPED TO ADDRESS GENERAL QUESTIONS RELATED TO THE HEALTH OF THE COMMUNITY. THE SURVEY WAS DISTRIBUTED TO AND COMPLETED BY, LOCAL COMMUNITY GROUPS, CHAMBERS OF COMMERCE MEMBERS, HOSPITAL BOARD MEMBERS, EMPLOYEES AND OTHER KEY COMMUNITY MEMBERS REPRESENTING A MIX OF THE COMMUNITY DEMOGRAPHICS. THE SURVEYS WERE RETURNED FOR INDEPENDENT REVIEW AND ANALYSIS. ONCE THE HEALTH NEEDS WERE PRIORITIZED, THE ADVISORY COMMITTEE DEVELOPED AN IMPLEMENTATION STRATEGY IN ORDER TO HAVE A CLEAR SET OF GOALS TO RESPOND TO THE PRIORITIES IDENTIFIED THROUGH THE CHNA. THE IMPLEMENTATION STRATEGY INCLUDED A WRITTEN PLAN THAT ADDRESSED EACH OF THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA, DESCRIBED HOW THE HOSPITAL PLANNED TO MEET THE HEALTH NEEDS, AND IDENTIFIED HEALTH NEEDS THE HOSPITAL DID NOT INTEND TO MEET AND WHY. THE FOLLOWING TOP PRIORITIES WERE IDENTIFIED THROUGH THE CHNA PROCESS. FOR EACH PRIORITY, AN OBJECTIVE OR STRATEGY WAS IDENTIFIED. EACH OBJECTIVE INCLUDED TACTICS ON HOW TO ACHIEVE THE OBJECTIVE, THE RESOURCES NEEDED, THE IMPACT THE PROGRAM OR RESOURCES WOULD HAVE, THE ACCOUNTABLE PARTIES, AND ANY PARTNERSHIPS OR COLLABORATIONS. 1.BETTER COORDINATION OF RESOURCES 2.WOMEN'S HEALTH 3.DIABETIC RESOURCES 4.HEALTH EDUCATION SOME HEALTH ISSUES OR NEEDS THAT WERE IDENTIFIED THROUGH THE CHNA PROCESS ARE NOT PRIORITIZED AS THIS TIME DUE TO BEING OUTSIDE THE SCOPE/ABILITIES OF NCMC AND/OR THE ISSUE IS BEING ADDRESSED BY OTHER COMMUNITY RESOURCES OR ORGANIZATIONS. IN OTHER INSTANCES, THERE ARE ALREADY INITIATIVES IN PLACE AT NORTH CANYON MEDICAL CENTER TO ADDRESS SOME NEEDS. NCMC IS NOT IGNORING THESE ISSUES BUT PLANS TO COLLABORATE (WITHIN ITS ABILITY) WITH OTHER ORGANIZATIONS TO ADDRESS AND MAKE PROGRESS. NCMC ALSO HAS PROGRAMS IN PLACE INCLUDING A SLIDING FEE SCALE, WALK IN CLINIC, PATIENT TRANSPORT, AND FINANCIAL COUNSELORS AVAILABLE WHICH HELP TO ADVOCATE FOR THE PATIENT. DUE TO THE SHORTAGE IN RURAL AREAS INCLUDING GOODING COUNTY, NCMC HAS HAD A DIFFICULT TIME RECRUITING SPECIALISTS FOR PEDIATRICS AND OBGYN SERVICES. NCMC ALSO HAS TO EVALUATE QUALITY AND ECONOMICAL CONSIDERATIONS WHEN ASSESSING THE NEED IN ITS SERVICE AREA IN ORDER TO SUPPORT HAVING SUCH SPECIALISTS. NCMC OPENED A NEW CLINIC IN JEROME, ID, IN SEPTEMBER 2020, AND EMPLOYS A FULLTIME PEDIATRICIAN. FACILITY 1, NORTH CANYON MEDICAL CENTER, INC. - PART V, LINE 16J THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS ALSO COMMUNICATED VERBALLY UPON ADMISSION. THE LATEST FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON THE HOSPITAL WEBSITE. FACILITY 1, NORTH CANYON MEDICAL CENTER, INC. - PART V, LINE 24 PATIENTS ARE BILLED THE GROSS CHARGE FOR ALL SERVICES RECEIVED. IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE BILL IS ADJUSTED AS DETERMINED BY OUR CHARITY CARE POLICY GUIDELINES. 6 NORTH CANYON FAMILY MEDICINE 267 NORTH CANYON DRIVE GOODING ID 83330 RURAL HEALTH CLINIC NORTH CANYON BUHL CLINIC 718 HWY 30 BUHL ID 83316 RURAL HEALTH CLINIC NORTH CANYON ORTHOPEDICS 2167 VILLAGE PARK AVE SUITE 200 TWIN FALLS ID 83301 OUTPATIENT CLINIC NORTH CANYON JEROME CLINIC 491 HERITAGE DR JEROME ID 83338 RURAL HEALTH CLINIC NORTH CANYON HAILEY CLINIC 15 W GALENA STREET HAILEY ID 83333 OUTPATIENT CLINIC NORTH CANYON COSMETIC SURGERY 1341 FILLMORE ST SUITE 200 TWIN FALLS ID 83301 OUTPATIENT CLINIC SCHEDULE H, PART I, LINE 7 THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES FOR AMOUNTS REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, TOTAL COMMUNITY BENEFIT, AND TOTAL COMMUNITY BUILDING EXPENSES). SCHEDULE H, PART II GOODING COUNTY IS DESIGNATED AS MEDICALLY UNDERSERVED AND HAS A SHORTAGE IN THE AREA OF HEALTH PROFESSIONALS. THE HOSPITAL IS CONTINUALLY RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ITS RURAL SERVICE AREA TO HELP IMPROVE ACCESS TO HEALTHCARE SERVICES AS IDENTIFIED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT. SCHEDULE H, PART III, LINE 2 THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON SCHEDULE H, PART III, LINE 2 INCLUDES THE COST TO CHARGE RATIO OF PATIENT CARE. SCHEDULE H, PART III, LINE 3 THE HOSPITAL DOES NOT OFFER DISCOUNTS FOR PAYMENT ON BAD DEBT. THE HOSPITAL APPLIES FUNDS COLLECTED ON BAD DEBT AGAINST THE PATIENT ACCOUNT. WE ESTIMATE THAT OF THE CHARITY CARE APPLICATIONS GIVEN OUT, ABOUT HALF OF THEM COME BACK. DURING THE YEAR, WE RECORDED 268,192 OF CHARITY CARE AT GROSS PATIENT CHARGES WHICH WAS CONVERTED TO 136,778 UTILIZING THE COST TO CHARGE RATIO OF PATIENT CARE. THEREFORE, WE ESTIMATE AN ADDITIONAL 131,414 OF BAD DEBT EXPENSE WHICH COULD BE ATTRIBUTABLE TO PATIENTS UNDER THE CHARITY CARE POLICY. SCHEDULE H, PART III, LINE 4 THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 5 ON PAGE 15 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR EXPLICIT PRICE CONCESSIONS (BAD DEBT) IS INCLUDED IN FOOTNOTE 10 STARTING ON PAGE 22 OF THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8 ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. SCHEDULE H, PART III, LINE 9B THE BILLING DEPARTMENT BILLS PATIENTS AND INSURANCE WITHIN 4 DAYS FROM THE DATE OF SERVICE. AFTER INSURANCE PAYMENTS ARE MADE, THE OPEN ACCOUNT GOES TO SELF PAY STATUS AND IS BILLED DIRECTLY TO PATIENTS. ON THE 1ST DAY AFTER INSURANCE HAS PAID, SELF PAY ACCOUNTS ARE SENT A STATEMENT OF CHARGES, WHICH SERVES AS AN INVOICE. THE SAME IS TRUE AFTER INSURANCE PAYMENTS ARE MADE AND THE OPEN ACCOUNT GOES TO SELF PAY STATUS. THROUGHOUT A FULL 120 DAYS, VARIOUS PHONE CALLS AND LETTERS ARE USED TO CONTACT THE PATIENT IN ORDER TO FOLLOW THROUGH WITH COLLECTION PROCESSES AND TO TRY TO QUALIFY PATIENTS FOR CHARITY CARE OR FINANCIAL ASSISTANCE. AT 121 DAYS, A LIST OF UNPAID ACCOUNTS IS COMPILED TO BE SENT TO OUTSIDE COLLECTIONS. THE HOSPITAL'S PATIENT FINANCIAL COUNSELORS REVIEW THIS LIST FOR ACCURACY PRIOR TO SENDING IT TO AN OUTSIDE COLLECTION AGENCY. ANY COLLECTIONS FROM THE OUTSIDE COLLECTION AGENCY ARE APPLIED AS A RECOVERY AGAINST BAD DEBT. SCHEDULE H, PART VI, LINE 2 THE HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES BY CONSIDERING SERVICES BEYOND THE TYPICAL SCOPE OF A CRITICAL ACCESS HOSPITAL TO DETERMINE WHICH SERVICES TO PROVIDE BASED UPON STATISTICAL ANALYSIS AND SERVICE REQUIREMENTS THAT THE COMMUNITY IS DEMANDING. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY AND COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT THE FOLLOWING URL: HTTPS://NORTHCANYON.ORG/ABOUT/IN-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS- ASSESSMENTS/ SCHEDULE H, PART VI, LINE 3 THE HOSPITAL HAS A PATIENT FINANCIAL SERVICES (PFS) DEPARTMENT THAT STRIVES TO TREAT ALL PATIENTS EQUITABLY, WITH DIGNITY, RESPECT AND COMPASSION. PFS INFORMS PATIENTS ABOUT PROGRAMS AVAILABLE, INCLUDING THE CHARITY CARE PROGRAM. IF THE PATIENT IS INTERESTED IN THE PROGRAM, PFS WILL VERBALLY INFORM THE PATIENT ABOUT THE GUIDELINES AND/OR SEND FORMS THAT ARE REQUIRED TO JOIN THE PROGRAM(S). SCHEDULE H, PART VI, LINE 4 GOODING, IDAHO IS A RURAL COMMUNITY WITH APPROXIMATELY 3,700 RESIDENTS. THERE ARE TWO OTHER HOSPITALS IN COMMUNITIES WITHIN 35 MILES. THE MARKET PLACE IS PRIMARILY COMPRISED OF MEDICAID AND MEDICARE RESIDENTS, DEMONSTRATED BY THE HOSPITAL'S PAYOR MIX. MEDICAID AND MEDICARE MAKE UP APPROXIMATELY 42% OF THIS MIX. SCHEDULE H, PART VI, LINE 5 THE HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY MEMBERS REPRESENTING MULTIPLE FACETS OF OUR COMMUNITY FROM BUSINESS OWNERS TO HOMEMAKERS TO RETIREES. THIS VOLUNTEER BOARD HAS DEDICATED THEIR TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. MEDICAL STAFF PRIVILEGES AT THE HOSPITAL ARE AVAILABLE TO QUALIFIED AND INTERESTED PHYSICIANS IN THE COMMUNITY WE SERVE. WE ENCOURAGE PRACTITIONERS FROM NUMEROUS SPECIALTIES TO MEET THE EVER GROWING HEALTHCARE NEEDS OF THE COMMUNITY. ANY SURPLUS FUNDS ARE REINVESTED INTO OUR FACILITIES, EQUIPMENT, AND PROFESSIONAL EDUCATION OF OUR EMPLOYEES IN ORDER TO PROVIDE THE HIGHEST QUALITY HEALTHCARE POSSIBLE. THE HOSPITAL ALSO ASSESSES THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY TO DETERMINE IF ADDITIONAL SERVICES TO OUR PATIENTS ARE NEEDED. THE HOSPITAL ALSO PROMOTES HEALTH IN THE COMMUNITY BY OFFERING OR PARTICPATING IN THE FOLLOWING SERVICES: OPERATES AN EMERGENCY ROOM THAT IS AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY PARTICIPATES IN EDUCATION OF HEALTHCARE PROFESSIONALS PARTICIPATES IN GOVERNMENT SPONSORED HEALTH PROGRAMS SUCH AS MEDICARE AND MEDICAID VOLUNTEER OPPORTUNITIES AVAILABLE SPONSORS AN ANNUAL HEALTH FAIR THAT GIVES COMMUNITY MEMBERS OPPORTUNITIES TO HAVE TESTS PERFORMED AT VERY DISCOUNTED RATES SCHEDULE H, PART VI, LINE 6 N/A SCHEDULE H, PART VI THE COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST. EMTALA POLICY DISCLOSURE: THE HOSPITAL HAS MAINTAINED AND FOLLOWED AN EMERGENCY MEDICAL CARE POLICY, BUT SUCH POLICY DID NOT CONTAIN A SPECIFIC STATEMENT PROHIBITING THE HOSPITALS FACILITY FROM ENGAGING IN ACTIVITIES THAT DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE AS DESCRIBED IN TREAS. REG. 1.501(R)- 4(C)(2) (PROHIBITION LANGUAGE). THE LACK OF THE PROHIBITION LANGUAGE WAS CORRECTED WHEN THE HOSPITALS BOARD OF DIRECTORS APPROVED THE ADDITION OF THE PROHIBITION LANGUAGE TO THE HOSPITALS EMERGENCY MEDICAL CARE POLICY ON JULY 25, 2023. IN ADDITION, THE BOARD HAS ESTABLISHED A PROCEDURE UNDER WHICH THE HOSPITALS POLICIES WILL BE REVIEWED FROM TIME TO TIME TO ENSURE COMPLIANCE WITH ALL OF THE REQUIREMENTS OF SECTION 501(R) OF THE FEDERAL TAX CODE. true CHILDREN'S MUSEUM OF THE MAGIC VALL PO BOX 2139 TWIN FALLS ID 83303 832068910 501C3 10000 MUSEUM CONSTRUCTION 1 SCHEDULE I, PAGE 1, PART I, LINE 2 FUNDS ARE PAID DIRECTLY TO VENDORS OR SUPPLIERS ON BEHALF OF THE DESIGNATED BENEFICIARY OF THE GRANTS OR CONTRIBUTIONS. REQUESTS FOR FINANCIAL ASSISTANCE ARE APPROVED BY THE BOARD PRIOR TO DISBURSEMENT. X false true false false false false false false false TOBY ANDERTON TRUSTEE/PHYSICIAN 748092 240169 9150 997411 GUY GROOMS PHYSICIAN 611063 78469 9150 698682 KYLE GROOMS PHYSICIAN 240251 287954 5772 533977 RICHARD KENT SANDERS PHYSICIAN 333978 125812 10845 470635 CORY BATES PHYSICIAN 384813 1300 6300 392413 DAVID VERST PHYSICIAN 343635 41962 4368 389965 J'DEE ADAMS TRUSTEE/CEO 169448 11300 232 8038 9180 198198 SCHEDULE J, PART III PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE HOSPITAL PAYS ANNUAL PREMIUMS TO A SPLIT DOLLAR LIFE INSURANCE PLAN FOR THE CEO AND CFO. WHAT THE HOSPITAL PAYS TO THE LIFE INSURANCE POLICIES WILL CONVERT TO FUNDING A 457(F) PLAN AT RETIREMENT AGE. NO PAYMENTS WERE RECEIVED FROM THE PLAN DURING THE YEAR AND IF THE CEO OR CFO LEAVES BEFORE THE RETIREMENT AGE OF THE PLAN, NOTHING IS RECEIVED. A IDAHO HEALTH FACILITIES AUTHORITY 826051863 451295XYO 2015-11-25 15500000 PAYOFF MORTGAGE OF HOSPITAL FACILITY false false false A 1625000 15500000 1068446 630277 13823498 2016 false false true true A false false false false false false false A false false false false false false false false true A false PURPOSE OF ISSUE DESCRIPTION IDAHO HEALTH FACILITIES AUTHORITY PAYOFF MORTGAGE OF HOSPITAL FACILITY FORM 990, PAGE 1, PART I, LINE 6 VOLUNTEERS CONTRIBUTE THEIR TIME AND TALENTS TO ENHANCE THE HOSPITAL FOUNDATION, THRIFT STORE, AND INTERNAL VOLUNTEER POSITIONS. FORM 990, PAGE 2, PART III, LINE 4D NCMC PROVIDES A WIDE RANGE OF HEALTHCARE SERVICES IN TECHNOLOGICALLY ADVANCED FACILITIES. SERVICES INCLUDE ORTHOPEDICS, SPINE CARE, FOOT AND ANKLE, HAND AND WRIST, GENERAL SURGERY, PAIN MANAGEMENT, UROLOGY, BEHAVIORAL HEALTH, CARDIOLOGY, DERMATOLOGY, SLEEP STUDIES, AND REHABILITATION SERVICES. OUR REHABILITATION SERVICES ARE PROVIDED BY TRAINED, LICENSED PROFESSIONALS WHO SPECIALIZE IN PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. WE PROVIDE INPATIENT AND OUTPATIENT THERAPY AT NCMC. ADDITIONAL SERVICES PROVIDED BY NCMC INCLUDE DIAGNOSTIC IMAGING, ADDICTION MEDICINE, NUTRITION SERVICES, A SPECIALTY CLINIC, FAMILY PRACTICE CLINICS, AND WOUND CARE. NCMC OFFERS STATE OF THE ART RADIOLOGY EQUIPMENT NOT NORMALLY FOUND IN A RURAL SETTING. NCMC EMPLOYS ONLY CERTIFIED RADIOLOGIC TECHNOLOGISTS TO PERFORM EXAMS, EACH HAVING SPECIALIZED TRAINING IN THE TYPE OF EXAM BEING GIVEN. NCMC EMPLOYS A RADIOLOGIST WHO READS EXAMS ON SITE. ALSO, NCMC RECEIVED DONATIONS FROM THE TOUGH ENOUGH TO WEAR PINK ORGANIZATION THAT WAS USED TO FURTHER BREAST CANCER AWARENESS BY AIDING IN PURCHASING A NEW ULTRASOUND. NCMC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 268,192 FOR CHARITY CARE, 15,806,462 FOR MEDICARE, 9,729,425 FOR MEDICAID, AND 25,420,649 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR. FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE CEO AND CFO WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD. THE FINANCE COMMITTEE MAKES A MOTION TO APPROVE THE 990. ONCE THE BOARD HAS APPROVED THE 990, THE CEO AUTHORIZES THE PREPARER TO FINALIZE THE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C A CONFLICT OF INTEREST POLICY CERTIFICATION IS SIGNED BY OFFICERS AND BOARD MEMBERS OF THE ORGANIZATION WHEN THEY BECOME AN EMPLOYEE OR BOARD MEMBER, AND IS UPDATED ANNUALLY FOR ANY CHANGES. OFFICERS AND BOARD MEMBERS ARE SUBJECT TO SELF DISCLOSURE IN THE INTERIM. AT ALL LEVELS THE BOARD IS RESPONSIBLE TO ASSESS, REVIEW AND RESOLVE SUCH CONFLICTS. WHERE A CONFLICT EXISTS, THE AFFECTED PARTIES MUST EXCUSE THEMSELVES FROM PARTICIPATION IN THE SITUATION. FORM 990, PAGE 6, PART VI, LINE 15A NORTH CANYON MEDICAL CENTER'S BOARD OF DIRECTORS EVALUATES THE CEO ON A YEARLY BASIS. THE CEO'S PERFORMANCE EVALUATION IS BASED ON THE FOLLOWING CRITERIA: STRATEGIC THINKING, BUDGET/FINANCIAL MANAGEMENT, EFFECTIVE COMMUNICATION, MOTIVATING AND INSPIRATION, INDIVIDUAL AND TEAM DEVELOPMENT, INNOVATION AND CHANGE, STRATEGIC RESULTS, AND MANAGEMENT OF SELF. EACH BOARD MEMBER EVALUATES THE CEO'S PERFORMANCE ON THE ABOVE MENTIONED CRITERIA AND MEETS TOGETHER TO DISCUSS THE RESULTS. ANY INCREASE OR BONUS IS VOTED ON BY THE BOARD FOLLOWING THIS REVIEW. THE REVIEW IS DONE ANNUALLY AND COINCIDES WITH NCMC'S PERFORMANCE EVALUATION PERIOD. FORM 990, PAGE 6, PART VI, LINE 15B SEE FORM 990, PART VI, LINE 15A ABOVE. FORM 990, PAGE 6, PART VI, LINE 19 NCMC MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES 7,239,975 2,335,311 6 FORM 990, PART XI, LINE 9 CHANGE IN CASH VALUE LIFE INSURANCE 391