2023-11-15T07:53:33-06:00 2022-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2022-01-01 853977236 Barton Medical Foundation BART 5305413420 PO Box 9578 South Lake Tahoe CA 96158 Kelly Neiger Treasurer/Secretary/CFO 5305413420 2023-11-14 1 Kelly Neiger 999009999 1 Kim Hunwardsen CPA P00484560 6122536500 2023-11-14 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z Clint Purvance PO Box 9578 South Lake Tahoe CA 96158 300680 0 X www.bartonhealth.org X 2020 CA To arrange for the provision of health care services. 3 0 0 0 0 0 0 0 0 300680 0 0 0 0 0 300680 0 0 0 0 0 0 0 0 0 0 969089 0 969089 0 -668409 0 375171 0 1043580 0 -668409 To arrange for the provision of health care services. 0 0 969089 300680 The organization arranges for the provision of charitable healthcare services, conducting medical research and health education. The organization began operations and contracted with its first medical providers during the second half of 2022. During this time very minimal activity was incurred. 969089 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 1 0 1 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 CA X X Kelly Neiger 5305413420 PO Box 9578 South Lake Tahoe CA 96158 X Clint Purvance Chair/CEO 2.00 38.00 X X 0 1150056 55076 Kelly Neiger Treasurer/Secretary/CFO 2.00 38.00 X X 0 559498 53253 Matthew Wonnacott Trustee 2.00 38.00 X 0 671492 46043 0 2381046 154372 0 0 1 0 Matthew Wonnacott MD PC dba Sierra Healt 2170 South Ave South Lake Tahoe CA 96150 Physician Services 455902 1 Patient Service Revenu 621990 300680 300680 300680 300680 300680 0 0 X 838696 838696 2106 2106 46101 46101 200 200 3341 3341 Bad Debt Expense 7805 7805 Medical Supplies 2031 2031 68809 68809 969089 969089 0 0 28152 14571 0 332448 0 375171 83 0 1043497 0 1043580 X 0 -668409 0 0 0 -668409 0 375171 -668409 0 X 0 1 X 0 0 X Form 990, Schedule A: Our organization has tax exempt status as a hospital; however, we are not required to be licensed as a hospital and therefore do not need to complete Schedule H, Hospitals. 0 Right of Use Assets 332448 332448 Related Party Payables 711049 Lease Obligations 332448 1043497 X Part X, Line 2: The Medical Foundation believes that it has appropriate support for any tax positions taken affecting their annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Medical Foundation 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. 0 1 0 0 0 0 0 0 0 Clint Purvance Chair/CEO 0 655105 0 491932 0 3019 0 15250 0 39826 0 1205132 0 0 Matthew Wonnacott Trustee 0 478327 0 190146 0 3019 0 15250 0 30793 0 717535 0 0 Kelly Neiger Treasurer/Secretary/CFO 0 400620 0 155859 0 3019 0 11389 0 41864 0 612751 0 0 Part I, Line 4b Clint Purvance received payments of $119,168 from a related organization, BHC MSO, LLC, for participation in a 409(A) plan. Matthew Wonnacott MD PC dba Sierra Health Trustee Accounts Receivable X 14571 0 1 0 14571 Matthew Wonnacott MD PC dba Sierra Health Board Member owns 100% 455902 Physician Services 0 Form 990, Part VI, Section A, line 2 Clint Purvance, Kelly Neiger and Matthew Wonnacott, MD all have a business relationship with each other. Form 990, Part VI, Section A, line 4 The bylaws were amended in 2022 to change the following: 1) Board of Directors is comprised of five directors: three appointed by the sole member, one is a community representative appointed by the Barton Medical Foundation's board, and one must be a member of the Physician Executive Council that is nominated by the Physician Executive Council, but approved by the Barton Medical Foundation's board. 2) Directors will serve a three year term, at which time they will continue to serve one year terms until removed, resign from the Board, or a successor is elected. 3) Removal of Board members: The sole member can remove any of their three board members at any time with or without cause. The community representative can be removed at any time with or without cause by the entire board. The director from the Physician Executive Council is removed if they no longer serve on that Council, or by majority vote of the entire board. Form 990, Part VI, Section A, line 6 Barton Healthcare System is the sole member. Form 990, Part VI, Section A, line 7a Board of Directors comprises of five directors. Three directors are appointed by the sole member. The sole member can remove any of these three board members at any time with or without cause. One director must be a member of the Physician Executive Council that is nominated by the Physician Executive Council, but approved by the Barton Medical Foundation's board. Form 990, Part VI, Section A, line 7b The following actions are reserved solely to the member: - Appointment and removal of the Foundation's directors. - Approval of borrowing or lending money or the incurrence or guarantee of any debt or other financial obligation, directly or indirectly, by the Foundation that exceeds a financial threshold. - Approval of any strategic plan, business plan, or mission plan of the Foundation, including without limitation authorization of any material changes in the scope of services offered by the Foundation, or any amendments thereto (subject in each case to the right of the Member, as part of the approval process, to make modifications as the Member deems necessary or appropriate). - Any acquisition, purchase, sale, lease, mortgage, or other transfer or encumbrance of any property in excess of a financial threshold (whether or not strictly monetary) established by the Member from time to time or any real property of the Foundation, irrespective of the value and any dissolution, merger, consolidation, sale, or other corporate restructuring of the Foundation. Form 990, Part VI, Section A, line 8b There are no committees that have the authority to act on behalf of the governing board. Form 990, Part VI, Section B, line 11b Each member of the governing Board of Directors and officers are provided with an electronic copy of the Form 990 for review prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c The governing board members are required to complete an annual conflict of interest questionnaire pursuant to written policy. The Board members are precluded from participating in debate and voting on any issue in which the member(s) (or family member) may have a personal or business interest. The Board Chair and/or hospital counsel will determine if there is a conflict. Form 990, Part VI, Section B, line 15 The CEO and CFO are paid by a related management company, BHC MSO, LLC. A related nonprofit organization, Barton Healthcare Systems reviews and approves the compensation for all three board members and officers listed in Part VII. Form 990, Part VI, Section C, line 19 Documents requiring public disclosure are available upon request and are posted on the organization's website: https://www.bartonhealth.org/about-us/barton-990/. Organization contact Mindi Befu 530-543-5601. Part VII The compensation reported on Part VII reflects compensation for services to Barton Healthcare System and related organizations. Form 990, Part IX, line 11g Medical Fees: Program service expenses 537,929. Management and general expenses 0. Fundraising expenses 0. Total expenses 537,929. Support Services Expense: Program service expenses 295,826. Management and general expenses 0. Fundraising expenses 0. Total expenses 295,826. Other Purchased Services: Program service expenses 4,941. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,941. Barton Memorial Hospital Foundation Inc PO Box 529 Zephyr Cove NV 89449 880268799 Fundraising NV 501(c)(3) Line 12a, I Barton Healthcare System 0 Barton Healthcare System PO Box 9578 South Lake Tahoe CA 96158 946050274 Hospital CA 501(c)(3) Line 3 N/A 0 ACO Collaborative LLC 7600 S Minnesota Ave Ste 200 Sioux Falls SD 57108 870984717 Arrange for the provision of Health Care Services DE N/A 0 0 BHC MSO LLC PO Box 9578 South Lake Tahoe CA 96158 853297586 Management Services CA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0