2023-11-15T07:47:37-06:00 2022-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2022-01-01 946050274 Barton Healthcare System BART 5305413420 PO Box 9578 South Lake Tahoe CA 96158 Kelly Neiger CFO 5305413420 2023-11-14 1 Kelly Neiger 999009999 1 Kim Hunwardsen P00484560 6122536500 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Clinton Purvance MD PO Box 9578 South Lake Tahoe CA 96158 239154041 0 X www.bartonhealth.org X 1960 CA Barton Health delivers safe, high quality care and engages the community in the improvement of health and wellness. Barton Health is the community health leader known for compassion and chosen for quality. 11 10 1126 135 0 0 5987100 695660 207155820 224035657 12220345 7647683 3234847 384134 228598112 232763134 483618 683061 0 0 94143685 104510981 0 0 0 111822938 126326598 206450241 231520640 22147871 1242494 350905731 337614864 57119233 57769278 293786498 279845586 X Barton Health delivers safe, high quality care and engages the community in the improvement of health and wellness. Barton Health is the community health leader known for compassion and chosen for quality. 0 0 166453916 683061 216509052 Barton Healthcare System (Barton Health) is a 501(c)(3) community health system that includes a licensed 63-bed full-service, general acute care hospital with a 24-hour emergency room; 48 bed skilled nursing and long-term care facility; and 23 ambulatory outpatient clinics. Barton Health is a bi-state health system serving the greater Lake Tahoe region in addition to transient-based patients. Nine ventilators and eight emergency rescue ventilators were also on-hand.Barton Health provides exceptional medical care regardless of an individual's ability to pay.Continued on Schedule O...The following programs are community outreach programs that benefit the health of Barton Health Lake Tahoe South Shore Community.Community health events: Barton Health provides free or discounted services at community health events including community health fairs, lab draws, mammograms, EKG tests, vaccination clinics, cancer wellness program, and community event medical services.Youth programs: Barton Health promotes health within youth populations through programs that educate about the ramifications of drug and alcohol use; drunk driving; the sponsorship of youth activities that promote health; free sports physicals; sports injury prevention; and health career promotion activities.Community health education programs: mailed community newsletter, mailed community benefit report, free online e-newsletters and health library; childbirth education classes; child/infant CPR and first-aid; new mom's support program; and free virtual community health webinar series.Collaboration: collaborated with El Dorado County regarding public and private agencies to create healthier communities especially within our vulnerable populations; telehealth for Tahoe that brings additional specialty health accessible through telemedicine; and hosting and chairing the Emergency Management Community Council that meets with area agencies every other month to discuss emergency preparedness and education within our community. Barton additionally partners with Covered California as a certified enrollment entity that assists residents with enrolling for health coverage at no cost.Community health improvement efforts: Barton leads the Community Health Advisory Committee (25-member all volunteer community board) which is focused on identifying and then addressing unmet health needs. Barton participates in the Behavioral Health Network (25-member all-volunteer community advisory board) which is focused primarily on identifying and addressing the gaps in our community's mental health services. In addition, the Barton Foundation funds the Barton Health grants program which provides $100,000 annually to area nonprofits that provide programs and services that closely align with our community's needs. 6846942 7125107 The Barton Community Health Center provides routine medical care to Medicare and Medi-Cal beneficiaries, those with insurance but very high deductibles or those who are uninsured. Same day appointments are usually available which improves medical outcomes. The Barton Community Health Center combines the efforts of numerous skilled professionals including nurse practitioners, physician assistants, medical assistants, nurses, other medical support staff, and contracts with family and specialty physicians. Specialty physicians who see patients at the clinic include pediatrics, sleep medicine, orthopedics, obstetrics, gynecology, child psychiatry, adult psychiatry, ADHD Continued on Schedule O...treatment, urology, ENT, dermatology, infection disease, psychology, rheumatology, endocrinology, and neurology. Patients are sometimes undocumented migrant workers not eligible for Medi-Cal or are insured low-income patients with very high deductibles. Underinsured and uninsured private pay patients are charged on a sliding scale based on income and services provided. Barton's Community Health Center serves as a gateway for patients in need of health care including those seeking family planning services, preconception information and referrals for sterilization, Level 1 infertility services, STD treatment, referrals for HIV services and screening for DES (diethylstilbestrol) exposure. 5526965 The Helping Hands program assists patients of Barton Memorial Hospital with their medical bills. It matches the patients' ability to pay according to their unique circumstance. Patients are asked to complete an application and provide financial information about their income to determine their ability to pay. The discount patients receive on their medical bill depends on their adjusted gross income compared with the U.S. Department of Health & Human Services poverty income guidelines. The program is designed for those patients who cannot afford their medical bills. Barton Health provides discounts for those with incomes up to 400 percent of the most recent poverty income guidelines, and/or under special circumstances. During the current year this program provided over $5.5 million of gross charges in charity care. 178827823 1 1 0 1 0 0 0 1 0 1 1 0 1 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 0 0 1 248 0 1 1126 1 0 0 0 0 0 0 0 0 0 0 1 0 X 11 10 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 1 1 CA X X Kelly Neiger 5305413420 PO Box 9578 South Lake Tahoe CA 96158 Wendy David Chairperson 5.00 0.00 X X 0 0 0 Abby Killebrew Vice Chairperson/Secretary 5.00 0.00 X X 0 0 0 Kirk Ledbetter Trustee 5.00 0.00 X 0 0 0 Charles Scharer Trustee 5.00 0.00 X 0 0 0 Patrick Fry Trustee 5.00 0.00 X 0 0 0 Stefan Schunk Trustee 5.00 0.00 X 110655 0 0 Shawn Anderson Trustee 5.00 0.00 X 0 0 0 Baghdassar Pat Baghkikian MD Trustee 5.00 0.00 X 0 0 0 Sherry Milynsky Trustee (as of May) 5.00 0.00 X 0 0 0 Kathryn Biasotti Trustee 5.00 0.00 X 0 0 0 Jeff Rahbeck Trustee 5.00 0.00 X 0 0 0 Clinton Purvance MD CEO 37.00 3.00 X 0 1150056 55076 Kelly Neiger CFO 37.00 3.00 X 0 559498 53253 Matthew Wonnacott CMO 38.00 2.00 X 671492 0 46043 Julie Clayton CNO (thru Oct) 40.00 0.00 X 718531 0 33529 Sioban Keller Director of Surgical Services 40.00 0.00 X 253855 0 48785 Thomas Davis Admin Director of Ancillary Services 40.00 0.00 X 204516 0 38814 Karen Conant Director of Ambulatory Operations 40.00 0.00 X 186347 0 47855 Jeffrey Koeck Directory of Pharmacy 40.00 0.00 X 248087 0 45275 Christopher Kiser Director of Foundation 0.00 40.00 X 249250 0 47435 Jennifer Whisnant Pulmonary Services Supervisor 40.00 0.00 X 252089 0 46183 Blair Caley RNFA 40.00 0.00 X 260799 0 34413 Julie Howes Controller 40.00 0.00 X 116521 148930 21035 3272142 1858484 517696 279 0 1 0 Tahoe Carson Valley Medical Group Inc 2155 South Ave Ste 24 South Lake Tahoe CA 96150 Physician Services 19048772 FocusOne Solutions LLC 13609 California Street Omaha NE 68154 Staff Labor Services 7205961 Tahoe Orthopedics & Sports PO Box 11889 Zephyr Cove NV 89448 Physician Services 4930884 HealthSource Global Staffing Inc 2735 Collection Center Drive Chicago IL 60693 Staff Labor Services 4554082 Lake Tahoe Orthopedic Institute Inc PO Box 11889 Zephyr Cove NV 89448 Physician Services 2446529 38 348024 124824 222812 222812 695660 Net Patient Service Revenue 621990 218044653 218044653 Supporting Revenue 621990 2958730 2958730 Investment in Washoe Barton Medic 621110 2928776 2928776 Cafeteria 722514 397620 397620 Investment in ACO Collaborative 621110 -294122 -294122 224035657 2513809 2513809 384134 0 384134 384134 384134 4015281 7509500 3774193 2616714 241088 4892786 5133874 5133874 232763134 223638037 0 8429437 X 643534 643534 39527 39527 2360421 1752984 607437 117347 117347 79620122 58018683 21601439 2369723 1643436 726287 14248438 9846684 4401754 5794930 4195302 1599628 829914 452 829462 101180 101180 212260 212260 59309255 48727756 10581499 476420 476420 7718358 4378445 3339913 4535677 640320 3895357 4037312 1762084 2275228 142441 79300 63141 521630 521630 11738465 11221884 516581 1387706 1387706 Medical Supplies 25889186 25546512 342674 Relief Expense 6251977 5839837 412140 Non-Medical Supplies 2982944 2389874 593070 Bad Debt Expense 191873 191873 231520640 178827823 52692817 0 21500445 10440937 3399868 34410926 45145115 150000 150000 4192255 4213276 3249497 3361523 251371393 134739983 121283545 116631410 54418166 87123526 44600449 3729808 47744218 49345710 15956362 17473559 350905731 337614864 25185922 22408183 12716004 8640799 3505221 15700000 15712086 11020296 57119233 57769278 X 293786117 279845586 381 0 293786498 279845586 350905731 337614864 1242494 -15183406 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 1 44495 44495 0 Part II-B, Line 1: Written correspondence for advocacy efforts in conjunction with California Hospital Association for issues affecting our hospital; may include in person meetings as part of legislators' outreach efforts. 122999 X 0 3969431 22411 3991842 3956933 12798 3969731 3848820 107813 176165 176165 3956633 3816534 28286 220734 216734 3848820 3738620 81914 152556 156556 3816534 0.00000 1.00000 0.00000 0 1 1 23902299 7245041 31147340 119533787 61140991 58392796 6075367 3209040 2866327 87096894 67585766 19511128 122999 7395006 2804186 4713819 116631410 Investment in Washoe Barton Medical Clinic 49708550 C ACO Collaborative LLC Stock 5500 C Investment in BHC MSO LLC -368340 C 49345710 California Hospital Fee Program Receivable 11782432 Right of Use Assets 2843381 Deposits 837208 Other Receivables 2010538 17473559 Due to Third Party Payors 1369159 Claims Reserve 5910185 Lease Obligations 2843381 457b Plan Payable 930662 Other Long Term Obligations 200000 Due to/from Related Parties -233091 11020296 X Part III, Line 4: General photographs, paintings, etc. on display for our patients and guests. Part V, Line 4: Barton Memorial Hospital Foundation, Inc., a related 501(c)(3) entity, holds an endowment fund in which the earnings are used to support Barton Healthcare System. Part X, Line 2: The Hospital believes that they have 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 Hospital 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. Central America and the Caribbean 0 0 Investment 3628407 0 0 0 0 0 0 3628407 0 3628407 1 0 1 1 0 0 Part III Accounting Method: Schedule F, Part IV: The Barton Healthcare System reviews its direct and indirect investments during the tax period for determining required foreign filings. The Barton Healthcare System makes direct and indirect transfers to a foreign corporation. The Barton Healthcare System would file Form 926 if the transfers met the requirements for filing. The Barton Healthcare System's transfers to foreign corporations did require filing Form 926. The Barton Healthcare System has ownership interests in a foreign corporation. The Barton Healthcare System would file Form 5471 if the ownership met the requirements for filing. The Barton Healthcare System's ownership in foreign corporations did not require filing Form 5471. The Barton Healthcare System invests in a corporation that holds direct or indirect interests in passive foreign investment companies (PFICs). The Barton Healthcare System would file Form 8621s for underlying investments that generate unrelated business income. The Barton Healthcare System would not file Form 8621s where the investment partnerships have properly filed Form 8621s, or where the underlying investments did not generate any unrelated business income. The Barton Healthcare System did not require filing Form 8621. 1 1 X 1 X 1 X 1 1 0 1 1 1807000 1807000 0.00780 30921214 24160517 6760697 0.02920 32728214 24160517 8567697 0.03700 1011518 364644 646874 0.00280 550777 299229 251548 0.00110 17108012 3115249 13992763 0.06050 208663 208663 0.00090 18878970 3779122 15099848 0.06530 51607184 27939639 23667545 0.10230 154175 154175 0.00070 1060594 12357 1048237 0.00450 2153960 788518 1365442 0.00590 473968 473968 0.00200 3842697 800875 3041822 0.01310 1 23000883 2949426 19529325 28723179 -9193854 X 1 1 1 1 Barton Memorial Hospital 2170 South Avenue South Lake Tahoe CA 96150 www.bartonhealth.org 030000013 X X X Barton Memorial Hospital 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X See Part V, Page 8 X X 1 21 1 See Part V, Page 8 0 1 X 100.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X 1 X 0 X X X X 1 X 0 0 Barton Memorial Hospital Part V, Section B, Line 5: A community health phone survey was conducted to record community feedback. The sample design used for this effort consisted of a stratified random sample of 400 individuals age 18 and older in the primary service area, separated into four sub-communities. Once the interviews were completed, these were weighted in proportion to the actual population distribution so as to appropriately represent the primary service area as a whole. All administration of the surveys, data collection and data analysis was conducted by PRC. Additionally, to solicit input from key informants, those individuals who have a broad interest in the health of the community, an online key informant survey also was implemented as part of this process. Barton Memorial Hospital Part V, Section B, Line 7d: Community presentations to chamber leadership, Barton auxiliary, city council, community benefit organizations, service clubs, etc. Barton Memorial Hospital Part V, Section B, Line 11: In our most recent CHNA our community highlighted the following 12 areas of opportunity for our hospital: Improving access to health care services, providing and educating about the benefits of colorectal cancer screening, providing and educating on care related to diabetes management, providing education about heart disease and stroke, expanding prenatal care, expanding services and education related to mental health, providing nutrition and physical activity services, providing education related to high-impact chronic pain, continue providing education and medical services related to COVID-19, expanding treatment and education related to substance abuse and educating on the harms caused by the use of vaping products. Our organization has strategies in place to address each of the 12 needs identified, but in the last year our focus has been on the top three priorities: improving access to healthcare, substance abuse and mental health. These priorities were ranked by our Community Health Advisory Committee which is made up of community-based agencies, health system leaders, and governmental partners. They based their rankings on scope and severity, prevalence, and ability to impact.In 2022 Barton Health achieved the following goals as part of our organizational strategic plan:1. Increased the number of patients with assigned Barton primary care providers by 300.2. Analyzed the average lead time for all ambulatory practices in order to establish a baseline of measurement.3. Increased the number of patients attending annual wellness visits by 2% each: 2% for Medicare Annual Wellness Visits and 2% for Well Child Checks 4. Increased depression screenings in primary care offices by 3%.5. Recruited and hired an additional mental health provider to increase access to mental health services.6. Created a mental health subcommittee that will serve as a working group within the Community Health Advisory Committee. 7. Organized two community talks educating the community on substance use. Barton Memorial Hospital Part V, Section B, Line 13b: In addition to the FPG, the Hospital considers if the patient is uninsured and/or underinsured when determining if they qualify for free care or discounted care. Form 990, Schedule H, Part V, Line 7a: https://www.bartonhealth.org/about-us/caring-for-our-community/community-health-needs-assessment/ Form 990, Schedule H, Part V, Line 10a: https://www.bartonhealth.org/about-us/caring-for-our-community/community-health-needs-assessment/ Form 990, Schedule H, Part V, Line 16a, FAP Website: https://www.bartonhealth.org/patients-family/billing-financial-services/financial-aid/ Form 990, Schedule H, Part V, Line 16b, FAP Application Website: https://www.bartonhealth.org/patients-family/billing-financial-services/financial-aid/ Form 990, Schedule H, Part V, Line 16c, FAP Plain Language Summary: https://www.bartonhealth.org/patients-family/billing-financial-services/financial-aid/ 23 1 - Barton Center of Orthopedics & Wellness 2170 B South Avenue South Lake Tahoe CA 96150 Orthopedics/Rehab/Performance/Fitness/Rheumatology 2 - Lake Tahoe Surgery Center 212 Elks Point Road Ste 201 Zephyr Cove NV 89448 Ambulatory Surgery Center 3 - Barton Community Health Center 2201 2209 South Avenue South Lake Tahoe CA 96150 Rural Family Health Clinic 4 - Barton Multi-Specialty Clinic 1139 Third Street South Lake Tahoe CA 96150 General Surgery/Gastroenterology/Cardiology/Oncology/Plastic Surgery 5 - Barton Family Medicine 1080 Third Street South Lake Tahoe CA 96150 Family Practice Clinic 6 - Tahoe Orthopedic & Sports Medicine 935 Mica Drive Bldg C Ste 13 14 Carson City NV 89705 Orthopedic Clinic 7 - Tahoe Orthopedic & Sports Medicine 212 Elks Point Road Ste 200 Zephyr Cove NV 89448 Orthopedic Clinic 8 - Barton Urgent Care & Occupational Health 155 Highway 50 Stateline NV 89449 Urgent Care/Occupational Health Clinic/Employee Health 9 - Primary Care at Stateline 165 Highway 50 Stateline NV 89449 Family Medicine 10 - Barton Home HealthHospicePalliative 2092 Lake Tahoe Blvd Suite 500 South Lake Tahoe CA 96150 Home Health/Hospice Services/Advanced Care 11 - Barton Ear Nose & Throat 2169 South Ave South Lake Tahoe CA 96150 ENT/Audiology Clinic 12 - Tahoe Orthopedic & Sports Medicine 925 Tahoe Blvd Units 105-106 Incline Village NV 89451 Orthopedic Clinic 13 - Behavioral Health and TeleMedicine 2209 South Ave South Lake Tahoe CA 96150 Psychiatry and Telemedicine 14 - Barton Primary Care 1108 4th Street South Lake Tahoe CA 96150 Family Medicine 15 - Barton Cardiology and Physiatry 155 Highway 50 Ste 203 Stateline NV 89449 Cardiology/Physiatry 16 - Barton Medical Clinic Kirkwood Mtn 1501 Kirkwood Meadows Drive Kirkwood CA 95646 Medical Ski Clinic 17 - Barton Psychiatry 155 Highway 50 Stateline NV 89449 Psychiatry Clinic 18 - Barton Urology 2169 South Ave South Lake Tahoe CA 96150 Urology Clinic 19 - Barton Obstetrics & Gynecology 897 Ironwood Dr Minden NV 89423 Obstetrics/Gynecology 20 - Barton Home Health & Hospice 155 Highway 50 Stateline NV 89449 Home Health/Hospice Services Care 21 - Barton Women's Health 2175 South Avenue South Lake Tahoe CA 96150 Obstetrics/Gynecology 22 - Barton Neurology 1067 Fourth Street South Lake Tahoe CA 96150 Neurology 23 - Barton Mem Clinic Sierra-At-Tahoe 1111 Sierra-At-Tahoe Road Twin Bridges CA 95735 Medical Ski Clinic Part I, Line 7: The costing methodology used the overall cost to charge ratio obtained for each patient segment and applied against gross charges from the cost report. This ratio was used for lines 7a, 7b and 7g. Actual operating costs were used to calculate lines 7e, 7f, and 7i. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 191,873. Part I, Line 6a: The organizations' commnunity benefit report can be found at https://www.bartonhealth.org/about-us/caring-for-our-community/. Part II, Community Building Activities: Community SupportFood Insecurity Program: We continued our partnership with Whole Foods and Starbucks while expanding our distribution of high-quality food to local pantries, individuals, families, and faith-based organizations. We expanded our food distribution from 3 to 5-days per week (T, W, TH ,F and SUN) as well as adding additional dates as necessary when our partners were not able to pick up. Homelessness: Barton participated in South Tahoe Alternative Collaborative Services (STACS). a community stakeholder group led by our local police department and homelessness advocates (Tahoe Coalition for the Homeless). The purpose of this group is to create infrastructure to coordinate appropriate interventions for this vulnerable group of community members during time of crisis, create trust building opportunities, and link the relevant community agencies to create a "no wrong door" network.Emergency Management Preparedness: Barton Health chairs and hosts the emergency management community council. This council meets every other month with area agencies to discuss emergency preparedness and education to the south Lake Tahoe community. Exercise drills, emergency preparedness materials and other programs come out of this group. The group was designed with the health and safety of our community in mind. The group includes representatives from Barton Health, Red Cross, El Dorado County Health and Human Services, area fire departments, police, sheriff, Ham radio, school districts, public utilities and other representatives who would have a response capability in our community. The purpose is to protect the health of our community by being prepared for disasters, and knowing our emergency partners in the event of an emergency to better form a cohesive response in the South Lake Tahoe area, which will assist in getting the community back on its feet after a disaster. The impact of this program is the coordination amongst local emergency providers to ensure emergency readiness for the next local disaster. Barton Health further supports various organizations by providing health grants, sponsorships, and other support. Barton Health additionally assists our needy patients by assisting with transportation costs and medication.Coalition buildingSocial Determinants of Health: Barton participated in and financially supported the following community-based programs related to environmental factors that influence our community members health and wellness.Transportation: South Shore Transit Management Association-A volunteer board that has created a free micro transit service (Lake Link) designed to serve at-risk populations and provide transportation to and from work, medical care, and basic services.Housing Instability: Tahoe Prosperity Center-Participation in a multi-year advisory board working to provide affordable housing in the Lake Tahoe Basin.Housing Instability: Saint Joseph Land Trust-participation in a working group as part of the Sugar Pine Village project. A 248 unit affordable housing complex that includes access to key social determinants of health (SDOH) services for all residents on site and is part of Governor Newsom's Executive Order promoting affordable housing development.Healthcare Disparity: Barton participated in two steering committees that help serve our Latino community members. The Multicultural Celebration provided the opportunity to educate our community members about the health system's offerings as well as eliminate real or perceived barriers to access appropriate care. The Multicultural Alliance is a subcommittee led by the City of South Lake Tahoe that seeks to engage our Latino community on pressing issues in our South Lake Tahoe and trust build for future relationships and initiatives.Community Health Improvement Advocacy: Barton leads the Community Health Advisory Committee (25-member all volunteer community board) which is focused on identifying and then addressing unmet health needs. Barton facilitated a stakeholder workgroup to re-engage with the Behavioral Health Network leaders. This 12-person working group is focused primarily on identifying and addressing the gaps in our community's mental health services and now reports as a subcommittee of the Community Advisory Committee.Workforce Development: Barton Health facilities are designated as a Health Professional Shortage Area (HPSA) and to maintain patient access to essential services in our community, the organization incurs recruitment costs for various providers. Part III, Line 2: The organziation determines its estimate of implicit price concessions based on its historical collection experience with each class of patients and residents.Includes implicit price concessions estimate of $22,687,892 and bad debt expense of $312,991. Part III, Line 3: The portion of implicit price concessions that could be community benefit is calculated by multipling the portion of line 2 that is just implicit price concessions by the 13% of the population considered to be under the 200% Federal Poverty Guidelines per Schedule H, Part VI, Line 4 narrative. Part III, Line 4: The footnote to the organization's financial statements that describes implicit price concessions is located on page 14-15 of the attached financial statements. Part III, Line 8: The Organization provides a broad range of services to its Medicare patients without regard to revenue realized from the services provided.The Organization is a rural hospital with the nearest additional hospital approximately 36 miles away. Costs excluded from the organization's Medicare cost report include costs associated with physician clinics, the auxiliary, community relations, and other non-reimbursable costs. The Organization utilizes the cost to charge ratio as provided in its annual cost report.Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall, if any, is considered a community benefit. Part III, Line 9b: 1. ECAs may begin only when 120 days have passed since the first post-discharge statement was provided. However, at least 30 days before initiating ECAs to obtain payment, Barton Health shall do the following: - Provide the individual with a written notice that indicates the availability of financial assistance, lists potential ECAs that may be taken to obtain payment for care and gives a deadline after which ECAs may be initiated. - Provide a plain-language summary of the FAP, along with the notice described above. - Attempt to notify the individual orally about the FAP and how he or she may get assistance with the application process.2. After making reasonable efforts to determine financial assistance eligibility as outlined above, Barton Health (or its authorized business partners) may take the following ECA to obtain payment for care: - Report adverse information to credit reporting agencies and/or credit bureaus. - Litigation.3. If a patient has an outstanding balance for previously provided care, Barton Health may engage the ECA process for deferring, denying, or requiring payment before providing additional medically necessary (but non-emergent) care only when the following steps are taken: - Barton Health provides the patient with a FAP application and a plain language summary of the FAP. - Barton Health provides a written notice indicating the availability of financial assistance and specifying any deadline, after which a completed application for assistance for the previous care episode will no longer be accepted. This Application period is the later of 30 days after the notice date or 240 days after the first post-discharge billing statement for prior care, whichever is later. - Barton Health makes a reasonable effort to orally notify the individual about the financial assistance policy and explain how to receive assistance with the application process. - Barton Health processes on an expedited basis any FAP applications for previous care received within the stated deadline. - Final authority in determining whether an individual is FAP- eligible will be made by the financial assistance committee. The committee includes but is not limited to the CFO, the Revenue Cycle Director, the Manager of Patient access, the Manager(s) of Patient Financial Services, the Patient Access Supervisor, and the Financial Counselor. - If an application for Financial Assistance is received but is incomplete, a letter will be sent to the patient outlining what is missing from the application. The application will be pended for two weeks to allow time for response. If the additional information is not received within two weeks, Barton will send a denial letter to the patient stating that the application was not complete and the missing information was not received. Part VI, Line 2: Barton Health is a member of numerous community collaboratives working to address the health needs in our community. Barton participates in the Community Behavioral Health Network Committee which focuses on coordinating mental health services amongst our community providers. We lead the Community Health Advisory Committee, with our top three health priorities determining how funding and resources are utilized. Additionally, we attend the monthly Lake Tahoe collaborative, focusing on collaborations for youth; and we fill the healthcare seat on our community's drug-free community coalition. Part VI, Line 3: Every self-pay patient is screened for eligibility under our financial assistance policy which begins at admission or when otherwise feasible. In addition, reference to our financial assistance program is posted at the emergency room and admitting departments, disclosed on our website, referenced to in the patient handbook, and on patient billing statements. Part VI, Line 4: The primary service area for Barton Memorial Hospital sits within the Sierra Nevada Mountains on the border between California and Nevada. This area encompasses the South Lake Tahoe Basin from Tahoma, CA on the west through Glenbrook, NV on the east. The demographics for this area are as follows: approximately 54% male, 46% female, 20.6% under the age of 18, 11.6% aged 18-24, 30.0% aged 25-44, 28.1% aged 45-64 and 9.8% who were 65 years of age or older; 63.5% are Caucasian and 28% are Hispanic, and 8.5% represent other races, 13% of the community is low income below the 200% federal poverty level. Part VI, Line 5: As described in the Community Benefit section of the 990, Barton Health contributes to our community's health in a variety of ways: our governing body is represented by individuals of our community. Surplus funds are used to maintain a high level of patient care through reinvestment. Barton Health has on open medical staff with privileges available to all qualified physicians in the area. Our laboratory offers discounted lab draws; numerous physicians and employees participate in our free community wellness lectures; our emergency department participates in youth education programs and the drug store project; many of our nurses and practitioners participate in offering medical coverage for special events throughout the community; Barton primary care offer free student sports physicals; Barton Health donates to and sponsors youth programs and local non-profit organizations; staff from various departments like Barton education, family birthing center, Barton rehabilitation participate in community events and have information and educational booths for the community; Barton Memorial Hospital operates an emergency room available to all regardless of ability to pay.In October 2022, Barton hosted a Community Health Fair at Bijou Elementary School with approximately 200 community members in attendance. The purpose of the fair was to meet underserved segments of our community where they live, and offer health services, free of cost. Free services included flu & COVID vaccines, blood pressure checks, glucose testings, hearing screenings, osteoporosis screenings, Covered CA enrollment assistance, CPR training and community agency booth participation. Part VI, Line 7, Reports Filed With States CA 1 Bread & Broth 1041 Lyons Ave South Lake Tahoe CA 96150 453954503 501(c)(3) 10000 0 Community grant Family Resource Center 3501 Spruce Ave B South Lake Tahoe CA 96150 942284118 501(c)(3) 10000 0 Community grant Lake Tahoe Wildlife Care Inc PO Box 18530 South Lake Tahoe CA 96151 942799765 501(c)(3) 0 53881 Book Value Excess Supplies Supplies donated to Wildlife Ctr Tahoe Coalition For The Homeless PO Box 13514 South Lake Tahoe CA 96150 474825924 501(c)(3) 10000 0 Community grant SOS Outreach PO Box 2020 Avon CO 81620 841332544 501(c)(3) 10000 0 Community grant Mountain High Recovery Center PO Box 19007 South Lake Tahoe CA 96151 843156753 501(c)(3) 9255 0 Community grant Live Violence Free 2941 Lake Tahoe Blvd South Lake Tahoe CA 96150 942598256 501(c)(3) 10000 0 Community grant Encompass Youth PO Box 10264 South Lake Tahoe CA 96158 872603862 501(c)(3) 10000 0 Community grant Barton Memorial Hospital Foundation PO Box 529 Zephyr Cove NV 89448 880268799 501(c)(3) 474398 0 Overhead Funding Tahoe Fund PO Box 7124 Tahoe City CA 96145 010974628 501(c)(3) 10000 0 Annual Dinner Sponsor El Dorado Community Foundation 312 Main St 201 Placerville CA 95667 680255556 501(c)(3) 8500 0 Community grant Lake Tahoe Community College One College Dr South Lake Tahoe CA 96150 800543620 State of CA 12500 0 Wellness Program 12 0 Patient Assistance 399 36527 Athletic Sponsorships 3 3000 Part I, Line 2: The Organization pays the general overhead expenses of BMH Foundation (a related 501(c)(3)). For 2022 - the total amount funded was $474,398. The organization provides assistance to various patients in need including prescription medication, taxi fare, lodging, etc. Total patient assistance provided during 2022 totaled $36,527. Additionally, funds donated to various community groups totaled $169,136. X X X X X 1 1 0 0 0 0 0 0 0 Clinton Purvance MD CEO 0 655105 0 491932 0 3019 0 15250 0 39826 0 1205132 0 0 Julie Clayton CNO (thru Oct) 332585 0 193744 0 192202 0 13221 0 20308 0 752060 0 0 0 Matthew Wonnacott CMO 478327 0 190146 0 3019 0 15250 0 30793 0 717535 0 0 0 Kelly Neiger CFO 0 400620 0 155859 0 3019 0 11389 0 41864 0 612751 0 0 Sioban Keller Director of Surgical Services 222090 0 29720 0 2045 0 11692 0 37092 0 302639 0 0 0 Jennifer Whisnant Pulmonary Services Supervisor 243348 0 8741 0 0 0 4337 0 41846 0 298272 0 0 0 Christopher Kiser Director of Foundation 221214 0 25953 0 2083 0 10583 0 36851 0 296684 0 0 0 Blair Caley RNFA 255704 0 5095 0 0 0 13118 0 21295 0 295212 0 0 0 Jeffrey Koeck Directory of Pharmacy 227420 0 18405 0 2262 0 6732 0 38543 0 293362 0 0 0 Julie Howes Controller 102782 119799 12762 27973 977 1158 5806 3957 4938 6335 127265 159222 0 0 Thomas Davis Admin Director of Ancillary Services 197424 0 5212 0 1880 0 10425 0 28390 0 243331 0 0 0 Karen Conant Director of Ambulatory Operations 158118 0 26695 0 1534 0 9609 0 38246 0 234202 0 0 0 Part I, Lines 4a-b Line 4a: Julie Clayton, Chief Nursing Officer, received a severance payment in the amount of $111,950. Line 4b: Clinton Purvance received payments of $119,168 from a related organization, BHC MSO, LLC, for participation in a 409(a) plan. This is reported on Part II column (ii). A City of South Lake Tahoe 941610868 000000000 2014-06-12 18000000 Equipment 0 0 0 A 9359201 18000000 249697 17750303 2017 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 Michael Neiger Spouse of Officer - Kelly Neiger, CFO 117347 Employee 0 Michael Fry Family member of Board Trustee, Patrick Fry 20506 Independent Contractor 0 X 222812 Thrift Shop Value 0 0 1 0 Form 990, Part VI, Section A, line 2 Kirk Ledbetter and Jeff Rahbeck have a business relationship. Form 990, Part VI, Section A, line 6 There are two classes of members in the Organization: voting members and associate members. Class I voting members are those who have contributed $200 or more prior to July 11, 1986. Each class I voting member has the right to cast one vote, but not more than five votes for each $200 contribution. Class II voting members are those individuals admitted after July 10, 1986 who have contributed $1,500 or more. Each class II voting member has the right to cast one vote, but not more than five votes, for each $1,500 contribution. Associate members do not have voting rights. Members do not have the right to approve significant decisions nor receive distributions upon dissolution. Form 990, Part VI, Section A, line 7a The Chairman of the organization shall appoint a committee of not more than five or less than three members to serve as a nominating committee in the election of the Board of Directors. Any seven members may also nominate candidates for Director. If more people are nominated for the Board than can be elected, members are permitted to vote and the candidates receiving the highest number of votes shall be elected. Form 990, Part VI, Section A, line 7b Bylaw amendments are subject to approval by the voting members. Form 990, Part VI, Section A, line 8b There are no committes 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 a family member) may have a personal or business interest. The Board Chair and/or Hospital counsel will determine if there is a conflict. Employees are provided with a copy of the conflict of interest policy that is within ane electronic policy software program that requires employees to mark as read as new hires or as changes are made and monitored by their immediate supervisors. Employees are required to be familiar with the policy at all times. They do not formally review the policy annually but are required to still disclose any potential conflicts that may arise. Form 990, Part VI, Section B, line 15 The CEO is paid by a related management company, BHC MSO, LLC. The organization engaged an independent firm to conduct an executive compensation survey. The independent firm issued a certification of reasonableness upon comparing executive compensation with similar organizations. The compensation committee consisting of board members reviews the CEO compensation and approves changes to the executive team's contracts. The committee substantiates this process in their minutes. The CEO approves the compensation for the remaining executive team using data obtained from annual surveys performed by the California Healthcare Association and/or independent compensation evaluation firms as well as comparisons of specific compensation of executives from similar-sized hospitals both in California and nationwide. Barton Healthcare System is a bi-state healthcare provider that includes a licensed 63-bed full-service hospital with a 24-hour emergency room; designated level III trauma center; 48-bed skilled nursing and long-term care facility; state of the art operating rooms and rehabilitation departments; center of orthopedics and wellness; home health, hospice and palliative care services; Lake Tahoe surgery center; 50% ownership in Carson Valley Medical Center (a full-service hospital located in the Carson Valley); satellite lab facilities; Barton education (providing clinical and community health education); Barton auxiliary; and Barton Memorial Hospital Foundation (a 50l(c)(3) supporting organization). The system further includes 23 outpatient physician clinics which encompass orthopedic clinics, OB/GYN clinics, pediatrics, internal medicine, performance, multi-specialty general surgery/GI, plastic surgery, rheumatology/wellness, physiatry, palliative care, cardiology, neurology, urology, ENT/audiology, urgent care/occupational health clinics, family care clinics, low-income rural health clinic, behavioral health and seasonal ski clinics. 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. Form 990, Part IX, line 11g Consulting: Program service expenses 354,177. Management and general expenses 2,775,592. Fundraising expenses 0. Total expenses 3,129,769. Other Purchased Services: Program service expenses 7,226,515. Management and general expenses 7,385,247. Fundraising expenses 0. Total expenses 14,611,762. Medical - Physicians and Directorships: Program service expenses 31,290,398. Management and general expenses 355,095. Fundraising expenses 0. Total expenses 31,645,493. Other Medical Services: Program service expenses 1,860,595. Management and general expenses 65,565. Fundraising expenses 0. Total expenses 1,926,160. Medical - Contracted Housing: Program service expenses 15,422. Management and general expenses 0. Fundraising expenses 0. Total expenses 15,422. Medical - Contracted Education & Travel: Program service expenses 3,475. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,475. Purchased RN Personnel Services: Program service expenses 7,977,174. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,977,174. Accountable Care Collaborative LLC 155 Highway 50 PO Box 5637 Stateline NV 89449 853358643 Operate accountable care organization DE -294122 5500 Barton Healthcare System Barton Memorial Hospital Foundation Inc PO Box 50 Stateline NV 89449 880268799 Supporting Organization NV 501(c)(3) Line 12a, I Barton Healthcare System 1 Barton Medical Foundation PO Box 529 Zephyr Cove NV 89448 853977236 Provides Medical Services CA 501(c)(3) Line 3 Barton Healthcare System 1 ACO Collaborative LLC 7600 S Minnesota Sioux Falls SD 57108 870984717 Arrange for the provision of health care services DE Barton Healthcare System Related 5000 0 1 0.50000 BHC MSO LLC PO Box 9578 South Lake Tahoe CA 96158 853297586 Management Services NV Barton Healthcare System C 3631420 831823 1.00000 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 Barton Memorial Hospital Foundation B 474398 Book Value/Actual Barton Memorial Hospital Foundation C 348024 Book Value/Actual Barton Memorial Hospital Foundation Q 410931 Book Value/Actual Barton Medical Foundation Q 711049 Book Value/Actual Barton Medical Foundation P 295826 Book Value/Actual ACO Collaborative LLC P 294122 Book Value/Actual BHC MSO LLC P 3650284 Book Value/Actual BHC MSO LLC C 60755 Book Value/Actual