Totals
- Total revenue
- $79,721,172
- Total expenses
- $77,873,461
- Contributions and grants received
- $1,376,957
- Grants paid
- $43,364
- Program service revenue
- $77,769,620
- Investment income
- $14,826
- Other revenue
- $559,769
- Total assets, end of year
- $35,316,975
- Total liabilities, end of year
- $8,021,084
- Net assets or fund balances, end of year
- $27,295,891
- Program services expenses (Part IX)
- $63,665,219
- Management and general expenses
- $14,136,161
- Fundraising expenses
- $72,081
- Program service expenses (Part III)
- $63,665,219
Program services were 81.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Line items
Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.
Revenue
Part VIII, the statement of revenue.
-
1d · Related organizations
$49,290
-
1e · Government grants (contributions)
$1,150,970
-
1f · All other contributions, gifts and grants
$176,697
-
2a · Program service revenue: PATIENT SERVICE REVENUE
total $75,995,419 · related or exempt $75,995,419
-
2b · Program service revenue: PHARMACY CONTRACT REVENUE
total $1,156,436 · related or exempt $1,156,436
-
2c · Program service revenue: OTHER INCOME
total $404,892 · related or exempt $404,892
-
2d · Program service revenue: CAFETERIA
total $212,873 · related or exempt $212,873
-
3 · Investment income
total $14,826 · excluded $14,826
-
6a · Gross rents
real property $41,380
-
6b · Less rental expenses
real property $0
-
6c · Rental income or loss
real property $41,380
-
6d · Net rental income or loss
total $41,380 · related or exempt $41,380
-
11a · Other revenue: INSURANCE RECOVERIES
total $518,389 · excluded $518,389
-
11e · Other revenue, total
$518,389
Functional expenses
Part IX, the statement of functional expenses.
-
2 · Grants to domestic individuals
total $43,364 · program services $43,364
-
5 · Compensation of officers, directors and key employees
total $1,618,115 · program services $1,129,303 · management and general $488,812
-
7 · Other salaries and wages
total $29,233,159 · program services $24,666,743 · management and general $4,513,838 · fundraising $52,578
-
8 · Pension plan contributions
total $608,461 · program services $487,177 · management and general $120,672 · fundraising $612
-
9 · Other employee benefits
total $7,683,470 · program services $4,427,315 · management and general $3,255,720 · fundraising $435
-
10 · Payroll taxes
total $1,974,445 · program services $1,612,392 · management and general $357,805 · fundraising $4,248
-
11a · Fees: management
total $613,438 · management and general $613,438
-
11b · Fees: legal
total $18,808 · management and general $18,808
-
11c · Fees: accounting
total $50,994 · management and general $50,994
-
11g · Fees: other
total $8,511,293 · program services $7,481,546 · management and general $1,029,605 · fundraising $142
-
12 · Advertising and promotion
total $198,397 · program services $99,084 · management and general $97,056 · fundraising $2,257
-
13 · Office expenses
total $198,073 · program services $111,403 · management and general $86,670
-
14 · Information technology
total $1,229,584 · program services $151,126 · management and general $1,078,079 · fundraising $379
-
16 · Occupancy
total $1,469,685 · program services $657,977 · management and general $811,708
-
17 · Travel
total $187,576 · program services $168,293 · management and general $19,162 · fundraising $121
-
20 · Interest
total $138,126 · program services $4,117 · management and general $134,009
-
22 · Depreciation, depletion and amortization
total $925,677 · program services $381,261 · management and general $544,416
-
23 · Insurance
total $749,955 · management and general $749,955
-
24a · Other expenses: MEDICAL SUPPLIES
total $14,233,428 · program services $14,233,428
-
24b · Other expenses: PROVISION FOR BAD DEBTS
total $5,830,756 · program services $5,830,756
-
24c · Other expenses: PROVISION FOR INSURANCE
total $998,967 · program services $998,967
-
24d · Other expenses: FOOD
total $642,466 · program services $597,730 · management and general $33,427 · fundraising $11,309
-
24e · All other expenses
total $715,224 · program services $583,237 · management and general $131,987
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $9,995,491 · end of year $5,408,357
-
2 · Savings and temporary cash investments
beginning of year $192,637 · end of year $0
-
4 · Accounts receivable
beginning of year $18,271,610 · end of year $15,115,099
-
7 · Other notes and loans receivable
beginning of year $236,511 · end of year $319,298
-
8 · Inventories for sale or use
beginning of year $1,715,383 · end of year $1,842,799
-
9 · Prepaid expenses and deferred charges
beginning of year $620,592 · end of year $445,923
-
10a · Land, buildings and equipment: cost or other basis
$15,778,941
-
10b · Land, buildings and equipment: accumulated depreciation
$10,059,820
-
10c · Land, buildings and equipment, net
beginning of year $5,215,534 · end of year $5,719,121
-
15 · Other assets
beginning of year $0 · end of year $6,466,378
-
17 · Accounts payable and accrued expenses
beginning of year $5,332,522 · end of year $4,913,636
-
21 · Escrow or custodial account liability
beginning of year $7,764 · end of year $7,879
-
23 · Secured mortgages and notes payable
beginning of year $3,038,324 · end of year $3,099,569
-
25 · Other liabilities
beginning of year $2,420,968 · end of year $0
-
27 · Net assets without donor restrictions
beginning of year $25,448,180 · end of year $27,295,891
Mission and programs · 2022
Mission
CARING FOR YOU
Activities or mission (Part I)
PROVISION OF HEALTHCARE SERVICES
-
POWELL VALLEY HEALTH CARE, INC. (HOSPITAL) PROVIDES QUALITY CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE THESE ESSENTIAL SERVICES. IT IS THE HOSPITAL'S MISSION TO SERVE THE SURROUNDING AREA BY PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION TO ALL COMMUNITY MEMBERS. DURING THE YEAR ENDED JUNE 30, 2023, THE HOSPITAL PROVIDED $282,634 OF MEDICAL SERVICES, BASED ON THE AMOUNTS OF CHARGES FOREGONE, UNDER THE HOSPITAL'S CHARITY CARE POLICY AND GUIDELINES TO INDIVIDUALS WHO WERE DETERMINED UNABLE TO PURCHASE SUCH SERVICES. IN ADDITION TO FREE CARE AND/OR SUBSIDIZED CARE, CARE IS ALSO PROVIDED AT BELOW COST RATES TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. THE UNREIMBURSED VALUE (BASED ON COST) OF PROVIDING CARE TO ALL PATIENTS WAS $5,936,480 FOR THE YEAR ENDED JUNE 30, 2023. DURING THE FISCAL YEAR ENDED JUNE 30, 2023, THE HOSPITAL PROVIDED 2,736 DAYS OF HOSPITAL SERVICES, THE NURSING HOME PROVIDED 18,989 DAYS OF RESIDENT SERVICES, AND THE ASSISTED LIVING FACILITY PROVIDED 6,441 DAYS OF RESIDENT SERVICES. THE HOSPITAL ALSO PROVIDES COMMUNITY CARE AND SERVICES THROUGH MANY HEALTH ACTIVITIES AND PROGRAMS PROVIDED TO SUPPORT THE COMMUNITY. THESE ACTIVITIES INCLUDE SUPPORT TO HERITAGE HEALTH CENTER CLINIC, A COMMUNITY HEALTH CENTER FQHC, WELLNESS PROGRAM, COMMUNITY EDUCATION PROGRAM, SPECIAL PROGRAMS FOR SPECIFIC PURPOSES, AND A VARIETY OF COMMUNITY SUPPORTED ACTIVITIES.
Expenses $63,665,219 · Grants $43,364 · Revenue $77,811,000
As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.
Listed in Part VII
-
Rj KostRJ KOST
PRESIDENT
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Chris CoxCHRIS COX
VICE PRESIDENT
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Bonita KatzBONITA KATZ
SECRETARY
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Nathaniel Rieb MDNATHANIEL RIEB MD
TREASURER
- Total calculated
- $0
- Hours/week
- 1
-
Syd ThompsonSYD THOMPSON
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Shelly HillSHELLY HILL
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Joni BennettJONI BENNETT
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Scott McKenzieSCOTT MCKENZIE
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Brian JonesBRIAN JONES
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Aaron Billin MDAARON BILLIN MD
DIRECTOR/PHYSICIAN
- Total calculated
- $351,085
- From this org
- $312,966
- From related orgs
- $0
- Other
- $38,119
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $279,313
- Bonus
- $0
- Other
- $33,653
- Deferred
- $8,622
- Nontaxable benefits
- $29,497
- Filer's total
- $351,085
-
Valerie Lengfelder MDVALERIE LENGFELDER MD
DIRECTOR/PHYSICIAN
- Total calculated
- $310,944
- From this org
- $272,099
- From related orgs
- $0
- Other
- $38,845
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $221,806
- Bonus
- $0
- Other
- $50,293
- Deferred
- $9,348
- Nontaxable benefits
- $29,497
- Filer's total
- $310,944
-
Jenkins ClarksonJENKINS CLARKSON
DIRECTOR/PHYSICIAN
- Total calculated
- $467,275
- From this org
- $428,628
- From related orgs
- $0
- Other
- $38,647
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $325,000
- Bonus
- $0
- Other
- $103,628
- Deferred
- $9,150
- Nontaxable benefits
- $29,497
- Filer's total
- $467,275
-
Terry OdomTERRY ODOM
CEO
- Total calculated
- $259,517
- From this org
- $238,769
- From related orgs
- $0
- Other
- $20,748
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $228,161
- Bonus
- $0
- Other
- $10,608
- Deferred
- $7,163
- Nontaxable benefits
- $13,585
- Filer's total
- $259,517
-
Joy CoulstonJOY COULSTON
CFO
- Total calculated
- $229,295
- From this org
- $198,232
- From related orgs
- $0
- Other
- $31,063
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $180,232
- Bonus
- $0
- Other
- $18,000
- Deferred
- $5,947
- Nontaxable benefits
- $25,116
- Filer's total
- $229,295
-
William JarvisWILLIAM JARVIS
PHYSICIAN
- Total calculated
- $905,746
- From this org
- $867,099
- From related orgs
- $0
- Other
- $38,647
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $650,000
- Bonus
- $125,440
- Other
- $91,659
- Deferred
- $9,150
- Nontaxable benefits
- $29,497
- Filer's total
- $905,746
-
Carletta CollinsCARLETTA COLLINS
PHYSICIAN
- Total calculated
- $596,041
- From this org
- $557,394
- From related orgs
- $0
- Other
- $38,647
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $539,834
- Bonus
- $17,560
- Other
- $0
- Deferred
- $9,150
- Nontaxable benefits
- $29,497
- Filer's total
- $596,041
-
Nicole MasonNICOLE MASON
PHYSICIAN
- Total calculated
- $391,625
- From this org
- $352,978
- From related orgs
- $0
- Other
- $38,647
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $221,822
- Bonus
- $107,361
- Other
- $23,795
- Deferred
- $9,150
- Nontaxable benefits
- $29,497
- Filer's total
- $391,625
-
Kelly ChristensenKELLY CHRISTENSEN
PHYSICIAN
- Total calculated
- $424,492
- From this org
- $387,176
- From related orgs
- $0
- Other
- $37,316
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $221,822
- Bonus
- $126,139
- Other
- $39,215
- Deferred
- $12,200
- Nontaxable benefits
- $25,116
- Filer's total
- $424,492
-
Brian KellyBRIAN KELLY
PHYSICIAN
- Total calculated
- $558,631
- From this org
- $519,984
- From related orgs
- $0
- Other
- $38,647
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $519,984
- Bonus
- $0
- Other
- $0
- Deferred
- $9,150
- Nontaxable benefits
- $29,497
- Filer's total
- $558,631
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
- 3 · Approval by the board or compensation committee
- 6a · Pay contingent on this organization's net earnings
Answered no
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
- 4c · Equity-based compensation arrangement
- 5a · Pay contingent on this organization's revenues
- 5b · Pay contingent on a related organization's revenues
- 6b · Pay contingent on a related organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- PART I, LINE 5
- BONUSES ARE CALCULATED AS A PERCENTAGE OF NET REVENUE PER QUARTER PER CONTRACT FOR EACH INDIVIDUAL BASED ON BILLED CHARGES FOR THAT QUARTER.
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
No itemized grants to organizations on this return.
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
POWELL HOSPITAL DISTRICT #1
GOVERNMENT · RELATED - PROVISION OF HEALTH CARE SERVICES · WY
-
501(C)(3) · PROMOTE PUBLIC HEALTH AND IMPROVE FACILITIES AROUND THE CITY OF POWELL, WY · WY
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 7 May 2024
- IRS schema version
- 2022v5.0
- Source object
- 202441299349301984
Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.
The source document this was parsed from is served over the API, which is where bulk and document access live.