Form 990 for tax year 2022

Revenue

Part VIII, the statement of revenue.

• 1d · Related organizations

  $34,916

• 1e · Government grants (contributions)

  $95,610

• 1f · All other contributions, gifts and grants

  $1,958

• 2a · Program service revenue: MEDICARE/MEDICAID

  total $34,328,366 · related or exempt $34,328,366

• 2b · Program service revenue: NET PATIENT SERVICE REVENUE

  total $32,579,015 · related or exempt $32,579,015

• 2c · Program service revenue: 340B REVENUE

  total $754,772 · related or exempt $754,772

• 2d · Program service revenue: SCHOOL REHAB REVENUE

  total $158,903 · related or exempt $158,903

• 2f · All other program service revenue

  total $381,336 · related or exempt $381,336

• 3 · Investment income

  total $688,373 · excluded $688,373

• 7b · Less cost or other basis and sales expenses

  other assets $37,107

• 7c · Gain or loss

  other assets -$37,107

• 7d · Net gain or loss

  total -$37,107 · excluded -$37,107

• 11a · Other revenue: CAFETERIA

  total $140,630 · excluded $140,630

• 11e · Other revenue, total

  $140,630

Functional expenses

Part IX, the statement of functional expenses.

• 1 · Grants to domestic organizations and governments

  total $31,250 · program services $31,250

• 5 · Compensation of officers, directors and key employees

  total $1,816,030 · program services $1,524,186 · management and general $291,844

• 6 · Compensation of disqualified persons

  total $108,987 · program services $108,987

• 7 · Other salaries and wages

  total $26,535,823 · program services $24,274,474 · management and general $2,261,349

• 8 · Pension plan contributions

  total $838,300 · program services $760,575 · management and general $77,725

• 9 · Other employee benefits

  total $5,788,664 · program services $5,337,975 · management and general $450,689

• 10 · Payroll taxes

  total $1,785,002 · program services $1,649,528 · management and general $135,474

• 11a · Fees: management

  total $274,459 · management and general $274,459

• 11b · Fees: legal

  total $11,673 · management and general $11,673

• 11c · Fees: accounting

  total $57,323 · management and general $57,323

• 11g · Fees: other

  total $9,097,100 · program services $8,352,133 · management and general $744,967

• 13 · Office expenses

  total $912,906 · program services $795,161 · management and general $117,745

• 14 · Information technology

  total $901,449 · program services $813,902 · management and general $87,547

• 16 · Occupancy

  total $1,149,621 · program services $1,031,619 · management and general $118,002

• 17 · Travel

  total $175,773 · program services $155,947 · management and general $19,826

• 19 · Conferences, conventions and meetings

  total $186,710 · program services $79,878 · management and general $106,832

• 20 · Interest

  total $1,124,527 · program services $1,019,796 · management and general $104,731

• 22 · Depreciation, depletion and amortization

  total $4,000,957 · program services $3,725,107 · management and general $275,850

• 23 · Insurance

  total $604,333 · program services $250 · management and general $604,083

• 24a · Other expenses: MEDICAL SUPPLIES

  total $8,142,277 · program services $8,142,277

• 24b · Other expenses: BAD DEBTS

  total $1,427,280 · program services $1,427,280

• 24c · Other expenses: RECRUITING FEES

  total $527,792 · program services $512,353 · management and general $15,439

• 24d · Other expenses: FOOD PRODUCTS

  total $389,259 · program services $389,259

• 24e · All other expenses

  total $485,140 · program services $289,125 · management and general $196,015

Balance sheet

Part X, book values.

• 1 · Cash, non-interest-bearing

  beginning of year $361,790 · end of year $237,726

• 2 · Savings and temporary cash investments

  beginning of year $41,877,043 · end of year $36,686,593

• 4 · Accounts receivable

  beginning of year $9,892,268 · end of year $10,346,979

• 7 · Other notes and loans receivable

  beginning of year $462,821 · end of year $892,692

• 8 · Inventories for sale or use

  beginning of year $1,698,330 · end of year $1,874,761

• 9 · Prepaid expenses and deferred charges

  beginning of year $871,738 · end of year $1,004,107

• 10a · Land, buildings and equipment: cost or other basis

  $74,532,864

• 10b · Land, buildings and equipment: accumulated depreciation

  $38,571,531

• 10c · Land, buildings and equipment, net

  beginning of year $37,450,147 · end of year $35,961,333

• 11 · Investments: publicly traded securities

  beginning of year $9,258,356 · end of year $8,275,298

• 14 · Intangible assets

  beginning of year $0 · end of year $649,707

• 15 · Other assets

  beginning of year $1,389,518 · end of year $1,184,641

• 17 · Accounts payable and accrued expenses

  beginning of year $6,063,295 · end of year $5,620,981

• 19 · Deferred revenue

  beginning of year $4,312,837 · end of year $0

• 20 · Tax-exempt bond liabilities

  beginning of year $7,901,171 · end of year $7,456,924

• 23 · Secured mortgages and notes payable

  beginning of year $29,414,730 · end of year $28,961,631

• 25 · Other liabilities

  beginning of year $5,030,865 · end of year $3,676,924

• 27 · Net assets without donor restrictions

  beginning of year $50,539,113 · end of year $51,397,377

The filer's explanations (Part III)

SCHEDULE J, PART III:

JASON PETIK, CEO, RECEIVES COMPENSATION FROM POUDRE VALLEY MEDICAL GROUP, AN UNRELATED ENTITY. POUDRE VALLEY MEDICAL GROUP PROVIDES MANAGEMENT SERVICES TO ITS CLIENTS, INCLUDING THE SIDNEY REGIONAL MEDICAL CENTER. THE SIDNEY REGIONAL MEDICAL CENTER'S BOARD OF DIRECTORS SETS THE COMPENSATION FOR MR. PETIK. MR. PETIK RECEIVED TOTAL COMPENSATION OF $274,459. MR. PETIK'S COMPENSATION IS REFLECTED IN PART IX, LINE 11A.