Nevada Hospital Reporting (Pursuant to NRS 449.490, Sections 2 through 4) Demographic Information Name of Organization Location (City & State) Fiscal Year Ended (mm/dd/yyyy) Description of Organization (number of facilities, bed size, major services & centers of excellence) Governance/Organizational Structure (tax exempt status, affiliated entities) University Medical Center of Southern Nevada Las Vegas, Nevada 06/30/2014 541 Bed Acute Care Hospital, Children’s Hospital, Level 1 Trauma Center, Burn Care Unit, and 17 clinical care centers located throughout Clark County County Owned, Non-Profit, Tax Exempt Capital Improvements New Service Lines: New Service Lines: List each new service line offered. Major Facility Expansion: Prior Years Costs Description INDUCED DRAFT CLOSED LOOP COOLING TOWERS IT EQUIPMENT FOR DELTA POINT BUILD-OUT $ $ Current Year Cost $ $ 367,551 505,694 R=Repl ace N=New Const. In Progress ? R N Major Equipment: Prior Years Costs Description CUSTOM COMMVAULT SOFTWARE SOLUTION FP XPER FD20 BIPLANE R8.1 HOSPITAL BED, VERSACARE VC755 (90) TURNKEY PROJECT, ALLURA BIPLANE FD20/20 OEC 9900 ELITE DIGITAL MOBILE STD C-ARM (2) AVALON FM50 FETAL MONITORS (19) STERIS 4085 GENERAL SURGICAL TABLE (7) ULTRASOUND MACHINE/TEE PROBE, 3D CAPABLE EQUIP, NEW CM6-CONNECT TO EXISTING CS1K INTELLIVUE MX700 PATIENT MONITOR (11) ADVANCED CONTROL RETRACTABLE BASE SAFE PLACE SYSTEM (2) $ $ $ $ $ $ $ $ $ $ $ $ Current Year Cost $ 1,481,641 $ 1,465,030 $ 891,302 $ 573,936 $ 342,823 $ 306,122 $ 268,527 $ 240,163 $ 228,760 $ 192,085 $ 148,867 $ 142,111 R=Repl ace N=New R R R R R R R R R R R R Expansi on RIGHTFAX 10.5 ENTERPRISE SUITE LICENSE, WORKFORCE EMPLOYEE V7 ANESTHESIA MACHINES, AVANCE CS2 (2) QUANTUM Q-RAD: DS-3V SYSTEM PACKAGE (2) FCR CARBON XL (2) HANA HIP AND KNEE ARTHROPLASTY TABLE ELEVATOR DOOR MODERNIZATION, 7 STORY BLD OPTIPLEX 7010 ULTRA SMALL FORM FACTOR INJECTOR, MARK 7 ARTERION, TABLE MOUNT (5) STERRAD 100S STERILIZER PAGEWRITER TC70 CARDIOGRAPH (6) BUNDLE NIM RESPONSE 3.0 (2) INSTALL LOADING DOCK DOORS STELLANT DUAL INJECTOR W/PEDESTAL (2) ULTRASOUND SYSTEM, VOLUSON S8 BT12 NURSE CALL SYSTEM, NAVICARE TRAUMA UPGRADE, CV M3145 UPGRADE REL N.0 3100A OSCILLATORS (2) SURGISLUSH SURGICAL SLUSH FREEZER FDR D-EVO WIRELESS, ADD ON/RPLC DETECTOR HARMONY VLED DUAL LIGHT PKG, NON-CAMERA (2) DELL LATITUDE E6430 446 ELECTRIC STERILIZER UNIT ULTRASOUND SYSTEM, LOGIQ E BT12 INJECTOR, MARK 7 ARTERION, PEDESTAL, SYS (2) MRI IV PUMP W/INTEGRATED SP02 MONITORING DELL R420 SERVER FLOORING REPLACEMENT, BOULDER QC SURGICAL TABLE, 3085 SP BATTERY POWERED LION'S BURN CARE SIGN CHALLENGE MS-5 DRILL BLADDER SCANNERS, BIOCON 700 W/PRINTER (2) HP SB BL465C GEN8 6320 2P 64G SVR M3150 UPGRADE REL N.0 TSCD II STERILE TUBING WELDER MPM TRIUMPH 4850-EP FORCEFXC GENERATOR S-TYPE SOUNDSTRUCTURE C8 W/TEL1 ANALOG PHONE CARD SCANNER, FUJITSU FI-677OA ADF/FBSCAN EQP MAGNAPUNCH 2.0 PUNCH MACHINE VIDEO CONFERENCE CART OPTIPLEX 7010 MINITOWER BASE RHINO-LARYNGO VIDEOSCOPE (2) CUBELET ICEMAKER/DISPENSER FCR XG5000 PLUS HIGH MULTI-CASSETTE RDR $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 126,093 111,672 111,275 105,104 105,026 99,753 97,850 93,300 88,000 85,471 75,654 66,494 61,838 60,720 58,310 56,532 55,161 54,448 51,041 49,500 48,000 44,227 44,190 41,420 40,646 38,525 37,814 35,727 31,795 31,484 23,749 21,227 19,568 15,810 13,899 13,256 11,148 7,791 7,045 6,828 6,796 6,739 5,901 5,713 5,390 1,419 R R R R R R R R R R R R N R R R R R R R R R R R R R R R R R N R N R R R R R R R R R R N R R 2 IT HARDWARE AND SOFTWARE (Electronic Health Record Project) OTHER CAPITAL ITEMS AND EQUIPMENT $ $ 11,339,670 7,903,362 Other Additions and Total Additions for the Period: Other capital additions for the period not included above Total Additions for the Period (Sum of Expansion, Equipment & Other Additions) $ 9,333,961 Home Office Allocation Describe the methodology used to allocate home office costs to the hospital Clark County Government Methodology Used: The Clark County Indirect Cost Allocation Plan (The Plan) uses a double-apportionment method to allocate centralized county government service cost to the various county departments. In the first apportionment, the cost from the indirect cost pools is allocated to both direct and indirect cost centers. In the second apportionment, the remaining costs from the indirect cost pools, which would be the cost stepped down from the first apportionment, are allocated to the direct cost pools Community Benefits Structure Hospital Mission Statement Hospital Vision Hospital Values To provide leadership that ensures safe, high quality, accessible, comprehensive healthcare to the community and visitors while ensuring financial viability and social responsiveness. Become the model community healthcare provider and hospital of choice. Medical excellence, responsible business practices, social and financial accountability, community partnership, inclusiveness. Hospital Community Benefit Plan (groups to target, decision makers, goals) Mission Mapping (these are not required fields) Yes Does your mission map to your strategic planning process? Do you have a dedicated community benefits coordinator? Do you have a charitable foundation? Do you conduct teaching and research? Do you operate a Level I or Level II trauma center? Are you the sole provider in your geographic area of any specific clinical services? (If Yes, list services.) No Yes No Yes Yes Yes – Level I Yes - Burn Care Unit Level I Trauma Organ Transplant Community Health Improvements Services Benefit $ Community Health Education Community-Based Clinical Services Health Care Support Services $ $ $ 10,782,272 52,195 4,102,100 6,627,977 3 Health Professions Education Benefit $ Physicians/Medical Students (net of Direct GME payments) Nurses/Nursing Students Other Health Professional Education Scholarships/Funding for Professional Education $ $ $ $ 21,644,651 20,637,095 330,000 677,556 Subsidized Health Services Benefit $ Total Uncompensated Cost from Uncompensated Cost Report filed with DHCFP Less: Medicaid Disproportionate Share Payments received for the Period Less: Other Payments Received for these Accounts (County Supplemental Funds, etc.) Net Uncompensated Care Uncompensated SCHIP (Nevada Checkup) Cost Uncompensated Medicare Cost (see instructions) Uncompensated Clinic or Other Cost Other Subsidized Health Services Less: Cost Reported in Another Category Add: IGT Paid by Clark County on behalf of UMC Total Subsidized Health Services $ $ $ $ $ $ $ $ $ $ $ 199,455,680 (69,515,597) (30,242,227) 99,697,856 959,131 23,484,111 9,426,970 (29,975,331) 08,754 77,340,026 180,932,763 Research Benefit $ Clinical Research Community Health Research Other $ $ $ 302,158 302,158 Financial Contributions Benefit $ Cash Donations Grants In-Kind Donations Cost of Fund Raising for Community Programs $ $ $ $ 978,937 181,220 797,717 Community Building Activities Physical Improvements and Housing Economic Development Community Support Environmental Improvements Leadership Development and Leadership Training for Community Members Coalition Building Benefit $ $ $ $ 150,949 49,600 $ $ $ 100,000 4 Community Health Improvement Advocacy Workforce Development $ $ 1,349 Community Benefit Operations Dedicated Staff Community Health Needs/Health Assets Assessment Other Resources Benefit $ $ $ $ Other Community Benefits (Briefly explain other community Benefits provided but not captured in sections above) Other Community Benefits Subtotal Benefit $ $ $ $ Total Community Benefit Benefit $214,791,730 Other Community Support Property Tax Sales and Use Tax Modified Business Tax Other Tax (describe) Assessment for not meeting minimum care obligation of NRS 439B.340 Total Other Community Support Benefit $ $ $ $ $ $ $ Total Community Benefits & Other Community Support $ $214,791,730 List and briefly explain educational classes offered 5 Patient Management Seminars for Physicians Continuing Education for Health Care Professionals Nutrition & Exercise Classes Health Education for Senior Citizens List and briefly describe other community benefits provided to the community for which the costs cannot be captured Diabetes Counseling Prenatal, Childbirth & Post Partum Care for Mother & Child Infant and Child CPR Community Disaster Management Emergency Preparedness Pedestrian Safety Advocacy efforts on behalf of homeless patients Discounted Services & Reduced Charges Policy & Procedures Charity Care Policy: (attach copies of actual policies if first filing or policy changed) Does the hospital have a policy? (Yes or No) Policy covers up to what % of Federal Poverty Level? Discounts given up to what %? Amount of time to make arrangements (in days or months) Other comments Prompt Pay or Other Discounts: (attach copies of actual policies if first filing or policy changed) Does the hospital have a policy? (Yes or No) Discounts given up to what %? Amount of time to make arrangements? (in days or months) Other comments Policy Effective Date: Yes 500% 70% 24 months Policy Effective Date: New Rates effective 11-1-2007 Yes (County Resident Rates) Inpatient: Per Diems, Carve Outs, & Case Rates, min of 30% Outpatient: 55% of charges 24 Months Collection of Accounts Receivable Policies & Procedures Effective Date of Policy Does hospital have established policy? Does hospital make every reasonable effort to help patient to obtain coverage? (Yes or No) Number of patient contacts before referral to collection agency Is collection policy consistent with the Fair Debt Collection Practices Act? (Yes or No) Methods of communication with patient (e.g. phone, letter, etc.) Number of days prior to referral to collection agency Is the patient notified in writing of referral to collection agency? Is the patient notified in writing prior to a lawsuit being begun? Other comments 8/01/1999 Yes Yes 4 Yes Phone, Letter 120 days Yes N/A – UMC does not sue patients Collection agencies may pursue legal action. 6 Chargemaster Is hospital chargemaster available in accordance with NRS 449.490 (4) requirements? (Yes or No) Is the chargemaster updated at least monthly? (Yes or No) How is the chargemaster made available? (E.g. format, location, etc.) Yes Yes Viewable on Laptop in Admitting 7