Nevada Hospital Reporting
(Pursuant to NRS 449.490, Sections 2 through 4)
Demographic Information
Name of Organization Orthopedic Specialty Hospital of Nevada
NPI 1336540491
Location (City & State) Las Vegas, NV
Fiscal Year Ended 12/31/2019      
Legal Entity Status LLC
Description of Organization
Number of Facilities Licensed Beds Staffed Beds Major Services & Centers of Excellence
1 hospital 130 23 Orthopedics
Capital Improvements
New Service Lines (List each new service line offered)
 
 
 
 
 
Major Facilitiy Expansion:
Description Prior Year's Cost Current Year Cost R=Replace††††††††† N= New Construction in Progress
  $0.00 $0.00    
  $0.00 $0.00    
  $0.00 $0.00    
  $0.00 $0.00    
  $0.00 $0.00    
Total $0.00 $0.00    
Major Equipment
Description Prior Year's Cost Current Year Cost R=Replace††††††††† N= New Expansion
  $0.00 $0.00    
  $0.00 $0.00    
  $0.00 $0.00    
  $0.00 $0.00    
  $0.00 $0.00    
Total $0.00 $0.00    
Other Additions and Total Additions for the Period:
Other capital additions for the period not included above $166,969.00
         
Total Additions for the Period (Sum of Expansion, Equipment & Other Additions) $166,969.00
Home Office Allocation
Describe the methodology used to allocate home office costs to the hospital        
Allowable costs are allocated based on total accumulated cost of facilities.        
         
Indicate services included in Hospital's Home Office Allocation:      
Please complete tab "HO SVC".  
         
Community Benefits Structure
Hospital Mission Statement Our mission is to always provide compassionate care to the community which we serve and to inspire our associates to embrace a passion for service. By assisting patients in achieving their maximum quality of life and health, we endeavor to provide care that will enhance overall wellness.
Hospital Vision We envision a professional and culturally diverse hospital that sets the standard for excellence in healthcare service to the community achieved through sound ethical practices and community partnerships
Hospital Values Quality, Integrity, Innovation, Dedication, Genuine Compassion
Hospital Community Benefit Plan (groups to target, decision makers, goals)        
Mission Mapping
  Yes No
Does your mission map to your strategic planning process?   x
Do you have a dedicated community benefits coordinator?   x
Do you have a charitable foundation?   x
Do you conduct teaching and research?   x
Do you operate a Level I or Level II trauma center?   x
Are you the sole provider in your geographic area of any specific clinical services? (If Yes, list services.) No
Community Health Improvements Services
Benefit $
Community Health Education $0.00
Community-Based Clinical Services $0.00
Health Care Support Services $0.00
Total $0.00
Health Professions Education
Benefit $
Physicians/Medical Students (net of Direct GME payments) $0.00
Nurses/Nursing Students $0.00
Other Health Professional Education $0.00
Scholarships/Funding for Professional Education $0.00
Total $0.00
Subsidized Health Services
Benefit $
Total Uncompensated Cost from Uncompensated Cost Report filed with DHCFP $0.00
Less: Medicaid Disproportionate Share Payments received for the Period $0.00
Less: Other Payments Received for these Accounts (County Supplemental Funds, etc.) $0.00
††† Net Uncompensated Care $0.00
 
Uncompensated SCHIP (Nevada Checkup) Cost $0.00
Uncompensated Medicare Cost (see instructions) $0.00
Uncompensated Clinic or Other Cost $0.00
Other Subsidized Health Services $0.00
Less: Cost Reported in Another Category†††† $983.55
Total Subsidized Health Services -$983.55
Research
Benefit $
Clinical Research $0.00
Community Health Research $0.00
Other $0.00
Total $0.00
Financial Contributions
Benefit $
Cash Donations $978.00
Grants $0.00
In-Kind Donations $0.00
Cost of Fund Raising for Community Programs $0.00
Total $978.00
Community Building Activities
Benefit $
Physical Improvements and Housing $0.00
Economic Development $0.00
Community Support $0.00
Environmental Improvements $0.00
Leadership Development and Leadership Training for Community Members $0.00
Coalition Building $0.00
Community Health Improvement Advocacy $0.00
Workforce Development $0.00
Total $0.00
Community Benefit Operations
Benefit $
Dedicated Staff $0.00
Community Health Needs/Health Assets Assessment $0.00
Other Resources $0.00
Total $0.00
Other Community Benefits
Benefit $
(Briefly explain other community Benefits provided but not captured in sections above) $0.00
 
Unmet Free Care Obligation (Assessment for not meeting minimum care obligation of NRS 439B.340) $149,588.00
Other Community Benefits Subtotal $149,588.00
Total Community Benefit
Benefit $
   
Total $149,582.45
Other Community Support
Benefit $
Property Tax $209,073.00
Sales and Use Tax $0.00
Modified Business Tax $118,334.00
Commerce Tax $0.00
State UI Tax + NV Bond Factor $48,320.00
  $0.00
††† Total Other Community Support $375,727.00
Total Community Benefits & Other Community Support
$525,309.45
List and briefly explain educational classes offered
 
 
 
 
List and briefly describe other community benefits provided to the community for which the costs cannot be captured
 
 
 
 
Discounted Services & Reduced Charges Policy & Procedures
Charity Care Policy: (attach copies of actual policies iffirst filing or policy changed) Policy Effective Date:  
††† Does the hospital have a policy? (Yes or No) 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) Policy Effective Date:  
††† Does the hospital have a policy? (Yes or No) No
††† Discounts given up to what %?  
††† Amount of time to make arrangements? (in days or months)  
††† Other comments  
Collection of Accounts Receivable Policies & Procedures
Effective Date of Policy  
7/1/2015 Yes No
Does hospital have established policy? X  
Does hospital make every reasonable effort to help patient to obtain coverage? (Yes or No) X  
Is collection policy consistent with the Fair Debt Collection Practices Act? (Yes or No) X  
Is the patient notified in writing of referral to collection agency? N/A  
Is the patient notified in writing prior to a lawsuit being begun?    
 
Methods of communication with patient (e.g. phone, letter, etc.) letters/bills; phone contact
Number of patient contacts before referral to collection agency We donít have a policy regarding referral to an external collection agency; however accounts can be referred to Fundamental's collection department after the hospital's efforts have been exhausted - minimum 3 written letters/bills and 6 phone contact attempts.
Number of days prior to referral to collection agency 120; again referral is to Fundamental's collection department, not an external agency.
Other comments  
Chargemaster
  Yes No
Is hospital chargemaster available in accordance with NRS 449.490 (4) requirements? (Yes or No) X  
Is the chargemaster updated at least monthly? (Yes or No)   Chargemaster is updated as items change
 
How is the chargemaster made available? (E.g. format, location, etc.) Electronic format; can be printed off at the hospital upon request.
Brian Falkler - Director of Reimbursement 8/5/2020
Name and Title of Person Completing the Report: Date
Tony Adams - Hospital Administrator 8/5/2020
Name and Title of Person who Reviewed and Approved Date