MT GRAHAM REGIONAL MEDICAL CENTER INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- MT GRAHAM REGIONAL MEDICAL CENTER INC (EIN 23-7094247)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-15
- IRS object ID
- 202303199349302655
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-15T07:46:43-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237094247 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mt Graham Regional Medical Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MTGR | BusinessNameControlTxt |
| Phone | 9283484000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 S 20th Avenue | AddressLine1Txt |
| City | Safford | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85546 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kathleen Williams | PersonNm |
| Person Title | VP Finance/CFO | PersonTitleTxt |
| Phone | 9283484000 | PhoneNum |
| Signature | 2023-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Kathleen | PersonFirstNm |
| Person Last | Williams | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2023-11-07 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Roland Knox | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 S 20th Avenue | AddressLine1Txt |
| City | Safford | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85546 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $85,395,987 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.mtgraham.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1970 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | To provide quality and compassionate health care services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 616 | TotalEmployeeCnt |
| Total Volunteers | 48 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $14,265,515 | PYContributionsGrantsAmt |
| CY Contributions Grants | $302,317 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $84,553,077 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $83,657,311 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,443,518 | PYInvestmentIncomeAmt |
| CY Investment Income | $981,693 | CYInvestmentIncomeAmt |
| PY Other Revenue | $391,700 | PYOtherRevenueAmt |
| CY Other Revenue | $450,071 | CYOtherRevenueAmt |
| PY Total Revenue | $100,653,810 | PYTotalRevenueAmt |
| CY Total Revenue | $85,391,392 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $38,462,142 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $39,371,718 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $40,555,229 | PYOtherExpensesAmt |
| CY Other Expenses | $43,070,926 | CYOtherExpensesAmt |
| PY Total Expenses | $79,017,371 | PYTotalExpensesAmt |
| CY Total Expenses | $82,442,644 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $21,636,439 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,948,748 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $112,315,284 | TotalAssetsBOYAmt |
| Total Assets EOY | $116,885,615 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,006,952 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,926,987 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $105,308,332 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $102,958,628 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | We are caring people committed to improving community health. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $66,162,507 | ExpenseAmt |
| Revenue | $83,657,311 | RevenueAmt |
| Desc | Mt. Graham Regional Medical Center, Inc. is a 25-bed hospital located in Graham County, Arizona. Effective September 28, 2021, the Medical Center became licensed as a Critical Access Hospital by the Centers for Medicare & Medicaid Services for reimbursement of services provided to Medicare beneficiaries. We are a nonprofit, community-owned and governed facility providing extensive medical services for Graham and Greenlee counties of Arizona. Our services include medical/surgical services, intensive care, obstetrics, emergency services, infusion therapy, chemotherapy, respiratory therapy, laboratory services, radiology, digital mammography, ultrasound, CT scans, MRI scans, and nuclear medicine. (Continued on Schedule O.)In addition to the services provided by the Medical Center, each month the following specialty care clinics are provided on the hospital campus: allergy and immunology; Otolaryngologist (Ear Nose Throat); cardiology; dermatology; oncology; orthopedics; pediatric cardiology; pediatric endocrinology; pediatric pulmonary; kidney, disability; endocrinology; and urology.In 2022, the Medical Center had 4,229 total inpatient days and 101,313 visits.The Medical Center provides health care services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Hospital does not pursue collection of these amounts, they are not reported as patient service revenue. The estimated cost of providing these services was approximately $334,000 for the year ended December 31, 2022, calculated by multiplying the ratio of cost to gross charges for the Medical Center by the gross uncompensated charges associated with providing charity care to its patients. | Desc |
| Total Program Service Expenses | $66,162,507 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 133 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 616 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kathleen Williams | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9283484060 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 S 20th Avenue | AddressLine1Txt |
| City | Safford | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85546 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Caro Gaethje | ||||||||
| Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Debbie Watson | ||||||||
| Vice Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Cindy Bryce | ||||||||
| Secretary/Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Bart J Carter MD FACS | ||||||||
| Member/General Surgery | 40.00 | Yes (X) | $642,407 | $0 | $32,613 | |||
| David Bryce DO | ||||||||
| Chief of Staff/ER Physicia | 40.00 | Yes (X) | $632,165 | $0 | $33,225 | |||
| Brandon Welker DO | ||||||||
| Member/Vice Chief of Staff | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Cecil L Evans | ||||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Jean Reynolds | ||||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Susan J Jones MD | ||||||||
| Member | 24.00 | Yes (X) | $18,000 | $0 | $0 | |||
| Carolyn McCormies | ||||||||
| Member until Jun 2022 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Steve Goodman | ||||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John Martin | ||||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Eldon Woodall | ||||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Jim Palmer | ||||||||
| Member starting Feb 2022 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Kip Kempton | ||||||||
| Member starting Mar 2022 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Clinton Damron DO | ||||||||
| Member starting Nov 2022 | 12.00 | Yes (X) | $9,750 | $0 | $0 | |||
| Roland Knox | ||||||||
| President & CEO | 40.00 | Yes (X) | $298,885 | $0 | $28,424 | |||
| Kathleen Williams | ||||||||
| VP Finance & CFO | 40.00 | Yes (X) | $151,541 | $0 | $13,733 | |||
| Lori Ray | ||||||||
| CNO | 40.00 | $165,014 | $0 | $35,691 | Yes (X) | |||
| Eric Neal | ||||||||
| COO | 40.00 | $170,904 | $0 | $32,198 | Yes (X) | |||
| William B Bendall MD | ||||||||
| Emergency Medicine | 36.00 | $520,170 | $0 | $29,665 | Yes (X) | |||
| Clayton Hargis DO | ||||||||
| Emergency Medicine | 36.00 | $484,636 | $0 | $38,650 | Yes (X) | |||
| Jorden B Marble MD | ||||||||
| General Surgeon | 40.00 | $470,474 | $0 | $31,200 | Yes (X) | |||
| Bryant McNeill MD | ||||||||
| Hospitalist Internal Medic | 40.00 | $398,607 | $0 | $42,162 | Yes (X) | |||
| Eric Ingulsrud MD | ||||||||
| Emergency Medicine | 40.00 | $368,478 | $0 | $20,501 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,331,031 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $338,062 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 47 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Roadrunner Rehab | |||||
| 2290 16th Street | Safford | AZ | 85546 | Physical therapy services | $1,466,650 |
| Mountain View Anesthesia PC | |||||
| PO Box 1318 | Thatcher | AZ | 85552 | Anesthesia services | $1,400,000 |
| Medical Solutions LLC | |||||
| PO Box 850737 | Minneapolis | MN | 55485 | Locum Respiratory, Lab, Surgery, & Medsu | $1,362,556 |
| Sonora Quest Laboratories LLC | |||||
| PO Box 29661 Dept 2059 | Phoenix | AZ | 85038 | Lab services | $508,971 |
| Liver Institute | |||||
| 5295 E Knight Drive | Tucson | AZ | 85712 | GI services | $489,328 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $276,442 | GovernmentGrantsAmt |
| All Other Contributions | $25,875 | AllOtherContributionsAmt |
| Total Contributions | $302,317 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net patient service revenue | 621110 | $82,954,968 | $82,954,968 |
| EHR Incentive | 900099 | $133,183 | $133,183 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $569,160 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $569,160 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $83,657,311 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $601,165 | TotalRevenueColumnAmt |
| Exclusion | $601,165 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $454,666 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $4,595 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $450,071 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $450,071 | TotalRevenueColumnAmt |
| Exclusion | $450,071 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $374,788 | SecuritiesAmt |
| Other | $5,740 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $374,788 | SecuritiesAmt |
| Other | $5,740 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $380,528 | TotalRevenueColumnAmt |
| Exclusion | $380,528 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $85,391,392 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $83,657,311 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,431,764 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,264,545 | TotalAmt |
| Program Services | $1,771,964 | ProgramServicesAmt |
| Management And General | $492,581 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,259,551 | TotalAmt |
| Program Services | $1,259,551 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,831,586 | TotalAmt |
| Program Services | $24,812,990 | ProgramServicesAmt |
| Management And General | $5,018,596 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $814,262 | TotalAmt |
| Program Services | $680,865 | ProgramServicesAmt |
| Management And General | $133,397 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,991,158 | TotalAmt |
| Program Services | $2,589,094 | ProgramServicesAmt |
| Management And General | $402,064 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,210,616 | TotalAmt |
| Program Services | $1,844,172 | ProgramServicesAmt |
| Management And General | $366,444 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,458 | TotalAmt |
| Management And General | $143,458 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,631 | TotalAmt |
| Management And General | $122,631 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,433,097 | TotalAmt |
| Program Services | $8,223,682 | ProgramServicesAmt |
| Management And General | $2,209,415 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,255 | TotalAmt |
| Program Services | $3,539 | ProgramServicesAmt |
| Management And General | $145,716 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,512,133 | TotalAmt |
| Program Services | $2,087,329 | ProgramServicesAmt |
| Management And General | $4,424,804 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $702,815 | TotalAmt |
| Program Services | $700,875 | ProgramServicesAmt |
| Management And General | $1,940 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,461 | TotalAmt |
| Program Services | $55,841 | ProgramServicesAmt |
| Management And General | $43,620 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,647 | TotalAmt |
| Program Services | $40,567 | ProgramServicesAmt |
| Management And General | $40,080 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,598 | TotalAmt |
| Program Services | $70,598 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,366,776 | TotalAmt |
| Program Services | $5,366,776 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,175,994 | TotalAmt |
| Management And General | $1,175,994 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $10,328,759 | $10,328,289 | $470 |
| Bad Debt Expense | $5,317,634 | $5,317,634 | |
| Repairs & Maintenance | $2,430,718 | $990,982 | $1,439,736 |
| Dietary | $125,207 | $14,681 | $110,526 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,743 | TotalAmt |
| Program Services | $3,078 | ProgramServicesAmt |
| Management And General | $8,665 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,442,644 | TotalAmt |
| Program Services | $66,162,507 | ProgramServicesAmt |
| Management And General | $16,280,137 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,039,590 | BOYAmt |
| EOY | $4,328,319 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,561,531 | BOYAmt |
| EOY | $12,598,750 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $239,896 | BOYAmt |
| EOY | $100,066 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,128,759 | BOYAmt |
| EOY | $2,127,404 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,477,491 | BOYAmt |
| EOY | $1,961,600 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $99,427,503 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $68,344,605 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,228,816 | BOYAmt |
| EOY | $31,082,898 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,076,908 | BOYAmt |
| EOY | $48,162,533 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,370,630 | BOYAmt |
| EOY | $6,055,446 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,490 | BOYAmt |
| EOY | $155,112 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,173 | BOYAmt |
| EOY | $28,815 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $10,284,672 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,315,284 | BOYAmt |
| EOY | $116,885,615 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,324,735 | BOYAmt |
| EOY | $5,666,709 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $693,675 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,682,217 | BOYAmt |
| EOY | $7,566,603 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,006,952 | BOYAmt |
| EOY | $13,926,987 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,152,327 | BOYAmt |
| EOY | $102,783,154 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,005 | BOYAmt |
| EOY | $175,474 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,308,332 | BOYAmt |
| EOY | $102,958,628 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,315,284 | BOYAmt |
| EOY | $116,885,615 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,948,748 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$5,298,074 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$378 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,843,866 | OtherCostOrOtherBasisAmt |
| Book Value | $1,843,866 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,448,869 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,787,522 | DepreciationAmt |
| Book Value | $16,661,347 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $92,292 | OtherCostOrOtherBasisAmt |
| Depreciation | $63,295 | DepreciationAmt |
| Book Value | $28,997 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $50,306,407 | OtherCostOrOtherBasisAmt |
| Depreciation | $40,023,314 | DepreciationAmt |
| Book Value | $10,283,093 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,736,069 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,470,474 | DepreciationAmt |
| Book Value | $2,265,595 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $31,082,898 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Alternative investments | Desc |
| Book Value | $6,055,446 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $6,055,446 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Estimated third-party settlements | $631,741 |
| Lease receivable | $701,060 |
| Right-to-use lease assets | $8,011,986 |
| Supplemental payments | $939,885 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $10,284,672 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Lease Liabilities | Desc |
| Amt | $7,566,603 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,566,603 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $74,704,708 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$5,298,074 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$5,388,610 | OtherRevenueAmt |
| Revenue Not Reported | -$10,686,684 | RevenueNotReportedAmt |
| Revenue Subtotal | $85,391,392 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $85,391,392 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $77,054,412 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $77,054,412 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $5,388,232 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $5,388,232 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $82,442,644 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 2d - Other Adjustments: | Interest Expense Included in Expenses on Form 990 -70,598. Change in CHS Investment Reported as Change in Net Assets on Form 990 -378. Bad Debt Expense Included in Expense on Form 990 -5,317,634. |
| Part XII, Line 4b - Other Adjustments: | Interest Expense Included in Revenue on Audit 70,598. Bad Debt Expense Included in Rvenue on Audit 5,317,634. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $334,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $334,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00430 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $334,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $334,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00430 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,554,171 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,719,805 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,834,366 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04970 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,554,171 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,719,805 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,834,366 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04970 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,888,171 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,719,805 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,168,366 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05400 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,317,634 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,084,797 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,631,673 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,647,323 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$15,650 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mt Graham Regional Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 S 20th Avenue | AddressLine1Txt |
| City | Safford | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85546 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.mtgraham.org | WebsiteAddressTxt |
| State License | H0140 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | 1 provider based rural health clinic | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mt Graham Regional Medical Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.mtgraham.org/about-us/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.mtgraham.org/about-us/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.mtgraham.org/cope-charity-care/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.mtgraham.org/cope-charity-care/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.mtgraham.org/cope-charity-care/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Mt. Graham Regional Medical Center, Inc. | Part V, Section B, Line 5: Between July and September 2022, a Community Health Needs Assessment (CHNA) was conducted by Mt. Graham Regional Medical Center (MGRMC) in partnership with Graham and Greenlee County Health Departments for the approximately 47,769 residents of Graham and Greenlee Counties.The information-gathering phases of the assessment were initiated and conducted by MGRMC, Graham, and Greenlee County Health Department. As partners, we held meetings with community members and formed a survey.Members of the underserved population were not represented directly. However, individuals who specifically serve these populations through government agencies, hospital clinics for the uninsured or underinsured, and non-profit organizations that solely exist to meet the needs of the underserved were invited and did participate so that the issues these individuals face would be addressed. |
| Mt. Graham Regional Medical Center, Inc. | Part V, Section B, Line 6b: Graham County Health DepartmentGreenlee County Health Department |
| Mt. Graham Regional Medical Center, Inc. | Part V, Section B, Line 11: The Hospital conducted its most recent CHNA in 2022. The following are needs the hospital will address over the next 3 years: Outpatient Mental Health, substance use/abuse, diabetes, Obesity/weight management, inpatient mental health, nutrition, heart disease, and cancer.At this time, the following needs will not be addressed by the facility CHNA-AP due to lack of urgency or priority as determined by MGRMC's CHNA Committee: dental care, fitness, primary care (adult), older adult/elder services, eating disorders, primary care (pediatric/children), and pediatric specialties. MGRMC will address the following needs outside of the CHNA as part of our strategic plan: primary care (adult) and primary care (pediatric/children). Mount Graham Regional Medical Center conducted a Community Health Needs Assessment in 2019. The following statements include the 2022 actions taken to address the needs identified.Improved Treatment and Services for Substance Abuse:MGRMC has continued to offer support to the Graham County Substance Abuse Coalition in its efforts to combat opioid abuse and response in the Gila Valley. The hospital continues to collaborate with a local pain management clinic located on the hospital's campus. MGRMC is diligent in ensuring appropriate referrals to substance abuse treatment services and includes such services in its employee benefits program. Improved Treatment and Services Associated with Mental Health:In 2022, our primary care clinic hired a Psychiatric Mental Health Nurse Practitioner to meet the high demand of mental health providers in our community. MGRMC continues to collaborate with a variety of providers of mental health services to offer in-person and telepsych services in the hospital and hospital clinics. The hospital's Employee Assistance Program provides easy access to mental health and related services to hospital employees and their families. MGRMC's Case Management partners with local programs that specialize in mental health to make sure all patients have access to the mental healthcare that they need. The hospital works closely with mental health providers both in the community and the Phoenix and Tucson metropolitan areas to ensure the appropriate referral of patients for needed care. Improve Services for Diabetes:MGRMC employs a dietician who oversees our Diabetes Family Support Group as well as our Diabetes education classes. These classes cover individual nutrition counseling, diabetes education, and how best to support family members who may have diabetes. Our dietician works on expanding diabetes knowledge through school visits and community health fairs. Improved Opportunities for Wellness:The hospital's Copper Mountain Clinic, a federally designated rural health clinic, provides access to primary care services including wellness visits, immunizations, illness care, and health education. The hospital provides a financial incentive to employees for membership in fitness programs. The hospital also provides a wellness app for all employees who participate in our medical plan. This app encourages employees to cultivate good health habits, track daily step counts, fitness activities, nightly sleep, nutrition and water intake, wellness checkups, and participate in wellness challenges with co-workers. MGRMC is also part of the Gila Valley Food Coalition with local partners to provide nutritional food and items to underserved communities in food deserts across Graham and Greenlee Counties. The hospital continued to promote wellness community health fairs, sponsoring health-related community events, and working with local clubs, organizations, and wellness facilities to promote wellness activities. The hospital and its foundation also provide support for runs, golf outings and tournaments, and other sports and wellness-related activities.Additional Specialty Services:MGRMC welcomed the local OB/GYN clinic as a new hospital-owned medical practice to help meet our goal to continue to grow their services and providers to meet the needs of the community. MGRMC hosts many independent specialists on our campus, including a full-service cardiology group, orthopedics, podiatry, dermatology, and pain management. Our Specialty Clinic leases space to visiting providers including oncology, urology, pediatrics, and nephrology. Additionally, some of the specialists offer telemedicine to increase their presence in the community. MGRMC partnered with our local health department and United Way to provide free drive thru COVID testing to our community. |
| Mt. Graham Regional Medical Center, Inc. | Part V, Section B, Line 16j: A summary, including contact information, was included in our emergency rooms, waiting rooms, admissions offices, and provided to patients on admission to the hospital facility. |
| Mt. Graham Regional Medical Center, Inc. | Part V, Section B, Line 24: All individuals eligible under the Medical Center's financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. |
| Part V, Section B, Line 7a: | Community Health Needs assessment www.mtgraham.org/about-mgrmc/community-health-needs-assessment |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - Mt Graham Specialty Clinic | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 S 20th Avenue Building E | AddressLine1Txt |
| City | Safford | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85546 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Physician clinic | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | Charity care was converted to cost using an overall cost-to-charge ratio addressing all patient segments. Community health improvement services community benefit expense is reported based on the actual cost in the general ledger. The cost for subsidized health services was determined using the Medicare Cost Report. |
| 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 $ 5,317,634. |
| Part III, Line 2: | Accounts are not written off to bad debt until all payments, discounts, and contractual allowances are applied. When a payment is received on an account previously written off to bad debt, the payment reduces the current year's bad debt expense.Bad debt expense on line 2 is reported at charges as presented on the financial statements. |
| Part III, Line 3: | The amount of bad debt expense attributable to patients eligible for charity care is based on the 20.4% of individuals living below the federal poverty level. |
| Part III, Line 4: | The footnote to the Organization's financial statements can be found on page 17 of the attached audited financial statements. |
| Part III, Line 8: | The entire Medicare shortfall is considered a community benefit. Services are provided to patients under the Medicare program even though the hospital knows they will not recover all of the costs from providing the services. This program is considered subsidized by the hospital and other payors. Patients rely on these services for their health and well-being and are essential for their access to healthcare. The costs associated with Medicare were taken from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. |
| Part III, Line 9b: | The Hospital must determine whether an individual is FAP-eligible or provide required notices during a notification period ending 120 days after the date of the first billing statement. Although the Hospital may use extraordinary collection efforts after the 120-day notification period, we must still accept and process a FAP application for an additional 120 days. The total period during which we must accept and process FAP applications is 240 days from the date of the first billing statement. If the hospital receives a FAP application during the application period, we must suspend any extraordinary collection efforts started until the application is processed, and if the individual is FAP-eligible, must seek to reverse the extraordinary collection efforts and promptly refund any overpaid amounts. Debts may be referred to third parties to assist with collection efforts, they may not be sold to third parties during the notification period until an eligibility determination has been made. |
| Part VI, Line 2: | Throughout the year, the hospital works closely with community clinics on recruiting, scheduling, and services review. The hospital also continues to expand its charity care program. |
| Part VI, Line 3: | Mt. Graham Regional Medical Center provides brochures for charity care at time of admission. Patients are given additional information with contact information at time of inpatient admission and discharge. Brochures with information about charity care are located in admission areas and other areas of the organization in which eligible patients are likely to be present. Charity care brochures are also provided to local physicians to provide information to their patients who may need services at Mt. Graham Regional Medical Center. When patients are contacted by phone for collection purposes, patients are given additional information regarding our charity care program. Mt. Graham Regional Medical Center has contracted HPS (Hospital Patient Services) to assist patients with government benefits such as Medicaid. The Hospital employs a financial counselor to assist patients with enrollment in AHCCCS/Cope as part of the charity care and financial assistance. |
| Part VI, Line 4: | Mt. Graham Regional Medical Center is an acute care hospital located in Safford which is in Graham County, Arizona. Graham County is a rural area with a population of approximately 39,050. MGRMC serves Graham, Greenlee and northern Cochise counties. The median household income is $55,693, and 20.4% of Graham County is below poverty level. The median age of population in Graham County is 33.7 with 46.2% female and 53.8% male. The two facilities closest to our facility are approximately 50-75 miles away, and both are critical access facilities. In its rural setting, the hospital serves the population with general surgery and orthopedic surgery. Other specialists come to the hospital on a weekly or monthly basis to provide service to community members. |
| Part VI, Line 5: | The majority of MGRMC's governing body is comprised of persons who reside in the Organization's primary service area. MGRMC extends medical staff privileges to all qualified physicians in the community. MGRMC provides emergency room services regardless of ability to pay.Mt. Graham Regional Medical Center (MGRMC) is a facility dedicated to promoting the health of the community. MGRMC provides services through our Community Health Department and Rural Health such as diabetes education and Annual Gila Valley Health Fair. The amount reported as community health improvement services represents the excess of costs for these events over the funds received from government agencies to put on the events. MGRMC supports the education and training of healthcare professionals. MGRMC offers volunteer opportunities to the community through our auxiliary. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bart J Carter MD FACS | ||||||||||||||
| Member/General Surgery | $642,173 | $0 | $217 | $0 | $17 | $0 | $10,675 | $0 | $21,938 | $0 | $675,020 | $0 | $0 | $0 |
| David Bryce DO | ||||||||||||||
| Chief of Staff/ER Physicia | $631,938 | $0 | $217 | $0 | $10 | $0 | $10,675 | $0 | $22,550 | $0 | $665,390 | $0 | $0 | $0 |
| William B Bendall MD | ||||||||||||||
| Emergency Medicine | $519,953 | $0 | $217 | $0 | $0 | $0 | $9,233 | $0 | $20,440 | $0 | $549,843 | $0 | $0 | $0 |
| Clayton Hargis DO | ||||||||||||||
| Emergency Medicine | $484,419 | $0 | $217 | $0 | $0 | $0 | $10,903 | $0 | $27,855 | $0 | $523,394 | $0 | $0 | $0 |
| Jorden B Marble MD | ||||||||||||||
| General Surgeon | $470,257 | $0 | $217 | $0 | $0 | $0 | $10,675 | $0 | $20,588 | $0 | $501,737 | $0 | $0 | $0 |
| Bryant McNeill MD | ||||||||||||||
| Hospitalist Internal Medic | $398,390 | $0 | $217 | $0 | $0 | $0 | $10,675 | $0 | $31,543 | $0 | $440,825 | $0 | $0 | $0 |
| Eric Ingulsrud MD | ||||||||||||||
| Emergency Medicine | $368,261 | $0 | $217 | $0 | $0 | $0 | $10,675 | $0 | $9,827 | $0 | $388,980 | $0 | $0 | $0 |
| Roland Knox | ||||||||||||||
| President & CEO | $298,453 | $0 | $217 | $0 | $215 | $0 | $9,924 | $0 | $18,500 | $0 | $327,309 | $0 | $0 | $0 |
| Eric Neal | ||||||||||||||
| COO | $170,446 | $0 | $217 | $0 | $241 | $0 | $6,090 | $0 | $26,108 | $0 | $203,102 | $0 | $0 | $0 |
| Lori Ray | ||||||||||||||
| CNO | $164,702 | $0 | $217 | $0 | $95 | $0 | $6,005 | $0 | $29,687 | $0 | $200,706 | $0 | $0 | $0 |
| Kathleen Williams | ||||||||||||||
| VP Finance & CFO | $151,272 | $0 | $217 | $0 | $52 | $0 | $5,150 | $0 | $8,583 | $0 | $165,274 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (14 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Kerri Hopson | |||
| Daughter to Debra Watson - board member | $140,100 | Compensation and benefits as an employee | 0 |
| Amy Bodine | |||
| Daughter to Steve Goodman - board member | $72,231 | Compensation and benefits as an employee | 0 |
| Royann Goodman | |||
| Wife to Steve Goodman - board member | $99,902 | Compensation and benefits as an employee | 0 |
| Cecil Lee Evans | |||
| Son to Cecil Evans - board member | $77,505 | Compensation and benefits as an employee | 0 |
| Yummi Evans | |||
| Daughter-in-law to Cecil Evans - board member | $137,773 | Compensation and benefits as an employee | 0 |
| Michael Carter | |||
| Son to Bart Carter, MD - physician and board member | $109,247 | Compensation and benefits as an employee | 0 |
| Danielle Carter | |||
| Daughter to Bart Carter, MD - physician and board member | $101,341 | Compensation and benefits as an employee | 0 |
| Kyle Lines | |||
| Son-in-law to Bart Carter - board member and employee | $128,890 | Compensation and benefits as an employee | 0 |
| Shelli Carter | |||
| Daughter-in-law to Bart Carter - board member and employee | $12,422 | Compensation and benefits as an employee | 0 |
| Stacie Hincha | |||
| Daughter to Cindy Bryce - board member | $136,887 | Compensation and benefits as an employee | 0 |
| Randy Bryce | |||
| Son-in-law to Jim Palmer - board member | $216,393 | Compensation and benefits as an employee | 0 |
| Jamie Kelliher | |||
| Daughter to Lori Ray - key employee | $26,860 | Compensation and benefits as an employee | 0 |
| Mountain View Anesthesia PC | |||
| Cindy Bryce's son-in-law is >35% owner | $1,400,000 | Payment for services | 0 |
| Gila Valley Orthopedics PC | |||
| Cindy Bryce's brother-in-law is owner | $469,500 | Payment for Orthopedic services | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 7a | The Board includes two Directors who are members in good standing of the active Medical Staff, which includes the Chief of Staff. Five board members referred to as Designated Directors are members of the Mt. Graham Hospital District of Graham County, Arizona. The remaining open positions are appointed by the Corporate Board of Directors. The same individual may serve as a Designated Director in more than one capacity, but is entitled to only one vote and office as Director. |
| Form 990, Part VI, Section A, line 8b | The Organization does not have a committee with authority to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is provided to the board before it is filed. The Finance Committee, CFO and CEO review the Form 990. |
| Form 990, Part VI, Section B, line 12c | Each officer, director, and key employee is required to complete a conflict of interest disclosure annually. The forms are reviewed initially by the Compliance Officer as well as other officers or department directors as necessary. Any actual conflicts are reviewed by the Board of Directors. A person with a conflict is restricted from voting on related matters. |
| Form 990, Part VI, Section B, line 15a | The Board of Directors annually conducts an evaluation of the CEO and sets goals for the coming year. Compensation for the CEO is determined and approved by the Board of Directors. Comparability data is used and the process is documented. The compensation of CFO is approved by the CEO. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents, conflict of interest policy and financial statements are made available upon request at the administrative offices. |
| Form 990, Part IX, line 11g | Professional Fees: Program service expenses 1,637,655. Management and general expenses 951,452. Fundraising expenses 0. Total expenses 2,589,107. Purchased services: Program service expenses 1,750,709. Management and general expenses 1,189,700. Fundraising expenses 0. Total expenses 2,940,409. Medical Professional Fees: Program service expenses 4,835,318. Management and general expenses 68,263. Fundraising expenses 0. Total expenses 4,903,581. |
| Form 990, Part XI, line 9: | Change in Investment in CHS -378. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mt Graham Community Health Services Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 S 20th Avenue | AddressLine1Txt |
| City | Safford | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85546 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860733116 | EIN |
| Primary Activities | Phone answering service | PrimaryActivitiesTxt |
| Legal Domicile State | AZ | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mt Graham Regional Medical Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $22 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $155,112 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |