2023-11-15T07:46:43-06:00 2022-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2022-01-01 237094247 Mt Graham Regional Medical Center Inc MTGR 9283484000 1600 S 20th Avenue Safford AZ 85546 Kathleen Williams VP Finance/CFO 9283484000 2023-11-14 1 Kathleen Williams 999009999 1 Kim Hunwardsen CPA P00484560 6122536500 2023-11-07 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Roland Knox 1600 S 20th Avenue Safford AZ 85546 85395987 0 X www.mtgraham.org X 1970 AZ To provide quality and compassionate health care services. 15 6 616 48 0 0 14265515 302317 84553077 83657311 1443518 981693 391700 450071 100653810 85391392 0 0 0 0 38462142 39371718 0 0 0 40555229 43070926 79017371 82442644 21636439 2948748 112315284 116885615 7006952 13926987 105308332 102958628 X We are caring people committed to improving community health. 0 0 66162507 83657311 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. 66162507 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 0 1 133 0 1 616 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 6 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 1 1 1 0 0 X Kathleen Williams 9283484060 1600 S 20th Avenue Safford AZ 85546 Caro Gaethje Chair 1.00 X X 0 0 0 Debbie Watson Vice Chair 1.00 X X 0 0 0 Cindy Bryce Secretary/Treasurer 1.00 X X 0 0 0 Bart J Carter MD FACS Member/General Surgery 40.00 X 642407 0 32613 David Bryce DO Chief of Staff/ER Physicia 40.00 X 632165 0 33225 Brandon Welker DO Member/Vice Chief of Staff 1.00 X 0 0 0 Cecil L Evans Member 1.00 X 0 0 0 Jean Reynolds Member 1.00 X 0 0 0 Susan J Jones MD Member 24.00 X 18000 0 0 Carolyn McCormies Member until Jun 2022 1.00 X 0 0 0 Steve Goodman Member 1.00 X 0 0 0 John Martin Member 1.00 X 0 0 0 Eldon Woodall Member 1.00 X 0 0 0 Jim Palmer Member starting Feb 2022 1.00 X 0 0 0 Kip Kempton Member starting Mar 2022 1.00 X 0 0 0 Clinton Damron DO Member starting Nov 2022 12.00 X 9750 0 0 Roland Knox President & CEO 40.00 X 298885 0 28424 Kathleen Williams VP Finance & CFO 40.00 X 151541 0 13733 Lori Ray CNO 40.00 X 165014 0 35691 Eric Neal COO 40.00 X 170904 0 32198 William B Bendall MD Emergency Medicine 36.00 X 520170 0 29665 Clayton Hargis DO Emergency Medicine 36.00 X 484636 0 38650 Jorden B Marble MD General Surgeon 40.00 X 470474 0 31200 Bryant McNeill MD Hospitalist Internal Medic 40.00 X 398607 0 42162 Eric Ingulsrud MD Emergency Medicine 40.00 X 368478 0 20501 4331031 0 338062 47 0 1 0 Roadrunner Rehab 2290 16th Street Safford AZ 85546 Physical therapy services 1466650 Mountain View Anesthesia PC PO Box 1318 Thatcher AZ 85552 Anesthesia services 1400000 Medical Solutions LLC PO Box 850737 Minneapolis MN 55485 Locum Respiratory, Lab, Surgery, & Medsu 1362556 Sonora Quest Laboratories LLC PO Box 29661 Dept 2059 Phoenix AZ 85038 Lab services 508971 Liver Institute 5295 E Knight Drive Tucson AZ 85712 GI services 489328 17 276442 25875 302317 Net patient service revenue 621110 82954968 82954968 EHR Incentive 900099 133183 133183 569160 569160 83657311 601165 601165 454666 4595 450071 450071 450071 374788 5740 0 0 374788 5740 380528 380528 85391392 83657311 0 1431764 X 2264545 1771964 492581 1259551 1259551 29831586 24812990 5018596 814262 680865 133397 2991158 2589094 402064 2210616 1844172 366444 143458 143458 122631 122631 10433097 8223682 2209415 149255 3539 145716 6512133 2087329 4424804 702815 700875 1940 99461 55841 43620 80647 40567 40080 70598 70598 5366776 5366776 1175994 1175994 Medical Supplies 10328759 10328289 470 Bad Debt Expense 5317634 5317634 Repairs & Maintenance 2430718 990982 1439736 Dietary 125207 14681 110526 11743 3078 8665 82442644 66162507 16280137 0 2039590 4328319 11561531 12598750 239896 100066 2128759 2127404 2477491 1961600 99427503 68344605 30228816 31082898 56076908 48162533 7370630 6055446 155490 155112 36173 28815 0 10284672 112315284 116885615 5324735 5666709 693675 1682217 7566603 7006952 13926987 X 105152327 102783154 156005 175474 105308332 102958628 112315284 116885615 X 2948748 -5298074 -378 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1843866 1843866 42448869 25787522 16661347 92292 63295 28997 50306407 40023314 10283093 4736069 2470474 2265595 31082898 Alternative investments 6055446 F 6055446 Estimated third-party settlements 631741 Lease receivable 701060 Right-to-use lease assets 8011986 Supplemental payments 939885 10284672 Lease Liabilities 7566603 7566603 74704708 -5298074 -5388610 -10686684 85391392 0 85391392 77054412 0 77054412 5388232 5388232 82442644 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. 1 1 X 1 X 1 X 1 1 1 0 0 334000 334000 0.00430 334000 334000 0.00430 8554171 4719805 3834366 0.04970 8554171 4719805 3834366 0.04970 8888171 4719805 4168366 0.05400 0 5317634 1084797 8631673 8647323 -15650 X 1 1 1 1 Mt Graham Regional Medical Center 1600 S 20th Avenue Safford AZ 85546 www.mtgraham.org H0140 X X X X 1 provider based rural health clinic Mt Graham Regional Medical Center Inc 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X https://www.mtgraham.org/about-us/ X 1 22 1 https://www.mtgraham.org/about-us/ 0 1 X 150.000000000000 200.000000000000 X X X 1 1 X X X 1 X https://www.mtgraham.org/cope-charity-care/ X https://www.mtgraham.org/cope-charity-care/ X https://www.mtgraham.org/cope-charity-care/ X X X X X X X 1 X 0 X X X X 1 X 0 1 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 1 1 - Mt Graham Specialty Clinic 1600 S 20th Avenue Building E Safford AZ 85546 Physician clinic 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. X X X 0 0 0 0 0 0 0 0 0 Bart J Carter MD FACS Member/General Surgery 642173 0 217 0 17 0 10675 0 21938 0 675020 0 0 0 David Bryce DO Chief of Staff/ER Physicia 631938 0 217 0 10 0 10675 0 22550 0 665390 0 0 0 William B Bendall MD Emergency Medicine 519953 0 217 0 0 0 9233 0 20440 0 549843 0 0 0 Clayton Hargis DO Emergency Medicine 484419 0 217 0 0 0 10903 0 27855 0 523394 0 0 0 Jorden B Marble MD General Surgeon 470257 0 217 0 0 0 10675 0 20588 0 501737 0 0 0 Bryant McNeill MD Hospitalist Internal Medic 398390 0 217 0 0 0 10675 0 31543 0 440825 0 0 0 Eric Ingulsrud MD Emergency Medicine 368261 0 217 0 0 0 10675 0 9827 0 388980 0 0 0 Roland Knox President & CEO 298453 0 217 0 215 0 9924 0 18500 0 327309 0 0 0 Eric Neal COO 170446 0 217 0 241 0 6090 0 26108 0 203102 0 0 0 Lori Ray CNO 164702 0 217 0 95 0 6005 0 29687 0 200706 0 0 0 Kathleen Williams VP Finance & CFO 151272 0 217 0 52 0 5150 0 8583 0 165274 0 0 0 Kerri Hopson Daughter to Debra Watson - board member 140100 Compensation and benefits as an employee 0 Amy Bodine Daughter to Steve Goodman - board member 72231 Compensation and benefits as an employee 0 Royann Goodman Wife to Steve Goodman - board member 99902 Compensation and benefits as an employee 0 Cecil Lee Evans Son to Cecil Evans - board member 77505 Compensation and benefits as an employee 0 Yummi Evans Daughter-in-law to Cecil Evans - board member 137773 Compensation and benefits as an employee 0 Michael Carter Son to Bart Carter, MD - physician and board member 109247 Compensation and benefits as an employee 0 Danielle Carter Daughter to Bart Carter, MD - physician and board member 101341 Compensation and benefits as an employee 0 Kyle Lines Son-in-law to Bart Carter - board member and employee 128890 Compensation and benefits as an employee 0 Shelli Carter Daughter-in-law to Bart Carter - board member and employee 12422 Compensation and benefits as an employee 0 Stacie Hincha Daughter to Cindy Bryce - board member 136887 Compensation and benefits as an employee 0 Randy Bryce Son-in-law to Jim Palmer - board member 216393 Compensation and benefits as an employee 0 Jamie Kelliher Daughter to Lori Ray - key employee 26860 Compensation and benefits as an employee 0 Mountain View Anesthesia PC Cindy Bryce's son-in-law is >35% owner 1400000 Payment for services 0 Gila Valley Orthopedics PC Cindy Bryce's brother-in-law is owner 469500 Payment for Orthopedic services 0 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. Mt Graham Community Health Services Inc 1600 S 20th Avenue Safford AZ 85546 860733116 Phone answering service AZ Mt Graham Regional Medical Center Inc C 22 155112 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0