2022-11-15T13:41:39-06:00 2021-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2021-01-01 237094247 Mt Graham Regional Medical Center Inc MTGR 9283484000 1600 S 20th Avenue Safford AZ 85546 Kathleen Williams VP Finance/CFO 9283484000 2022-11-15 1 Kathleen Williams 999009999 Kim Hunwardsen CPA P00484560 6122536500 2022-11-04 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z Roland Knox 1600 S 20th Avenue Safford AZ 85546 100667433 0 X www.mtgraham.org X 1970 AZ To provide quality and compassionate health care services. 14 6 605 31 0 0 4771188 14265515 62741356 84553077 884179 1443518 360077 391700 68756800 100653810 0 0 0 0 34509376 38462142 0 0 0 33555539 40555229 68064915 79017371 691885 21636439 98886248 112315284 16421508 7006952 82464740 105308332 X We are caring people committed to improving community health. 0 0 62548888 84553077 Mt. Graham Regional Medical Center, Inc. is a 25-bed acute care hospital located in Graham County, Arizona. 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 2021, the Medical Center had 6,059 total inpatient days and 81,873 outpatient 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 that 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 $364,000 for the year ended December 31, 2021, 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. 62548888 1 1 0 0 0 0 0 0 0 0 1 1 0 0 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 1 113 0 1 605 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 6 0 0 1 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 648165 0 27922 David Bryce DO Chief of Staff/ER Physician 40.00 X 653580 0 35025 Brandon Welker DO Member/Vice Chief of Staff 1.00 X 0 0 0 Kimberly Mack Member 1.00 X 0 0 0 Cecil L Evans Member 1.00 X 0 0 0 Steve Goodman Member 1.00 X 0 0 0 Susan J Jones MD Member 1.00 X 4000 0 0 John Martin Member 1.00 X 0 0 0 Carolyn McCormies Member 1.00 X 0 0 0 Jean Reynolds Member 1.00 X 0 0 0 Eldon Woodall Member 1.00 X 0 0 0 Bruce Stanfield Member until Feb 2021 1.00 X 0 0 0 Roland Knox President & CEO 40.00 X 284107 0 27365 Keith Bryce VP Finance & CFO until April 2021 40.00 X 89743 0 11174 Kathleen Williams-Finance Dir thru April/VP Fin/CFO as of May 40.00 X 121110 0 14402 William B Bendall MD Emergency Medicine 36.00 X 510046 0 34236 Clayton Hargis DO Emergency Medicine 36.00 X 499453 0 41971 Jason Branch MD Emergency Medicine 36.00 X 480311 0 34541 Jorden B Marble MD General Surgeon 40.00 X 444798 0 43704 Bryant McNeill MD Hospitalist Internal Medic 40.00 X 388407 0 36287 4123720 0 306627 45 0 1 0 Roadrunner Rehab 2290 16th Street Safford AZ 85546 Rehab Services 1291899 Biofire Diagnostics LLC PO Box 581463 Salt Lake City UT 84158 Lab Svc 821702 Medical Solutions LLC PO Box 850737 Minneapolis MN 55485 Locum Respiratory, Lab, Surgery, & Medsu 708608 Liver Institute 5295 E Knight Drive Tucson AZ 85712 GI services 552154 Mountain View Anesthesia PC PO Box 1318 Thatcher AZ 85552 Anesthesia Services 544017 13 14035867 229648 14265515 Net patient service revenue 621110 83802798 83802798 EHR Incentive 900099 300510 300510 449769 449769 84553077 752573 752573 405323 13623 391700 391700 391700 681555 9390 0 0 681555 9390 690945 690945 100653810 84553077 0 1835218 X 1891172 1303792 587380 1106409 1106409 29116597 24604444 4512153 729242 639234 90008 3490190 2910673 579517 2128532 1791977 336555 45619 45619 94040 94040 8064200 6095178 1969022 193332 5994 187338 7404616 1842254 5562362 646982 645035 1947 30725 25537 5188 72146 52102 20044 65155 65155 3779167 3779167 1178925 1178925 Medical Supplies 11119346 11118464 882 Bad Debt Expense 5474849 5474849 Repairs & Maintenance 2274168 1070852 1203316 Dietary 109851 15664 94187 2108 2108 79017371 62548888 16468483 0 6636955 2039590 9675211 11561531 417320 239896 1693511 2128759 1698171 2477491 94619765 64390949 27110992 30228816 44938303 56076908 6516387 7370630 155868 155490 43530 36173 98886248 112315284 4404511 5324735 5947320 5685000 384677 1682217 16421508 7006952 X 82322998 105152327 141742 156005 82464740 105308332 98886248 112315284 X 21636439 1207531 -378 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1843865 1843865 39593719 24369853 15223866 92292 59069 33223 48102246 37607313 10494933 4987643 2354714 2632929 30228816 Alternative investments 7370630 F 7370630 Estimated third-party settlements 1682217 1682217 96320959 1207531 -5540382 -4332851 100653810 0 100653810 73477367 0 73477367 5540004 5540004 79017371 Part XI, Line 2d - Other Adjustments: Interest Expense Included in Expenses on Form 990 -65,155. Change in CHS Investment Reported as Change in Net Assets on Form 990 -378. Bad Debt Expense Included in Expense on Form 990 -5,474,849. Part XII, Line 4b - Other Adjustments: Interest Expense Included in Revenue on Audit 65,155. Bad Debt Expense Included in Rvenue on Audit 5,474,849. 1 1 X 1 X 1 X 1 1 1 0 0 364000 364000 0.00490 364000 364000 0.00490 424344 424344 0.00580 9202036 6417862 2784174 0.03790 9626380 6417862 3208518 0.04370 9990380 6417862 3572518 0.04860 66784 66784 0.00090 66784 66784 0.00090 0 5474849 832177 6272179 7060021 -787842 X 1 1 1 1 Mt Graham Regional Medical Center 1600 S 20th Avenue Safford AZ 85546 www.mtgraham.org H0140 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 19 1 0 0 1 X www.mtgraham.org/about-us/ X 1 19 1 www.mtgraham.org/about-us/ 0 1 X 150.000000000000 200.000000000000 X X X 1 1 X X X 1 X www.mtgraham.org/cope-charity-care X www.mtgraham.org/cope-charity-care X 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: As part of the process for evaluating community need, a CHNA steering committee was formed. This committee, which was commissioned to guide the CHNA process, was comprised of professionals from a variety of disciplines across the organization and from the community. This steering committee has provided guidance in all aspects of the CHNA process. The Steering Committee members included: *Mt. Graham Regional Medical Center (MGRMC) President and CEO *MGRMC Director of Marketing and Development *Eastern Arizona College Director of Nursing *Graham County Department of Health Services Director *MGRMC Emergency Department Director *MGRMC Rural Health Clinic Medical Director *MGRMC Director of Clinics *MGRMC Social WorkerAssessment Process:The CHNA process started with an overview of our primary service area. The service area was defined as the market where at least 80 percent of inpatient admissions originated. The steering committee then met to build a survey designed to identify gaps in health services available or gaps in access to health services available in MGRMC's service area. This survey was administered online and was also made available through physician offices, the county health department and through community outreach sessions conducted by members of the steering committee. Mt. Graham Regional Medical Center, Inc. Part V, Section B, Line 11: A Community Health Needs Assessment was conducted in 2019. The following statements includes the needs identified and the 2021 actions taken to address the needs.Improved Treatment and Services for Substance Abuse MGRMC continues to provide financial support to the Graham County Substance Abuse Coalition in their 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 to ensure appropriate referrals to substance abuse treatment services and includes coverage for such services in its employee benefits program. Improved Treatment and Services Associated with Mental Health MGRMC continues to collaborate with a variety of providers of mental health services to offer in-person and tele-psych 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 Department partners with local programs that specialize in mental health to make sure all patients have access to the mental healthcare that they are needing. The hospital works closely with mental health providers both in the community and in the Phoenix and Tucson metropolitan areas to ensure the appropriate referral of patients for needed care. Improve Services for Diabetes MGRMC employs a dietician that oversees Diabetes Family Support Group Services that includes individual nutrition counseling, diabetes education, and group support meetings. The dietician works on expanding diabetes knowledge through school visits and community health fairs. The hospital continues to support and participate in the Gila Valley Diabetes Coalition, which exists to increase awareness of and response to diabetes.Improved Opportunities for WellnessThe hospital's Copper Mountain Clinic, a federally designated rural health clinic, provides access to primary care services to include wellness visits, immunizations, illness care, health education, etc. The hospital provides a financial incentive to employees for membership in local fitness facilities. MGRMC is also part of a food coalition with local partners to provide nutritional food and items to underserved communities in food deserts. The hospital will continue to promote wellness through community health fairs, sponsoring health-related community events, and work with local clubs, organizations and wellness facilities to promote wellness activities. The hospital and it's foundation also provide support for runs, golf outings, and other sports and wellness related events.Additional Specialty Services Provided Locally MGRMC added a second general surgeon to our general surgery clinic. We supported a local clinic in the recruitment of family practice and obstetric physicians to the Gila Valley. MGRMC has recruited a full-service cardiology group to provide in-hospital consults, diagnostic reads and soon to provide clinical office services on our campus. We are pursuing clinical initiatives to expand our wound care and outpatient nursing services as well as starting inpatient dialysis services. We are in continuous pursuit of additional specialty services to provide care to our community through our Specialty Clinic that leases space to visiting providers to include oncology, urology, pediatrics, nephology to name a few. Additionally, some of the specialists are offering tele-medicine to increase their presence in the community. Covid Drive-Thru Clinic provided through the Rural Health Clinic from Covid Grant funds, partnership with United Way, MGRMC, and the Health Department. MGRMC opened a free drive-thru clinic that tested for Covid and flu-variants during the Covid Surge. 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 $ 5,474,849. Part II, Community Building Activities: The Hospital employs a financial counselor to assist patients with enrollment in AHCCCS/Cope as part of the charity care and financial assistance. 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 15.2% 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 16 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. 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 15.2% 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 David Bryce DO Chief of Staff/ER Physician 652972 0 608 0 0 0 10150 0 24885 0 688615 0 0 0 Bart J Carter MD FACS Member/General Surgery 646967 0 1198 0 0 0 10150 0 17772 0 676087 0 0 0 William B Bendall MD Emergency Medicine 508907 0 1139 0 0 0 8791 0 25454 0 544291 0 0 0 Clayton Hargis DO Emergency Medicine 497874 0 1579 0 0 0 10150 0 31925 0 541528 0 0 0 Jason Branch MD Emergency Medicine 478257 0 2054 0 0 0 10150 0 24426 0 514887 0 0 0 Jorden B Marble MD General Surgeon 443666 0 1132 0 0 0 10150 0 33611 0 488559 0 0 0 Bryant McNeill MD Hospitalist Internal Medic 386623 0 1784 0 0 0 10150 0 26193 0 424750 0 0 0 Roland Knox President & CEO 282695 0 1412 0 0 0 8730 0 18850 0 311687 0 0 0 Kerri Hopson Daughter to Debra Watson - board member 138753 Compensation and benefits as an employee 0 Royann Goodman Wife to Steve Goodman - board member 107419 Compensation and benefits as an employee 0 Yummi Evans Daughter-in-law to Cecil Evans - board member 126498 Compensation and benefits as an employee 0 Michael Carter Son to Bart Carter, MD - physician and board member 119941 Compensation and benefits as an employee 0 Danielle Carter Daughter to Bart Carter, MD - physician and board member 113518 Compensation and benefits as an employee 0 Stacie Hincha Daughter to Cindy Bryce - board member 140287 Compensation and benefits as an employee 0 Kelly Jo Masten Daughter to Carolyn McCormies - board member 33453 Compensation and benefits as an employee 0 Loni Sanders Daughter to Eldon Woodall - board member 62003 Compensation and benefits as an employee 0 Mountain View Anesthesia PC Cindy Bryce's son-in-law is >35% owner 544017 Payment for services 0 Gila Valley Orthopedics PC Cindy Bryce's brother-in-law is owner 468595 Payment for Orthopedic services 0 Amy Bodine Daughter to Steve Goodman - board member 80385 Compensation and benefits as an employee 0 Cecil Lee Evans Son to Cecil Evans - board member 92695 Compensation and benefits as an employee 0 Kyle Lines Son-in-law to Bart Carter - board member and employee 76662 Compensation and benefits as an employee 0 Shelli Carter Daughter-in-law to Bart Carter - board member and employee 14795 Compensation and benefits as an employee 0 Form 990, Part VI, Section A, line 4 Bylaw Amendment Article IV Section 1: The Board includes two Directors who are members in good standing of the active Medical Staff, which includes the Chief of Staff. The Vice-Chief of Staff was removed as a board member in the Chief of Staff's absence. Article IV, Section 2: The board, or a subcommittee, if designated by the board, appoints elected directors for the following year at the annual meeting of the board. Previously the District Board appointed Directors for the following year at the annual meeting. Article IV, Section 12: The board may go into executive sessions for any reason or no reason, unless prohibited by virtue of the presence of a quorum of the District Board and discussion of business of the District. This was previously limited. Article IV, Section 14: Any Elected Director may be removed by the vote of at lease two-thirds of the Directors, including the Director at issue. The amendment removes Designated Director that may be removed. 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 1,335,639. Management and general expenses 898,463. Fundraising expenses 0. Total expenses 2,234,102. Purchased services: Program service expenses 1,553,643. Management and general expenses 983,397. Fundraising expenses 0. Total expenses 2,537,040. Medical Professional Fees: Program service expenses 3,205,896. Management and general expenses 87,162. Fundraising expenses 0. Total expenses 3,293,058. 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 155490 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0