WINSLOW MEMORIAL HOSPITAL INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- WINSLOW MEMORIAL HOSPITAL INC (EIN 86-0107344)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-11
- IRS object ID
- 202032249349301823
- Schema version
- 2018v3.2
- 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 I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-11T14:59:49-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | 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 | 200 E 10TH ST STE 500 | AddressLine1Txt |
| City | SIOUX FALLS | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 571046375 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860107344 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINSLOW MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WINS | BusinessNameControlTxt |
| Phone | 9282894691 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1501 NORTH WILLIAMSON AVENUE | AddressLine1Txt |
| City | WINSLOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86047 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN J DEMPSEY | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9282894691 | PhoneNum |
| Signature | 2020-08-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAURIE HANSON | PreparerPersonNm |
| PTIN | P00851848 | PTIN |
| Phone | 6053391999 | PhoneNum |
| Preparation | 2020-08-04 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 96.2.77.247 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-04 | IPDt |
| IP Tm | 16:24:08 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 87C603189A7DF35062A6A77CB1DDE10F911D97AB | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-22 18:59:49Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITTLE COLORADO MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN J DEMPSEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1501 NORTH WILLIAMSON AVENUE | AddressLine1Txt |
| City | WINSLOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86047 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $38,229,922 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LCMCWMH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1951 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | 1 | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 318 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $11,900 | PYContributionsGrantsAmt |
| CY Contributions Grants | $15,889 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $39,512,267 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $38,152,765 | CYProgramServiceRevenueAmt |
| PY Investment Income | $14,619 | PYInvestmentIncomeAmt |
| CY Investment Income | $12,880 | CYInvestmentIncomeAmt |
| PY Other Revenue | $34,557 | PYOtherRevenueAmt |
| CY Other Revenue | $41,379 | CYOtherRevenueAmt |
| PY Total Revenue | $39,573,343 | PYTotalRevenueAmt |
| CY Total Revenue | $38,222,913 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $6,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,250 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,693,970 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,635,794 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $23,482,780 | PYOtherExpensesAmt |
| CY Other Expenses | $19,603,199 | CYOtherExpensesAmt |
| PY Total Expenses | $40,182,750 | PYTotalExpensesAmt |
| CY Total Expenses | $37,245,243 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$609,407 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $977,670 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $32,486,456 | TotalAssetsBOYAmt |
| Total Assets EOY | $33,576,544 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $18,187,246 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $18,299,632 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,299,210 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $15,276,912 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | COMPASSIONATE CARE FOR NORTHEASTERN ARIZONA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $32,532,334 | ExpenseAmt |
| Grant | $6,250 | GrantAmt |
| Revenue | $38,152,765 | RevenueAmt |
| Desc | WINSLOW MEMORIAL HOSPITAL D/B/A LITTLE COLORADO MEDICAL CENTER (LCMC) GENERAL MEDICAL & SURGICAL HOSPITAL - PRIMARILY ENGAGED IN PROVIDING DIAGNOSIS AND MEDICAL TREATMENT (BOTH SURGICAL AND NONSURGICAL) TO PATIENTS WITH A WIDE VARIETY OF MEDICAL CONDITIONS. LCMC MAINTAINED 25-BEDS, PROVIDED INPATIENTS WITH FOOD SERVICES THAT MET THEIR NUTRITIONAL REQUIREMENTS, AND USED AN ORGANIZED STAFF OF PHYSICIANS AND OTHER MEDICAL STAFF TO PROVIDE PROFESSIONAL CARE SERVICES AS WELL AS OTHER SERVICES. THESE SERVICES INCLUDE OUTPATIENT SERVICES, ANATOMICAL PATHOLOGY SERVICES, DIAGNOSTIC X-RAY SERVICES, CLINICAL LABORATORY SERVICES, OPERATING ROOM SERVICES FOR A VARIETY OF PROCEDURES, AND PHARMACY SERVICES IN THE CITY OF WINSLOW, NAVAJO COUNTY, ARIZONA. LCMC MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES WHICH INCLUDE THE COST OF SUPPLIES AND SERVICES FURNISHED UNDER THE CHARITY CARE POLICY ALONG WITH ASSOCIATED EQUIVALENT SERVICE STATISTICS. | Desc |
| Total Program Service Expenses | $32,532,334 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | 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 | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 38 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 318 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | 0 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AZ | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JANICE FREET | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9282894691 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1501 NORTH WILLIAMSON AVENUE | AddressLine1Txt |
| City | WINSLOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86047 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| BRIAN BUCINA | ||||||||
| MD, SURGEON | 40.00 | 0.00 | Yes (X) | $430,862 | $0 | $47,761 | ||
| RANDALL REID | ||||||||
| MD, GENERAL MEDICINE | 40.00 | 0.00 | Yes (X) | $292,862 | $0 | $42,666 | ||
| CRAIG SEAL | ||||||||
| MD, GENERAL MEDICINE | 40.00 | 0.00 | Yes (X) | $292,619 | $0 | $14,898 | ||
| THOMAS GREENWOOD | ||||||||
| DIRECTOR, MD, CHIEF OF STAFF | 40.00 | 0.50 | $243,081 | $0 | $33,284 | Yes (X) | ||
| JAMES PAGE | ||||||||
| MD, GENERAL MEDICINE | 40.00 | 0.00 | Yes (X) | $204,786 | $0 | $32,449 | ||
| JANICE FREET | ||||||||
| CFO | 40.00 | 0.00 | $178,003 | $0 | $16,727 | Yes (X) | ||
| JOHN SEARS | ||||||||
| MD, GENERAL MEDICINE | 40.00 | 0.00 | Yes (X) | $171,331 | $0 | $20,553 | ||
| LOREN SADLER | ||||||||
| CHAIRPERSON | 5.00 | 0.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| RHONDA GREER | ||||||||
| VICE-CHAIRPERSON | 1.00 | 0.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| FRANK ARMAO MD | ||||||||
| SECRETARY/TREASURER | 1.00 | 0.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| JR DESPAIN | ||||||||
| DIRECTOR | 1.00 | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| CHRIS BAVASI | ||||||||
| DIRECTOR | 1.00 | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| DAVID COOLIDGE | ||||||||
| DIRECTOR UNTIL 06/2019 | 1.00 | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| ROBERT SALABYE | ||||||||
| DIRECTOR | 1.00 | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| ELIAS JOUEN | ||||||||
| DIRECTOR UNTIL 06/2019 | 1.00 | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| DR MATTHEW SUTTON | ||||||||
| DIRECTOR, MD, CHIEF OF STAFF | 1.00 | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| ROBERTA CANO | ||||||||
| DIRECTOR FROM 06/2019 | 1.00 | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| ANDREW DITTO MD | ||||||||
| DIRECTOR FROM 06/2019 | 1.00 | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| JOHN J DEMPSEY | ||||||||
| CEO | 40.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,813,544 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $208,338 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | 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 |
|---|---|---|---|---|---|
| XTEND HEALTHCARE LLC | |||||
| 90 VOLUNTEER DR SUITE 150 | HENDERSONVILLE | TN | 37075 | BILLING SERVICES | $690,644 |
| MEDICAL SOLUTIONS LLC | |||||
| PO BOX 310737 | DES MOINES | IA | 50331 | TEMP STAFFING | $397,058 |
| WINNCARE LLC | |||||
| 1031 N WARREN | WINSLOW | AZ | 86047 | PHYSICIAN SERVICES | $381,600 |
| LEDBETTER LAW FIRM PLC THE | |||||
| 1003 NORTH MAIN STREET | COTTONWOOD | AZ | 86326 | LEGAL SERVCES | $371,922 |
| JG ANESTHESIA SERVICES LLC | |||||
| 2973 N KRISTEN DRIVE | FLAGSTAFF | AZ | 86001 | CRNA SERVICES | $252,525 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $8,835 | GovernmentGrantsAmt |
| All Other Contributions | $7,054 | AllOtherContributionsAmt |
| Total Contributions | $15,889 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $37,225,905 | $37,225,905 |
| PHARMACY REVENUE | 900099 | $534,247 | $534,247 |
| MEAL & VENDING REVENUE | 900099 | $61,611 | $61,611 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $331,002 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $331,002 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $38,152,765 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,889 | TotalRevenueColumnAmt |
| Exclusion | $19,889 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $41,379 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $41,379 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $41,379 | TotalRevenueColumnAmt |
| Exclusion | $41,379 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,009 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$7,009 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$7,009 | TotalRevenueColumnAmt |
| Exclusion | -$7,009 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,222,913 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $38,152,765 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $54,259 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,250 | TotalAmt |
| Program Services | $6,250 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $523,097 | TotalAmt |
| Program Services | $296,816 | ProgramServicesAmt |
| Management And General | $226,281 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,516,750 | TotalAmt |
| Program Services | $12,068,252 | ProgramServicesAmt |
| Management And General | $1,448,498 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $401,326 | TotalAmt |
| Program Services | $351,833 | ProgramServicesAmt |
| Management And General | $49,493 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,221,033 | TotalAmt |
| Program Services | $1,912,941 | ProgramServicesAmt |
| Management And General | $308,092 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $973,588 | TotalAmt |
| Program Services | $837,233 | ProgramServicesAmt |
| Management And General | $136,355 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $350,301 | TotalAmt |
| Management And General | $350,301 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,248 | TotalAmt |
| Management And General | $333,248 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,855 | TotalAmt |
| Management And General | $88,855 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,351,000 | TotalAmt |
| Program Services | $5,262,898 | ProgramServicesAmt |
| Management And General | $88,102 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,485 | TotalAmt |
| Management And General | $42,485 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,452,719 | TotalAmt |
| Program Services | $1,391,369 | ProgramServicesAmt |
| Management And General | $61,350 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,885 | TotalAmt |
| Management And General | $420,885 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $390,628 | TotalAmt |
| Program Services | $388,474 | ProgramServicesAmt |
| Management And General | $2,154 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,698 | TotalAmt |
| Program Services | $4,698 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $226,546 | TotalAmt |
| Program Services | $171,602 | ProgramServicesAmt |
| Management And General | $54,944 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $723,984 | TotalAmt |
| Program Services | $559,412 | ProgramServicesAmt |
| Management And General | $164,572 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,616,094 | TotalAmt |
| Program Services | $1,329,464 | ProgramServicesAmt |
| Management And General | $286,630 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $407,948 | TotalAmt |
| Program Services | $365,045 | ProgramServicesAmt |
| Management And General | $42,903 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $3,854,056 | $3,854,056 | |
| SUPPLIES | $2,659,607 | $2,646,122 | $13,485 |
| EQUIPMENT RENTAL & MAIN | $289,314 | $280,872 | $8,442 |
| FOOD | $134,270 | $130,971 | $3,299 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,256,561 | TotalAmt |
| Program Services | $674,026 | ProgramServicesAmt |
| Management And General | $582,535 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,245,243 | TotalAmt |
| Program Services | $32,532,334 | ProgramServicesAmt |
| Management And General | $4,712,909 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,080,853 | BOYAmt |
| EOY | $10,513,763 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,550,448 | BOYAmt |
| EOY | $6,777,393 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $173,925 | BOYAmt |
| EOY | $173,925 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $908,547 | BOYAmt |
| EOY | $977,948 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $329,055 | BOYAmt |
| EOY | $247,427 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $35,804,940 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $22,444,217 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,678,510 | BOYAmt |
| EOY | $13,360,723 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,423,118 | BOYAmt |
| EOY | $1,525,365 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $342,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,486,456 | BOYAmt |
| EOY | $33,576,544 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,518,840 | BOYAmt |
| EOY | $2,804,941 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,890,271 | BOYAmt |
| EOY | $14,581,684 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $778,135 | BOYAmt |
| EOY | $913,007 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,187,246 | BOYAmt |
| EOY | $18,299,632 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,299,210 | BOYAmt |
| EOY | $15,276,912 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,299,210 | BOYAmt |
| EOY | $15,276,912 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,486,456 | BOYAmt |
| EOY | $33,576,544 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $977,670 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $32 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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) |
|---|---|---|
| Investment Cost Or Other Basis | $135,526 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $72,347 | OtherCostOrOtherBasisAmt |
| Book Value | $207,873 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,594,516 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,813,713 | DepreciationAmt |
| Book Value | $7,780,803 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,950,463 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,630,504 | DepreciationAmt |
| Book Value | $5,319,959 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $52,088 | OtherCostOrOtherBasisAmt |
| Book Value | $52,088 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,360,723 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $627,407 |
| SETTLEMENT AGREEMENT | $138,000 |
| DEFERRED COMPENSATION | $147,600 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $913,007 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $34,368,889 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$3,854,024 | OtherRevenueAmt |
| Revenue Not Reported | -$3,854,024 | RevenueNotReportedAmt |
| Revenue Subtotal | $38,222,913 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $38,222,913 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $33,391,187 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $33,391,187 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $3,854,056 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,854,056 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $37,245,243 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE HOSPITAL WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS -3,854,056. CHANGE IN NET ASSETS OF FOUNDATION 32. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS 3,854,056. |
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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 125.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $258,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $258,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00770 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,204,779 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,394,670 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,810,109 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05420 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,462,779 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,394,670 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,068,109 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06190 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $57,884 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $57,884 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $105,923 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,797 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $98,126 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $163,807 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,797 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $156,010 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00460 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,626,586 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,402,467 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,224,119 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06650 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,854,056 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,233,298 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,029,053 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,022,369 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $6,684 | 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 | LITTLE COLORADO MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1501 N WILLIAMSON AVE | AddressLine1Txt |
| City | WINSLOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86047 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.LCMCWMH.COM | WebsiteAddressTxt |
| State License | RGH 0076 | 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 |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITTLE COLORADO MEDICAL CENTER | 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 | 16 | 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 | SEE 7D NARRATIVE | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.LCMCWMH.COM/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 | 125.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE 16A-C NARRATIVE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE 16A-C NARRATIVE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE 16A-C NARRATIVE | 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 |
| 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 Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| LITTLE COLORADO MEDICAL CENTER | PART V, SECTION B, LINE 5: LCMC SOLICITED INPUT FROM MULTIPLE SOURCES IN THE COMMUNITY, INCLUDING GROUPS THAT WORK WITH DISADVANTAGED POPULATIONS. LCMC CONDUCTED THE CHNA DURING THE YEAR ENDED 9/30/17. LCMC SOLICITED INPUT THROUGH FOCUS GROUPS, TOWN MEETINGS, COMMUNITY COALITIONS, COMMUNITY HEALTH SURVEYS, PUBLIC HEALTH AND HOSPITAL DATA, INTERVIEWS WITH MENTAL AND BEHAVIORAL HEALTH PROVIDERS, EMERGENCY SERVICES PERSONNEL, A COMMUNITY ADVISORY COMMITTEE, VOLUNTEER ORGANIZATIONS, AND INDIAN HEALTH SERVICES TO IDENTIFY THE NEEDS OF THE COMMUNITY. |
| LITTLE COLORADO MEDICAL CENTER | PART V, SECTION B, LINE 6B: COLLEGE OF PUBLIC HEALTH, THE UNIVERSITY OF ARIZONA, AND HEALTH EQUITY RESEARCH GROUP, NORTHERN ARIZONA UNIVERSITY. |
| LITTLE COLORADO MEDICAL CENTER | PART V, SECTION B, LINE 7D: THE CHNA REPORT IS AVAILABLE AT HTTPS://WWW.LCMCWMH.COM/ABOUT-US. |
| LITTLE COLORADO MEDICAL CENTER | PART V, SECTION B, LINE 11: THE FOLLOWING COMMUNITY HEALTH NEEDS WERE IDENTIFIED DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") PROCESS PERFORMED IN 2017. LCMC HAS COMMENCED WORK TO ADDRESS THOSE COMMUNITY CONDITIONS.LOW INCOME AND POVERTY A. ACCESS TO CARE LCMC CONTINUES TO ASSIST PEOPLE TO ENROLL IN ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM (AHCCCS) AND TRIES TO CONNECT THEM WITH RESOURCES WHEN THEY ARE IN THE HOSPITAL. PATIENTS ALSO HAVE ACCESS TO FINANCIAL COUNSELORS TO HELP THEM ENROLL IN AHCCCS. ADDITIONALLY, DURING THE 2019 FISCAL YEAR, LCMC HAS DEVELOPED STRONGER TIES AND COLLABORATION WITH LOCAL SOCIAL SERVICE AGENCIES TO SUPPORT THOSE LIVING IN POVERTY. LCMC ALSO WORKS TO HIRE LOCALLY AND OFFERS PROGRAMS TO SUPPORT AND TRAIN COMMUNITY MEMBERS FOR CAREERS AS NURSES.B. PROGRAM DEVELOPMENT THE HOSPITAL ALSO TRIES TO HIRE LOCALLY AND OFFERS PROGRAMS TO SUPPORT AND TRAIN COMMUNITY MEMBERS FOR CAREERS AS NURSES. LCMC WORKS CLOSELY WITH NORTHLAND PIONEER COLLEGE AS WELL AS OTHER EDUCATIONAL FACILITIES TO PROVIDE A PLACE FOR TRAINING AS WELL AS A FUTURE CAREER. LCMC NOW HAS RURAL HEALTH CLINIC (RHC) STATUS; THIS IS THE HOSPITAL'S FIRST FULL FISCAL YEAR DESIGNATED AS A RHC. LCMC IS WORKING TO CHANGE ITS CLINIC FROM HOSPITAL BASED TO AN RHC TO DECREASE COSTS TO PATIENTS BY ELIMINATING FACILITY FEES. C. EDUCATIONEDUCATION HAS BEEN RECOGNIZED AS AN IMPORTANT FACTOR IN REDUCING POVERTY, AS WELL AS PROVIDING A LADDER OUT OF POVERTY. LCMC MAINTAINS AND CONTINUES TO IMPROVE UPON ACTIVE ENGAGEMENT WITH THE LOCAL HIGH SCHOOL AND COMMUNITY COLLEGE, INCLUDING SERVICE ON THE HEALTH PROFESSIONS AND BUSINESS ADVISORY COMMITTEES. WE ANTICIPATE IMPLEMENTING OVER THE NEXT FISCAL YEAR A RENEWED VOLUNTEER PROGRAM, WHICH WILL INCLUDE A SPECIFIC FOCUS TO HIGH SCHOOL STUDENTS TO INTRODUCE THEM TO HEALTH PROFESSIONALS. II. MENTAL AND BEHAVIORAL HEALTH LCMC'S NURSING ADMINISTRATION AND SOCIAL WORK TEAM COLLABORATE ON PATIENT SPECIFIC BASIS WITH A LOCAL BEHAVIORAL HEALTH AGENCY, ADULT PROTECTIVE SERVICES AND SOCIAL SECURITY. LCMC IS ALSO DEVELOPING A CLINICALLY SUPPORTED TRANSPORTATION MODEL. THE HOSPITAL ACTIVELY COMMUNICATES WITH THE LOCAL PRISON AND DEPARTMENT OF CORRECTIONS STAFF REGARDING SAFE AND EFFECTIVE CARE OF INMATES WITH BEHAVIORAL HEALTH ISSUES. WE ALSO PARTICIPATE IN STATE AND HEALTH CHOICE INTEGRATED CARE, ASU BEHAVIORAL HEALTH CENTER, AND PLANNED ASSISTANCE NETWORK OF ARIZONA TO IMPROVE THE QUALITY OF BEHAVIORAL HEALTH AND INTEGRATED MEDICAL CARE. THE BEHAVIORAL HEALTH UNIT HAS IMPLEMENTED THE FOLLOWING ELEMENTS INTO ITS COMPREHENSIVE STRATEGY TO ADDRESS BEHAVIORAL HEALTH ISSUES:MEETING QUARTERLY WITH CHANGEPOINT INCLUDING THE LEADERSHIP TEAM FROM WINSLOW, HOLBROOK AND THE INPATIENT BEHAVIORAL HEALTH FACILITY IN SHOW LOW;MEETING MONTHLY WITH THE WIHCC CARE COORDINATORS AND SOCIAL WORK DIRECTOR;OUR CARE COORDINATION TEAM IS DEVELOPING RELATIONSHIPS WITH BEHAVIORAL HEALTH FACILITIES ACROSS ARIZONA TO ASSURE APPROPRIATE PLACEMENT OF PATIENTS IN NEED; PLANNING TRAINING FOR OUR SOCIAL WORKERS TO DO BEHAVIORAL HEALTH INTAKE ASSESSMENTS IN COORDINATION WITH CHANGEPOINT; AND, LOOKING INTO OFFERING TELEHEALTH BEHAVIORAL COUNSELING IN THE CLINIC.III. IMPROVED HEALTH CARE DELIVERYLCMC'S QUALITY DEPARTMENT COMMENCED A COMMUNITY COLLABORATION INITIATIVE. SEVERAL MEETINGS HAVE BEEN HELD WITH SOCIAL SERVICE AND CLINICAL ORGANIZATIONS IN THE WINSLOW COMMUNITY, INCLUDING: WIHCC; NORTH COUNTRY AND COMMUNITY BRIDGES; LOCAL BEHAVIORAL HEALTH AGENCIES; AND ADULT PROTECTIVE SERVICES AND SOCIAL SECURITY. THOSE MEETINGS HAVE ALREADY CONTRIBUTED TO MORE EFFECTIVE COLLABORATION ON PATIENT CARE MATTERS. LCMC CONTINUES TO WORK WITH REGIONAL GOVERNMENT AND PRIVATE AGENCIES TO DEVELOP A TRANSPORTATION MODEL IN SUPPORT OF VULNERABLE AND POOR MEMBERS OF OUR COMMUNITY. THE HOSPITAL CONTINUES ITS WORK WITH THE LOCAL PRISON AND DEPARTMENT OF CORRECTIONS STAFF REGARDING SAFE AND EFFECTIVE CARE OF INMATES WITH BEHAVIORAL HEALTH ISSUES. WE ALSO PARTICIPATE IN STATE AND HEALTH CHOICE INTEGRATED CARE AND PLANNED ASSISTANCE NETWORK OF ARIZONA TO IMPROVE THE QUALITY OF BEHAVIORAL HEALTH AND INTEGRATED MEDICAL CARE. IV. SUBSTANCE ABUSELCMC CONTINUES TO WORK WITH THE CITY AND TRIBAL AUTHORITIES TO ADDRESS THIS LONGSTANDING LOCAL ISSUE. LCMC'S CEO HAS CONTACTED NORTHERN ARIZONA BEHAVIORAL HEALTH ASSOCIATION (NARBA) REGARDING ISSUES WITH THE LOCAL DETOX CENTER DECLINING ADMISSION OF CERTAIN INDIVIDUALS.THE HOSPITAL HAS MADE THE FOLLOWING STRATEGIC CHOICES TO ADDRESS SUBSTANCE ABUSE IN THE COMMUNITY: DIRECT DELIVERY OF NARCAN KITS TO THE ED; MEMBERS OF THE HOSPITAL'S CARE COORDINATION TEAM HAVE GONE TO CONFERENCES TO LEARN MORE ON HOW TO ADDRESS THE OPIOID ISSUE AND REPORTED BACK WITH NEW IDEAS; AND CHRONIC PAIN PATIENTS THAT WERE BEING SEEN IN OUR CLINIC HAVE BEEN REFERRED TO PAIN MANAGEMENT SPECIALIST PROVIDERS FOR SPECIALIZED CARE.V. SENIOR HEALTH CARELCMC PROVIDES INFORMATION TO OUR PATIENTS ON THE SERVICES OFFERED BY THE SENIOR CENTER. ANOTHER NEED FOR SENIORS IS PHYSICAL THERAPY AND REHABILITATION. ALTHOUGH WINSLOW HAS AN EXCELLENT PHYSICAL THERAPY PRACTICE, IT IS NOT ABLE TO KEEP UP WITH THE INCREASING NEEDS OF THE AGING POPULATION. LCMC IS ACTIVELY WORKING TO EXPAND OUR SERVICES TO INCLUDE PHYSICAL THERAPY TO MEET THE INCREASED NEED WITHIN THE COMMUNITY. THERE IS SIGNIFICANT NEED FOR OUTPATIENT TREATMENTS FOR PATIENTS LOCALLY, SUCH AS WOUND CARE AND INTRAVENOUS ANTIBIOTICS. LCMC RECENTLY EXPANDED ITS WOUND CARE CLINIC ON THE HOSPITAL CAMPUS. LCMC ED HAS EXPANDED ITS INFUSION THERAPY FOR MANY ANTIBIOTICS AND CERTAIN OTHER INFUSIONS. MANY OF THE PATIENTS CURRENTLY USING THESE SERVICES WERE PREVIOUSLY TRAVELING TO FLAGSTAFF OR REQUIRING A STAY IN A NURSING HOME FOR TREATMENT. VI. OBESITY AND DIABETESLCMC CONTINUES TO PROVIDE HOT, NUTRITIOUS MEALS ON HOSPITAL PREMISES AND TO FACILITATE DELIVERY OF NUTRITIOUS MEALS TO HOME BOUND SENIORS. VII. PROVIDER SHORTAGELCMC HAS EFFECTIVELY WORKED WITH HRSA TO OBTAIN LCMC HPSA STATUS TO FACILITATE PROVIDER RECRUITMENT AND RETENTION, INCLUDING LOAN REPAYMENT QUALIFICATION. LCMC HAS RECRUITED A NEW EMERGENCY MEDICINE GROUP, INCLUDING SEVERAL NEW PROVIDERS DELIVERING CARE TO LCMC PATIENTS. LCMC HAS ALSO RECRUITED THREE PRIMARY CARE PROVIDERS TO THE LCMC CLINIC. FURTHERMORE, THE HOSPITAL PERFORMS OUTREACH TO THE LOCAL SCHOOL DISTRICT AND COMMUNITY COLLEGE TO INTRODUCE AND SUPPORT STUDENTS IN HEALTHCARE FIELDS. |
| LITTLE COLORADO MEDICAL CENTER | PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON A CASE-BY-CASE BASIS. |
| LITTLE COLORADO MEDICAL CENTER | PART V, SECTION B, LINE 16J: PART V, SECTION B, LINE 16A, B & C: THE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAUGE SUMMARY OF THE FAP ARE POSTED ON THE ORGANIZATION'S WEBSITE AT WWW.LCMCWMH.COM/PATIENTS---VISITORSPART V, SECTION B, LINE 16J:A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED IN THE EMERGENCY ROOM, WAITING ROOMS, ADMISSIONS OFFICE AND WAS MADE AVAILABLE UPON REQUEST.MORE THAN THE LESSER OF 5% OR 1,000 INDIVIDUALS IN THE SERVICE AREA ARE LEP. HOWEVER, THE LANGUAGE SPOKEN, NAVAJO, IS NOT A WRITTEN LANGUAGE. THE FACILITY HAS STAFF WHO SPEAK NAVAJO AND ARE ABLE TO ASSIST PATIENTS IN COMPLETING FINANCIAL ASSISTANCE FORMS. |
| LITTLE COLORADO MEDICAL CENTER | PART V, SECTION B, LINE 24: THE HOSPITAL FINANCIAL ASSISTANCE POLICY DOES NOT COVER ELECTIVE PROCEDURES. THE HOSPITAL MAY HAVE CHARGED FAP ELIGIBLE PATIENTS GROSS CHARGES FOR SERVICES THAT ARE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY. |
| PART V, LINE 10 IMPLEMENTATION STRATEGY | DESCRIPTION OF FAILURE:TYPE OF FAILURE: 501(R)(3) THE MOST RECENT AND PRIOR IMPLEMENTATION STRATEGY REPORTS WERE NOT AVAILABLE ON THE ORGANIZATION'S WEBSITE FOR A PERIOD OF TIME. THE DOCUMENTS WERE AVAILABLE BY CONTACTING THE HOSPITAL.CAUSE OF THE FAILURE: AN INADVERTENT TECHNOLOGICAL MALFUNCTION CAUSED THE DOCUMENTS TO BE REMOVED FROM THE WEBSITE.FACILITY OR FACILITIES WHERE THE FAILURE OCCURRED: THE FAILURE OCCURRED AT WINSLOW MEMORIAL HOSPITAL INC.THE DATE(S) OF THE FAILURE AND ITS DISCOVERY: UNKNOWN, MARCH 5, 2020THE NUMBER OF OCCURRENCES: NOT APPLICABLEDESCRIPTION OF THE CORRECTION OF THE FAILURE:METHOD OF CORRECTION: THE IMPLEMENTATION STRATEGY REPORTS WERE MADE AVAILABLE ON THE WEBSITE.DATE OF CORRECTION: MARCH 17, 2020DESCRIPTION OF THE PRACTICES OR PROCEDURES PUT INTO PLACE:THE IMPLEMENTATION STRATEGY REPORTS WERE POSTED ON THE WEBSITE AT WWW.LCMCWMH.COM/ABOUT-US. THE DOCUMENTS ARE ALSO AVAILABLE AT THE HOSPITAL. |
| PART V, LINE 16A FINANCIAL ASSISTANCE POLICY, AND 16C PLAIN LANGUAGE SUMMARY | DESCRIPTION OF FAILURE:TYPE OF FAILURE: 501(R)(4) THE FINANCIAL ASSISTANCE POLICY AND PLAIN LANGUAGE SUMMARY WERE NOT AVAILABLE ON THE ORGANIZATION'S WEBSITE FOR A PERIOD OF TIME. THE DOCUMENTS WERE AVAILABLE BY CONTACTING THE HOSPITAL AND WERE INCLUDED IN PATIENT BILLINGS AS REQUIRED.CAUSE OF THE FAILURE: AN INADVERTENT TECHNOLOGICAL MALFUNCTION CAUSED THE DOCUMENTS TO BE REMOVED FROM THE WEBSITE.FACILITY OR FACILITIES WHERE THE FAILURE OCCURRED: THE FAILURE OCCURRED AT WINSLOW MEMORIAL HOSPITAL INC.THE DATE(S) OF THE FAILURE AND ITS DISCOVERY: UNKNOWN, MARCH 5, 2020THE NUMBER OF OCCURRENCES: NOT APPLICABLEDESCRIPTION OF THE CORRECTION OF THE FAILURE:METHOD OF CORRECTION: THE FINANCIAL ASSISTANCE POLICY AND PLAIN LANGUAGE SUMMARY WERE MADE AVAILABLE ON THE WEBSITE.DATE OF CORRECTION: MARCH 17, 2020DESCRIPTION OF THE PRACTICES OR PROCEDURES PUT INTO PLACE:THE FINANCIAL ASSISTANCE POLICY AND PLAIN LANGUAGE SUMMARY WERE POSTED ON THE WEBSITE AT WWW.LCMCWMH.COM/PATIENTS---VISITORS. THE DOCUMENTS ARE ALSO AVAILABLE AT THE HOSPITAL. |
| 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 - LITTLE COLORADO PHYSICIANS OFFICE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 LEE STREET | AddressLine1Txt |
| City | WINSLOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86047 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | PROVIDER BASED RURAL HEALTH CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | IN ADDITION TO UTILIZING FPG TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE, THE HOSPITAL CONSIDERED MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS OF PATIENTS. PRESUMPTIVE ELIGIBILITY MAY BE USED ON A CASE-BY-CASE BASIS. |
| PART I, LINE 7: | CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. LINES 7B AND 7E WERE DETERMINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. LINE 7G WAS DETERMINED BASED ON THE COST REPORT. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE OF $3,854,056 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | LCMC GAVE $6,000 TO THE LOCAL SENIOR CENTER TO HELP FUND MEALS ON WHEELS AND OTHER HEALTH AND WELLNESS INITIATIVES. |
| PART III, LINE 2: | BAD DEBT EXPENSE ON PART III LINES 2 AND 3 IS BASED ON CHARGES. IF AN ACCOUNT IS WRITTEN OFF TO BAD DEBTS, PAYMENTS RECEIVED OR DISCOUNTS GIVEN AFTER THE WRITE OFF FOR THAT ACCOUNT ARE POSTED TO THE CURRENT YEAR RECOVERY FOR BAD DEBT ACCOUNT AS AN OFFSET AGAINST THE CURRENT BAD DEBT EXPENSE. |
| PART III, LINE 3: | THE BAD DEBT EXPENSE INCLUDES AN ESTIMATED $1,233,298 OF CHARITY CARE-ELIGIBLE ACCOUNTS THAT ARE CURRENTLY LISTED AS BAD DEBT. UPON REVIEWING THE ACCOUNTS AND THE POVERTY LEVELS OF NAVAJO AND APACHE COUNTIES IN ARIZONA, IT WAS FOUND THAT ABOUT 32% OF THE OUTSTANDING BALANCES MAY HAVE BEEN ELIGIBLE UNDER THE FACILITY'S CHARITY CARE POLICY. ALSO FOR THIS REVIEW PROCESS, ANY FAMILIES WITH PRIOR APPLICATIONS FOR CHARITY CARE WERE GIVEN CONSIDERATION. |
| PART III, LINE 4: | THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSES IS LOCATED IN FOOTNOTE 1 ON PAGES 7 & 8 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR THE FISCAL YEAR ENDING 9/30/2019. MEDICAL SERVICES ARE PROVIDED TO PATIENTS WITH MEDICARE COVERAGE REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED. PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE VITALLY NEEDED BY OUR COMMUNITY. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. |
| PART III, LINE 9B: | ONCE THE BALANCE ON THE PATIENT'S ACCOUNT IS READY FOR BILLING THE PATIENT RECEIVES AN INITIAL STATEMENT. THE PATIENT WILL THEN RECEIVE A SECOND STATEMENT AT DAY 30 ALONG WITH A FOLLOW UP PHONE CALL, A THIRD STATEMENT AT DAY 60, A FINAL STATEMENT AT DAY 90 WITH A FOLLOW UP PHONE CALL AND IF NO ATTEMPTS HAVE BEEN MADE TO RESOLVE THEIR ACCOUNT, THE PATIENT'S ACCOUNT IS TURNED TO COLLECTIONS AT DAY 121 WITH A NOTIFICATION LETTER SENT TO THE PATIENT INFORMING THEM OF SUCH. THE 90 DAY FINAL STATEMENT INCLUDES A NOTE INFORMING THE PATIENT THAT THE ACCOUNT MAY GO TO COLLECTIONS IF PAYMENT IN FULL OR OTHER ARRANGEMENTS ARE NOT MADE WITHIN THE NEXT 30 DAYS. IF OUR COLLECTION AGENCY IDENTIFIES A PATIENT IS MEETING FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA, THE PATIENT'S ACCOUNT MAY BE CONSIDERED FOR FINANCIAL ASSISTANCE. COLLECTION ACTIVITY WILL BE SUSPENDED ON ACCOUNTS, AND THE FINANCIAL ASSISTANCE APPLICATION WILL BE REVIEWED. IF THE ENTIRE ACCOUNT BALANCE IS ADJUSTED, THE ACCOUNT WILL BE RETURNED. IF A PARTIAL ADJUSTMENT OCCURS, THE PATIENT FAILS TO COOPERATE WITH THE FINANCIAL ASSISTANCE PROCESS, OR IF THE PATIENT IS NOT ELIGIBLE FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY WILL RESUME. REQUESTS FOR CHARITY SHALL BE PROCESSED PROMPTLY AND LITTLE COLORADO MEDICAL CENTER SHALL NOTIFY THE PATIENT OR APPLICANT IN WRITING WITHIN 30 DAYS OF RECEIPT OF A COMPLETED APPLICATION. ACCOUNTS ELIGIBLE FOR CHARITY CARE ARE TO BE ADDRESSED WITHIN 240 DAYS OF FIRST BILL. FOR FINANCIAL ASSISTANCE BEFORE AN ACCOUNT GETS TO COLLECTIONS. |
| PART VI, LINE 2: | LCMC ASSESSES HEALTH NEEDS BY EVALUATING THE PATIENTS SERVED IN THE CLINICS AND HOSPITAL. LCMC HAS STAFF THAT PARTICIPATE IN VARIOUS ORGANIZATIONS INCLUDING THE COUNCIL FOR AGING, ALICE'S PLACE, THE WINSLOW ROTARY, ETC. STAFF ARE MADE AWARE OF NEEDS OF THE COMMUNITY THROUGH THEIR INVOLVEMENT WITH THESE ORGANIZATIONS. ADDITIONALLY, LCMC HAS MONTHLY MEDICAL EXECUTIVE AND BI-ANNUAL MEDICAL STAFF MEETINGS TO DETERMINE THE HEALTH NEEDS OF THE COMMUNITY. |
| PART VI, LINE 3: | LCMC'S PATIENT BILLING STATEMENTS HAVE A NARRATIVE ATTACHED DESCRIBING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THE CONTACT INFORMATION FOR HOW TO OBTAIN ADDITIONAL INFORMATION. NOTICES OF FINANCIAL ASSISTANCE AVAILABILITY ARE POSTED IN THE ER, WAITING ROOMS, AND ADMISSIONS OFFICE. |
| PART VI, LINE 4: | LCMC IS LOCATED IN THE COMMUNITY OF WINSLOW WHICH IS LOCATED IN NAVAJO COUNTY, ARIZONA, AND SERVES THE HEALTHCARE NEEDS OF THE COMMUNITY AND SURROUNDING AREAS. THE SERVICE AREA IS MOSTLY RURAL WITH A POPULATION OF APPROXIMATELY 23,000 PEOPLE. THE AVERAGE HOUSEHOLD INCOME IS $47,236 WITH 50% OF THE POPULATION HAVING AN INCOME OF LESS THAN $35,000. MORE THAN 40% OF THE PATIENTS SERVED BY LCMC ARE ON THE ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM, AND MORE THAN 60% OF THE SERVICE AREA ARE OF NATIVE AMERICAN DESCENT. THE NEAREST HOSPITAL IS 60 MILES FROM WINSLOW. WINSLOW IS IN AN AREA FEDERALLY DESIGNATED AS A HEALTH PROFESSIONAL SHORTAGE AREA, A MEDICALLY UNDERSERVED AREA, AND A PERSISTENT POVERTY COUNTY. |
| PART VI, LINE 5: | LCMC'S BOARD OF DIRECTORS ALL RESIDE IN THE ORGANIZATION'S SERVICE AREA WITH THE EXCEPTION OF THREE MEMBERS AT LARGE WHO ARE FROM FLAGSTAFF, AZ. LCMC EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PROVIDERS IN ITS COMMUNITY AND SURROUNDING AREA FOR SOME OR ALL OF ITS DEPARTMENTS. LCMC REINVESTS SURPLUS FUNDS, IF ANY, TO IMPROVEMENTS IN PATIENT CARE, INCLUDING BUT NOT LIMITED TO EXPANSION OF SERVICES OFFERED, PATIENT EDUCATION, EMPLOYEE EDUCATION, AND EQUIPMENT AND FACILITY RENOVATIONS. |
| PART VI, LINE 6: | NONE |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINSLOW COUNCIL ON AGING | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 212 EAST SECOND STREET | AddressLine1Txt |
| City | WINSLOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86047 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 860310351 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $6,000 | CashGrantAmt |
| Purpose Of Grant | MEALS ON WHEELS PROGRAM ASSISTANCE | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | LCMC PROVIDES ASSISTANCE TO THE COALITION ON AGING TO ASSIST WITH MEALS ON WHEELS, FOOD BANK, AND TRANSPORTATION FOR SENIORS. LCMC MAY PERIODICALLY CONTACT THE COALITION AND REQUEST CONFIRMATION THAT FUNDS ARE USED AS INTENDED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRIAN BUCINA | ||||||||||||||
| MD, SURGEON | $430,862 | $0 | $0 | $0 | $0 | $0 | $18,960 | $0 | $29,557 | $0 | $479,379 | $0 | $0 | $0 |
| RANDALL REID | ||||||||||||||
| MD, GENERAL MEDICINE | $292,862 | $0 | $0 | $0 | $0 | $0 | $13,457 | $0 | $29,965 | $0 | $336,284 | $0 | $0 | $0 |
| CRAIG SEAL | ||||||||||||||
| MD, GENERAL MEDICINE | $271,619 | $0 | $21,000 | $0 | $0 | $0 | $13,257 | $0 | $1,640 | $0 | $307,516 | $0 | $0 | $0 |
| THOMAS GREENWOOD | ||||||||||||||
| DIRECTOR, MD, CHIEF OF STAFF | $243,081 | $0 | $0 | $0 | $0 | $0 | $10,243 | $0 | $29,798 | $0 | $283,122 | $0 | $0 | $0 |
| JAMES PAGE | ||||||||||||||
| MD, GENERAL MEDICINE | $204,786 | $0 | $0 | $0 | $0 | $0 | $3,728 | $0 | $29,478 | $0 | $237,992 | $0 | $0 | $0 |
| JANICE FREET | ||||||||||||||
| CFO | $163,003 | $0 | $15,000 | $0 | $0 | $0 | $8,263 | $0 | $8,865 | $0 | $195,131 | $0 | $0 | $0 |
| JOHN SEARS | ||||||||||||||
| MD, GENERAL MEDICINE | $171,331 | $0 | $0 | $0 | $0 | $0 | $7,726 | $0 | $13,580 | $0 | $192,637 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE CEO IS COMPENSATED THROUGH A MANAGEMENT AGREEMENT WITH NORTHERN ARIZONA HEALTHCARE (NAH), AN UNRELATED ORGANIZATION. NAH USES THE PROCESSES DESCRIBED IN PART I, QUESTION 3 TO DETERMINE APPROPRIATE COMPENSATION FOR THE CEO. |
| PART I, LINE 4B | LCMC ENTERED INTO AN AGREEMENT WITH JOHN DEMPSEY TO PAY HIM A RETENTION BONUS WHICH WILL BE VESTED ON 7/31/2020. THE FULL RETENTION BONUS WILL BE PAID OVER AN EIGHT-YEAR PERIOD IF HE STAYS IN HIS CURRENT POSITION AS CEO UNTIL JULY 31, 2020. THIS DEFERRED COMPENSATION BENEFIT BECAME EFFECTIVE JANUARY 1, 2019. THE ORGANIZATION ACCRUED $147,600 FOR THE 9 MONTHS ENDED SEPTEMBER 2019. |
| PART I, LINE 7 | BONUSES WERE PROVIDED BASED ON COMPLETION OF TASKS DETERMINED AS PART OF THEIR PERFORMANCE PLANS. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFFREY HAMBLIN | PersonNm |
| Relationship With Org | FORMER CEO | RelationshipWithOrgTxt |
| Loan Purpose | TO FUND PURCHASE OF SPLIT-DOLLAR LIFE INSURANCE POLICY | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $173,925 | OriginalPrincipalAmt |
| Balance Due | $173,925 | BalanceDueAmt |
| Default | Yes (1) | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $173,925 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | FRANK ARMAO, MD AND MATTHEW SUTTON, MD HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 3 | LCMC HAS ENTERED INTO A MANAGEMENT AGREEMENT WITH NORTHERN ARIZONA HEALTHCARE, INC., TO PROVIDE MANAGEMENT SERVICES FOR THE FACILITY. THE CEO OF LCMC IS AN EMPLOYEE OF NORTHERN ARIZONA HEALTHCARE. J. DEMPSEY SERVED AS CEO FOR FISCAL YEAR ENDED 9.30.19. COMPENSATION AND BENEFITS FOR J. DEMPSEY WERE $350,301 FOR HIS SERVICES AS CEO OF LCMC. THE DUTIES OF THE CEO INVOLVE COMPREHENSIVE OVERSIGHT OF ALL CLINICAL AND ADMINISTRATIVE ACTIVITIES. |
| FORM 990, PART VI, SECTION A, LINE 8B | ALL COMMITTEES UTILIZED BY LCMC ARE STRICTLY ADVISORY IN NATURE. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION'S CEO AND CFO WILL REVIEW THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS REVIEWED ON AN ANNUAL BASIS. BOARD MEMBERS, ADMINISTRATOR, AND MANAGERS ARE COVERED UNDER LITTLE COLORADO MEDICAL CENTER'S CONFLICT OF INTEREST POLICY. WHEN A CONFLICT OF INTEREST ARISES, THE COVERED PERSON IS TO DISCLOSE THE CONFLICT TO HIS OR HER IMMEDIATE SUPERVISOR BEFORE A DECISION INVOLVING THE AREA OF CONFLICT IS MADE. MEMBERS WITH A CONFLICT OF INTEREST ARE ALSO NOT ALLOWED TO PARTICIPATE IN THE DECISION MAKING PROCESS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,814,966. MANAGEMENT AND GENERAL EXPENSES 13,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,827,966. PROFESSIONAL FEES - MEDICAL: PROGRAM SERVICE EXPENSES 2,254,019. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,254,019. PURCH SVCES-OTHER: PROGRAM SERVICE EXPENSES 1,193,913. MANAGEMENT AND GENERAL EXPENSES 75,102. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,269,015. |
| FORM 990, PART XI, LINE 9: | CHANGE IN NET ASSETS OF FOUNDATION 32. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITTLE COLORADO HEALTHCARE FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1501 NORTH WILLIAMSON AVENUE | AddressLine1Txt |
| City | WINSLOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86047 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208504703 | EIN |
| Primary Activities | CHARITABLE | PrimaryActivitiesTxt |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 11 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINSLOW MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | 0 | 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 | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |