2015-05-15T15:54:03-05:00 2014-06-30 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 100 STOCKTON CA 952192367 990 2013-07-01 860427850 CASA GRANDE COMMUNITY HOSPITAL CASA 5203816300 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 SCOTT DAVIS TRUSTEE 5203816300 2015-05-15 1 TRACY S PAGLIA P00366884 2099556100 2013 2016-02-25 16:41:14Z CASA GRANDE REGIONAL MED CTR RONA CURPHY 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 187255342 0 X WWW.CASAGRANDEHOSPITAL.COM X 1982 AZ HEALTH CARE AND HEALTH CARE MANAGEMENT SERVICES THROUGH ACUTE CARE AND SPECIALTY CARE PROGRAMS. 9 6 970 370 0 0 516467 0 140446405 122142010 206380 444175 758877 32898898 141928129 155485083 6430 2710 0 0 59824236 53952662 0 0 56412 93158746 83938094 152989412 137893466 -11061283 17591617 79849467 23119078 87178263 12890241 -7328796 10228837 X CASA GRANDE REGIONAL MEDICAL CENTER PROVIDES ACUTE INPATIENT AND OUTPATIENT HEALTHCARE SERVICES INCLUDING URGENT CARE AND EMERGENCY SERVICES FOR PATIENTS. IT ALSO PROMOTES HEALTH AWARENESS TO THE CASA GRANDE COMMUNITY THROUGH EVENTS, PROGRAMS, AND SERVICES SUCH AS NUTRITIONAL EDUCATION, PHYSICIANS LUNCH AND LEARN TALKS, LAB DRAWS, SAFETY AND HEALTH FAIRS, AND A CARDIAC INTERVENTIONAL PROGRAM. 0 1 130905138 2710 122142010 CASA GRANDE REGIONAL MEDICAL CENTER PROVIDES ACUTE INPATIENT AND OUTPATIENT HEALTHCARE SERVICES AND EMERGENCY ROOM MEDICAL CARE SERVICES FOR PATIENTS. IT ALSO PROMOTES HEALTH AWARENESS TO THE CASA GRANDE COMMUNITY THROUGH EVENTS AND PROGRAMS SUCH AS DIABETES EDUCATION, LAB DRAWS, SAFETY AND HEALTH FAIRS, AND A CARDIAC INTERVENTIONAL PROGRAM. 130905138 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 1 1 1 0 0 1 50 0 1 970 1 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 0 1 1 1 0 AZ X LESA ABBEY 5203816913 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 THOMAS ERICKSON MD TREASURER 1.00 0.50 X X 0 0 0 DAVID FITZGIBBONS VICE CHAIRPERSON 2.00 2.10 X X 0 0 0 HENRY GIVRE MD TRUSTEE 2.00 1.60 X 42000 0 0 CHARIE WALLACE TRUSTEE 1.00 X 0 0 0 JR MCEVOY SECRETARY 2.00 2.10 X X 0 0 0 CHUCK GOODMILLER TRUSTEE 1.00 0.50 X 0 0 0 RAJEESH PUNNAKKATTU MD CHIEF OF STAFF 1.00 X 96000 0 0 EVELYN CASUGA TRUSTEE 2.00 1.50 X 0 0 0 CHERIE MCGLYNN CHAIRPERSON 2.00 2.10 X X 0 0 0 RONA CURPHY CEO 54.20 5.80 X 0 422596 5532 KAREN FRANCIS CFO 51.00 4.00 X 0 295120 14354 CHERYSE AUSTIN CHIEF NURSING OFFICER 36.00 1.00 X 0 165764 8745 PAUL MADEJSKI MD PHYSICIAN 40.00 X 142968 0 14354 DREW DAVENPORT MD PHYSICIAN 40.00 X 325000 0 0 PHILIP KAPSOS MD PHYSICIAN 40.00 X 325000 0 0 ANJU SHIRVASTAVA MD PHYSICIAN 40.00 X 325000 0 0 BLANCHE LOWRY PHYSICIAN 40.00 X 330417 0 0 1586385 883480 42985 64 0 1 0 CERNER CORPORATION PO BOX 730112 KANSAS CITY MO 64141 CLINICAL SYSTEMS 4868799 O GRADY PEYTON INTL 4441 COLLECTIONS CENTER DR CHICAGO IL 60693 NURSING REGISTRY 2823586 BROWNSTEIN HYATT FARBER SHRECK PO BOX 172168 DENVER CO 80217 LEGAL SERVICES 1884273 GRANT THORNTON LLP 201 S COLLEGE ST CHARLOTTE NC 28244 BANKRUPTCY CONSULTING 1873762 HEART HEALTH ORGANIZATION 333 N DOBSON RD STE 11 CHANDLER AZ 85224 CARDIOLOGY SERVICES 1710720 33 NET PATIENT SERVICES 621990 117997126 117997126 RENTAL INCOME 531120 108621 108621 4036263 4036263 122142010 156843 156843 32057591 31770259 287332 287332 287332 REORGANIZATION INCOME 900099 32772064 32772064 126834 126834 32898898 155485083 122142010 0 33343073 X 2710 2710 132000 132000 45890949 44235635 1609333 45981 4915617 4738654 172047 4916 3014096 2905589 105493 3014 1991888 1991888 97279 97279 18769991 17391825 1378166 98398 86519 11297 582 442133 425951 15563 619 3493004 1951879 1541125 6757 5257 1000 500 130099 127799 1500 800 4709343 4709343 3971262 3971262 2513187 2513187 BAD DEBT 28605702 28605702 PATIENT USE CHARGEABLES 5401331 5401331 PHARMACEUTICALS 3465020 3465020 MEDICAL SUPPLIES 3072669 3072669 7170031 7162806 7225 137893466 130905138 6931916 56412 9573379 23013265 13787180 0 2713616 0 851753 0 0 0 35454412 0 9369457 0 18979 105813 8080691 0 79849467 23119078 11387093 7429887 4618510 3920784 65011177 4539356 0 1622127 1539570 87178263 12890241 X -7328796 10228837 -7328796 10228837 79849467 23119078 X 17591617 -33984 X 0 0 0 X 0 ESTIMATED SELF-INSURANCE COSTS 1539570 1539570 1 1 1 X 1 X 1 1 1 0 0 793998 793998 0.00730 23446607 17224295 6222312 0.05690 24240605 17224295 7016310 0.06420 24240605 17224295 7016310 0.06420 9 0 9000 9000 0.00010 9 9000 9000 0.00010 1 28605702 2488696 24944440 24944440 X 1 1 1 1 CASA GRANDE REGIONAL MEDICAL CENTER 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 X X X CASA GRANDE REGIONAL MEDICAL CENTER 1 1 X X X X X X X X X 12 1 0 1 X WWW.BANNERHEALTH.COM X X X 0 0 1 1 100.000000000000 1 200.000000000000 1 X X 1 1 X 1 0 X X X X 1 X 0 0 CASA GRANDE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 3: SEE LINE 7 EXPLANATION. CASA GRANDE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 7: FROM THE TOP 3 NEEDS THAT WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS THAT WAS COMPLETED IN MARCH 2013. THE TOP PRIORITY WAS OBESITY WHICH HAS HAD SIGNIFICANT WORK ON ADDRESSING THIS NEED. WE ARE ADDRESSING THIS THROUGH A COMMUNITY COMMITTEE THAT IS MADE UP OF COMMUNITY BUSINESS LEADERS, SUN LIFE FAMILY HEALTH CENTER AND CASA GRANDE REGIONAL MEDICAL CENTER WHO CHAIRS THIS EFFORT. WE HAVE APPLIED FOR A GRANT TO ASSIST US IN THIS WORK. WE IDENTIFIED 3 NEEDS AND OUR MAJOR FOCUS HAS BEEN ON OBESITY PREVENTION. THE OTHER TWO ARE: CHRONIC DISEASE AND SUBSTANCE ABUSE AND MENTAL HEALTH NEEDS. 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 $ 28,605,702. PART II, LINE 7 CGRMC PROMOTES HEALTH AWARENESS TO THE CASA GRANDE COMMUNITY THROUGH EVENTS, PROGRAMS, AND SERVICES. PART III, LINE 4: CGRMC DID NOT RECEIVE AUDITED FINANCIAL STATEMENTS FOR THE FISCAL YEAR ENDED JUNE 30, 2014. THE COMPANY REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS DUE FROM THIRD-PARTY PAYORS, PATIENTS, AND OTHERS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE COMPANY ANALYZES ITS HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS, AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS, AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. AS A SERVICE TO THE PATIENT, THE COMPANY BILLS THIRD-PARTY PAYORS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE COMPANY ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE COMPANY RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PATIENT ACCOUNTS RECEIVABLE BALANCES PAST DUE MORE THAN 150 DAYS ARE CONSIDERED DELINQUENT. DELINQUENT RECEIVABLES ARE CHARGED OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT OR THIRD-PARTY PAYOR. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THERE IS NO COSTING METHODOLOGY IN DETERMINING BAD DEBTS. THE ACTUALWRITE OFF METHOD IS USED. THE AMOUNT REPORTED OF $2,488,696 IS THE ACTUAL CHARITY WRITE OFFS ACCORDING TO THE POLICY. PART III, LINE 8: THE COMPANY HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE COMPANY AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. THESE PAYMENT ARRANGEMENTS INCLUDE:MEDICARE - INPATIENT ACUTE CARE SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES PER DISCHARGE. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC AND OTHER FACTORS. OUTPATIENT SERVICES RELATED TO MEDICARE BENEFICIARIES ARE PAID BASED ON AMBULATORY PATIENT CLASSIFICATION (APC) RATES, WHICH VARY WITH THE CLINICAL INDICATORS FOR EACH PATIENT. THE HOSPITAL IS REIMBURSED FOR CERTAIN SERVICES AT TENTATIVE RATES WITH FINAL SETTLEMENT DETERMINED AFTER SUBMISSION OF ANNUAL COST REPORTS BY THE COMPANY AND AUDITS THEREOF BY THE MEDICARE ADMINISTRATIVE CONTRACTOR. THE HOSPITAL'S MEDICARE COST REPORTS HAVE BEEN AUDITED BY THE MEDICARE FISCAL INTERMEDIARY THROUGH 2010. THE HOSPITAL'S CLASSIFICATION OF PATIENTS UNDER THE MEDICARE PROGRAM AND THE APPROPRIATENESS OF THEIR ADMISSION ARE SUBJECT TO AN INDEPENDENT REVIEW BY A PEER REVIEW ORGANIZATION.ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM (AHCCCS) - HEALTH CARE SERVICES TO MEDICAID AND INDIGENT PATIENTS ARE PROVIDED AT RATES PUBLISHED BY THE STATE OF ARIZONA UNDER THE STATE'S AHCCCS PROGRAM. APPROXIMATELY 21% OF THE HOSPITAL'S NET PATIENT SERVICE REVENUE IS PAID BY THE AHCCCS PROGRAM. THE COMPANY HAS ALSO ENTERED INTO PAYMENT AGREEMENTS WITH CERTAIN COMMERCIAL INSURANCE CARRIERS, HEALTH MAINTENANCE ORGANIZATIONS AND PREFERRED PROVIDER ORGANIZATIONS. THE BASIS FOR PAYMENT TO THE COMPANY UNDER THESE AGREEMENTS INCLUDES PROSPECTIVELY DETERMINED RATES PER DISCHARGE, DISCOUNTS FROM ESTABLISHED CHARGES AND PROSPECTIVELY DETERMINED DAILY RATES.THE COMPANY RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE COMPANY RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE COMPANY'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE COMPANY RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. PART III, LINE 9B: THE COMPANY PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES TO PATIENTS MEETING CERTAIN CRITERIA UNDER THEIR CHARITY CARE POLICY. BECAUSE THE COMPANY DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THE AMOUNT OF CHARITY CARE PROVIDED FLUCTUATES DEPENDING ON CHANGES IN PATIENT DEMOGRAPHICS AND ECONOMIC CONDITIONS. CHARGES, AT COST, EXCLUDED FROM REVENUE UNDER THE COMPANY'S CHARITY CARE POLICY FOR THE YEARS ENDED JUNE 30, 2014 AND 2013 WERE APPROXIMATELY $3,043,000 AND 3,663,000, RESPECTIVELY. PART VI, LINE 2: THE ORGANIZATION CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT ON MARCH 1, 2013. SEE SCHEDULE H, PART V, SECTION B FOR MORE INFORMATION. PART VI, LINE 3: PATIENT COMPLETION OF A CONFIDENTIAL FINANCIAL DISCLOSURE FORM IS REQUIRED BEFORE CGRMC CAN MAKE AN ELIGIBILITY DETERMINATION. CGRMC STAFF WILL PROVIDE ASSISTANCE TO THOSE INDIVIDUALS WHO NEED HELP TO COMPLETE THE FORM, WHICH CAN BE OBTAINED IN THE ADMISSIONS OFFICE OR PATIENT BILLING. PATIENTS ARE ENCOURAGED TO COMPLETE THE APPLICATION PRIOR TO TREATMENT WHENEVER POSSIBLE. PATIENTS WORKING WITH OUR ELIGIBILITY VENDOR TO DETERMINE ELIGIBILITY FOR AHCCCS, SECTION 1011, CRIME VICTIM ASSISTANCE OR OTHER RESOURCES MAY ALSO APPLY FOR FINANCIAL ASSISTANCE, HOWEVER, HOSPITAL FINANCIAL ASSISTANCE IS CONSIDERED LAST, ONCE ALL OTHER RESOURCES HAVE BEEN EXHAUSTED. PART VI, LINE 4: CASA GRANDE IS A DYNAMIC, INVOLVED COMMUNITY, A MODERN CITY WITH RURAL HERITAGE AND OLD-FASHIONED VALUES. ITS ECONOMIC BASE IS A MIX OF RETAIL TRADE, MANUFACTURING AND AGRICULTURE. FOUNDED IN 1879, CASA GRANDE WAS NAMED FOR THE FAMOUS HOHOKAM INDIAN RUINS 20 MILES TO THE NORTHEAST. MIDWAY BETWEEN PHOENIX AND TUCSON, THE CITY HAS GROWN TO BE THE LARGEST COMMUNITY IN WESTERN PINAL COUNTY SINCE ITS INCORPORATION IN 1915. ONCE DEPENDENT ON AGRICULTURE AND MINING, THE COMMUNITY HAS EVOLVED INTO A DIVERSIFIED FULL-SERVICE AREA WITH MANUFACTURING, RETAIL TRADE, GOVERNMENT AND TOURIST-RELATED EMPLOYMENT. ALL OF PINAL COUNTY IS A DESIGNATED ENTERPRISE ZONE. PART VI, LINE 5: IN ADDITION TO PROVIDING PATIENT CARE WITHIN ITS 177 PRIVATE ROOMS, THERE IS AN IMPRESSIVE LINEUP OF ADDITIONAL SERVICES AVAILABLE AT CGRMC. THESE SERVICES PROVIDE THE COMMUNITY WITH MORE CONVENIENT ACCESS TO THE LATEST PROCEDURES AND EQUIPMENT AVAILABLE IN INTERVENTIONAL CARDIOLOGY, MEDICAL IMAGING, AND OUTPATIENT SURGERY. A WOUND CARE CENTER FEATURES TWO HYPERBARIC OXYGEN CHAMBERS. THERE IS ALSO A SLEEP LAB, OUTPATIENT PHYSICAL THERAPY, FULL SERVICE LABORATORY AND AN URGENT CARE CENTER.CGRMC IS PROUD TO SERVE AS A BASE STATION, PROVIDING MEDICAL DIRECTION TO MORE THAN 12 EMERGENCY MEDICAL SERVICE PROVIDERS IN PINAL COUNTY. AN AIREVAC HELICOPTER IS BASED AT THE CGRMC CAMPUS.THERE ARE MORE THAN 170 PHYSICIANS WHO ARE MEMBERS OF THE CGRMC MEDICAL STAFF. A FEW OF THE MEDICAL SPECIALTIES OFFERED INCLUDE: CARDIOLOGY, GASTROENTEROLOGY, GYNECOLOGY, NEUROLOGY, ONCOLOGY, PEDIATRICS, AND UROLOGY.CGRMC IS FORTUNATE TO HAVE DESERT REFLECTIONS IMAGING CENTER (DRIC) LOCATED ON CAMPUS. DRIC PROVIDES THE MOST UP-TO-DATE EQUIPMENT WITH PET CT, BREAST STEREOTACTIC SYSTEM, BONE DENSITOMETRY, HIGH-DEFINITION MRI, MULTI-SLICE CT SCANS, DIGITAL RADIOLOGY, DIGITAL MAMMOGRAPHY INCLUDING HIGH-DEFINITION BREAST MRI AND ULTRASOUND. BY UTILIZING THEIR STATE-OF-THE-ART VOICE RECOGNITION SYSTEM, TEST RESULTS CAN BE MADE AVAILABLE WITHIN ONE HOUR.CGRMC OPERATES AN URGENT CARE CENTER IN AN EFFORT TO BETTER MEET THE DEMANDS OF THE COMMUNITY FOR AFTER-HOURS, NON-EMERGENT MEDICAL CARE. THE URGENT CARE IS STAFFED WITH BOTH A PHYSICIAN AND PHYSICIAN ASSISTANT SEVEN DAYS A WEEK. PART VI, LINE 6: N/APART VI, LINE 7: N/A 0 0 0 0 0 0 0 0 0 RONA CURPHY CEO 0 422596 0 0 0 0 0 0 0 5532 0 428128 0 0 KAREN FRANCIS CFO 0 295120 0 0 0 0 0 0 0 14354 0 309474 0 0 CHERYSE AUSTIN CHIEF NURSING OFFICER 0 158264 0 7500 0 0 0 0 0 8745 0 174509 0 0 PAUL MADEJSKI MD PHYSICIAN 142968 0 0 0 0 0 0 0 14354 0 157322 0 0 0 DREW DAVENPORT MD PHYSICIAN 325000 0 0 0 0 0 0 0 0 0 325000 0 0 0 PHILIP KAPSOS MD PHYSICIAN 325000 0 0 0 0 0 0 0 0 0 325000 0 0 0 ANJU SHIRVASTAVA MD PHYSICIAN 325000 0 0 0 0 0 0 0 0 0 325000 0 0 0 BLANCHE LOWRY PHYSICIAN 330417 0 0 0 0 0 0 0 0 0 330417 0 0 0 PART I, LINE 3: THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THE METHODS LISTED TO ESTABLISH TOP MANAGEMENT OFFICIAL'S COMPENSATION. JR MCEVOY OFFICER OF THE ORG. 549881 INSURANCE 0 PROPERTY AND EQUIPMENT 2014-06-08 32057591 COMPARABLES 450233470 BANNER HEALTH 1441 NORTH 12TH STREET PHOENIX CA 85006 501(C)(3) 0 1 0 0 PART II, LINE 2E: PERSON(S) INVOLVED: RONA CURPHY AND KAREN FRANCIS PART II, LINE 2E: EXPLANATION OF INVOLVEMENT: RONA CURPHY CONTINUES AS THE CEO OF BANNER CASA GRANDE MEDICAL CENTER, AND KAREN FRANCIS IS THE CFO OF BANNER BOSWELL MEDICAL CENTER. FORM 990, PART III, LINE 3 CASA GRANDE REGIONAL MEDICAL CENTER FILED FOR BANKRUPTCY AND WAS ACQUIRED BY BANNER HEALTH. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER IS REGIONAL CARE SERVICES CORPORATION, AN ARIZONA NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE RIGHT TO APPOINT OR REMOVE TRUSTEES TO OR FROM THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION CANNOT AMEND OR MODIFY THE ARTICLES OF INCORPORATION WITHOUT THE CONSENT OF THE MEMBER. ADDITIONAL POWERS, AUTHORITY AND PREROGATIVES MAY BE GRANTED AND RESERVED TO THE MEMBER AS SET FORTH IN THE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THE CEO AND THE DIRECTOR OF FINANCE REVIEWED THE FORM 990 PRIOR TO FILING. THE CEO WILL PROVIDE AN OVERVIEW AFTER FILING TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A POLICY FOR EMPLOYEES TO DISCLOSE ANY CONFLICTS OF INTEREST BY REPORTING TO HR OR THE CEO. THIS WILL PRECLUDE THE STAFF MEMBER FROM PARTICIPATING IN ANY ACTIVITY WHICH CONFLICT. AT THE BOARD LEVEL EACH BOARD MEMBER AND SR. STAFF SIGN AN ANNUAL CONFLICT OF INTEREST STATEMENT THAT REQUIRES THEM TO DISCLOSE AND CONFLICT. WHEN THIS HAS OCCURRED WE GENERALLY EXCUSE THEM FROM ANY DELIBERATIONS OR DECISION MAKING ON THAT ISSUE. IF SOMETHING WOULD BE DISCOVERED AFTER THE FACT THAT WOULD GO BEFORE THE BOARD CHAIRPERSON TO ASSESS THE CONFLICT AND IF ANYTHING NEEDS TO BE DONE AT THAT POINT. THERE WERE NO IDENTIFIED CONFLICTS AFTER THE FACT DISCOVERED IN 2013. FORM 990, PART VI, SECTION B, LINE 15 THIS FILING ORGANIZATION DOES NOT SET OR PAY COMPENSATION TO THE CEO. OTHER OFFICERS, BEING CFO AND CNO, AND OTHER TOP OFFICIALS OF THE ORGANIZATION THE COMPENSATION IS SET BY THE CEO IN CONSULTATION WITH THE BOARD CHAIRPERSON WHICH INCLUDED BASE SALARY AND ANY BONUS THAT WAS GIVEN. THE REVIEW OF COMPENSATION WAS DONE UTILIZING OTHER ORGANIZATIONS 990, OTHER SURVEYS AND AN INDEPENDENT CONSULTATION IN 2009 AND 2012. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST, ARE UPLOADED TO EMMA SITE ON THE INTERNET, AND ARE FILED WITH THE STATE OF ARIZONA AS REQUIRED BY STATE STATUTE. FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 5,518,393. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,518,393. MEDICAL & ANCILLARY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 11,873,432. MANAGEMENT AND GENERAL EXPENSES 1,378,166. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,251,598. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -33,984. REGIONAL CARE PHYSICIANS GROUP INC 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 263096262 HEALTHCARE AZ 501(C)(3) 9 REGIONAL CARE SERVICES CORPORATION 1 CASA GRANDE REGIONAL RETIREMENT COMMUNITY 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 742558095 HEALTHCARE AZ 501(C)(3) 11A, I REGIONAL CARE SERVICES CORPORATION 1 REGIONAL CARE SERVICES CORPORATION 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 860919714 HEALTHCARE AZ 501(C)(3) 11A, I N/A 0 CASA GRANDE COMMUNITY HOSPITAL FOUNDATION INC 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 311726569 HEALTHCARE AZ 501(C)(3) 7 REGIONAL CARE SERVICES CORPORATION 1 REGIONAL HEALTHCARE VENTURES 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 262199660 HEALTHCARE AZ N/A C 0 0 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 REGIONAL CARE PHYSICIANS GROUP INC N 82356 CASH VALUE REGIONAL CARE PHYSICIANS GROUP INC O 1457160 CASH VALUE REGIONAL CARE PHYSICIANS GROUP INC Q 110295 CASH VALUE REGIONAL CARE PHYSICIANS GROUP INC D 8656561 LOAN BALANCE