LA PAZ REGIONAL HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- LA PAZ REGIONAL HOSPITAL (EIN 86-0260959)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-07-28
- IRS object ID
- 201102109349300000
- Schema version
- 2009v1.7
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-07-28T23:46:29-07:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TCA Partners LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 East Herndon Avenue Suite 211 | AddressLine1 |
| City | Fresno | City |
| State | CA | State |
| ZIP Code | 93720 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860260959 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | La Paz Regional Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LAPA | NameControl |
| Phone | 9286699201 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 Mohave Rd | AddressLine1 |
| City | Parker | City |
| State | AZ | State |
| ZIP Code | 85344 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | M Victoria Clark | Name |
| Title | CEO | Title |
| Date Signed | 2011-07-28 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Inger Sullenger CPA | Name |
| Phone | 5594317708 | Phone |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | M Victoria Clark | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 Mohave Rd | AddressLine1 |
| City | Parker | City |
| State | AZ | State |
| ZIP Code | 85344 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 23758473 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c | X | Organization501c |
| Web Site | lapazhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2000 | YearFormation |
| State Legal Domicile | AZ | StateLegalDomicile |
| Activity Or Mission Description | To provide healthcare to the residents of La Paz County and the surrounding California areas of Big River and Earp. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 253 | TotalNbrEmployees |
| Total Nbr Volunteers | 45 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 178099 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 94920 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 19526313 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 23247809 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 175574 | InvestmentIncomePriorYear |
| Investment Income Current Year | 84081 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 284383 | OtherRevenuePriorYear |
| Other Revenue Current Year | 331663 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 20164369 | TotalRevenuePriorYear |
| Total Revenue Current Year | 23758473 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9146416 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10099380 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 4370 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9756243 | OtherExpensePriorYear |
| Other Expenses Current Year | 12134106 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 18902659 | TotalExpensesPriorYear |
| Total Expenses Current Year | 22233486 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1261710 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1524987 | RevenuesLessExpensesCY |
| Total Assets BOY | 20536851 | TotalAssetsBOY |
| Total Assets EOY | 21312282 | TotalAssetsEOY |
| Total Liabilities BOY | 3402978 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2653422 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 17133873 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 18658860 | NetAssetsOrFundBalancesEOY |
| Mission Description | To provide healthcare to the residents of La Paz County and the surrounding California areas of Big River and Earp. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 20171608 | Expense |
| Revenue | 23528845 | Revenue |
| Description | La Paz Regional Hospital is a 39-bed rural hospital, designated a Sole Community Provider by CMS. LPRH operates the hospital and rural health clinics in Salome, Bouse and Quartzsite. The clinics are the only health care available in Salome and Bouse, and the only full time service in Quartzsite. The hospital is the only general hospital in La Paz County. Between our hospital and clinics, we are an essential component of county health and welfare and served 35,649 patients in 2010. Inpatient admissions were 1125.Our mission is to serve the residents of La Paz County and the surrounding California areas of Big River and Earp, two unincorporated areas without any healthcare resources and several hours from resources in San Bernardino. Our 13 member board of directors are chosen from our communities such that we have representation from across the county. Directors are unpaid and give tirelessly of their time and energies.LPRH saw an increase in admissions over the prior year, due to the recruiting of a cardiologist and the addition of a Cath Lab.The Hospital is operating a satellite x-ray and CT scan unit in Quartzite, Arizona, and a surgical addition in Parker that includes nuclear medicine and a cardiac cath lab. Nuclear medicine opened in November 2009 and the cath lab and surgical suite opened in January 2010. | Description |
| Total Program Service Expense | 20171608 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 20 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 253 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | AZ | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | James Ehasz | NamePerson |
| Telephone Number | 9286697400 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 Mohave Rd | AddressLine1 |
| City | Parker | City |
| State | AZ | State |
| ZIP Code | 85344 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | OfficerOfficer |
|---|---|---|---|---|---|---|---|
| Roger Crossman | |||||||
| Member | 2.00 | X | 0 | 0 | 0 | ||
| Robert Wall | |||||||
| Member | 2.00 | X | 0 | 0 | 0 | ||
| R O Cramer | |||||||
| Member | 2.00 | X | 0 | 0 | 0 | ||
| Norman Mendoza MD | |||||||
| Physician | 45.00 | 215303 | 0 | 19452 | X | ||
| Michael Roman | |||||||
| Pharmacy Dir | 45.00 | 123045 | 0 | 15780 | X | ||
| M Victoria Clark | |||||||
| CEO | 45.00 | 173278 | 0 | 14596 | X | ||
| Kevin Klopfenstein MD | |||||||
| Member | 2.00 | X | 0 | 0 | 0 | ||
| Kevin Hess | |||||||
| Member | 2.00 | X | 0 | 0 | 0 | ||
| Keith Shillito MD | |||||||
| Member | 2.00 | X | 0 | 0 | 0 | ||
| Julian Barbara | |||||||
| Vice Chairman | 4.00 | X | 0 | 0 | 0 | ||
| Juanita F Phelps | |||||||
| Secretary/Treas | 4.00 | X | 0 | 0 | 0 | ||
| Janice Shelton | |||||||
| Member | 2.00 | X | 0 | 0 | 0 | ||
| James Ehasz | |||||||
| CFO | 45.00 | 106519 | 0 | 12515 | X | ||
| Jacquelyn Thomason | |||||||
| Member | 2.00 | X | 0 | 0 | 0 | ||
| Greta Brown MD | |||||||
| Physician | 45.00 | 167008 | 0 | 17463 | X | ||
| George Franklin DO | |||||||
| Physician | 45.00 | 205015 | 0 | 19571 | X | ||
| Cheryl Montijo | |||||||
| Chairman | 4.00 | X | 0 | 0 | 0 | ||
| Bonnie Viloria | |||||||
| CNO | 45.00 | 102548 | 0 | 13548 | X | ||
| Bernie Hatmaker | |||||||
| Dir of Radiology | 0. | 118004 | 0 | 15914 | X | ||
| Amanda Leivas-Sharpe | |||||||
| Member | 2.00 | X | 0 | 0 | 0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1210720 | TotalReportableCompFromOrg |
| Total Other Compensation | 128839 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| William Borman | |||||
| 31798 Rio Vista Rd | Parker | AZ | 85344 | CRNA | 154327 |
| Kenn Speer | |||||
| 1150 S 8th St | Cottonwood | AZ | 86326 | CRNA | 131250 |
| Jack Dunn MD | |||||
| 2610 Patio Simpatico | Lake Havasu City | AZ | 86406 | Radiologist | 694595 |
| Frank Kresock MD | |||||
| 1413 | th St | AZ | 85344 | Physician | 174771 |
| Emcare Physician Services | |||||
| 815 S Palafox St | Pensacola | FL | 32502 | ER Room Physicians | 170904 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Related Organizations | 44500 | RelatedOrganizations |
| All Other Contributions | 50420 | AllOtherContributions |
| Total Contributions | 94920 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient service revenues | Description |
| Total Revenue Column | 23247809 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23247809 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 23247809 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 84081 | TotalRevenueColumn |
| Exclusion | $84,081 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 50627 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 50627 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 50627 | TotalRevenueColumn |
| Exclusion | $50,627 | ExclusionAmount |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| Tax revenues & Other | 157577 | 157577 |
| Laundry & Meals to HIS | 74831 | 74831 |
| Cafeteria & Vending | 48628 | 48628 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 281036 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 23758473 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23528845 | RelatedOrExemptFunctionIncome |
| Exclusion | $134,708 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 382345 | Total |
| Program Services | 99348 | ProgramServices |
| Management And General | 279797 | ManagementAndGeneral |
| Fundraising | 3200 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7841389 | Total |
| Program Services | 6884071 | ProgramServices |
| Management And General | 956148 | ManagementAndGeneral |
| Fundraising | 1170 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 186674 | Total |
| Program Services | 163918 | ProgramServices |
| Management And General | 22756 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1069974 | Total |
| Program Services | 939544 | ProgramServices |
| Management And General | 130430 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 618998 | Total |
| Program Services | 543542 | ProgramServices |
| Management And General | 75456 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6183 | Total |
| Management And General | 6183 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36425 | Total |
| Management And General | 36425 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1265645 | Total |
| Program Services | 1265645 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33788 | Total |
| Program Services | 33788 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 355290 | Total |
| Program Services | 311980 | ProgramServices |
| Management And General | 43310 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40309 | Total |
| Program Services | 30908 | ProgramServices |
| Management And General | 9401 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44777 | Total |
| Program Services | 44777 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1300278 | Total |
| Program Services | 1141774 | ProgramServices |
| Management And General | 158504 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 259052 | Total |
| Program Services | 227474 | ProgramServices |
| Management And General | 31578 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Supplies | 3481709 | 3378072 | 103637 |
| Purchased Svcs | 673787 | 525962 | 147825 |
| Postage and Shipping | 59978 | 9271 | 50707 |
| Equipment Rent & Maintenance | 1483114 | 1483114 | |
| Bad Debt | 3012304 | 3012304 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81467 | Total |
| Program Services | 76116 | ProgramServices |
| Management And General | 5351 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22233486 | Total |
| Program Services | 20171608 | ProgramServices |
| Management And General | 2057508 | ManagementAndGeneral |
| Fundraising | 4370 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28802 | BOY |
| EOY | 904 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3865731 | BOY |
| EOY | 3983064 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2064740 | BOY |
| EOY | 2623933 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 460020 | BOY |
| EOY | 608544 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 234229 | BOY |
| EOY | 236739 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 24541952 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 12073002 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12477878 | BOY |
| EOY | 12468950 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1405451 | BOY |
| EOY | 1390148 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20536851 | BOY |
| EOY | 21312282 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 253591 | BOY |
| EOY | 227331 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1158355 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1991032 | BOY |
| EOY | 2426091 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3402978 | BOY |
| EOY | 2653422 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17133873 | BOY |
| EOY | 18658860 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17133873 | BOY |
| EOY | 18658860 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20536851 | BOY |
| EOY | 21312282 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 53474 | OtherCostOrOtherBasis |
| Book Value | 53474 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11431284 | OtherCostOrOtherBasis |
| Depreciation | 3462225 | Depreciation |
| Book Value | 7969059 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 188631 | OtherCostOrOtherBasis |
| Depreciation | 104412 | Depreciation |
| Book Value | 84219 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12705359 | OtherCostOrOtherBasis |
| Depreciation | 8506365 | Depreciation |
| Book Value | 4198994 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 163204 | OtherCostOrOtherBasis |
| Book Value | 163204 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 12468950 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Other Receivables | 114082 |
| Joint Ventures, La Paz Clinical Ventures | 147000 |
| Estimated Third Party Payor Settlements | 157352 |
| Deferred Costs & Notes Receivable | 865942 |
| Assets limited as to use | 105772 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1390148 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Estimated Third Party Payor Settlements | $1,509,233 |
| Accrued Payroll | $916,858 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2426091 | TotalOfAmounts |
| Total Revenue | 23758473 | TotalRevenue |
| Total Expenses | 22233486 | TotalExpenses |
| Excess Or Deficit For Year | 1524987 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 1524987 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 23758473 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 23758473 | RevenueSubtotal |
| Total Revenue Per Form990 | 23758473 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 22233486 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 22233486 | ExpensesSubtotal |
| Total Expenses Per Form990 | 22233486 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300.000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 75233 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 75233 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00340 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4333805 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2855574 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1478231 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06650 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4333801 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2855574 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1478227 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06650 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8742839 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5711148 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3031691 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13640 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 25 | NumberOfActivitiesOrPrograms |
| Persons Served | 3357 | PersonsServed |
| Total Community Benefit Expense | 238324 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 238324 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 25 | NumberOfActivitiesOrPrograms |
| Persons Served | 3357 | PersonsServed |
| Total Community Benefit Expense | 238324 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 238324 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01070 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 25 | NumberOfActivitiesOrPrograms |
| Persons Served | 3357 | PersonsServed |
| Total Community Benefit Expense | 8981163 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5711148 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3270015 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.14710 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,062,809 | BadDebtExpenseAmount |
| Amount Attributable To | 500000 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 7662753 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 8406425 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -743672 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | La Paz Clinical Ventures | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | Lease Diagnostic Equipment | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.70000 | OrganizationProfitOrOwnership |
| Physicans Profit Or Ownership | 0.30000 | PhysicansProfitOrOwnership |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | La Paz Regional Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 Mohave Rd | AddressLine1 |
| City | Parker | City |
| State | AZ | State |
| ZIP Code | 85344 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Footnote | The Hospital does not have a financial statement footnote that describes bad debt expense, but does include a footnote related to charity care:Charity Care: The Hospital generally accepts all patients regardless of their ability to pay. A patient is classified as a charity patient by reference to certain established policies of the Hospital. Essentially, these policies define charity services as those services for which no payment is anticipated. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as net patient service revenues. Services provided are recorded as gross patient service revenues and then written off entirely as an adjustment to net patient service revenues. | BadDebtFootnote |
| Shortfall As Community Benefit | Entire shortfall was attributable to community benefit, as these were additional costs incurred to administer charity care. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | PURPOSE:This Policy is written to establish standards and procedures for Admitting Patients and collecting payments. This policy applies to LaPaz Regional Hospital (LPRH) and the Clinics. POLICY: All Admitting Personnel will be responsible for the following actions: 1.Greet all customers using our current AIDET Customer Service Program. 2.Collect & Input the following data to the CPSI System: a)Copy of Medical Cards (All Insurance); b)Copy of Drivers License or some form of Identification Social Security Card; c) Retirement Date (Medicare) 3. Admitting and Clinic Staff are responsible for ensuring that ALL NON-Emergency and Elective patients are screened for the ability to pay; a)If patients do not have insurance, establish their ability to pay & then brief them on applying for State Aid, supplying appropriate forms; b)If patients do not qualify for State Aid, & are considered not fully able to pay the bill, brief them on LPRHs Financial Assistance Program and the forms for application in accordance with LPRH Policy 2.2.1;c)An estimate of the patient responsibility for the service will be made by Admitting in cooperation with the Business Office. Patients will need to make a deposit of a minimum of 50% of the estimated amount due. If patients do not make the minimum deposit & have not made arrangements to pay for non-emergency & elective procedures, service will not be provided. 4.EMTALA dictates that patients admitted under Emergency Conditions must be seen by a qualified medical professional and receive a medical screening exam prior to Admitting personnel requesting information or obtaining payment. Therefore, Emergency patients will ONLY be contacted after the qualified medical professional has performed a medical screening exam of the patient. Admitting staff will be responsible for calculating the patients expected liability and for requesting that payment prior to discharge. Nursing Staff and Unit Secretaries are required to ensure that Admitting Staff is informed of all discharges in ample time so they can visit the patient in their room to finish the registration process and collect payments if applicable. If the patient is determined not to need emergency service, the service will be treated as non-emergency or elective service & be subject provisions of section 3.c of this policy. 5. For ALL non-emergency and elective services, LPRH Staff personnel will, when scheduling a patient, ensure that the referring Doctor has obtained required Authorizations prior to the procedure. LPRH Staff will inform the patient that Authorization is required for the specific procedure or service and if not on hand, will require the Patient to sign an Insurance Denial Waiver or contact their Doctor to obtain Authorization prior to providing the service. Under no circumstances should LPRH Staff personnel provide services knowingly without authorization being obtained. This will ensure that LPRH will be reimbursed for procedures and services provided. Patients with unpaid prior account balances including accounts sent to bad debt, that are determined to be receiving non-emergency or elective services will need to pay the entire amount of the service in advance of receiving treatment. 6. In calculating charges, LPRH Staff will use the following factors to come up with the amount due: a) Clinic: Collect all Co-Pays and/or Deductibles. Clinic Staff will review Patients prior accounts for outstanding balances & based on Patients requested service, collect for current charges (Per Cost Sheet)& outstanding balances; b) Admitting: The estimated charges will include hospital charges only. (Be advised to consider late or missed charges). Also, check Unpaid PRIOR Account Balances to use as a basis for the estimate. Collect on any outstanding account as well as the new one; c) Payments will also be requested from patients for services requested or authorized that are not covered by their insurer; d)Uninsured patients will be offered an automatic 30% discount, but charity care can be up to 100% depending on income/circumstances. | DebtCollectionPolicy |
| Number Of Facility Type Expln | Besides the main hospital, there are 3 rural health clinics. | NumberOfFacilityTypeExpln |
| General Explanation | Part III, Section B, line 8 - The Costing medthodology or source used to determine the amount reported on line 6 of Part III, Section B, is the: Medicare Cost Report. | GeneralExplanation |
| Needs Assessment | La Paz Regional Hospital performs a needs assessment every three years. This is a survey distributed through a general mailing to all La Paz County residents. The survey asks general demographic and health questions and questions about services needed and difficulty in obtaining services. We are very rural,so we ask about what services residents are driving out of the area to receive. The results are tabulated internally and compared to previous surveys. We use this survey to try and provide the services that are needed by our residents that are within the financial ability of La Paz Regional Hospital to provide. | NeedsAssessment |
| Patient Education Assistance | Information about La Paz Regional Hospital Financial Assistance Program is posted in the registration area of the hospital and all clinics. Any self-pay patient who presents for service is scanned in the Medi-Fax system for eligibility for AHCCCS or Medical if a California resident. The patient is referred to the local DES office for assistance and is informed of the financial assistance program and given an application. The LPRH Case Manager meets with every patient. The Case Manager assists the patient in applying for AHCCCS or Medical. She helps the patient complete the financial assistance forms. The Case Manager arranges for after inpatient hospital care with the input of the patient. | PatientEducationAssistance |
| Community Information | La Paz Regional Hospital serves the residents of La Paz County Arizona and residents of the far Western portion of San Bernardino County, California. There are approximately 20,000 residents in our service area. The service area includes the Colorado River Indian Tribe reservation with about 2,500 tribal members. The population is 46% white, 24% Hispanic, 24% Native American,and 6% other. The median household income is $31,000. 25% of the population is below the Federal poverty level. 33% of the population is over the age of 65. La Paz Regional Hospital is very dependent of government health care programs with the majority of its business funded by Medicare and Medicaid. | CommunityInformation |
| Community Building Activities | N/A | CommunityBuildingActivities |
| Other Information | N/A | OtherInformation |
| Affiliated Health Care System | N/A | AffiliatedHealthCareSystem |
| Reports Filed With States | AZ | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|---|
| Norman Mendoza MD | ||||
| 215303 | 7882 | 11570 | 234755 | 243197 |
| M Victoria Clark | ||||
| 173278 | 6730 | 7866 | 187874 | 222271 |
| Greta Brown MD | ||||
| 167008 | 6577 | 10886 | 184471 | 198715 |
| George Franklin DO | ||||
| 205015 | 8001 | 11570 | 224586 | 233218 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Financial statements are available on various websites that post 990 information. Form 990, as well as governing documents and the conflict of interest policy are available upon request. |
| Form 990, Part VI, Line 15b | Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | The compensation is determined via approval from the CEO and other Officers of the organization. |
| Form 990, Part VI, Line 12c | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Each Board Member and key employee is required to complete the conflict of interest form annually. |
| Form 990, Part VI, Line 11 | Form 990, Part VI, Line 11: Form 990 Review Process | The Finance Committee of the organization meets in a separate meeting to review the 990 with the Chief Financial officer and the Chief Execuitve Officer. The accounting firm that assembled and filed the report is present to review the report and to answer any questions. The 990 is included in the Board materials for the meeting prior to filing. The 990 information is presented by the CFO as well as the minutes from the Finance Committee meeting to the Board. Any questions are answered. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | La Paz Regional Hospital Auxiliary | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1606 | AddressLine1 |
| City | Parker | City |
| State | AZ | State |
| ZIP Code | 85344 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860516206 | EIN |
| Primary Activities | Support La Paz Regional Hospital | PrimaryActivities |
| Legal Domicile State | AZ | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 509a3 Type III Other | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | La Paz Clinical Ventures LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 Mohave Rd | AddressLine1 |
| City | Parker | City |
| State | AZ | State |
| ZIP Code | 85344 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263388545 | EIN |
| Primary Activity | Diagnostic | PrimaryActivity |
| Legal Domicile State | AZ | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Share Of Total Income | 27585 | ShareOfTotalIncome |
| Share Of EOY Assets | 1812158 | ShareOfEOYAssets |
| Disproportionate Allocations | false | DisproportionateAllocations |
| General Or Managing Partner | false | GeneralOrManagingPartner |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| La Paz Clinical Ventures LLC | |
| i | 747858 |
| La Paz Regional Hospital Auxiliary | |
| r | 44500 |