2011-07-28T23:46:29-07:00 2010-09-30 TCA Partners LLP 1111 East Herndon Avenue Suite 211 Fresno CA 93720 990 2009-10-01 860260959 La Paz Regional Hospital LAPA 9286699201 1200 Mohave Rd Parker AZ 85344 M Victoria Clark 2011-07-28 Inger Sullenger CPA 5594317708 X 2009 2016-02-24 21:20:13Z M Victoria Clark 1200 Mohave Rd Parker AZ 85344 23758473 false false X lapazhospital.org X 2000 AZ To provide healthcare to the residents of La Paz County and the surrounding California areas of Big River and Earp. 12 12 253 45 0 178099 94920 19526313 23247809 175574 84081 284383 331663 20164369 23758473 0 0 9146416 10099380 0 4370 9756243 12134106 18902659 22233486 1261710 1524987 20536851 21312282 3402978 2653422 17133873 18658860 To provide healthcare to the residents of La Paz County and the surrounding California areas of Big River and Earp. false false 20171608 23528845 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. 20171608 true true false false false false false false false false true true false false false false false false false false false true false false true false false false false false false false false false false false false false false false false true true false false true 20 0 true 253 true false false false false false false false false false false false 0 false false false false false false false false 12 12 false false false false false false false true true false false false true true true true true true true true false false AZ X X James Ehasz 9286697400 1200 Mohave Rd Parker AZ 85344 Roger Crossman 2.00 X 0 0 0 Robert Wall 2.00 X 0 0 0 R O Cramer 2.00 X 0 0 0 Norman Mendoza MD 45.00 X 215303 0 19452 Michael Roman 45.00 X 123045 0 15780 M Victoria Clark 45.00 X 173278 0 14596 Kevin Klopfenstein MD 2.00 X 0 0 0 Kevin Hess 2.00 X 0 0 0 Keith Shillito MD 2.00 X 0 0 0 Julian Barbara 4.00 X 0 0 0 Juanita F Phelps 4.00 X 0 0 0 Janice Shelton 2.00 X 0 0 0 James Ehasz 45.00 X 106519 0 12515 Jacquelyn Thomason 2.00 X 0 0 0 Greta Brown MD 45.00 X 167008 0 17463 George Franklin DO 45.00 X 205015 0 19571 Cheryl Montijo 4.00 X 0 0 0 Bonnie Viloria 45.00 X 102548 0 13548 Bernie Hatmaker 0. X 118004 0 15914 Amanda Leivas-Sharpe 2.00 X 0 0 0 1210720 128839 9 false true false 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 6 44500 50420 94920 Patient service revenues 23247809 23247809 23247809 84081 84081 0 0 50627 50627 50627 50627 0 0 0 0 Tax revenues & Other 157577 157577 Laundry & Meals to HIS 74831 74831 Cafeteria & Vending 48628 48628 281036 23758473 23528845 134708 0 0 0 0 382345 99348 279797 3200 0 7841389 6884071 956148 1170 186674 163918 22756 1069974 939544 130430 618998 543542 75456 0 6183 6183 36425 36425 0 0 0 1265645 1265645 33788 33788 0 0 0 355290 311980 43310 40309 30908 9401 0 0 44777 44777 0 1300278 1141774 158504 259052 227474 31578 Supplies 3481709 3378072 103637 Purchased Svcs 673787 525962 147825 Postage and Shipping 59978 9271 50707 Equipment Rent & Maintenance 1483114 1483114 Bad Debt 3012304 3012304 81467 76116 5351 22233486 20171608 2057508 4370 28802 904 3865731 3983064 0 2064740 2623933 0 0 0 460020 608544 234229 236739 24541952 12073002 12477878 12468950 0 0 0 0 1405451 1390148 20536851 21312282 253591 227331 1158355 1991032 2426091 3402978 2653422 X 17133873 18658860 17133873 18658860 20536851 21312282 X false true true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 53474 53474 11431284 3462225 7969059 188631 104412 84219 12705359 8506365 4198994 163204 163204 12468950 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 1390148 Estimated Third Party Payor Settlements 1509233 Accrued Payroll 916858 2426091 23758473 22233486 1524987 1524987 23758473 23758473 23758473 22233486 22233486 22233486 true true X true X 300.000000000 true X true true true false true true 75233 75233 0.00340 4333805 2855574 1478231 0.06650 4333801 2855574 1478227 0.06650 8742839 5711148 3031691 0.13640 25 3357 238324 238324 0.01070 25 3357 238324 238324 0.01070 25 3357 8981163 5711148 3270015 0.14710 true 1062809 500000 7662753 8406425 -743672 X true true La Paz Clinical Ventures Lease Diagnostic Equipment 0.70000 0.30000 La Paz Regional Hospital

1200 Mohave Rd Parker AZ 85344

X X X 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. Entire shortfall was attributable to community benefit, as these were additional costs incurred to administer charity care. 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. Besides the main hospital, there are 3 rural health clinics. 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. 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. 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. 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. N/A N/A N/A AZ X X X false false false false false false false false false false 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 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. La Paz Regional Hospital Auxiliary PO Box 1606 Parker AZ 85344 860516206 Support La Paz Regional Hospital AZ 501(c)(3) 509a3 Type III Other N/A La Paz Clinical Ventures LLC 1200 Mohave Rd Parker AZ 85344 263388545 Diagnostic AZ NA 27585 1812158 false false false false false false false false false false true false false false false false false false false true La Paz Clinical Ventures LLC i 747858 La Paz Regional Hospital Auxiliary r 44500