2011-05-13T11:19:39-05:00 2010-06-30 Moss Adams LLP 3121 West March Lane Suite 100 Stockton CA 952192303 990 2009-07-01 860427850 Casa Grande Community Hospital CASA 5203816300 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 Karen Francis 5203816300 2011-05-12 1 TRACY S PAGLIA 2099556100 2009 2016-02-24 21:20:13Z Casa Grande Regional Med Ctr Rona Curphy 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 125375871 0 X WWW.CASAGRANDEHOSPITAL.COM X 1982 AZ Health care and health care management services through acute care and specialty care programs. 9 5 942 200 0 0 155010 109837 115439564 124770242 203301 10566 1074597 302387 116872472 125193032 92025 8263 0 49899662 52268153 0 0 68289278 66269581 118280965 118545997 -1408493 6647035 92221928 90677806 105613868 94789476 -13391940 -4111670 We exist to make a positive difference in the lives of those we serve through compassion and excellence in patient care. 1 0 105618022 8263 124770242 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. 105618022 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 1 67 0 1 942 1 0 0 0 0 0 0 0 0 0 9 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 1 1 0 AZ X MARK GAWORSKI 5203816913 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 Cherie McGlynn 1.00 X X 0 0 0 Tom Erickson MD 1.00 X X 26000 0 0 Evelyn Casuga 1.00 X 0 0 0 David Fitzgibbons 1.00 X X 0 0 0 Henry Givre MD 1.00 X 32500 0 0 Charie Wallace 1.00 X 0 0 0 JR McEvoy 1.00 X X 0 0 0 John Hendren 1.00 X 0 0 0 Chuck Goodmiller 1.00 X 0 0 0 Rona Curphy 36.00 X 0 257258 6665 Karen Francis 36.00 X 0 208410 15372 Cheryse Austin 40.00 X 149152 0 8596 Joseph Moncayo 40.00 X 137354 0 8650 William Stubbs 40.00 X 257856 0 6093 Paul Madejski 40.00 X 268396 0 13899 Amelita Hitsman 40.00 X 155401 0 9516 Marcia Whitbeck 40.00 X 153168 0 8003 Susan Emrick 40.00 X 151327 0 6489 RAMON MOURELO MD 40.00 X 0 332019 13239 John Dernier 40.00 X 0 208891 5277 1193800 1006578 93149 72 1 1 0 CERNER CORPORATION PO BOX 730112 KANSAS CITY MO 64141 CLINICAL SYSTEMS 1194041 Sonoran Desert Anesthesia Inc PO Box 93173 Phoenix AZ 95070 Anesthesia Services 1085448 O GRADY PEYTON INTERNATIONAL 4441 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 Nursing Registry 862237 SODEXHO DEPARTMENT 42383 LOS ANGELES CA 90088 LINEN SERVICES 571120 MASTERPLAN 9582 TOPANGA CANYON BLVD CHATSWORTH CA 91311 CLINICAL EQUIPMENT SERVICES 545421 13 109837 109837 Net patient services 621990 123400253 123400253 Rental Income 531120 768673 768673 Lab Tests 621500 159319 159319 Cancer Center 621500 88077 88077 353920 353920 124770242 193405 193405 182839 -182839 -182839 -182839 DEBT RESTRUCTURE GAIN 900099 758901 758901 Cafeteria 722210 307385 307385 DERIV. NET REAL. LOSS 900099 -836514 -836514 72615 72615 302387 125193032 124770242 0 312953 8263 8263 564485 508378 56107 41211418 37115184 4096234 7320536 6592907 727629 3171714 2856460 315254 89747 78977 10770 556316 489558 66758 102932 90580 12352 242790 213655 29135 10340748 9099858 1240890 107511 94610 12901 7974427 7017496 956931 810073 712864 97209 1269007 1116726 152281 391106 344173 46933 5751152 5061014 690138 5586323 4915964 670359 1188239 1045650 142589 BAD DEBT 16345848 14384346 1961502 PATIENT USE CHARGEABLE 5488964 4830288 658676 PHARMACEUTICALS 4105643 3612966 492677 PROSTHESIS 1254097 1103605 150492 REAGENT RENTAL 829494 729956 99538 3835164 3594544 240620 118545997 105618022 12927975 0 9767782 18662915 3438481 11823 13422885 12758331 176751 104131 2226914 2478457 905502 759376 100046259 59209073 43334291 40837186 13145144 9736179 368232 256309 5435946 5073099 92221928 90677806 11735366 10211153 5048316 4921806 70320452 69196416 9988606 7507877 8521128 2952224 105613868 94789476 X -13451238 -4111670 59298 0 -13391940 -4111670 92221928 90677806 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3363312 3363312 49071043 24066597 25004446 40849560 30920601 9928959 6762344 4221875 2540469 40837186 DEFERRED COSTS, NET OF AMORTization 1353573 Third PArty Settlement receivable 120777 Due from Affiliates 3598749 5073099 ESTIMATED SELF-INSURANCE COSTS 2510267 DERIVATIVE INSTRUMENTS 418017 DEPOSITS 23940 2952224 Part X: Description of Uncertain Tax Positions Under FIN 48: RCSC adopted the provisions of ASC 740-10, Income Taxes, relating to accounting for uncertain tax positions on July 1, 2009, which had no financial statement impact to RCSC. RCSC recognizes the tax benefit from uncertain tax positions only if it is more likely than not that the tax positions will be sustained on examination by the tax authorities, based on the technical merits of the position. The tax benefit is measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. RCSC recognizes interest and penalties related to income tax matters in income tax expense. 1 1 1 X 1 X 1 1 1 0 0 1 441 378961 0 378961 0.00320 33302516 27776857 5525659 0.04660 1 441 33681477 27776857 5904620 0.04980 1 441 33681477 27776857 5904620 0.04980 22 17000 29500 29500 0.00030 25 5120 16250 16250 0.00020 47 22120 45750 45750 0.00050 1 13356691 1170677 29170631 26968892 2201739 X 1 1 Casa Grande Regional Medical Center

1800 E Florence Blvd Casa Grande AZ 85122

X X X Part III, Line 4: The Hospital and the Group report patient accounts receivable for services rendered at net realizable amounts due from third-party payers, patients and others. The Hospital and the Group provides an allowance for doubtful accounts, which is based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the Hospital and the Group bill third-party payers directly and bill the patient when the patient's liability is determined. Patient accounts receivable balances past due more than 120 days are considered delinquent. Delinquent receivables are written off based on individual credit evaluation and specific circumstances of the patient or third-party payer.There is no costing methodology in determining bad debts. The actual write off method is used. The amount reported of $1,170,677 is the actual charity write offs according to the policy. Part III, Line 8: The Hospital and the Group have agreements with third-party payers that provide for payments to the Hospital 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 Hospital and audits thereof by the Medicare Administrative Contractor. The Hospital's Medicare cost reports have been audited by the Medicare fiscal intermediary through 2007. 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 26% of the Hospital's net patient service revenue is paid by the AHCCCS program. All Arizona Hospital reimbursement rates have been frozen since October 1, 2008. The State anticipates reducing Hospital payments across the board on April 1, 2011, by 5%, which could reduce the Hospital's net patient reimbursement by approximately $1.3 million annually. There continues to be significant uncertainty regarding future payment cuts by the State's AHCCCS reimbursement program due to the ongoing State budget shortfalls.The Hospital and the Group have also entered into payment agreements with certain commercial insurance carriers, health maintenance organizations and preferred provider organizations. The basis for payment to the Hospital and the Group under these agreements includes prospectively determined rates per discharge, discounts from established charges and prospectively determined daily rates. Part III, Line 9b: The Hospital and the Group provide care without charge or at amounts less than their established rates to patients meeting certain criteria under their charity care policy. Because the Hospital and the Group do 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 excluded from revenue under the Hospital and the Group's charity care policy for the years ended June 30, 2010 and 2009 were approximately $1,174,000 and $618,000, respectively. Part VI, Line 2: Periodic Community Needs Assessments are conducted with the help of external consultants and hospital personnel. 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, factory outlet shopping, 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 187 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. We offer behavioral health for inpatients.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, psychiatry, 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 nurse practitioner seven days a week. 0 X X 1 0 0 0 0 0 0 0 0 Rona Curphy 0 257258 0 0 0 0 0 1728 0 4937 0 263923 0 0 Karen Francis 0 208410 0 0 0 0 0 1756 0 13616 0 223782 0 0 Cheryse Austin 149152 0 0 0 0 0 1008 0 7588 0 157748 0 0 0 William Stubbs 257856 0 0 0 0 0 1202 0 4891 0 263949 0 0 0 Paul Madejski 268396 0 0 0 0 0 0 0 13899 0 282295 0 0 0 Amelita Hitsman 155401 0 0 0 0 0 418 0 9098 0 164917 0 0 0 Marcia Whitbeck 153168 0 0 0 0 0 1115 0 6888 0 161171 0 0 0 Susan Emrick 151327 0 0 0 0 0 1177 0 5312 0 157816 0 0 0 RAMON MOURELO MD 0 332019 0 0 0 0 0 0 0 13239 0 345258 0 0 John Dernier 0 0 0 0 0 208891 0 2049 0 3228 0 214168 0 0 Part I, Line 4a John Dernier received severance pay of 6 months at his regular salary during calendar year 2009. Supplemental Information Part III 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 Off. of the Org. 321817 Ins. Prem. 0 Great Western Bank Entity where John Hendren, Trustee serves as President 352930 Interest expenses and Bank fees 0 Form 990, Part III, line 2 New Program Services The hospital added a new cardiac program during the year. Form 990, Part VI, Section B, line 11 The CFO and Director of Finance reviewed the Form 990 and will meet with the Board of Directors to review the return after filing. Form 990, Part VI, Section B, line 12c The organization requires an annual signature on the conflict of interest forms. Form 990, Part VI, Section B, line 15 This filing organization does not set or pay compensation to the CEO. Salary surveys are used to set compensation for the filing organization's key employees. 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 VII HOURS DEVOTED TO RELATED ORGANIZATIONS: Rona Curphy spends a total average of 40 hours per week performing CEO services for the Regional Care Services Corporation and Affiliates, which includes Casa Grande Community Hospital. Karen Francis spends a total average of 40 hours per week performing CFO services for the Regional Care Services Corporation and Affiliates, which includes Casa Grande Community Hospital. John Dernier is the former CEO of Regional Care Services Corporation and Affiliates and provided an average of 40 hours per week performing services for Casa Grande Community Hospital. regional Care Physicians Group Inc 1800 E Florence Blvd Casa Grande AZ 85122 263096262 Healthcare AZ 501(c)(3) 9 REGIONAL CARE SERVICES CORPORATION 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 REGIONAL CARE SERVICES CORPORATION 1800 E Florence Blvd Casa Grande AZ 85122 860919714 Healthcare AZ 501(c)(3) 11a, I N/A 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 REGIONAL HEALTHCARE VENTURES 1800 E FLORENCE BLVD Casa Grande AZ 85122 262199660 HEALTHCARE AZ N/A C 0 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0