2024-11-13T16:31:13-06:00 2023-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-01-01 237094247 Mt Graham Regional Medical Center Inc MTGR 9283484000 1600 S 20th Avenue Safford AZ 85546 Kathleen Williams VP Finance/CFO 9283484000 2024-11-12 1 1 Kim Hunwardsen CPA P00484560 6122536500 2024-11-12 2023 2024-10-15 13:58:12Z Roland Knox 1600 S 20th Avenue Safford AZ 85546 97469620 0 X www.mtgraham.org X 1970 AZ To provide quality and compassionate health care services. 14 4 630 34 0 0 302317 263207 83657311 95157086 981693 1470690 450071 448373 85391392 97339356 0 0 0 0 39371718 45953617 0 0 0 43070926 44849619 82442644 90803236 2948748 6536120 116885615 129968887 13926987 17937257 102958628 112031630 X We are caring people committed to improving community health. 0 0 73984495 95157086 Mt. Graham Regional Medical Center, Inc. is a 25-bed hospital located in Graham County, Arizona. Effective September 28, 2021, the Medical Center became licensed as a Critical Access Hospital by the Centers for Medicare & Medicaid Services for reimbursement of services provided to Medicare beneficiaries. We are a nonprofit, community-owned and governed facility providing extensive medical services for Graham and Greenlee counties of Arizona. Our services include medical/surgical services, intensive care, obstetrics, emergency services, infusion therapy, chemotherapy, respiratory therapy, laboratory services, radiology, digital mammography, ultrasound, CT scans, MRI scans, and nuclear medicine. (Continued on Schedule O.)In addition to the services provided by the Medical Center, each month the following specialty care clinics are provided on the hospital campus: allergy and immunology; Otolaryngologist (Ear Nose Throat); cardiology; dermatology; oncology; orthopedics; pediatric cardiology; pediatric endocrinology; pediatric pulmonary; kidney, disability; endocrinology; and urology.In 2023, the Medical Center had 3,508 total inpatient days and 117,691 visits.The Medical Center provides health care services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Hospital does not pursue collection of these amounts, they are not reported as patient service revenue. The estimated cost of providing these services was approximately $358,000 for the year ended December 31, 2023, calculated by multiplying the ratio of cost to gross charges for the Medical Center by the gross uncompensated charges associated with providing charity care to its patients. 73984495 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 0 1 138 0 1 630 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 4 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 1 1 1 0 0 X Kathleen Williams 9283484060 1600 S 20th Avenue Safford AZ 85546 Caro Gaethje Chair 1.00 X X 0 0 0 Debbie Watson Vice Chair 1.00 X X 0 0 0 Cindy Bryce Secretary/Treasurer 1.00 X X 0 0 0 Bart J Carter MD FACS Member/General Surgery 41.00 X 661384 0 40365 Brandon Welker DO Member/Chief of Staff 24.00 X 22769 0 0 Clayton Hargis DO Member/Vice Chief of Staff 37.00 X 463906 0 44252 Cecil L Evans Member 1.00 X 0 0 0 Jean Reynolds Member 1.00 X 0 0 0 Susan J Jones MD Member 1.00 X 0 0 0 Steve Goodman Member 1.00 X 0 0 0 John Martin Member until Oct 2023 1.00 X 0 0 0 Eldon Woodall Member 1.00 X 0 0 0 Jim Palmer Member 1.00 X 0 0 0 Kip Kempton Member 1.00 X 0 0 0 Clinton Damron DO Member 12.00 X 12000 0 0 Roland Knox President & CEO 40.00 X 322688 0 33661 Kathleen Williams VP Finance & CFO 40.00 X 172304 0 15772 Lori Ray CNO 40.00 X 184656 0 30897 Eric Neal COO 40.00 X 184187 0 38789 Mansur Khan MD Gastroenterology 40.00 X 703637 0 12646 Douglas Harrison MD OB/GYN 40.00 X 653293 0 17072 David Bryce DO Emergency Medicine 36.00 X 600420 0 44340 Jordan Marble MD General Surgeon 40.00 X 494446 0 33280 Taz Brinkerhoff MD Emergency Medicine 36.00 X 473291 0 35772 4948981 0 346846 69 0 1 0 BFL Construction Company 700 E Broadway Blvd Ste 200 Tucson AZ 85719 Construction Services 2576325 Medical Solutions LLC 1010 North 102nd St Ste 300 Omaha NE 68114 Locum Respiratory, Lab, Surgery, & Medsu 1786145 Roadrunner Rehab 2290 16th Street Safford AZ 85546 Physical therapy services 1681948 Sentinel Technologies Inc PO Box 85080 Chicago IL 606800851 IT Support Services 864561 Mountain View Anesthesia PC PO Box 1318 Thatcher AZ 85552 Anesthesia services 816667 60 99025 164182 263207 Net patient service revenue 621110 94418066 94418066 EHR Incentive 900099 1383 1383 737637 737637 95157086 1512909 1512909 452968 4595 448373 448373 448373 83450 125669 0 -125669 83450 -42219 -42219 97339356 95157086 0 1919063 X 2228749 1684014 544735 1379604 1379604 34852385 29115150 5737235 959426 808601 150825 4051263 3349528 701735 2482190 2075158 407032 201360 201360 93916 93916 10061739 7514627 2547112 174869 174869 5961182 2322080 3639102 902129 902129 167397 98457 68940 127736 68784 58952 73358 73358 6020381 6020381 1368474 1368474 Medical Supplies 10399299 10398963 336 Bad Debt Expense 7115344 7115344 Repairs & Maintenance 2088227 1034609 1053618 Dietary 91295 22075 69220 2913 1633 1280 90803236 73984495 16818741 0 4328319 4400922 12598750 11614722 100066 65008 2127404 2035211 1961600 1590628 104662177 71526521 31082898 33135656 48162533 50599921 6055446 6926093 155112 155410 28815 325430 10284672 19119886 116885615 129968887 5666709 6479010 693675 572803 7566603 10885444 13926987 17937257 X 102783154 111841713 175474 189917 102958628 112031630 116885615 129968887 X 6536120 2536584 298 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1843865 1843865 45140283 27288012 17852271 92292 67521 24771 53900753 41567601 12333152 3684984 2603387 1081597 33135656 Alternative investments 6926093 F 6926093 Estimated third-party settlements 1819877 Lease receivable 580698 Right-to-use lease assets 6886887 Supplemental payments 8905784 Right-to-use subscription IT assets 926640 19119886 Lease Liabilities 6591805 Supplemental Payments 3840964 Subscription IT Liabilities 452675 10885444 92687966 2536584 -7187974 -4651390 97339356 0 97339356 83614964 430 430 83614534 7188702 7188702 90803236 Part XI, Line 2d - Other Adjustments: Interest Expense Included in Expenses on Form 990 -73,358. CHS Revenue Excluded on Form 990 728. Bad Debt Expense Included in Expense on Form 990 -7,115,344. Part XII, Line 2d - Other Adjustments: CHS Expense Excluded on Form 990 430. Part XII, Line 4b - Other Adjustments: Interest Expense Included in Revenue on Audit 73,358. Bad Debt Expense Included in Rvenue on Audit 7,115,344. 1 1 X 1 X 1 X 1 1 1 0 0 358000 358000 0.00430 358000 358000 0.00430 7781238 2620960 5160278 0.06170 7781238 2620960 5160278 0.06170 8139238 2620960 5518278 0.06600 0 7115344 1053071 9576017 9662789 -86772 X 1 1 1 1 Mt Graham Regional Medical Center 1600 S 20th Avenue Safford AZ 85546 www.mtgraham.org H0140 X X X X 1 provider based rural health clinic Mt Graham Regional Medical Center Inc 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X https://www.mtgraham.org/about-us/ X 1 22 1 https://www.mtgraham.org/about-us/ 0 1 X 150.000000000000 200.000000000000 X X X 1 1 X X X 1 X https://www.mtgraham.org/financial/ X https://www.mtgraham.org/wp-content/uploads/2021/06/Charity-Care-App.pdf X https://www.mtgraham.org/financial/ X X X X X X X 1 X 0 X X X X 1 X 0 1 Mt. Graham Regional Medical Center, Inc. Part V, Section B, Line 5: Between July and September 2022, a Community Health Needs Assessment (CHNA) was conducted by Mt. Graham Regional Medical Center (MGRMC) in partnership with Graham and Greenlee County Health Departments for the approximately 47,769 residents of Graham and Greenlee Counties.The information-gathering phases of the assessment were initiated and conducted by MGRMC, Graham, and Greenlee County Health Department. As partners, we held meetings with community members and formed a survey.Members of the underserved population were not represented directly. However, individuals who specifically serve these populations through government agencies, hospital clinics for the uninsured or underinsured, and non-profit organizations that solely exist to meet the needs of the underserved were invited and did participate so that the issues these individuals face would be addressed. Mt. Graham Regional Medical Center, Inc. Part V, Section B, Line 6b: Graham County Health DepartmentGreenlee County Health Department Mt. Graham Regional Medical Center, Inc. Part V, Section B, Line 11: The Hospital conducted its most recent CHNA in 2022. The following are needs the hospital will address over the next 3 years: Outpatient and Inpatient Mental Health, Substance use/abuse, Diabetes, Obesity/Weight Management, Nutrition, Heart Disease, and Cancer.At this time, the following needs will not be addressed by the facility CHNA due to lack of urgency or priority as determined by MGRMC's CHNA Committee: dental care, fitness, primary care (adult), older adult/elder services, eating disorders, primary care (pediatric/children), and pediatric specialties. MGRMC will address the following needs outside of the CHNA as part of our strategic plan: primary care (adult) and primary care (pediatric/children). -Improved Treatment and Services for Substance AbuseMGRMC has continued to offer support to the Graham County Substance Abuse Coalition in its efforts to combat opioid abuse and response in the Gila Valley. The hospital purchased a local pain management clinic in the community to ensure the success of the clinic and continued availability for our community. MGRMC sponsors substance abuse prevention and recovery events and programs working with the Graham County Substance Abuse Coalition. MGRMC is diligent in ensuring appropriate referrals to substance abuse treatment services and includes such services in its employee benefits program.-Improved Treatment and Services Associated with Mental HealthIn 2022, our primary care clinic hired a Psychiatric Mental Health Nurse Practitioner to meet the high demand of mental health providers in our community. In 2023 we hired a second psychiatric mental health practitioner. MGRMC continues to collaborate with a variety of providers of mental health services to offer in-person and telepsych services in the hospital and hospital clinics. The hospital's Employee Assistance Program provides easy access to mental health and related services to hospital employees and their families. MGRMC's Case Management partners with local programs that specialize in mental health to make sure all patients have access to the mental healthcare that they need. The hospital works closely with mental health providers both in the community and the Phoenix and Tucson metropolitan areas to ensure the appropriate referral of patients for needed care. MGRMC sponsors and promotes community mental health awareness events including 5k/10k walk/runs.-Improve Services for DiabetesMGRMC employs a dietician who oversees our Diabetes Family Support Group as well as our Diabetes education classes. These classes cover individual nutrition counseling, diabetes education, and how best to support family members who may have diabetes. Our dietician works on expanding diabetes knowledge through school visits and community health fairs. -Improve Opportunities for Obesity/Weight Management and Nutrition The hospital's Copper Mountain Clinic, a federally designated rural health clinic, provides access to primary care services including wellness visits, immunizations, illness care, and health education. The hospital provides a financial incentive to employees for membership in fitness programs. The hospital also provides a wellness app for all employees who participate in our medical plan. This app encourages employees to cultivate good health habits, track daily step counts, fitness activities, nightly sleep, nutrition and water intake, wellness checkups, and participate in wellness challenges with co-workers. MGRMC is also part of the Gila Valley Food Coalition with local partners to provide nutritional food and items to underserved communities in food deserts across Graham and Greenlee Counties. The hospital continued to promote wellness community health fairs, sponsoring health-related community events, and working with local clubs, organizations, and wellness facilities to promote wellness activities. The hospital and its foundation also provide support for runs, golf outings and tournaments, and other sports and wellness-related activities.-Additional Specialty Services Heart Disease and CancerAfter acquiring MGRMC OB/GYN clinic as a new hospital-owned medical practice, in 2023 we added another OBGYN provider with plans to add another in 2024 to help meet our goal to continue to grow their services and providers to meet the needs of the community. MGRMC brought two more clinics, Mount Graham Spine and Pain, and Mt Graham Orthopedics substantially to ensure their continued operation in our community by adding new providers to those clinics as existing providers get closer to retirement. MGRMC hosts many independent specialists on our campus, including a full-service cardiology group, orthopedics, podiatry, dermatology, and physical therapy. Our Specialty Clinic leases space to visiting providers including oncology, urology, pediatrics, and nephrology. Additionally, some of the specialists offer telemedicine to increase their presence in the community. Mt. Graham Regional Medical Center, Inc. Part V, Section B, Line 16j: A summary, including contact information, was included in our emergency rooms, waiting rooms, admissions offices, and provided to patients on admission to the hospital facility. Mt. Graham Regional Medical Center, Inc. Part V, Section B, Line 24: All individuals eligible under the Medical Center's financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. Part V, Section B, Line 7a: Community Health Needs assessment www.mtgraham.org/about-mgrmc/community-health-needs-assessment 1 1 - Mt Graham Specialty Clinic 1600 S 20th Avenue Building E Safford AZ 85546 Physician clinic Part I, Line 7: Charity care was converted to cost using an overall cost-to-charge ratio addressing all patient segments. The cost for subsidized health services was determined using the Medicare Cost Report. 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 $ 7,115,344. Part III, Line 2: Accounts are not written off to bad debt until all payments, discounts, and contractual allowances are applied. When a payment is received on an account previously written off to bad debt, the payment reduces the current year's bad debt expense.Bad debt expense on line 2 is reported at charges as presented on the financial statements. Part III, Line 3: The amount of bad debt expense attributable to patients eligible for charity care is based on the 14.8% of individuals living below the federal poverty level. Part III, Line 4: The footnote to the Organization's financial statements can be found on page 17 of the attached audited financial statements. Part III, Line 8: The entire Medicare shortfall is considered a community benefit. Services are provided to patients under the Medicare program even though the hospital knows they will not recover all of the costs from providing the services. This program is considered subsidized by the hospital and other payors. Patients rely on these services for their health and well-being and are essential for their access to healthcare. The costs associated with Medicare were taken from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: The Hospital must determine whether an individual is FAP-eligible or provide required notices during a notification period ending 120 days after the date of the first billing statement. Although the Hospital may use extraordinary collection efforts after the 120-day notification period, we must still accept and process a FAP application for an additional 120 days. The total period during which we must accept and process FAP applications is 240 days from the date of the first billing statement. If the hospital receives a FAP application during the application period, we must suspend any extraordinary collection efforts started until the application is processed, and if the individual is FAP-eligible, must seek to reverse the extraordinary collection efforts and promptly refund any overpaid amounts. Debts may be referred to third parties to assist with collection efforts, they may not be sold to third parties during the notification period until an eligibility determination has been made. Part VI, Line 2: Throughout the year, the hospital works closely with community clinics on recruiting, scheduling, and services review. The hospital also continues to expand its charity care program. Part VI, Line 3: Mt. Graham Regional Medical Center provides brochures for charity care at time of admission. Patients are given additional information with contact information at time of inpatient admission and discharge. Brochures with information about charity care are located in admission areas and other areas of the organization in which eligible patients are likely to be present. Charity care brochures are also provided to local physicians to provide information to their patients who may need services at Mt. Graham Regional Medical Center. When patients are contacted by phone for collection purposes, patients are given additional information regarding our charity care program. Mt. Graham Regional Medical Center has contracted HPS (Hospital Patient Services) to assist patients with government benefits such as Medicaid. The Hospital employs a financial counselor to assist patients with enrollment in AHCCCS/Cope as part of the charity care and financial assistance. Part VI, Line 4: Mt. Graham Regional Medical Center is an acute care hospital located in Safford which is in Graham County, Arizona. Graham County is a rural area with a population of approximately 39,050. MGRMC serves Graham, Greenlee and northern Cochise counties. The median household income is $55,693, and 14.8% of Graham County is below poverty level. The median age of population in Graham County is 33.7 with 46.2% female and 53.8% male. The two facilities closest to our facility are approximately 50-75 miles away, and both are critical access facilities. In its rural setting, the hospital serves the population with general surgery and orthopedic surgery. Other specialists come to the hospital on a weekly or monthly basis to provide service to community members. Part VI, Line 5: The majority of MGRMC's governing body is comprised of persons who reside in the Organization's primary service area. MGRMC extends medical staff privileges to all qualified physicians in the community. MGRMC provides emergency room services regardless of ability to pay.Mt. Graham Regional Medical Center (MGRMC) is a facility dedicated to promoting the health of the community. MGRMC provides services through our Community Health Department and Rural Health such as diabetes education and Annual Gila Valley Health Fair. The amount reported as community health improvement services represents the excess of costs for these events over the funds received from government agencies to put on the events. MGRMC supports the education and training of healthcare professionals. MGRMC offers volunteer opportunities to the community through our auxiliary. X X X 0 0 0 0 0 0 0 0 0 Mansur Khan MD Gastroenterology 653420 0 50217 0 0 0 11050 0 1794 0 716481 0 0 0 Bart J Carter MD FACS Member/General Surgery 661167 0 217 0 0 0 14514 0 26131 0 702029 0 0 0 Douglas Harrison MD OB/GYN 613076 0 40217 0 0 0 11708 0 5892 0 670893 0 0 0 David Bryce DO Emergency Medicine 600203 0 217 0 0 0 11050 0 33305 0 644775 0 0 0 Jordan Marble MD General Surgeon 494229 0 217 0 0 0 11050 0 22294 0 527790 0 0 0 Taz Brinkerhoff MD Emergency Medicine 473074 0 217 0 0 0 11050 0 24743 0 509084 0 0 0 Clayton Hargis DO Member/Vice Chief of Staff 463689 0 217 0 0 0 12674 0 31768 0 508348 0 0 0 Roland Knox President & CEO 322471 0 217 0 0 0 11029 0 22847 0 356564 0 0 0 Eric Neal COO 180100 0 4087 0 0 0 6536 0 32493 0 223216 0 0 0 Lori Ray CNO 180927 0 3729 0 0 0 6597 0 24399 0 215652 0 0 0 Kathleen Williams VP Finance & CFO 169155 0 3149 0 0 0 5948 0 9919 0 188171 0 0 0 Kerri Hopson Daughter to Debra Watson - board member 155121 Compensation and benefits as an employee 0 Amy Bodine Daughter to Steve Goodman - board member 75167 Compensation and benefits as an employee 0 Royann Goodman Wife to Steve Goodman - board member 116377 Compensation and benefits as an employee 0 Cecil Lee Evans Son to Cecil Evans - board member 69812 Compensation and benefits as an employee 0 Yummi Evans Daughter-in-law to Cecil Evans - board member 142384 Compensation and benefits as an employee 0 Michael Carter Son to Bart Carter, MD - physician and board member 107659 Compensation and benefits as an employee 0 Danielle Carter Daughter-in-law to Bart Carter, MD - physician and board member 114010 Compensation and benefits as an employee 0 Kyle Lines Son-in-law to Bart Carter - board member and employee 128952 Compensation and benefits as an employee 0 Shelli Carter Daughter-in-law to Bart Carter - board member and employee 19233 Compensation and benefits as an employee 0 Stacie Hincha Daughter to Cindy Bryce - board member 150449 Compensation and benefits as an employee 0 Randy Bryce Son-in-law to Jim Palmer - board member 221092 Compensation and benefits as an employee 0 Jamie Kelliher Daughter to Lori Ray - key employee 17097 Compensation and benefits as an employee 0 Mountain View Anesthesia PC Cindy Bryce's son-in-law is >35% owner 816667 Payment for services 0 Gila Valley Orthopedics PC Cindy Bryce's brother-in-law is owner 468150 Payment for Orthopedic services 0 Kenzi Jurado Daughter to Caro Gaethje - board member 62252 Compensation and benefits as an employee 0 Form 990, Part VI, Section A, line 7a The Board includes two Directors who are members in good standing of the active Medical Staff, which includes the Chief of Staff. Five board members referred to as Designated Directors are members of the Mt. Graham Hospital District of Graham County, Arizona. The remaining open positions are appointed by the Corporate Board of Directors. The same individual may serve as a Designated Director in more than one capacity, but is entitled to only one vote and office as Director. Form 990, Part VI, Section A, line 8b The Organization does not have a committee with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the board before it is filed. The Finance Committee, CFO and CEO review the Form 990. Form 990, Part VI, Section B, line 12c Each officer, director, and key employee is required to complete a conflict of interest disclosure annually. The forms are reviewed initially by the Compliance Officer as well as other officers or department directors as necessary. Any actual conflicts are reviewed by the Board of Directors. A person with a conflict is restricted from voting on related matters. Form 990, Part VI, Section B, line 15a The Board of Directors annually conducts an evaluation of the CEO and sets goals for the coming year. Compensation for the CEO is determined and approved by the Board of Directors. Comparability data is used and an analysis is prepared by the Vice President of Human Resources for the state of Arizona region. The process is documented. The compensation for the key employees and CFO is approved by the CEO on an annual basis. Comparability data is used and an analysis is prepared by the Vice President of Human Resources for the state of Arizona region. The process is documented in the personnel files. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy and financial statements are made available upon request at the administrative offices. Form 990, Part IX, line 11g Professional Fees: Program service expenses 1,284,437. Management and general expenses 749,260. Fundraising expenses 0. Total expenses 2,033,697. Purchased services: Program service expenses 2,759,337. Management and general expenses 1,753,262. Fundraising expenses 0. Total expenses 4,512,599. Medical Professional Fees: Program service expenses 3,470,853. Management and general expenses 44,590. Fundraising expenses 0. Total expenses 3,515,443. Form 990, Part XI, line 9: Change in Investment in CHS 298. Mt Graham Community Health Services Inc 1600 S 20th Avenue Safford AZ 85546 860733116 Phone answering service AZ Mt Graham Regional Medical Center Inc C 728 155410 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0