2018-11-13T16:12:02-06:00 2017-12-31 450250958 EIDE BAILLY LLP 621 N ROBINSON AVE STE 200 OKLAHOMA CITY OK 731026232 990 2017-01-01 237094247 Mt Graham Regional Medical Center Inc MTGR 9283484000 1600 S 20th Avenue Safford AZ 85546 Keith Bryce CFO 9283484000 2018-10-31 1 Kim Hunwardsen CPA P00484560 4055942000 2018-10-31 98.173.248.226 2018-10-31 09:17:32 CD P E10085862974BF89EE8F231EB831862A8F193D10 B602D594AFD2B0B327E07A06F36CA6A7E42546D0 2017 2019-02-21 02:37:17Z Mark Marchetti 1600 S 20th Avenue Safford AZ 85546 64023342 0 X www.mtgraham.org X 1970 AZ To provide quality and compassionate health care services. 17 8 590 130 0 0 187836 45729 60110876 61653970 667824 811506 340645 372410 61307181 62883615 0 0 0 0 31073482 29148905 0 0 0 27777840 31280213 58851322 60429118 2455859 2454497 81482299 79865993 9095926 3582646 72386373 76283347 X We are caring people committed to improving community health. 0 0 49684141 61653970 Mt. Graham Regional Medical Center, Inc. is a 49-bed acute care hospital located in Graham County, Arizona. 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, nuclear medicine, home care and hospice. (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; audiology; cardiology; dermatology; oncology; orthopedics; pediatric cardiology; pediatric neurology; pulmonary and urology. In 2017, the Medical Center had 4,861 inpatient visits and 71,253 outpatient 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 that 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 $181,000 for the year ended December 31, 2017, 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. 49684141 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 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 70 0 1 590 1 0 0 0 0 0 0 0 0 0 0 X 17 8 1 0 0 0 0 1 0 1 0 0 0 1 1 1 1 1 1 1 0 0 AZ X Keith Bryce 9283484099 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 Trent Batty MD Chief of Staff 2.00 X 18000 0 0 Matthew Sampson MD Vice Chief of Staff 1.00 X 3000 0 0 Rex Bryce MD Member 1.00 X 0 0 0 Bart J Carter MD Member 1.00 X 0 0 0 Matt Clifford Member 1.00 X 0 0 0 Cecil L Evans Member 1.00 X 0 0 0 Steve Goodman Member 1.00 X 0 0 0 Susan J Jones MD Member 5.00 X 13350 0 0 Tom Johnson Member 1.00 X 0 0 0 John Martin Member 1.00 X 0 0 0 Carolyn McCormies Member 1.00 X 0 0 0 Bruce Stanfield Member 1.00 X 0 0 0 Jean Reynolds Member 1.00 X 0 0 0 Eldon Woodall Member 1.00 X 0 0 0 Mark Marchetti President & CEO 40.00 X 225798 0 56635 Keith Bryce CFO 40.00 X 168369 0 51788 Jason Branch MD ER Physician 36.00 X 395263 0 52316 Clayton Hargis MD ER Physician 36.00 X 368042 0 56822 Vincent Bournique MD Cardiologist 40.00 X 394054 0 53882 Llaura Beach Hospitalist 36.00 X 293813 0 20782 David Bryce MD ER Physician 36.00 X 417503 0 41655 2297192 0 333880 25 0 1 0 Roadrunner Rehab 2290 16th Street Safford AZ 85546 Physical Therapy Services 1015048 Gila Valley Orthopedics PC 2270 W 16th Street Safford AZ 85546 Orthopedic Services 495393 Sonora Quest Labs PO Box 29661 Dept 2059 Phoenix AZ 850389661 Laboratory Services 387397 Mountain View Anesthesia PC 2466 N Webster Road Central AZ 85531 Anesthesia Services 384000 Barton Associates Inc 300 Jubilee Drive Peabody MA 01960 Provide Traveling Workers 359608 13 45729 45729 Patient service revenue 622110 60880871 60880871 EHR incentive 900099 215400 215400 Equity in affiliate 900099 3447 3447 554252 554252 61653970 540404 540404 377971 5561 372410 372410 372410 1378673 26595 1134166 0 244507 26595 271102 271102 62883615 61653970 0 1183916 X 502591 502591 641067 641067 23007099 19594008 3413091 626729 563611 63118 2748216 2340142 408074 1623203 1353429 269774 110662 110662 74198 74198 6067232 4747146 1320086 149920 182 149738 3875838 1535720 2340118 731514 731514 113902 88500 25402 81128 61734 19394 94084 94084 4242127 4242127 1175297 70355 1104942 Medical Supplies 8474895 8474895 Bad debt expense 3674727 3674727 Repairs & maintenance 2194635 1259021 935614 Dietary 119841 112911 6930 100213 98968 1245 60429118 49684141 10744977 0 5257985 535348 5588288 6529691 18000 1473763 1460888 1872547 1891304 76288304 51263913 27512478 25024391 34926242 38823794 4782111 5448107 152470 50885 0 81482299 79865993 3527844 3186371 5457819 110263 396275 9095926 3582646 X 69182578 76120770 3203795 162577 72386373 76283347 81482299 79865993 2454497 1442477 0 X 0 1 X 1 0 X 1843865 1843865 32895848 19903509 12992339 92292 42163 50129 38740280 29414859 9325421 2716019 1903382 812637 25024391 Alternative investments 5448107 F 5448107 Estimated third-party settlements 49655 Self-insurances claims 346620 396275 60477543 1442477 -3848549 -2406072 62883615 0 62883615 56580569 2091 2091 56578478 3850640 3850640 60429118 Part XI, Line 2d - Other Adjustments: Bad debt expense recorded in revenue for financial statements -3,674,727. Interest expense recorded in revenue for financial statements -94,084. Grant expenses recorded in revenue for financial statements -68. Other expenses recorded in revenue for financial statements -81,761. Mt. Graham Community Health Services, Inc. eliminated for 990 reporting 2,091. Part XII, Line 2d - Other Adjustments: Mt. Graham Community Health Services, Inc. eliminated for 990 reporting 2,091. Part XII, Line 4b - Other Adjustments: Bad debt expense recorded in revenue for financial statements 3,674,727. Interest expense recorded in revenue for financial statements 94,084. Grant expenses recorded in revenue for financial statements 68. Other expenses recorded in revenue for financial statements 81,761. 1 1 X 1 X 1 X 1 1 1 0 1 1 181000 181000 0.00320 13708002 8518747 5189255 0.09140 13889002 8518747 5370255 0.09460 36923 9995 26928 0.00050 677496 239248 438248 0.00770 45729 45729 0.00080 760148 249243 510905 0.00900 14649150 8767990 5881160 0.10360 0 3674727 220484 8619163 9797135 -1177972 X 1 1 1 1 Mt Graham Regional Medical Center 1600 S 20th Avenue Safford AZ 85546 www.mtgraham.org H0140 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 16 1 0 0 1 X See Part V, Page 8 X 1 16 1 www.mtgraham.org/chna-implementation-plan.aspx 0 1 X 150.000000000000 200.000000000000 X X X 1 1 X X X 1 X www.mtgraham.org/charity-care-policy.aspx X www.mtgraham.org/cope-charity-care.aspx X www.mtgraham.org/cope-charity-care.aspx 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: To ensure that all individuals within our service area were represented, MGRMC invited individuals from our community representing not only civic and non-profit organizations, but also a wide scope of ethnicities and cultural backgrounds. Local health care providers and county public health department officials were also included to provide additional professional perspective. The underserved population in Graham County was represented through government agencies, hospital clinics for the uninsured or underinsured, and non-profit organizations that solely exist to meet the needs of the underserved. It was our goal to guarantee that the needs of all Graham County residents would be addressed. Mt. Graham Regional Medical Center, Inc. Part V, Section B, Line 11: MGRMC is continuing its efforts to attract additional medical providers to the Gila Valley. MGMRC continues its efforts to recruit for a Family Practitioner as a provider and Medical Director of the Copper Mountain Clinic, a hospitalist, and an ED physician. Telemedicine is still being explored to provide additional physician coverage.MGRMC continues to provide financial support to the Graham County Substance Abuse Coalition in their efforts to combat opioid abuse and response in the Gila Valley.The feasibility of instituting Tele-Psych into the Emergency department continues to be explored.In early 2017, the hospital employed a Registered Dietician on a full-time basis to oversee nutrition and diabetes services, replacing a part-time contract dietician. The hospital continues to sponsor and support the Gila Valley Diabetes Coalition which exists to increase awareness of and response to diabetes.Transportation is still an ongoing issue. MGRMC is committed to remaining an active participant in community conversations and solutions.MGRMC services pricing is reviewed on a regular basis relative to cost and market conditions. The hospital's prompt pay discount program and charity care program provide financial support and are continually being expanded.MGRMC will once again review the financial feasibility of offering expanded oncology services through our Cancer Center. It is the mission of MGRMC to offer as many health care solutions locally as possible while maintaining a secure financial position so that the future of the organization is not compromised. 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: www.mtgraham.org/community-health-needs-assessment.aspx 2 2 - Mt Graham Hospice 1600 S 20th Avenue Building E Safford AZ 85546 Hospice services 3 - 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. Unreimbursed Medicaid was calculated using the costing methods to prepare the cost reports. Community health improvement services and cash and in-kind contributions were reported based on expenses recorded in the general ledger. The cost for subsidized health services was determined using the Medicare Cost Report. Part I, Ln 7 Col(f): Bad debt expense in the amount of $3,674,727 was removed from total expenses to determine the percent of total expense on Worksheet 1. 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 percentage of applications that have been denied because they were incomplete. Part III, Line 4: The footnote to the Organization's financial statements can be found on page 14 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. 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 37,220. MGRMC serves Graham, Greenlee and northern Cochise counties. The median household income is $40,609, and 21.5% of Graham County is below poverty level. 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 teen pregnancy prevention, tobacco cessation program, 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 Mark Marchetti President & CEO 225509 0 101 0 188 0 31539 0 25096 0 282433 0 0 0 Keith Bryce CFO 164804 0 101 0 3464 0 28393 0 23394 0 220156 0 0 0 Jason Branch MD ER Physician 388471 0 102 0 6690 0 27275 0 25041 0 447579 0 0 0 Clayton Hargis MD ER Physician 367872 0 102 0 68 0 27272 0 29550 0 424864 0 0 0 Vincent Bournique MD Cardiologist 393820 0 102 0 132 0 33968 0 19915 0 447937 0 0 0 Llaura Beach Hospitalist 293693 0 102 0 18 0 5300 0 15482 0 314595 0 0 0 David Bryce MD ER Physician 417379 0 102 0 22 0 16445 0 25210 0 459158 0 0 0 Gila Valley Orthopedics PC Rex Bryce, MD, board member, is owner of organization 495393 Payment for Orthopedic services 0 Michael Carter Son to Bart Carter, MD - physician and board member 71117 Compensation and benefits as an employee 0 Cecil Lee Evans Son to Cecil Evans - board member 68683 Compensation and benefits as an employee 0 Staci Hincha Daughter to Cindy Bryce - board member 102857 Compensation and benefits as an employee 0 Kerri Hopson Daughter to Debra Watson - board member 97369 Compensation and benefits as an employee 0 Loni Sanders Daughter to Eldon Woodall - board member 88310 Compensation and benefits as an employee 0 Danielle Carter Daughter to Bart Carter, MD - physician and board member 46717 Compensation and benefits as an employee 0 Kyle Lines Son-in-law to Bart Carter, MD - physician and board member 52468 Compensation and benefits as an employee 0 Yummi Evans Daughter-in-law to Cecil Evans - board member 91234 Compensation and benefits as an employee 0 Bart J Carter MD PC Bart Carter, MD, physician and board member, is owner 242100 Payment for services 0 Alexis Carter Daughter to Bart Carter, MD - physician and board member 22312 Compensation and benefits as an employee 0 Mountain View Anesthesia PC Cindy Bryce's son-in-law is >35% owner 384000 Payment for services 0 Form 990, Part VI, Section A, line 1 Of the two Designated Directors from the Medical Staff, one is the Chief of Staff, or in his or her absence, the Vice-Chief of Staff, and the other is approved by the District Board. Only two are considered Designated Directors with one vote each. Form 990, Part VI, Section A, line 2 Cindy Bryce, Secretary/Treasurer of the Board and Rex Bryce, MD, board member, have a family relationship. Form 990, Part VI, Section A, line 7a The Board includes two members of the active Medical Staff and five Directors who are members of the Board of Directors of the Mt. Graham Hospital District of Graham County, Arizona. These members are referred to as Designated Directors. The Designated Directors must be approved and confirmed by the District Board before taking office. The same individual may serve as a Designated Director in more than one capacity, but is entitled to only one vote as Director. If the dual appointment reduces the number of Directors below the minimum, then the District Board will appoint a new 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 the process is documented. The compensation of CFO is approved by the CEO. 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 2,183,315. Management and general expenses 621,636. Fundraising expenses 0. Total expenses 2,804,951. Purchased services: Program service expenses 976,612. Management and general expenses 680,450. Fundraising expenses 0. Total expenses 1,657,062. Medical consultants: Program service expenses 1,587,219. Management and general expenses 18,000. Fundraising expenses 0. Total expenses 1,605,219. 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 3447 152597 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0