2018-02-21T14:57:37-06:00 2017-06-30 860683059 BEACHFLEISCHMAN PC 1985 E RIVER ROAD SUITE 201 TUCSON AZ 85718 990 2016-07-01 866007695 BENSON HOSPITAL BENS 5205862261 PO BOX 2290 BENSON AZ 85602 KENNETH GORANSON CFO 5205862261 2018-02-13 1 KAREN K MCCLOSKEY CPA P00099644 5203214600 208.87.239.202 2018-02-13 14:06:26 US P 23AB17895BAC7DA56F918F3357BB5DF74DD723A1 374F92A1CAE4D53B1A657F70CE012C071B2F41E5 2016 2021-01-29 14:40:06Z RICHARD POLHEBER PO BOX 2290 BENSON AZ 85602 14249567 0 X WWW.BENSONHOSPITAL.ORG X 1960 AZ QUALITY MEDICAL CARE INCLUDING EMOTIONAL, SOCIAL AND SPIRITUAL NEEDS 6 5 174 30 0 0 928660 912594 13062315 13262434 7237 5880 47682 68659 14045894 14249567 0 0 0 0 8585811 8972104 0 0 0 5333680 6839788 13919491 15811892 126403 -1562325 6669679 5247742 2147469 2287857 4522210 2959885 THE MISSION OF BENSON HOSPITAL IS TO STRIVE TO SURPASS THE CUSTOMER'S EXPECTATIONS IN THE DELIVERY OF QUALITY MEDICAL CARE INCLUDING THEIR EMOTIONAL, SOCIAL, AND SPIRITUAL NEEDS. 0 0 12715857 13262434 BENSON HOSPITAL IS A RURAL HOSPITAL THAT PROVIDES MEDICAL CARE ON AN INPATIENT, OUTPATIENT AND EMERGENCY BASIS TO PATIENTS IN AND AROUND THE TOWN OF BENSON, ARIZONA. THE HOSPITAL HAS 22 ACUTE CARE BEDS AND IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL BY THE STATE OF ARIZONA. CARE PROVIDED INCLUDES EMERGENCY, OBSTETRICS, OCCUPATIONAL MEDICINE, RESPIRATORY THERAPY, DIAGNOSTIC IMAGING, NUTRITION SERVICES, LABORATORY SERVICES, PHARMACY, SURGICAL AND PHYSICAL REHABILITATION. CARE IS PROVIDED REGARDLESS OF RACE, CREED, COLOR OR ABILITY TO PAY. 12715857 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 62 0 1 174 1 0 0 0 0 0 0 0 0 0 0 X 6 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 AZ X KENNETH GORANSON 5205862261 450 S OCOTILLO AVE BENSON AZ 85602 DAN BARRERA MEMBER 2.00 X 0 0 0 BARBARA HARTLEY MEMBER 20.00 X 196843 0 0 ANCIETO MALDONADO MEMBER 2.00 X 0 0 0 ANN E COOK PRESIDENT 2.00 X X 0 0 0 WILLIAM LINDLEY VICE PRESIDENT 2.00 X X 0 0 0 BOB LUJAN SECRETARY/TREASURER 2.00 X X 0 0 0 RICHARD POHLEBER CEO 40.00 X 246030 0 5251 KENNETH GORANSON CFO 40.00 X 177646 0 13923 TERESA VINCIFORA CCO 40.00 X 159377 0 3486 JAMES RICHEY PHARMACIST 40.00 X 156143 0 13200 GARY MALUF LAB DIRECTOR 40.00 X 124371 0 2685 JOHN ROBERTS INFORMATION TECHNOLOGY DIRECTOR 40.00 X 112371 0 11952 REX HEATON NURSE PRACTICIONER 40.00 X 116871 0 12149 1289652 0 62646 8 0 1 0 NES INC PO BOX 277001 ATLANTA GA 30384 EMERGENCY DEPARTMENT PROFESSIONAL SVCS 554900 MEDHOST OF TN INC 2739 MOMENTUM PLACE CHICAGO IL 60689 ELEC. HEALTH RECORDS, FIN. REP. SYSTEM 413401 MEDICAL DIAGNOSTIC IMAGING GROUP PO BOX 17049 PHOENIX AZ 85011 RADIOLOGY PROFESSIONAL SVCS 278020 MEDICAL SOLUTIONS INC 1010 N 102ND ST STE 300 OMAHA NE 68114 NURSING PROFESSIONAL SERVICES 153108 4 904017 8577 912594 PATIENT SERVICES 621300 13218296 13218296 OTHER REVENUE 621300 44138 44138 13262434 5880 5880 18800 0 18800 18800 18800 CAFETERIA 722100 49859 49859 49859 14249567 13262434 0 74539 X 474064 118516 355548 7039125 5875963 1163162 79859 19965 59894 842426 682681 159745 536630 437401 99229 22949 5737 17212 3432120 3041790 390330 34717 8679 26038 41515 24856 16659 441639 320622 121017 120810 88986 31824 42892 27880 15012 285418 185522 99896 162153 40538 121615 MEDICAL SUPPLIES 1802842 1647680 155162 OTHER EXPENSES 306379 98631 207748 PROFESSIONAL DEVELOPMEN 146354 90410 55944 15811892 12715857 3096035 0 56244 44104 755436 2921490 2433362 397398 267459 72526 111484 8048748 5657415 2466585 2391333 6669679 5247742 1210053 1564932 937416 722925 2147469 2287857 X 4522210 2959885 4522210 2959885 6669679 5247742 -1562325 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8000 8000 3431207 1629053 1802154 4588074 4028362 559712 21467 21467 2391333 X 14249567 0 14249567 0 14249567 15811892 0 15811892 0 15811892 PART X, LINE 2: FINANCIAL STATEMENT FIN 48 (ASC 740) FOOTNOTE: THE HOSPITAL HAS BEEN RECOGNIZED AS A TAX-EXEMPT ORGANIZATION FOR FEDERAL INCOME TAX PURPOSES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL IS ONLY SUBJECT TO INCOME TAXES ON UNRELATED BUSINESS TAXABLE INCOME (UBTI). ACCORDINGLY, NO PROVISION OR LIABILITY FOR INCOME TAXES IS MADE IN THE FINANCIAL STATEMENTS. MANAGEMENT IS NOT AWARE OF ANY MATTERS THAT WOULD CAUSE THE HOSPITAL TO LOSE ITS TAX-EXEMPT STATUS. MANAGEMENT HAS PERFORMED ITS EVALUATION OF TAX POSITIONS TAKEN ON ALL OPEN TAX RETURNS AND HAS DETERMINED THAT THERE WERE NO POSITIONS TAKEN THAT DO NOT MEET THE "MORE LIKELY THAN NOT" STANDARD. ACCORDINGLY, THERE ARE NO PROVISIONS FOR INCOME TAXES, PENALTIES OR INTEREST RECEIVABLE OR PAYABLE RELATING TO UNCERTAIN INCOME TAX PROVISION IN THE ACCOMPANYING FINANCIAL STATEMENTS. FROM TIME TO TIME, THE HOSPITAL MAY BE SUBJECT TO PENALTIES AND INTEREST ASSESSED BY VARIOUS TAXING AUTHORITIES, WHICH WILL BE CLASSIFIED AS GENERAL AND ADMINISTRATIVE EXPENSES, IF THEY OCCUR. 1 1 1 X 0 1 1 1 0 1 1 177857 177857 0.01120 3138383 2259147 879236 0.05560 3316240 2259147 1057093 0.06680 11750 11750 0.00070 11750 11750 0.00070 3327990 2259147 1068843 0.06750 1 1555362 3654399 5139264 -1484865 X 1 1 1 1 BENSON HOSPITAL CORPORATION 450 S OCOTILLO STREET BENSON AZ 85602 X X X X BENSON HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X WWW.BENSONHOSPITAL.ORG X 1 15 1 WWW.BENSONHOSPITAL.ORG 0 1 X 150.000000000000 0.000000000000 X X 1 1 X X X X 1 X WWW.BENSONHOSPITAL.ORG X WWW.BENSONHOSPITAL.ORG X WWW.BENSONHOSPITAL.ORG X X X X X X X 1 X 0 X X X X 1 X 0 0 BENSON HOSPITAL PART V, SECTION B, LINE 5: BENSON HOSPITAL HAD INPUT FROM 5 HEALTH CARE PROFESSIONALS, INCLUDING HOSPITAL STAFF. THE FOLLOWING PROFESSIONALS PROVIDED INPUT: PRESIDENT OF BENSON HOSPITAL GOVERNING BOARD, HOSPITALIST, CHIEF NURSING OFFICER, EMERGENCY ROOM SUPERVISOR, AND NURSING STAFF. BENSON HOSPITAL PART V, SECTION B, LINE 11: SIGNIFICANT HEALTH NEEDS ARE IDENTIFIED IN THE ASSESSMENT AND ARTICULATED TO THE STRATEGIC PLAN, WITH IMPLEMENTATION STRATEGIES IDENTIFIED AND ASSIGNED TO KEY HOSPITAL PERSONNEL. BENSON HOSPITAL PART V, SECTION B, LINE 16J: POSTED SIGNS AT FOOD BANK, LIBRARY, POLICE/FIRE STATIONS. PART I, LINE 3C: THE HOSPITAL USES 150% OF FEDERAL POVERTY GUIDELINES (FPG) FOR FEE CARE. THIS IS THE ONLY TEST USED TO DETERMINE FREE CARE. SELF-PAY PATIENTS HAVE THEIR BILLS DISCOUNTED TO 45% OF THE FEE SCHEDULE WITH AN ADDITIONAL 5% DEDUCTION FOR IMMEDIATE PAYMENT. PART I, LINE 7: THE FINANCIAL ASSISTANCE IS BASED ON THE CHARITY CARE PROVIDED AT THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2. THE GROSS PATIENT CHARGES ARE BASED ON COST REPORT DATA FOR THE CURRENT PERIOD. PART II, COMMUNITY BUILDING ACTIVITIES: WE PARTICIPATE IN COMMUNITY EVENTS INCLUDING FREE BLOOD PRESSURE SCREENINGS, PARTICIPATION IN THE RELAY FOR LIFE, ONSITE HEALTH FAIRS, AND INVOLVEMENT IN THE RESPIRATORY SUPPORT GROUP. IN ADDITION, THERE ARE REGULAR BLOOD DRIVES HELD ONSITE AS WELL AS DIETARY COUNSELING. PART III, LINE 2: THE BAD DEBT EXPENSE IS BASED ON HISTORICAL BAD DEBT WRITE OFFS BY FINANCIAL PAY CLASS, I.E., COMMERCIAL INSURANCE, GOVERNMENT PAYERS - MEDICARE AND MEDICAID AND SELF-PAY. THE PAST PERFORMANCE IS USED TO ESTIMATE THE MONTHLY REVENUE AND OUTSTANDING RECEIVABLE BALANCE. THE ESTIMATE IS UPDATED MONTHLY TO REFLECT ACTUAL ACTIVITY TO DATE. ANY DISCOUNTS TO PATIENT BILLS ARE INCLUDED IN THE BAD DEBT EXPENSE SINCE THEY ARE BILLED NET OF ANY CONTRACTUAL ADJUSTMENTS OR SELF-PAY DISCOUNTS. ANY PAYMENTS ON ACCOUNTS ARE APPLIED TO THE ACCOUNTS. IF A PAYMENT IS RECEIVED AFTER AN ACCOUNT HAS BEEN WRITTEN OFF TO BAD DEBT, THE BAD DEBT ACCOUNT WILL BE REDUCED BY THE PAYMENT. PART III, LINE 3: THE AMOUNT RELATED TO BAD DEBT CANNOT BE QUANTIFIED. THE FINANCIAL ASSISTANCE BENEFIT IS BASED ON THE FEE SCHEDULE RATES DISCOUNTED TO EXPECTED NET REVENUE FOR ALL FINANCIAL CLASSIFICATIONS SO IT COMBINES THE BAD DEBT AND CONTRACTUAL ADJUSTMENTS. PART III, LINE 4: THE HOSPITAL GRANTS UNSECURED CREDIT TO ITS PATIENTS AND INSURANCE COMPANIES WITHOUT INTEREST. GENERALLY, ACCOUNTS RECEIVABLE ARE CONSIDERED TO BE PAST DUE AFTER 60 DAYS. PATIENT ACCOUNTS RECEIVABLE ALSO INCLUDE AN ESTIMATE FOR CHARGES WITH DATES OF SERVICE PRIOR TO YEAR END THAT WERE SUBSEQUENT TO THAT DATE (UNBILLED ACCOUNTS RECEIVABLE). THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS EQUAL TO THE ESTIMATED COLLECTION LOSSES THAT WILL BE INCURRED. THE ESTIMATED LOSSES ARE BASED ON HISTORICAL COLLECTION EXPERIENCE COUPLED WITH REVIEW OF THE CURRENT STATUS OF EXISTING RECEIVABLES. AS A RESULT, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. DOUBTFUL ACCOUNTS ARE PERIODICALLY REVIEWED FOR COLLECTABILITY AND ARE CHARGED OFF TO THE ALLOWANCE WHEN MANAGEMENT DETERMINES THAT ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED. PART III, LINE 8: THE ALLOWABLE COSTS ARE BASED ON THE MEDICARE COST REPORT, SCHEDULE D1 -LINE 49 WHICH IS BASED ON THE NUMBER OF PATIENT DAYS TIMES THE COST PER DIEM. PART III, LINE 9B: EVERY PATIENT IS INFORMED ABOUT THE FINANCIAL ASSISTANCE PROGRAM PRIOR TO BILLING AND THIS IS OFTEN REVIEWED WHEN COLLECTION CALLS ARE MADE. PART VI, LINE 2: THE BENSON HOSPITAL HAS AN OPEN DOOR POLICY TO HEAR THE NEEDS AND CONCERNS OF PATIENTS. WE LISTEN TO WHAT OUR COMMUNITY PHYSICIANS SAY ABOUT SERVING THE NEEDS OF THE COMMUNITY. THE HOSPITAL ADMINISTRATION ALSO SURVEYS OTHER SMALL HOSPITALS TO COMPARE SERVICES. THE HOSPITAL SPONSORED A RETREAT TO DISCUSS HEALTHCARE CONCERNS AND INVITED LOCAL PHYSICIANS AS WELL AS COMMUNITY LEADERS TO DEVELOP COMMUNITY HEALTH GOALS AND NEEDS. A COMMUNITY WELLNESS COMMITTEE WAS CREATED BY THE HOSPITAL TO ADDRESS THE CONCERNS. PART VI, LINE 3: THE BENSON HOSPITAL HAS A STAFF MEMBER WHO IS DEDICATED TO THE EDUCATION OF PATIENTS WHO MAY NEED ASSISTANCE. THAT STAFF MEMBER IS AVAILABLE TO ENROLL PATIENTS IN ALL OF THE APPLICABLE STATE ASSISTANCE PROGRAMS. PART VI, LINE 4: BENSON HOSPITAL DEFINES THEIR SERVICE AREA AS THE ENTIRE SAN PEDRO VALLEY HOSPITAL DISTRICT (SPVHD), AND AREAS WITHIN A 25 MILE RADIUS OF THE HOSPITAL THAT EXTEND INTO PIMA AND PINAL COUNTIES. THE SPVHD IS A GEOGRAPHICAL AREA OF APPROXIMATELY 1,100 SQUARE MILES IN THE NORTHWEST CORNER OF COCHISE COUNTY. IT CONTAINS THE COMMUNITIES OF BENSON, ST. DAVID, POMERENE AND DRAGOON. TWO MAIN AREAS FALL WITHIN THE 25 MILE RADIUS, BUT OUTSIDE THE BOUNDARIES OF THE DISTRICT. THE J-6/MESCAL AREA EXTENDS INTO PIMA COUNTY. IT IS VISUALIZED AS AN AREA ALONG I-10 GOING WEST SOME 20 MILES FROM THE COCHISE COUNTY LINE. ANOTHER AREA EXTENDS NORTH OF CASCABEL ALONG THE SAN PEDRO RIVER INTO PIMA COUNTY, THEN INTO PINAL COUNTY. COLLECTIVELY, THE SPVHD AND THE J-6/MESCAL AND CASCABEL EXTENSIONS COMPRISE THE BENSON HOSPITAL SERVICE AREA. THIS REGION WAS FOUNDED AS A MINING AND TRANSPORTATION CENTER IN THE LATE 1800'S. IT IS HIGH DESERT, WITH MOUNTAINS, GRASSLANDS AND NATIVE SUCCULENTS PREDOMINATING. SPREAD OVER THE ENTIRE DISTRICT THE POPULATION DENSITY IS ABOUT 17 PERSONS/SQUARE MILE. THE CITY OF BENSON HAS A POPULATION DENSITY OF ABOUT 135 PERSONS/SQUARE MILE. THIS IS A RURAL SETTING. THE SPVHD AREA HAS BEEN ESTIMATED BY THE BENSON HOSPITAL STRATEGIC PLANNING COMMITTEE TO CONTAIN APPROXIMATELY 16,500 PEOPLE. THE J-6 AND CASCABEL EXTENSIONS ARE ESTIMATED TO ADD 1,500 PEOPLE FOR A TOTAL OF 18,000. ALTHOUGH THE U.S. CENSUS GIVES A POPULATION OF 12,500 FOR THIS AREA, THE COMMITTEE'S ESTIMATE INCLUDES WINTER VISITORS WHO ARE NOT COUNTED BY CENSUS METHODS. THE RACIAL MAKEUP IS COMPRISED OF 91% WHITE, 1% AMERICAN INDIAN, 1% BLACK, 1% ASIAN/PACIFIC ISLANDER, 6% OTHER. THE U.S. CENSUS BUREAU CONSIDERS HISPANIC AN ETHNICITY, NOT A RACE, FOR THIS REASON THERE IS NO SEPARATE RACIAL CLASSIFICATION FOR HISPANICS. IF THERE WERE, THE HISPANIC PORTION OF THE AREA WOULD BE AROUND 30%. THE SPVHD POPULATION IS EXPECTED TO GROW APPROXIMATELY 2%/YEAR INTO THE INDEFINITE FUTURE.THE SPVHD AGE DISTRIBUTION IS 21.4% UNDER 20 YEARS OF AGE, 21.4% BETWEEN 20 AND 44, 30.1% BETWEEN 45 AND 64, AND 27.1% OVER 65. ALMOST ONE THIRD OF THE POPULATION IS MEDICARE AGE. THIS HAS IMPLICATIONS FOR HEALTH CARE PLANNING. THE MEDIAN AGE OF THE AREA IS APPROXIMATELY 50. THIS IS RATHER HIGHER THAN COCHISE COUNTY (37), AND THE STATE (34). MALES AND FEMALES ARE APPROXIMATELY 50/50%.THE SPVHD MEDIAN HOUSEHOLD INCOME IS $38,290. THIS IS CONSIDERABLY LOWER THAN THAT FOR THE COUNTY ($44,000), THE STATE ($53,000), AND THE NATION ($55,000). UNEMPLOYMENT IN THE AREA IS HIGHER THAN IN OTHER LOCALITIES. RECENT ESTIMATES SHOW UNEMPLOYMENT HOVERING AROUND 13%. PART VI, LINE 5: BENSON HOSPITAL FURTHERS ITS EXEMPT PURPOSE IN SEVERAL WAYS. BENSON HOSPITAL IS GOVERNED BY A VOLUNTEER BOARD MADE UP OF MEMBERS FROM THE COMMUNITY. THE HOSPITAL HAS AN OPEN MEDICAL STAFF AND PROMOTES THE HEALTH OF THE COMMUNITY THROUGH EVENTS LIKE HOSTING A HEALTH FAIR, INVOLVEMENT AND SPONSORSHIP IN LOCAL COMMUNITY EVENTS TO PROMOTE HEALTHCARE. THE HOSPITAL PROVIDES A RESPIRATORY SUPPORT GROUP, FREE BLOOD PRESSURE SCREENINGS, AND DIETARY CONSULTATION. PART VI, LINE 7, REPORTS FILED WITH STATES AZ X X 0 0 0 0 0 0 0 0 0 BARBARA HARTLEY MEMBER 196843 0 0 0 0 0 0 0 0 0 196843 0 0 0 RICHARD POHLEBER CEO 244674 0 1356 0 0 0 4886 0 365 0 251281 0 0 0 KENNETH GORANSON CFO 177115 0 531 0 0 0 4026 0 9897 0 191569 0 0 0 TERESA VINCIFORA CCO 159377 0 0 0 0 0 3036 0 450 0 162863 0 0 0 JAMES RICHEY PHARMACIST 156143 0 0 0 0 0 3434 0 9766 0 169343 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY AN INDEPENDENT CPA AND A DRAFT IS PROVIDED TO THE CFO FOR REVIEW. UPON THE CFO'S APPROVAL, A COPY IS PROVIDED TO THE ENTIRE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD ANNUALLY. THE POLICY COVERS THE DIRECTORS, OFFICERS, COMMITTEE MEMBERS OR A PERSON RELATED TO SUCH A PERSON. A CONFLICT IS DEFINED AS A SITUATION WHERE AN INTERESTED PERSON HAS A BENEFICIAL INTEREST OR OTHER LINK TO A TRANSACTION THAT WOULD REASONABLY BE EXPECTED TO EXERT INFLUENCE ON THAT PERSON'S JUDGEMENT. CONFLICTING INTEREST TRANSACTIONS ALSO INCLUDE TRANSACTIONS INVOLVING ENTITIES WITH WHICH AN INTERESTED PERSON IS AFFILIATED, PERSONS WHO CONTROL ENTITIES WITH WHICH AN INTERESTED PERSON IS AFFILIATED AND PERSONS WHO ARE GENERAL PARTNERS, PRINCIPALS, OR EMPLOYERS OF AN INTERESTED PERSON. INTERESTED PERSONS MUST DISCLOSE CONFLICTING INTERESTS TO THE BOARD WHEN AND WHERE APPROPRIATE AND CANNOT PLAY A DIRECT OR INDIRECT ROLE IN DELIBERATIONS OF VOTE ON THE RELATED MATTER. DIRECTORS OR COMMITTEE MEMBERS WHO DO NOT HAVE A CONFLICTING INTEREST WITH THE TRANSACTION VOTE TO APPROVE THE RELATED TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S BYLAWS REQUIRE THAT, IN DETERMINING COMPENSATION FOR ANY OFFICER, DIRECTOR, COMMITTEE MEMBER, OR KEY EMPLOYEE OF THE CORPORATION: A. THE INDIVIDUALS ON THE BOARD THAT APPROVE COMPENSATION ARRANGEMENTS SHALL FOLLOW THE CONFLICTING INTEREST PROVISIONS OF THESE BYLAWS AND THE CORPORATION'S CONFLICT OF INTEREST POLICIES IN EFFECT AT THE TIME OF THE DETERMINATION. B. ANY COMPENSATION ARRANGEMENT MUST BE APPROVED BY THE BOARD IN ADVANCE OF PAYING COMPENSATION. C. THE BOARD SHALL DOCUMENT IN WRITING THE DATE AND TERMS OF EACH APPROVED COMPENSATION ARRANGEMENT. D. THE BOARD SHALL RECORD IN WRITING THE DECISION MADE BY EACH INDIVIDUAL WHO DECIDED OR VOTED ON EACH COMPENSATION ARRANGEMENT. E. THE BOARD WILL APPROVE COMPENSATION ARRANGEMENTS BASED ON INFORMATION ON COMPENSATION PAID BY SIMILARLY-SITUATED TAXABLE OR TAX-EXEMPT ORGANIZATIONS, CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS, OR ACTUAL WRITTEN OFFERS FROM SIMILARLY-SITUATED ORGANIZATIONS; AND F. THE BOARD WILL RECORD IN WRITING BOTH THE INFORMATION ON WHICH THE BOARD RELIED TO BASE THE COMPENSATION DECISION AS WELL AS ITS SOURCE. THE LAST REVIEW WAS PERFORMED IN NOVEMBER 2015. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 334,182. MANAGEMENT AND GENERAL EXPENSES 390,330. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 724,512. MEDICAL PROFESSIONALS: PROGRAM SERVICE EXPENSES 2,707,608. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,707,608.