KINGMAN HEALTHCARE INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
KINGMAN HEALTHCARE INC (EIN 94-2916102)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-03-30
IRS object ID
201840899349300709
Schema version
2016v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-03-30T10:39:49-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 South Tejon Suite 800AddressLine1Txt
CityColorado SpringsCityNm
State AbbreviationCOStateAbbreviationCd
ZIP809039848ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN942916102EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Kingman Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% KINGMAN HOSPITAL INCInCareOfNm
Business Name ControlKINGBusinessNameControlTxt
Phone9287572101PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13269 STOCKTON HILL ROADAddressLine1Txt
CityKINGMANCityNm
State AbbreviationAZStateAbbreviationCd
ZIP86409ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIMOTHY BLANCHARDPersonNm
Person TitleCFOPersonTitleTxt
Phone9287572101PhoneNum
Signature2018-03-28SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAdam R Smith CPAPreparerPersonNm
PTINP00958966PTIN
Phone7194714290PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id84022720180895000012FederalOriginalSubmissionId
Federal Original Submission Id2018-03-30FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdED42049D66F1046E576A4D4BB44938B540F74564AtSubmissionCreationDeviceId
At Submission Filing Device Id7E88F371C52F321CAC265BAA5887B5821BA85A3CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Kingman Regional Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerBRIAN TURNEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13269 STOCKTON HILL ROADAddressLine1Txt
CityKINGMANCityNm
State AbbreviationAZStateAbbreviationCd
ZIP86409ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$309,393,875GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressAZKRMC.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1980FormationYr
Legal Domicile StateAZLegalDomicileStateCd
Activity Or MissionOUR VISION IS TO PROVIDE THE REGION'S BEST CLINICAL CARE AND PATIENT SERVICE THROUGH AN ENVIRONMENT THAT FOSTERS RESPECT FOR OTHERS AND PRIDE IN PERFORMANCE.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee2295TotalEmployeeCnt
Total Volunteers114TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$86,586PYContributionsGrantsAmt
CY Contributions Grants$89,205CYContributionsGrantsAmt
PY Program Service Revenue$288,126,178PYProgramServiceRevenueAmt
CY Program Service Revenue$302,845,942CYProgramServiceRevenueAmt
PY Investment Income$1,895,268PYInvestmentIncomeAmt
CY Investment Income$925,880CYInvestmentIncomeAmt
PY Other Revenue$4,902,796PYOtherRevenueAmt
CY Other Revenue$5,289,733CYOtherRevenueAmt
PY Total Revenue$295,010,828PYTotalRevenueAmt
CY Total Revenue$309,150,760CYTotalRevenueAmt
PY Grants And Similar Paid$571,564PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$417,425CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$144,581,004PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$149,142,317CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$139,817,790PYOtherExpensesAmt
CY Other Expenses$153,025,661CYOtherExpensesAmt
PY Total Expenses$284,970,358PYTotalExpensesAmt
CY Total Expenses$302,585,403CYTotalExpensesAmt
PY Revenues Less Expenses$10,040,470PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,565,357CYRevenuesLessExpensesAmt
Total Assets BOY$257,488,989TotalAssetsBOYAmt
Total Assets EOY$286,332,303TotalAssetsEOYAmt
Total Liabilities BOY$28,451,146TotalLiabilitiesBOYAmt
Total Liabilities EOY$47,880,269TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$229,037,843NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$238,452,034NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOUR VISION IS TO PROVIDE THE REGIONS BEST CLINICAL CARE AND PATIENT SERVICE THROUGH AN ENVIRONMENT THAT FOSTERS RESPECT FOR OTHERS AND PRIDE IN PERFORMANCE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$247,181,382ExpenseAmt
Grant$417,425GrantAmt
Revenue$304,685,185RevenueAmt
DescMOHAVE COUNTY IS ONE OF THE FASTEST GROWING COUNTIES IN ARIZONA. THE AREA AROUND KINGMAN WHICH IS THE COUNTY SEAT IS EXPECTED TO CONTINUE GROWING STEADILY IN THE COMING YEARS. IN RESPONSE TO THE GROWTH, KINGMAN REGIONAL MEDICAL CENTER (KRMC) HAS CONTINUED TO EXPAND ITS SERVICES. WE NOW OFFER A FULL RANGE OF HEALTH AND WELLNESS SERVICES, INCLUDING A WELLNESS AND FITNESS CENTER, MULTIPLE PRIMARY CARE PHYSICIAN PRACTICES, ADVANCED MEDICAL PROGRAMS IN CARDIOLOGY, CANCER, AND REHABILITATION, AND HOME HEALTH AND HOSPICE CARE. MOREOVER, WE ARE HONORED TO SERVE AS A TEACHING HOSPITAL IN AFFILIATION WITH MIDWESTERN UNIVERSITY TO TRAIN DOCTORS SPECIALIZING IN FAMILY PRACTICE, AND EMERGENCY MEDICINE. WITH THE GROWING POPULATION, WE ARE EXPERIENCING A HIGHER VOLUME OF SELF-PAY AND MEDICAID PATIENTS WHO ARE WAITING TO SEEK MEDICAL CARE UNTIL THE TIME THAT THEY MUST GO TO THE EMERGENCY ROOM. OUR MEDICAID POPULATION IS 20.6% OF OUR TOTAL PATIENT POPULATION. OUR MEDICARE POPULATION IS 57.2% OF TOTAL PATIENT POPULATION. MAJOR STRATEGIES TO ADDRESS IDENTIFIED NEEDS AND PROBLEMS INCLUDE: - WE HAVE INCREASED RECRUITMENT EFFORTS OF RN'S, THERAPISTS AND SKILLED TECHNICIANS TO MEET THE GROWING NEEDS OF THE COMMUNITY. - WE CONTINUE TO RECRUIT PHYSICIANS OF VARIOUS SPECIALTIES TO THE AREA. - WE CONTINUE TO EXPAND OUR FACILITIES TO MEET THE NEEDS OF THE COMMUNITY. KRMC IS COLLABORATING WITH COMMUNITY ORGANIZATIONS TO IMPROVE COMMUNITY HEALTH, EXPAND ACCESS TO HEALTH CARE, OR IN OTHER WAYS BENEFIT THE COMMUNITY. SOME EXAMPLES ARE: - WE WORK WITH THE WOMEN'S HEALTH ORGANIZATION TO PROVIDE DISCOUNTED MAMMOGRAPHY TO SELF-PAY PATIENTS. - WE WORK WITH THE FOSTER GRANDPARENTS ASSOCIATION AND PROVIDE FREE PHYSICAL EXAMS. - WE PAY 50% AND WRITE OFF THE OTHER 50% FOR VICTIMS OF CRIME COLLABORATING WITH THE MOHAVE COUNTY ATTORNEY'S OFFICE. KRMC IS A TEACHING HOSPITAL WITH A GME PROGRAM IN ASSOCIATION WITH MIDWESTERN UNIVERSITY. KRMC OPERATES SEVERAL PHYSICIAN PRACTICES AND A CONTINUITY CLINIC. THERE ARE PLANS TO EXPAND THESE SERVICES TO THE OUTLYING AREAS OF OUR COMMUNITY. IN RECENT YEARS, KRMC HAS EXPANDED SERVICES TO INCLUDE SERVICES THAT ARE NOT USUALLY FOUND IN A RURAL COMMUNITY SUCH AS; INTERVENTIONAL CARDIOLOGY; CANCER DIAGNOSIS AND TREATMENT WITH A STATE-OF-THE-ART CANCER CENTER (CLINICAL AND RADIATION ONCOLOGY); A NEW OUTPATIENT IMAGING AND WOMEN'S HEALTH CENTER; ACUTE REHABILITATION UNIT; CARDIAC SURGICAL UNIT FOR OPEN HEART SURGERY; WOUND CARE AND HYPERBARIC CHAMBER THERAPY. OUR UNCOMPENSATED CARE POLICY IS CALLED QUALIFYING DISCOUNT PROGRAM. OUR PROGRAM IS DEFINED AS CHARITY CARE SERVICES PROVIDED FOR WHICH PAYMENT IS NOT ANTICIPATED BECAUSE OF AN INABILITY TO PAY, AND MAY APPLY TO AN ENTIRE ACCOUNT BALANCE OR A PORTION OF IT. CHARITY CARE IS SEPARATE AND DISTINCT FROM BAD DEBTS, WHICH ARE ACCOUNTS FOR WHICH CREDIT WAS EXTENDED AND PAYMENT IS ANTICIPATED, BUT NOT RECEIVED. OUR QUALIFYING DISCOUNT PROGRAM IS BASED ON A PERCENTAGE OF THE FEDERAL POVERTY LEVEL. KRMC HAS UPDATED ITS CHARITY CARE POLICY TO INCLUDE THOSE PATIENTS WHOSE HOUSEHOLD INCOME IS UP TO 350% OF THE FEDERAL POVERTY LEVEL. THIS PROGRAM IS FOR ALL PATIENTS REGARDLESS OF THEIR PRIMARY INSURANCE STATUS AND IS BASED ON THEIR FAMILY SIZE AND INCOME FROM ALL SOURCES. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION: KRMC OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY AND COMPLIES WITH ALL EMTALA REGULATIONS. WE HAVE NOTICES IN THE EMERGENCY ROOM THAT INFORMS THE PATIENTS OF THIS FACT; OUR ADMISSIONS STAFF ADVISES ALL PATIENTS WHO PRESENT FOR SERVICES THAT WE ARE CALLING FOR A NURSE AND WILL PERFORM A MEDICAL SCREENING EXAM REGARDLESS OF THEIR ABILITY TO PAY. WE ASSIST THEM AFTER THE MEDICAL SCREENING EXAM WITH DES APPLICATIONS AND IN-SERVICE THEM ON OUR CHARITY PROGRAM IF SHOULD THEY HAVE AN INABILITY TO PAY. KRMC HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA.Desc
Total Program Service Expenses$247,181,382TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document292IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee2295EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldAZStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKINGMAN HOSPITAL INCPersonNm
Phone9287572101PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13269 STOCKTON HILL ROADAddressLine1Txt
CityKINGMANCityNm
State AbbreviationAZStateAbbreviationCd
ZIP86409ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
DAVID FRENCH
CHAIRMAN1.00.0Yes (X)Yes (X)$0$0$0
DONALD VAWTER
VICE CHAIRMAN1.00.0Yes (X)Yes (X)$0$0$0
KRYSTAL BURGE
SECRETARY1.00.0Yes (X)Yes (X)$0$0$0
JAMES BAKER
TREASURER1.00.0Yes (X)Yes (X)$0$0$0
CORAL LOYD
DIRECTOR1.00.0Yes (X)$0$0$0
ROBERT MATHENY MD
DIRECTOR41.00.0Yes (X)$774,979$0$49,548
SANDY MOON
DIRECTOR1.00.0Yes (X)$0$0$0
CATHY OTT
DIRECTOR1.00.0Yes (X)$0$0$0
ROD MARQUARDT
DIRECTOR1.00.0Yes (X)$0$0$0
KALE BODILY
DIRECTOR1.00.0Yes (X)$0$0$0
SUSAN CHAN
DIRECTOR1.00.0Yes (X)$0$0$0
BRIAN TURNEY
CHIEF EXECUTIVE OFFICER40.00.0Yes (X)Yes (X)$742,576$0$43,951
RYAN KENNEDY
CHIEF OPERATING OFFICER40.00.0Yes (X)$248,359$0$42,924
TIMOTHY BLANCHARD
CHIEF FINANCIAL OFFICER40.00.0Yes (X)$329,507$0$44,185
KIM MIYAUCHI
CHIEF NURSING OFFICER40.00.0$213,327$0$30,918Yes (X)
THOMAS GAUGHAN
CHIEF MEDICAL OFFICER40.00.0$345,332$0$30,000Yes (X)
DENNIS DUNNING
PHYSICIAN40.00.0$1,081,103$0$35,239Yes (X)
ALAIN ASHER
PHYSICIAN40.00.0$739,715$0$26,655Yes (X)
JACOB OLDHAM
PHYSICIAN40.00.0$695,527$0$9,835Yes (X)
Jeffrey Lunn
PHYSICIAN40.00.0$797,375$0$40,152Yes (X)
Jamal Al-Khatib
PHYSICIAN40.00.0$762,298$0$41,599Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$6,730,098TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$395,006TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K168IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HIGH DESERT RADIOLOGY
695 COUNTRY CLUB DRIVEKINGMANAZ86041RADIOLOGISTS$7,919,286
Medicus Hospitalists
22 Roulston RdWINDHAMNH03087Hospitalists$3,596,707
MIDWESTERN UNIVERSITY
19555 N 59TH AVEGLENDALEAZ85308GME PROGRAM$1,946,772
MEDLIANT
969-G EDGEWATER BLVD 698FOSTER CITYCA94404NURSE AGENCY$2,529,105
AMN HEALTHCARE
P O BOX 281939ATLANTAGA303871939NURSE AGENCY$2,087,286
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K48CntrctRcvdGreaterThan100KCnt
Related Organizations$70,339RelatedOrganizationsAmt
All Other Contributions$18,866AllOtherContributionsAmt
Total Contributions$89,205TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue561110$178,034,056$178,034,056
Medicare & Medicaid revenue561110$121,983,742$121,983,742
EHR/PQRS/MEANINGFUL USE PAYMENTS900099$580,420$580,420
WELLNESS CENTER REVENUE561110$1,443,617$1,443,617
DURABLE MEDICAL EQUIPMENT REVENUE900099$392,592$392,592

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$411,515TotalRevenueColumnAmt
Related Or Exempt Func Income$411,515RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$302,845,942TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,201,521TotalRevenueColumnAmt
Exclusion$1,201,521ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$164,023RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$164,023RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$164,023TotalRevenueColumnAmt
Exclusion$164,023ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$96,751OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$372,392OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$275,641OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$275,641TotalRevenueColumnAmt
Exclusion-$275,641ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$343,277GrossSalesOfInventoryAmt
Cost Of Goods Sold-$129,277CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$214,000TotalRevenueColumnAmt
Exclusion$214,000ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Cafeteria722514$2,544,143$2,544,143
340B Pharmacy446110$639,938$639,938
Income from Equity Investees900099$60,175$60,175

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,667,454TotalRevenueColumnAmt
Related Or Exempt Func Income$1,139,090RelatedOrExemptFuncIncomeAmt
Exclusion$528,364ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$4,911,710OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$309,150,760TotalRevenueColumnAmt
Related Or Exempt Func Income$304,685,145RelatedOrExemptFuncIncomeAmt
Exclusion$4,376,410ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$223,304TotalAmt
Program Services$223,304ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$194,121TotalAmt
Program Services$194,121ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,841,454TotalAmt
Program Services$2,546,103ProgramServicesAmt
Management And General$295,351ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$115,888,670TotalAmt
Program Services$80,028,425ProgramServicesAmt
Management And General$35,860,245ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,744,420TotalAmt
Program Services$2,162,665ProgramServicesAmt
Management And General$581,755ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$20,194,620TotalAmt
Program Services$15,942,079ProgramServicesAmt
Management And General$4,252,541ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$7,473,153TotalAmt
Program Services$5,903,791ProgramServicesAmt
Management And General$1,569,362ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$258,097TotalAmt
Management And General$258,097ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$213,873TotalAmt
Management And General$213,873ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$44,197TotalAmt
Management And General$44,197ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$58,879TotalAmt
Management And General$58,879ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$38,426,173TotalAmt
Program Services$34,504,425ProgramServicesAmt
Management And General$3,921,748ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$528,861TotalAmt
Program Services$417,800ProgramServicesAmt
Management And General$111,061ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,333,316TotalAmt
Program Services$4,213,320ProgramServicesAmt
Management And General$1,119,996ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$5,966,664TotalAmt
Program Services$4,713,665ProgramServicesAmt
Management And General$1,252,999ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$5,188,071TotalAmt
Program Services$4,098,576ProgramServicesAmt
Management And General$1,089,495ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,124,349TotalAmt
Program Services$888,236ProgramServicesAmt
Management And General$236,113ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$110,530TotalAmt
Program Services$87,319ProgramServicesAmt
Management And General$23,211ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$15,374,213TotalAmt
Program Services$12,145,628ProgramServicesAmt
Management And General$3,228,585ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,111,109TotalAmt
Program Services$3,962,877ProgramServicesAmt
Management And General$148,232ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$43,862,710$43,862,710
Bad Debt Expense$23,374,268$23,374,268
Provider Fee$3,461,920$3,461,920
Food$2,186,940$1,727,683$459,257

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,401,490TotalAmt
Program Services$2,722,467ProgramServicesAmt
Management And General$679,024ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$302,585,403TotalAmt
Program Services$247,181,382ProgramServicesAmt
Management And General$55,404,021ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,206,618BOYAmt
EOY$3,514,637EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$17,736,329BOYAmt
EOY$49,205,177EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$58,945,847BOYAmt
EOY$53,735,924EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$327,336BOYAmt
EOY$260,394EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$6,353,951BOYAmt
EOY$6,126,413EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,673,399BOYAmt
EOY$2,486,160EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$254,638,684LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$153,959,554LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$100,795,076BOYAmt
EOY$100,679,130EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$58,252,287BOYAmt
EOY$62,150,922EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$4,201,521BOYAmt
EOY$5,493,460EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,591,978BOYAmt
EOY$1,712,080EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$404,647BOYAmt
EOY$968,006EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$257,488,989BOYAmt
EOY$286,332,303EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$24,291,567BOYAmt
EOY$23,858,858EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$109,849BOYAmt
EOY$81,089EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$19,337,208EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$649,097BOYAmt
EOY$633,923EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,400,633BOYAmt
EOY$3,969,191EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,451,146BOYAmt
EOY$47,880,269EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$227,196,659BOYAmt
EOY$236,481,642EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,841,184BOYAmt
EOY$1,970,392EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$229,037,843BOYAmt
EOY$238,452,034EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$257,488,989BOYAmt
EOY$286,332,303EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$6,565,357ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,728,732NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$120,102OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (true)DirectContactLegislatorsInd
Direct Contact Legislators$44,197DirectContactLegislatorsAmt
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$44,197TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1gFormAndLineReferenceDesc
ExplanationLobbying: Kingman Hospital pays annual dues in which a percentage of their dues is attributable to lobbying. The amount shown on the line above represents that percentage.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,298,675OtherCostOrOtherBasisAmt
Book Value$21,298,675BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$103,799,552OtherCostOrOtherBasisAmt
Depreciation$58,586,477DepreciationAmt
Book Value$45,213,075BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$122,025,102OtherCostOrOtherBasisAmt
Depreciation$92,097,542DepreciationAmt
Book Value$29,927,560BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,515,355OtherCostOrOtherBasisAmt
Depreciation$3,275,535DepreciationAmt
Book Value$4,239,820BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$100,679,130TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Estimated Self-Insurance Costs$1,153,000
Accrued Retirement Obligation$2,816,191
FieldValueIRS element (for citing)
Total Liability$3,969,191TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$287,590,171TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$2,728,732NetUnrealizedGainsInvstAmt
Other Revenue$249,379OtherRevenueAmt
Revenue Not Reported$2,978,111RevenueNotReportedAmt
Revenue Subtotal$284,612,060RevenueSubtotalAmt
Investment Expenses Not Incld$58,879InvestmentExpensesNotIncldAmt
Other Revenues Not Included$24,479,821OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$24,538,700RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$309,150,760TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$278,175,980TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$129,277OtherExpensesIncludedAmt
Expenses Not Reported$129,277ExpensesNotReportedAmt
Expenses Subtotal$278,046,703ExpensesSubtotalAmt
Investment Expenses Not Incld2$58,879InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$24,479,821OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$24,538,700ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$302,585,403TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART XI, LINE 2DREVENUE ON BOOKS, NOT ON RETURN: COST OF GOODS SOLD 129,277 CHANGE IN NET ASSETS OF KRMC FOUNDATION 120,102 TOTAL 249,379
SCHEDULE D, PART XI, LINE 4BREVENUE ON RETURN, NOT ON BOOKS: BAD DEBT NET WITH REVENUE ON FINANCIALS, TREATED AS EXPENSE ON TAX RETURN 23,374,268 ACTIVITY OF NARIC INCLUDED IN CONSOLIDATED FINANCIALS, REMOVED FOR TAX RETURN 1,105,553 TOTAL 24,479,821
SCHEDULE D, PART XII, LINE 2DEXPENSE ON BOOKS, NOT ON RETURN: COST OF GOODS SOLD 129,277
SCHEDULE D, PART XII LINE 4BEXPENSE ON RETURN, NOT ON BOOKS: BAD DEBT NET WITH REVENUE ON FINANCIALS, TREATED AS EXPENSE ON TAX RETURN 23,374,268 ACTIVITY OF NARIC INCLUDED IN CONSOLIDATED FINANCIALS, REMOVED FOR TAX RETURN 1,105,553 TOTAL 24,479,821
SCHEDULE D, PART X, LINE 2UNCERTAIN TAX POSITIONS: Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent350Yes (X)Percent350Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,441,731TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,441,731NetCommunityBenefitExpnsAmt
Total Expense0.00520TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$59,300,114TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,326,645DirectOffsettingRevenueAmt
Net Community Benefit Expns$41,973,469NetCommunityBenefitExpnsAmt
Total Expense0.15090TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$60,741,845TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,326,645DirectOffsettingRevenueAmt
Net Community Benefit Expns$43,415,200NetCommunityBenefitExpnsAmt
Total Expense0.15610TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$701,357TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$701,357NetCommunityBenefitExpnsAmt
Total Expense0.00250TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,053,933TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,198,376DirectOffsettingRevenueAmt
Total Expense0.00000TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$567,619TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$567,619NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,322,909TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,198,376DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,268,976NetCommunityBenefitExpnsAmt
Total Expense0.00450TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$65,064,754TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,525,021DirectOffsettingRevenueAmt
Net Community Benefit Expns$44,684,176NetCommunityBenefitExpnsAmt
Total Expense0.16060TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$23,374,268BadDebtExpenseAmt
Reimbursed By Medicare$71,632,630ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$70,810,199CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$822,431MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KINGMAN REGIONAL MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13269 STOCKTON HILL ROADAddressLine1Txt
CityKINGMANCityNm
State AbbreviationAZStateAbbreviationCd
ZIP86409ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.AZKRMC.COMWebsiteAddressTxt
State LicenseH-0010StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherCANCER CENTER CARDIAC CATH LAB ACUTE REHAB UNITOtherDesc
Facility Reporting Group1FacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1KINGMAN REGIONAL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLsee part V, Section C for URLOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLsee part V, Section C for URLStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care350.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLsee part v, section C for URLFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLsee part v, section C for URLFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLPart V, section for URLFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit Legal Judicial ProcessYes (X)PermitLegalJudicialProcessInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5AS PART OF THE COMMUNITY HEALTH ASSESSMENT PROCESS, MEMBERS OF THE MOHAVE COUNTY COMMUNITY HEALTH COALITION CONDUCTED INTERVIEWS WITH INDIVIDUALS WHO REPRESENT: A) BROAD INTERESTS OF THE COMMUNITY, B) POPULATIONS OF NEED, AND C) PERSONS WITH SPECIALIZED KNOWLEDGE IN PUBLIC HEALTH. THESE INDIVIDUALS CAME FROM THE FOLLOWING COMMUNITY SECTORS: - SOCIAL SERVICE AGENCIES - LOCAL SCHOOL SYSTEM AND COMMUNITY COLLEGE - LOCAL CITY AND COUNTY GOVERNMENT - PUBLIC HEALTH AGENCIES - INDUSTRY - FAITH COMMUNITY - MEDICAL PROVIDERS
SCHEDULE H, PART V, SECTION B, LINE 6BTHE CHNA FOR KINGMAN HOSPITAL INC. WAS CONDUCTED WITH MOHAVE COUNTY, ARIZONA.
SCHEDULE H, PART V, SECTION B, LINE 7ADIRECT URL WHERE CHNA REPORT IS MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE: https://www.azkrmc.com/wp-content/uploads/2016/08/KRMC_Mohave-County-Depar tment-of-Public-Health_CHA-Report_Final.pdf
SCHEDULE H, PART V, SECTION B, LINE 10ADIRECT URL WHERE IMPLEMENTATION PLAN IS MADE WIDELY AVAILABLE: https://www.azkrmc.com/wp-content/uploads/2016/08/KRMC-Implementation-Plan .pdf
SCHEDULE H, PART V, SECTION B, LINE 11In 2016, Kingman Hospital Inc. (KHI), in partnership with the Mohave County Department of Public Health (MCDPH), began the ongoing community health assessment and community health improvement planning process in Mohave County, AZ. Since then, KHI has actively participated with community stakeholders to identify and address health and quality of life issues in Mohave County, AZ. Our process involves performing a community health assessment and developing a community health improvement plan every three years. As a result of our initial community health assessment, which was published in 2013, KHI and MCDPH have led a coalition of community stakeholders in identifying priority health issues and in formulating community task forces to address the issues. These task forces continue to meet on a regular basis to set goals, objectives, and implement actions for improvement. KHI continues to lead and be an active participant in the community task forces to address priority health issues selected by community stakeholders and assist however possible in meeting community-directed goals. The current issues selected by community stakeholders, corresponding task forces, goals, and KHI activities are described below. A. Economic Conditions Economic insecurity is often associated with poor health. Mohave County's high rates of poverty, unemployment, and lack of educational achievement create barriers for accessing health services, healthy food, recreation, and other necessities that contribute to a healthy lifestyle. Mohave County Economic Task Force Goal: Strengthen new and existing businesses within Mohave County through education and one-on-one assistance utilizing existing Economic Development Agencies. KHI Strategies: 1) Maintain hospital growth and viability. A healthy, growing hospital with more physicians and healthcare services is vital to the economy of Kingman and surrounding communities. As the largest private employer in Mohave County, KHI has added 800 jobs to the Kingman economy over the past 10 years. 2) Purchase goods and services from local vendors. KHI gives priority to local businesses when procuring goods and services for various hospital functions, advertising and promotion, facility expansion, and other hospital operations. KHI spends over $10 million annually with local vendors. 3) Educate and employ local talent. KHI gives priority to hiring local applicants when filling open hospital positions. We coordinate with local high schools to inform students of career opportunities and partner with Mohave Community College and state universities to hire healthcare workers (nurses, medical technicians, etc.) trained through their respective programs. KHI funds scholarships to help local students who are pursuing careers in healthcare with their educational costs. We also provide tuition reimbursement to current employees seeking further education to advance their careers. 4) Support economic development, education, and job training efforts in our community. KHI is an active member of the Kingman Chamber of Commerce, participates in various committees that focus on business development, and supports education and job training efforts via scholarships, job shadowing and support of student organizations, such as HOSA (Health Occupation Student Association) in our local high schools. B. Youth Risk/Protective Factors The results of the community health assessment as reported in the Community Health Profile for Mohave County, 2016 show high rates of substance abuse, antisocial behavior, and delinquency among Mohave County youth as compared to state and national statistics. Therefore, our community coalition has chosen to address risk factors that can lead to problem behaviors among children and adolescents in our community.Mohave County Youth Task Force Goal: Reduce youth risk factors and increase youth protective factors in Mohave County. KHI Strategies: 1) Provide training and education to new parents. KHI provides culturally-appropriate information and education to new parents in our community to help increase family bonding and other protective factors in their child's life. 2) Provide outreach in schools to educate children on healthy living skills. Through KHI's Kare Bear program, we use a fun and engaging approach to educate local children on the importance of living healthy. Kare Bear visits local classrooms to talk about and demonstrate such topics as sun safety, hand hygiene, bike safety and helmet use, water safety, cough etiquette, oral hygiene. 3) Encourage physical fitness at community elementary schools. KHI sponsors a physical education program called Project Fit America at five elementary schools in Kingman. The program includes equipment, teacher training, curriculum, and other resources to help kids be active and healthy. 4) Provide free general health screenings at local schools and at special outreach events. Resident doctors with KHI's Family Practice Residency program visit each of Kingman's middle schools and high schools during the school year providing students a free basic physical, as well as information on making good healthcare choices and providing a forum for the students to talk about their health concerns. They also provide free immunizations, height and weight measurements at the hospitals annual "Kids Day Health Expo" where an average 700 children participate. 5) Provide youth opportunities for positive community engagement through the KHI Volunteen program. KHI's youth volunteer program (Volunteens) provides high school students (ages 14 to 19) an opportunity to serve the community in many areas of KHI- nursing, wellness center, laboratory, physician offices, nutrition services, and day care center. 6) Provide job shadowing to students interested in health-related occupations. In partnership with Kingman High School's HOSA (Health Occupations Students of America) program, KHI hosts hundreds of high school students every February who spend a day with hospital technologists, nurses, doctors, or administrators to observe their work activities. 7) Encourage youth responsibility and safety through the Safe Sitter program. KHI provides Safe Sitter training to area youth. This well-rounded youth development program aims to reduce the number of avoidable and unintentional deaths among children being cared for by babysitters. Program graduates are able to handle emergencies when caring for younger children and are equally equipped with the tools needed to stay safe when home alone. 8) Provide financial support to community youth organizations and activities. KHI provides donations and other support to many community organizations that provide programs, services, and support to local children and families. C. Substance Abuse & Mental Health The results of the community health assessment as reported in the Community Health Profile for Mohave County, 2016 show high rates of substance abuse and mental health problems among Mohave County adults as compared to state and national statistics. Unfortunately, most of rural America is without the necessary resources to adequately address the pandemic increase in people who are impacted by mental health and substance abuse problems. KHI does not have the resources that would be required to effect the changes that are needed to adequately address the lack of mental health and substance abuse care in our service area. However, we will continue to explore potential partnerships and internal strategies to find a way to provide these essential services to our patients. Every effort will be made to assist our existing mental health and substance abuse providers in maintaining and/or expanding the services that they currently provide. With that, KHI's strategies for addressing substance abuse and mental health issues in our community include: 1) Provide financial support and participate on community initiatives that address substance abuse in our community. KHI is actively involved in the following community initiatives; providing leadership, financial donations, and other resources. 2) Maintain a smoke-free campus at KHI. KHI is committed to promoting good health, which includes preventing as well as treating disease. Smoking related illnesses (including those related to environmental tobacco smoke) comprise the largest proportion of preventable diseases. Therefore, KHI prohibits smoking at all its facilities and on hospital grounds, including parking lots and ramps. D. Accessible/Affordable Healthcare Access to health resources is critical to the health of our community's residents. The results of the community health assessment as reported in the Community Health Profile for Mohave County, 2016 show that there are number of specific barriers to obtaining proper healthcare in Mohave County. Mohave County Accessible/Affordable Healthcare Task Force Goal: Increase provider availability and reduce financial, cultural, and transportation barriers that impede access to healthc
SCHEDULE H, PART V, SECTION B, LINE 16A - 16CDIRECT URL FOR FAP POLICY, AND PLAIN LANGUAGE SUMMARY: https://azkrmc.ellucid.com/documents/view/2507/?security=d3f302e5c4b6592fa fd6426cc38d133e69a18e9b DIRECT URL FOR FAP APPLICATION FORM: https://azkrmc.ellucid.com/documents/view/2896/?security=10bbcd6bcfbe5e62b 384d66a5ba639becd1790ab
SCHEDULE H, PART V, SECTION B, LINE 22BKingman Regional Medical Center will not charge patients who are eligible for financial assistance more for emergency care than the amounts generally billed (AGB) to insured patients. AGB is calculated using the "look-back" method based on claims sent to Medicare fee-for-service and all private commercial insurers for emergency and medically necessary care.
FieldValueIRS element (for citing)
Facility32FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (32 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
Outpatient Imaging Center
1033 SycamoreKingmanAZ86409imaging center
Kingman Cardiovascular Assoc
1739 Beverly Ave Suite 217KingmanAZ86409Cardiology Physicians
Kingman Urology Clinic
1739 Beverly Ave Suite 106KingmanAZ86409Urologist
GME Resident Clinic
2202 Stockton Hill Rd Suite 101KingmanAZ86401Family Medicine
Kingman ENT Clinic
1739 Beverly Ave Suite 106KingmanAZ86409Ear, Nose & Throat Physicians
Kingman Pulmonary Clinic
1739 Beverly AveSuite 203KingmanAZ86409Pulmonary Medicine
Mohave Surgical Specialists
3104 Stockton Hill RoadKingmanAZ86401General Surgeon
KRMC CARDIOTHORACIC SURGERY
1739 BEVERLY AVE SUITE 218KingmanAZ86409Cardiothoracic Surgeon
Kingman Orthopedics
1739 BEVERLY AVE SUITE 102KingmanAZ86409Orthopedic Physicians
High Desert Gastroenterolgy
1739 BEVERLY AVE SUITE 101KingmanAZ86409Gastroenterologist
Orthopedic Surgery Clinic
1739 BEVERLY AVE SUITE 102KingmanAZ86409Orthopedic Surgeons
Kingman Family Practice
1739 Beverly Ave Suite 209KingmanAZ86409Family Medicine
Hillcrest Surgical
3939 Stockton Hill RoadKingmanAZ86409General Surgeon
Mohave Pain Management
3801 SANTA ROSAKingmanAZ86401Pain Management Physicians
EMPLOYEE & OCCUPATIONAL HEALTH
1739 Beverly Ave Suite 118KingmanAZ86409Occupational Medicine
KRMC PRIMARY CARE
2226 HUALAPAI MTN ROADKingmanAZ86401PRIMARY CARE PHYSICIANS
Golden Valley Clinic
4995 W Hwy 68Golden ValleyAZ86413Family Medicine
Sunshine Canyon Healthcare
2202 Stockton Hill Rd Suite 100KingmanAZ86401Family Medicine
Kingman OBGYN Associates
1739 Beverly Ave Suite 200KingmanAZ86409Obstetrics/Gynecology
KRMC Urgent Care
1726 BEVERLY AVEKingmanAZ86401Urgent Care
KRMC PRE-OP CLINIC
1739 Beverly Ave Suite 103KingmanAZ86409Pre-op Care Facility
POST HOSPITAL CARE CLINIC
1726 BEVERLY AVEKingmanAZ86409POST HOSPITAL CARE
DESERT VIEW HEALTHCARE
1871 GATES AVEKINGMANAZ86401FAMILY MEDICINE
KRMC PHYSIATRY
3801 SANTA ROSAKingmanAZ86401Physical Medicine & Rehab
Meadview Medical Services
330 E MeadviewMeadviewAZ86444FAMILY MEDICINE
Kingman Rheumatology
1739 BEVERLY AVE SUITE 209KingmanAZ86409Rheumatologist
Joshua Tree Pediatrics
1739 BEVERLY AVE SUITE 204KingmanAZ86409PEDIATRICIAN
KRMC DISEASE MANAGEMENT CLINIC
3801 Santa RosaKINGMANAZ86409DISEASE MANAGEMENT
PAIN MANAGEMENT CLINIC
3801 Santa RosaKINGMANAZ86409PAIN MANAGEMENT
KRMC HOSPICE
3269 STOCKTON HILL ROADKINGMANAZ86409HOSPICE SERVICES
KRMC HUALAPAI CAMPUS
3801 SANTA ROSAKINGMANAZ86401ACUTE REHABILITATION
Infectious Disease Clinic
1739 Beverly Ave Suite 221KingmanAZ86409Infectious Disease Physician

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A AND 7B. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. THE INFORMATION FOR LINES 7E THROUGH 7I WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS.
SCHEDULE H, Part I, Line 7, Column (f)BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 BUT EXCLUDED FOR PURPOSES OF CALCULATING PERCENTAGES IN THIS COLUMN EQUAL $23,374,268.
SCHEDULE H, PART III, Section A, LINE 2THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS.
SCHEDULE H, PART III, Section A, LINE 3The organization does not consider any of its bad debt expense to be attributable to patients eligible under the organization's financial assistance policy.
SCHEDULE H, PART III, Section A, LINE 4THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSES IS LOCATED IN FOOTNOTE 1 ON PAGE 9 OF THE ATTACHED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, Section B, LINE 8The organization is a sole community not-for-profit hospital that provides healthcare services to community residents and visitors in a rural setting with limited access to Specialist care. Accessible, high-quality healthcare service is important for the overall health of all residents and not fully available in most rural settings. Where Medicare is calculated to pay at expected cost, Rural care is often more expensive as patients tend to have a higher than average acuity and length of stay due to limited Specialist care in the treatment and patient care follow up process. Additionally, patient volumes are more restricted and seasonally impacted in rural settings as compared to metropolitan settings, which affects the hospitals opportunity to spread the fixed costs over more patient care experiences. Also relative to the seasonal patient fluctuations, rural hospitals tend to have a higher need for agency travel nurses to supplement the higher census times which is 40% higher costs than employed staff. Physician recruitment is also a major challenge for sole community providers and therefore must utilize Locum Tenens physicians at a much higher cost than employed physicians.
SCHEDULE H, PART III, Section C, LINE 9bONCE THE PATIENT IS BILLED AND CONTACTED, THEY ARE INFORMED OF OPTIONS AND OF THE QUALIFYING DISCOUNT PROGRAM (QDP). THE OTHER OPTIONS INCLUDE PAYING UP FRONT OR NO INTEREST PAYMENTS WITHIN A SCHEDULED NUMBER OF DAYS. A CASH DISCOUNT IS AVAILABLE TO THE PATIENT. IF QUALIFIED FOR THE QDP, THE APPROPRIATE QUALIFYING AMOUNT IS ADJUSTED TO CHARITY CARE. IF A BALANCE REMAINS THAT DOES NOT QUALIFY, THE PATIENT HAS CASH DISCOUNT AND NO INTEREST PAYMENT PLAN AS DESCRIBED ABOVE. FOR PATIENTS THAT THE HOSPITAL IS UNABLE TO CONTACT: - EIGHT ACCOUNT STATEMENTS ARE SENT. - THREE LETTERS EXPLAINING THAT IF THE PATIENT FAILS TO CONTACT PATIENT FINANCIAL SERVICES, COLLECTION EFFORTS WILL BE PASSED TO AN AGENCY. THE ABOVE IS A MINIMUM OF 120 DAY PROCESS FOR ALL PATIENT PAYER TYPES. ONCE THE PATIENT ACCOUNT IS SUBMITTED TO A COLLECTION AGENCY, IT IS ADJUSTED TO BAD DEBT.
SCHEDULE H, PART VI, LINE 2NEEDS ASSESSMENT: SINCE 2011, KRMC, IN PARTNERSHIP WITH THE MOHAVE COUNTY DEPARTMENT OF PUBLIC HEALTH, HAS LED A MAJOR COMMUNITY INITIATIVE TO IMPROVE HEALTH AND QUALITY OF LIFE IN MOHAVE COUNTY. THE MOHAVE COUNTY COMMUNITY HEALTH IMPROVEMENT INITIATIVE INVOLVES PERFORMING A COMMUNITY HEALTH ASSESSMENT AND DEVELOPING A COMMUNITY HEALTH IMPROVEMENT PLAN EVERY THREE YEARS. A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR MOHAVE COUNTY WAS COMPLETED IN THE SPRING OF 2016 AND THE FINDINGS ARE DOCUMENTED IN THE COMMUNITY HEALTH PROFILE FOR MOHAVE COUNTY, ARIZONA, WHICH DETAILS HEALTH AND WELLNESS STATISTICS AND COMMUNITY NEEDS FOR HEALTH SERVICES IN MOHAVE COUNTY COMMUNITIES. ADDITIONALLY, KRMC DEVELOPED GOALS AND STRATEGIES FOR ADDRESSING THE PRIORITY HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT, WHICH ARE DOCUMENTED IN THE KINGMAN REGIONAL MEDICAL CENTER IMPLEMENTATION PLAN FOR THE MOHAVE COUNTY COMMUNITY HEALTH IMPROVEMENT INITIATIVE. THE CHNA AND IMPLEMENTATION PLAN ARE AVAILABLE FOR THE PUBLIC ON THE KRMC WEBSITE HTTP://WWW.AZKRMC.COM
SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: KRMC HAS POLICIES ONLINE TO EXPLAIN OUR FAP APPLICATION AS WELL AS ON OUR STATEMENTS. THERE IS INFORMATION ABOUT THE AFFORDABLE CARE ACT DURING OPEN ENROLLMENT AND WE PROVIDE A FAIR TO ASSIST. PUBLIC RELATIONS SENDS OUT ADS AS WELL AS POSTING ON TWITTER AND FACEBOOK. EACH PATIENT SERVICE REPRESENTATIVE HAS BEEN EDUCATED ABOUT OUR ASSISTANCE PROGRAMS AS WELL. WE ALSO HAVE A VENDOR ON SITE TO ASSIST WITH AHCCCS AND OTHER PROGRAMS FOR ASSISTANCE.
SCHEDULE H, PART VI, LINE 4COMMUNITY INFORMATION: KRMC SERVES AN APPROXIMATE 1500 SQUARE MILE GEOGRAPHIC AREA IN MOHAVE COUNTY, ARIZONA CALLED HOSPITAL DISTRICT NUMBER ONE OF MOHAVE COUNTY. THE DISTRICT INCLUDES THE CITY OF KINGMAN (POP. 28,500) AND NUMEROUS SMALLER OUTLAYING COMMUNITIES. THE TOTAL ESTIMATED POPULATION OF THE DISTRICT IS 78,000, WITH AN ESTIMATED 11.6 PERSONS PER SQUARE MILE. ACCORDING TO THE LATEST STATISTICS OF THE U.S. CENSUS BUREAU, THE RACIAL MIX OF THE POPULATION IS 77.5% CAUCASIAN, 1.4% AFRICAN AMERICAN, 3% NATIVE AMERICAN AND 16.2% HISPANIC OR LATINO ORIGIN. U.S. CENSUS BUREAU STATISTICS FOR 2014 SHOW 20.8% OF MOHAVE COUNTY'S POPULATION IS 100% BELOW THE FEDERAL POVERTY LEVEL. THE MEDIAN HOUSEHOLD INCOME IS $38,456. THE CURRENT UNEMPLOYMENT RATE IN MOHAVE COUNTY IS 7.5% (AS OF JUNE 2015) APPROXIMATELY 83.7% OF THE COUNTY'S POPULATION OVER AGE 25 ARE HIGH SCHOOL GRADUATES, WITH 12% OF THE POPULATION OVER AGE 25 HOLDING A BACHELOR'S DEGREE OR HIGHER.
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH: KINGMAN HOSPITAL INCORPORATED IS ORGANIZED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES RELATING TO HEALTHCARE IN HOSPITAL DISTRICT #1 OF MOHAVE COUNTY. ITS PRIMARY FUNCTION IS TO OPERATE KINGMAN REGIONAL MEDICAL CENTER (KRMC). KRMC'S BOARD OF DIRECTORS CONSISTS OF 13 MEMBERS HOLDING TERMS OF THREE YEARS. ALL BOARD MEMBERS ARE COMMUNITY-MINDED INDIVIDUALS WHO DO NOT RECEIVE COMPENSATION FOR THEIR SERVICES ON THE KRMC BOARD. ALL EXCESS FUNDS ARE KEPT FOR THE BENEFIT AND DEVELOPMENT OF THE COMMUNITY'S HEALTH SERVICES AS DETERMINED BY OUR LOCAL BOARD. WITH THIS, OUR HOSPITAL AVERAGE INPATIENT CHARGES HAVE REMAINED SIGNIFICANTLY BELOW THE ARIZONA AVERAGE FOR THE SAME TYPES OF PATIENTS. ADDITIONALLY, EXCESS FUNDS ACCUMULATED SINCE KRMC WAS ORGANIZED, HAVE BEEN UTILIZED TO PAY CAMPUS EXPANSION / IMPROVEMENTS, STATE-OF-THE-INDUSTRY TECHNOLOGY, AND COMPETITIVE SALARIES FOR EMPLOYEES. KRMC CONTINUALLY INVESTS IN ADVANCED MEDICAL TECHNOLOGIES. FROM SPECIALIZED DIAGNOSTIC CAPABILITIES TO ADVANCED TREATMENTS IN CARDIAC CARE AND CANCER, PATIENTS AT KRMC BENEFIT FROM SOME OF THE MOST SOPHISTICATED MEDICAL TECHNOLOGIES IN THE REGION. IN 2007, KRMC RECEIVED THE GOVERNOR'S ARIZONA INNOVATION AWARD IN RECOGNITION FOR ITS INVESTMENT IN TECHNOLOGY AND SERVICES NOT NORMALLY SEEN IN A RURAL COMMUNITY. KRMC IS A MAJOR COMMUNITY PARTNER DEDICATED TO ENHANCING THE OVERALL QUALITY-OF-LIFE IN NORTHWEST ARIZONA. WE OFFER MANY SERVICES AND PROGRAMS TO BENEFIT THE COMMUNITY, ESPECIALLY OUR MOST VULNERABLE CITIZENS- CHILDREN, ELDERLY, THOSE IN ILL HEALTH, AND THOSE IN SOCIO-ECONOMIC DISTRESS. EXAMPLES OF OUR COMMUNITY BUILDING ACTIVITIES INCLUDE: - CONDUCTING PUBLIC HEALTH LECTURES AT THE HOSPITAL AND AT AREA NURSING HOMES AND BUSINESSES (MONTHLY). - CONDUCTING HEALTH FAIRS, WHICH ARE FREE AND OPEN TO THE PUBLIC (8 HEALTH FAIRS PER YEAR) - OFFERING A VARIETY OF FREE SUPPORT GROUPS TO HELP PEOPLE WHO ARE WORKING TO CHANGE A BEHAVIOR OR WHO ARE DEALING WITH A LOSS, CONDITION, OR DISEASE. - PUBLISHING A QUARTERLY 8-PAGE NEWSLETTER (CALLED HEALTHWISE), WHICH CONTAINS IMPORTANT HEALTH INFORMATION FOR THE PUBLIC. THE NEWSLETTER IS FREE AND DISTRIBUTED THROUGHOUT NORTHWEST ARIZONA. - PROVIDING FREE GROWTH MATS AND CAR SEATS FOR BABIES BORN AT KRMC. - SPONSORING PHYSICAL FITNESS PROGRAMS AT COMMUNITY ELEMENTARY SCHOOLS TO HELP KIDS BE ACTIVE, FIT, AND HEALTHY. - PLACING DEFIBULATORS IN OUR COMMUNITY'S HIGH-TRAFFIC PUBLIC PLACES TO PROVIDE IMMEDIATE LIFESAVING TREATMENT TO SOMEONE WITH CARDIAC ARREST. - PROVIDING FREE OR LOW COST MAMMOGRAMS TO UNINSURED OR UNDERINSURED WOMEN RESIDING IN THE HOSPITAL DISTRICT OF MOHAVE COUNTY. - PROVIDING SCHOLARSHIPS FOR QUALIFIED INDIVIDUALS WHO CANNOT AFFORD A MEMBERSHIP TO KRMC'S DEL E. WEBB WELLNESS CENTER. - PROVIDING SCHOLARSHIPS TO HELP NURSING STUDENTS WITH THEIR EDUCATIONAL COSTS. - PROVIDING CASH CONTRIBUTIONS, FREE SERVICES, OR OTHER SUPPORT TO OVER 40 LOCAL ORGANIZATIONS THAT SERVE THE NEEDS OF OUR COMMUNITY (E.G, BOYS AND GIRLS CLUB, KINGMAN FOOD BANK, SARAH'S HOUSE, ETC.). - HELPING UNINSURED/UNDERINSURED PATIENTS WITH THEIR HEALTHCARE COSTS THROUGH KRMC'S CHARITY CARE PROGRAM. ADDITIONALLY, KRMC IS ONE OF THE AREA'S LARGEST CONTRIBUTORS TO THE LOCAL ECONOMY. WE EMPLOY OVER 1800 PEOPLE AND DURING THE PAST YEAR SPENT OVER $10,000,000 WITH LOCAL BUSINESSES.
Schedule H, Part VI, Line 7The community benefit report is filed in the following states: Arizona

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
BOYS & GIRLS CLUB OF KINGMAN
301 N 1ST STREETKINGMANAZ86401860743950501(C)(3)$15,000PROVIDES EDUCATION & MEALS TO CHILDREN
CORNERSTONE MISSION
3049 SYCAMOREKINGMANAZ86409860960036501(C)(3)$14,500HOMELESS SHELTER FOR MEN
ARIZONA YOUTH PARTNERSHIP
1902 PACIFIC AVEKINGMANAZ86401860669087501(C)(3)$7,500SUPPORT HOMELESS SHELTER FOR TEENAGE BOYS
KINGMAN AID TO ABUSED PEOPLE
1770 AIRWAY AVEKINGMANAZ86409860601113501(C)(3)$24,000SUPPORT FOR SHELTER FOR ABUSED PEOPLE
KINGMAN CANCER CARE
PO BOX 3014KINGMANAZ86402860753651501(C)(3)$10,000ASSISTS CANCER PATIENTS IN KINGMAN AREA
KATHERINE HEIDENREICH ADULT CENTER
1776 AIRWAY AVEKINGMANAZ86401860397271501(C)(3)$15,000TRANSPORTATION TO PHYSICIANS, MEALS FOR ELDERLY
Jerry Ambrose Veterans Council
PO Box 4463KingmanAZ86402461967830501(c)(3)$10,000Provide Assistance to Veterans
The kingsmen
PO Box 6211KingmanAZ86402860763188$6,000Rodeo Sponsorship
FieldValueIRS element (for citing)
Total501c3 Org7Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient81RecipientCnt
Cash Grant$194,121CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: FUND UsAGE IS PREDETERMINED BY THE BOARD OF DIRECTORS OF KINGMAN REGIONAL MEDICAL CENTER (KRMC). SCHOLARSHIPS ARE PROVIDED TO STUDENTS IN THE U.S. FOR TUITION AND RELATED EDUCATIONAL EXPENSES ONLY.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (true)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROBERT MATHENY MD
DIRECTOR$678,956$0$36,649$0$59,374$0$15,900$0$33,648$0$824,527$0$0$0
DENNIS DUNNING
PHYSICIAN$814,665$0$266,438$0$0$0$10,600$0$24,639$0$1,116,342$0$0$0
ALAIN ASHER
PHYSICIAN$702,780$0$0$0$36,935$0$2,337$0$24,318$0$766,370$0$0$0
JACOB OLDHAM
PHYSICIAN$658,522$0$19,005$0$18,000$0$7,063$0$2,772$0$705,362$0$0$0
Jeffrey Lunn
PHYSICIAN$683,746$0$84,394$0$29,235$0$13,250$0$26,902$0$837,527$0$0$0
Jamal Al-Khatib
PHYSICIAN$652,310$0$109,988$0$0$0$7,950$0$33,649$0$803,897$0$0$0
BRIAN TURNEY
CHIEF EXECUTIVE OFFICER$616,194$0$68,920$0$57,462$0$15,900$0$28,051$0$786,527$0$0$0
KIM MIYAUCHI
CHIEF NURSING OFFICER$188,991$0$14,030$0$10,306$0$12,997$0$17,921$0$244,245$0$0$0
RYAN KENNEDY
CHIEF OPERATING OFFICER$214,001$0$26,577$0$7,781$0$15,345$0$27,579$0$291,283$0$0$0
THOMAS GAUGHAN
CHIEF MEDICAL OFFICER$327,332$0$0$0$18,000$0$7,338$0$22,662$0$375,332$0$0$0
TIMOTHY BLANCHARD
CHIEF FINANCIAL OFFICER$293,897$0$35,610$0$0$0$10,600$0$33,585$0$373,692$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule J, Part I, line 6aFormAndLineReferenceDesc
ExplanationCompensation contingent on net earnings of the organization: Employed physicians are eligible for bonuses based on either revenues or business line income depending on their individual employment contracts.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Arizona Industrial Development AuthorityBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN813526584BondIssuerEIN
Bond Issued2017-03-31BondIssuedDt
Issue Price$20,000,000IssuePriceAmt
PurposeCapital ProjectsPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$662,792RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$20,000,000TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$0RefundingEscrowAmt
Issuance Costs From Proceeds$103,200IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$0WorkingCapitalExpendituresAmt
Capital Expenditures$7,456,601CapitalExpendituresAmt
Other Spent Proceeds$0OtherSpentProceedsAmt
Unspent$12,440,199UnspentAmt
Substantial Completion2017SubstantialCompletionYr
Current RefundingfalseCurrentRefundingInd
Advance RefundingfalseAdvanceRefundingInd
Final Allocation MadefalseFinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Private Bus Use By Others0PrivateBusUseByOthersPct
Bond Iss Meet Prvt Sec Pymt TestfalseBondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdYes (true)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetYes (true)RebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssuefalseVariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (true)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (true)ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BProcess to Review the Form 990: THE FORM 990 IS PREPARED BY A THIRD PARTY PREPARER WITH A DETAIL REVIEW BEING CONDUCTED BY THE GENERAL ACCOUNTING MANAGER AND ACCOUNTANT OF THE ORGANIZATION. A FINAL COPY OF THE FORM 990 IS THEN E-MAILED TO THE BOARD OF DIRECTORS BEFORE THE RETURN IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CProcess for Monitoring Compliance with Conflict of Interest Policy: THE EXECUTIVE ASSISTANT TO THE CEO ANNUALLY DISTRIBUTES THE POLICY DOCUMENTS AND FORMS TO ALL MANAGERS AND BOARD MEMBERS. THE RELATED FORMS CONTAIN WRITTEN EXPLANATIONS BY MANAGERS AND BOARD MEMBERS. IF A POTENTIAL CONFLICT ARISES, THE SITUATION IS THEN REVIEWED BY THE CEO. IF A CONFLICT OF INTEREST COVERED BY THIS POLICY EXISTS, WHETHER OR NOT LISTED ON A DISCLOSURE FORM, THEN THE PERSON INVOLVED WITH THE POTENTIAL CONFLICT OF INTEREST RECUSES THEMSELF FROM VOTING ON THE MATTER.
FORM 990, PART VI, SECTION B, LINE 15AReview of CEO or Top Mgmt Official Compensation: A BENEFITS AND COMPENSATION ANALYST PREPARES A STUDY BASED ON EXTERNAL COMPARISONS OF SIMILAR POSITIONS IN SIMILAR SIZED ORGANIZATIONS IN THE INDUSTRY. THE STUDY IS REVIEWED BY A COMPENSATION COMMITTEE THEN SUBMITTED TO THE EXECUTIVE BOARD FOR FINAL APPROVAL. CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION PROCESS ARE KEPT ON FILE. THIS STUDY IS CONDUCTED ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15BReview of Other Officer or Key Employees Compensation: A BENEFITS AND COMPENSATION ANALYST PREPARES A STUDY BASED ON EXTERNAL COMPARISONS OF SIMILAR POSITIONS IN SIMILAR SIZED ORGANIZATIONS IN THE INDUSTRY. THE STUDY IS REVIEWED BY A COMPENSATION COMMITTEE THEN SUBMITTED TO THE KHI BOARD OF DIRECTORS FOR FINAL APPROVAL. CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION PROCESS ARE KEPT ON FILE. THIS STUDY IS CONDUCTED ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19Describe how Governing Documents are made Available to the Public: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR A VALID BUSINESS PURPOSE.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS: CHANGE IN NET ASSETS OF KRMC FOUNDATION 120,102
FORM 990 PART IX LINE 11GDESCRIPTION:COLLECTIONS/CLAIMS ASSISTANCE TOTAL FEES:1058120
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING TOTAL FEES:1680247
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACT SERVICES TOTAL FEES:10999912
FORM 990 PART IX LINE 11GDESCRIPTION:EQUIPMENT SERVICE CONTRACTS TOTAL FEES:2561144
FORM 990 PART IX LINE 11GDESCRIPTION:INSTRUCTOR FEES TOTAL FEES:63592
FORM 990 PART IX LINE 11GDESCRIPTION:NURSE REGISTRY TOTAL FEES:4460047
FORM 990 PART IX LINE 11GDESCRIPTION:PHYSICIAN FEES TOTAL FEES:16717701
FORM 990 PART IX LINE 11GDESCRIPTION:RELAY HEALTH FEES TOTAL FEES:205504
FORM 990 PART IX LINE 11GDESCRIPTION:RECRUITING TOTAL FEES:102163
FORM 990 PART IX LINE 11GDESCRIPTION:BILLING TOTAL FEES:85027
FORM 990 PART IX LINE 11GDESCRIPTION:TESTING TOTAL FEES:492716

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1NORTHWESTERN ARIZONA REGIONAL INSURANCEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line14041 N CENTRAL AVEAddressLine1Txt
CityPHOENIXCityNm
State AbbreviationAZStateAbbreviationCd
ZIP85012ZIPCd
FieldValueIRS element (for citing)
EIN208081486EIN
Primary ActivitiesINSURERPrimaryActivitiesTxt
Legal Domicile StateAZLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLine 12aPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1KRMCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
NORTHWESTERN ARIZONA REGIONAL INSURANCE
D$443,756interco amount
NORTHWESTERN ARIZONA REGIONAL INSURANCE
M & R$2,395,978interco amount

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