KINGMAN HEALTHCARE INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- KINGMAN HEALTHCARE INC (EIN 94-2916102)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-04-24
- IRS object ID
- 201741149349300309
- Schema version
- 2015v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-04-24T09:42:37-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 South Tejon Suite 800 | AddressLine1Txt |
| City | Colorado Springs | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 809039848 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942916102 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kingman Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % KINGMAN HOSPITAL INC | InCareOfNm |
| Business Name Control | KING | BusinessNameControlTxt |
| Phone | 9287572101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3269 STOCKTON HILL ROAD | AddressLine1Txt |
| City | KINGMAN | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86409 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY BLANCHARD | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9287572101 | PhoneNum |
| Signature | 2017-04-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | David S Mason CPA | PreparerPersonNm |
| PTIN | P00137279 | PTIN |
| Phone | 7194714290 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kingman Regional Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRIAN TURNEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3269 STOCKTON HILL ROAD | AddressLine1Txt |
| City | KINGMAN | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86409 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $298,286,671 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | AZKRMC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | OUR 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 Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 2199 | TotalEmployeeCnt |
| Total Volunteers | 114 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $69,611 | PYContributionsGrantsAmt |
| CY Contributions Grants | $86,586 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $269,939,483 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $288,126,178 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,537,454 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,895,268 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,068,368 | PYOtherRevenueAmt |
| CY Other Revenue | $4,902,796 | CYOtherRevenueAmt |
| PY Total Revenue | $281,614,916 | PYTotalRevenueAmt |
| CY Total Revenue | $295,010,828 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $264,969 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $571,564 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $128,926,042 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $144,581,004 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $131,377,528 | PYOtherExpensesAmt |
| CY Other Expenses | $139,817,790 | CYOtherExpensesAmt |
| PY Total Expenses | $260,568,539 | PYTotalExpensesAmt |
| CY Total Expenses | $284,970,358 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $21,046,377 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $10,040,470 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $248,623,873 | TotalAssetsBOYAmt |
| Total Assets EOY | $257,488,989 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $28,206,722 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,451,146 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $220,417,151 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $229,037,843 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Our 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 Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $231,895,506 | ExpenseAmt |
| Grant | $571,564 | GrantAmt |
| Revenue | $289,852,466 | RevenueAmt |
| Desc | Mohave 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 400% 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 | $231,895,506 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 276 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 2199 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AZ | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KINGMAN HOSPITAL INC | PersonNm |
| Phone | 9287572101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3269 STOCKTON HILL ROAD | AddressLine1Txt |
| City | KINGMAN | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86409 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| DAVID FRENCH | |||||||||
| CHAIRMAN | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DONALD VAWTER | |||||||||
| VICE CHAIRMAN | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KRYSTAL BURGE | |||||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JAMES BAKER | |||||||||
| TREASURER | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CORAL LOYD | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT MATHENEY | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $720,611 | $0 | $55,363 | |||
| SANDY MOON | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| CATHY OTT | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROD MARQUARDT TREASURER | |||||||||
| THRU 08/2015, DIRECTOR | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KALE BODILY | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| SUSAN CHAN | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN TURNEY | |||||||||
| CHIEF EXECUTIVE OFFICER | 40.0 | 0.0 | Yes (X) | Yes (X) | $561,505 | $0 | $45,114 | ||
| BARBARA RICCA | |||||||||
| DIRECTOR THRU 08/2015 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| RYAN KENNEDY | |||||||||
| CHIEF OPERATING OFFICER | 40.0 | 0.0 | Yes (X) | $242,728 | $0 | $43,489 | |||
| TIMOTHY BLANCHARD | |||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | 0.0 | Yes (X) | $282,682 | $0 | $39,108 | |||
| KIM MIYAUCHI | |||||||||
| CHIEF NURSING OFFICER | 40.0 | 0.0 | $206,702 | $0 | $27,847 | Yes (X) | |||
| THOMAS GAUGHAN | |||||||||
| CHIEF MEDICAL OFFICER | 40.0 | 0.0 | $361,785 | $0 | $25,202 | Yes (X) | |||
| DENNIS DUNNING | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $979,883 | $0 | $31,201 | Yes (X) | |||
| ALAIN ASHER | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $748,851 | $0 | $19,602 | Yes (X) | |||
| JACOB OLDHAM | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $704,067 | $0 | $1,487 | Yes (X) | |||
| HAVEN MALISH | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $687,763 | $0 | $34,785 | Yes (X) | |||
| JEFFREY LUNN | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $686,395 | $0 | $33,567 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,182,972 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $356,765 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 159 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HIGH DESERT RADIOLOGY | |||||
| 695 COUNTRY CLUB DRIVE | KINGMAN | AZ | 86041 | RADIOLOGISTS | $7,590,987 |
| CHG COMPANIES DBA COMPHEALTH ASSOC | |||||
| P O BOX 972651 | DALLAS | TX | 753972651 | NURSE AGENCY | $2,965,755 |
| MIDWESTERN UNIVERSITY | |||||
| 19555 N 59TH AVE | GLENDALE | AZ | 85308 | GME PROGRAM | $1,792,820 |
| MEDLIANT | |||||
| 969-G EDGEWATER BLVD 698 | FOSTER CITY | CA | 94404 | NURSE AGENCY | $1,441,913 |
| AMN HEALTHCARE | |||||
| P O BOX 281939 | ATLANTA | GA | 303841939 | NURSE AGENCY | $2,751,686 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 51 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $61,163 | RelatedOrganizationsAmt |
| All Other Contributions | $25,423 | AllOtherContributionsAmt |
| Noncash Contributions | $61,163 | NoncashContributionsAmt |
| Total Contributions | $86,586 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 561110 | $170,780,582 | $170,780,582 |
| MEDICARE & MEDICAID REVENUE | 561110 | $113,901,685 | $113,901,685 |
| EHR/PQRS/MEANINGFUL USE PAYMENTS | 900099 | $1,383,524 | $1,383,524 |
| WELLNESS CENTER REVENUE | 561110 | $1,340,448 | $1,340,448 |
| DURABLE MEDICAL EQUIPMENT REVENUE | 900099 | $439,079 | $439,079 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $280,860 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $280,860 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $288,126,178 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,797,609 | TotalRevenueColumnAmt |
| Exclusion | $1,797,609 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $216,226 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $216,226 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $216,226 | TotalRevenueColumnAmt |
| Exclusion | $216,226 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,000,000 | SecuritiesAmt |
| Other | $305,030 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,921,434 | SecuritiesAmt |
| Other | $285,937 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $78,566 | SecuritiesAmt |
| Other | $19,093 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $97,659 | TotalRevenueColumnAmt |
| Exclusion | $97,659 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $61,347 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $68,472 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$7,125 | TotalRevenueColumnAmt |
| Exclusion | -$7,125 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA | 722514 | $2,436,042 | $2,436,042 | |
| 340B PHARMACY | 446110 | $999,657 | $999,657 | |
| INCOME FROM EQUITY INVESTEE | 900099 | $639,939 | $639,939 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $618,057 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $86,692 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $531,365 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,693,695 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $295,010,828 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $289,852,466 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $5,071,776 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,053 | TotalAmt |
| Program Services | $274,053 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,511 | TotalAmt |
| Program Services | $297,511 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,720,214 | TotalAmt |
| Program Services | $2,413,386 | ProgramServicesAmt |
| Management And General | $306,828 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,424,546 | TotalAmt |
| Program Services | $79,431,455 | ProgramServicesAmt |
| Management And General | $31,993,091 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,061,064 | TotalAmt |
| Program Services | $3,118,405 | ProgramServicesAmt |
| Management And General | $942,659 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,243,529 | TotalAmt |
| Program Services | $14,804,643 | ProgramServicesAmt |
| Management And General | $4,438,886 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,131,651 | TotalAmt |
| Program Services | $5,491,371 | ProgramServicesAmt |
| Management And General | $1,640,280 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,910 | TotalAmt |
| Management And General | $168,910 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,260 | TotalAmt |
| Management And General | $169,260 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,893 | TotalAmt |
| Management And General | $42,893 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,074 | TotalAmt |
| Management And General | $58,074 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,000,303 | TotalAmt |
| Program Services | $31,458,631 | ProgramServicesAmt |
| Management And General | $4,541,672 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $464,202 | TotalAmt |
| Program Services | $357,436 | ProgramServicesAmt |
| Management And General | $106,766 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,919,385 | TotalAmt |
| Program Services | $3,787,926 | ProgramServicesAmt |
| Management And General | $1,131,459 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,518,376 | TotalAmt |
| Program Services | $4,249,150 | ProgramServicesAmt |
| Management And General | $1,269,226 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,676,444 | TotalAmt |
| Program Services | $3,600,862 | ProgramServicesAmt |
| Management And General | $1,075,582 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,411,850 | TotalAmt |
| Program Services | $1,087,125 | ProgramServicesAmt |
| Management And General | $324,725 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,535 | TotalAmt |
| Program Services | $12,732 | ProgramServicesAmt |
| Management And General | $3,803 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,672,027 | TotalAmt |
| Program Services | $12,067,461 | ProgramServicesAmt |
| Management And General | $3,604,566 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,015,602 | TotalAmt |
| Program Services | $3,776,203 | ProgramServicesAmt |
| Management And General | $239,399 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $42,315,752 | $42,315,752 | |
| BAD DEBT EXPENSE | $14,979,642 | $14,979,642 | |
| PROVIDER FEE | $3,273,138 | $3,273,138 | |
| FOOD | $2,113,327 | $1,650,890 | $462,437 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,002,070 | TotalAmt |
| Program Services | $3,447,734 | ProgramServicesAmt |
| Management And General | $554,336 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,970,358 | TotalAmt |
| Program Services | $231,895,506 | ProgramServicesAmt |
| Management And General | $53,074,852 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,536,310 | BOYAmt |
| EOY | $6,206,618 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,399,384 | BOYAmt |
| EOY | $17,736,329 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,603,490 | BOYAmt |
| EOY | $58,945,847 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $359,653 | BOYAmt |
| EOY | $327,336 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,774,328 | BOYAmt |
| EOY | $6,353,951 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,376,376 | BOYAmt |
| EOY | $2,673,399 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $245,932,674 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $145,137,598 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,163,642 | BOYAmt |
| EOY | $100,795,076 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,071,810 | BOYAmt |
| EOY | $58,252,287 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,368,432 | BOYAmt |
| EOY | $4,201,521 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,536,456 | BOYAmt |
| EOY | $1,591,978 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $433,992 | BOYAmt |
| EOY | $404,647 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $248,623,873 | BOYAmt |
| EOY | $257,488,989 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,996,126 | BOYAmt |
| EOY | $24,291,567 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,149 | BOYAmt |
| EOY | $109,849 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,063,233 | BOYAmt |
| EOY | $649,097 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,012,214 | BOYAmt |
| EOY | $3,400,633 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,206,722 | BOYAmt |
| EOY | $28,451,146 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $218,580,009 | BOYAmt |
| EOY | $227,196,659 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,837,142 | BOYAmt |
| EOY | $1,841,184 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $220,417,151 | BOYAmt |
| EOY | $229,037,843 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $248,623,873 | BOYAmt |
| EOY | $257,488,989 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $10,040,470 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,475,300 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $55,522 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (true) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $42,893 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $42,893 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1g | FormAndLineReferenceDesc |
| Explanation | Lobbying: 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,972,469 | OtherCostOrOtherBasisAmt |
| Book Value | $15,972,469 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $101,798,453 | OtherCostOrOtherBasisAmt |
| Depreciation | $53,743,916 | DepreciationAmt |
| Book Value | $48,054,537 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $121,099,999 | OtherCostOrOtherBasisAmt |
| Depreciation | $88,187,468 | DepreciationAmt |
| Book Value | $32,912,531 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,061,753 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,206,214 | DepreciationAmt |
| Book Value | $3,855,539 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $100,795,076 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED RETIREMENT OBLIGATION | $2,278,633 |
| ESTIMATED SELF-INSURANCE COSTS | $1,122,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,400,633 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $278,191,161 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$1,475,300 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $123,994 | OtherRevenueAmt |
| Revenue Not Reported | -$1,351,306 | RevenueNotReportedAmt |
| Revenue Subtotal | $279,542,467 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $58,074 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $15,410,287 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $15,468,361 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $295,010,828 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $269,570,469 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $68,472 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $68,472 | ExpensesNotReportedAmt |
| Expenses Subtotal | $269,501,997 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $58,074 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $15,410,287 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $15,468,361 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $284,970,358 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART XI, LINE 2D | REVENUE ON BOOKS, NOT ON RETURN: COST OF GOODS SOLD 68,472 CHANGE IN NET ASSETS OF KRMC FOUNDATION 55,522 TOTAL 123,994 |
| SCHEDULE D, PART XI, LINE 4B | REVENUE ON RETURN, NOT ON BOOKS: BAD DEBT NET WITH REVENUE ON FINANCIALS, TREATED AS EXPENSE ON TAX RETURN 14,979,642 ACTIVITY OF NARIC INCLUDED IN CONSOLIDATED FINANCIALS, REMOVED FOR TAX RETURN 430,645 TOTAL 15,410,287 |
| SCHEDULE D, PART XII, LINE 2D | EXPENSE ON BOOKS, NOT ON RETURN: COST OF GOODS SOLD 68,472 |
| SCHEDULE D, PART XII LINE 4B | EXPENSE ON RETURN, NOT ON BOOKS: BAD DEBT NET WITH REVENUE ON FINANCIALS, TREATED AS EXPENSE ON TAX RETURN 14,979,642 ACTIVITY OF NARIC INCLUDED IN CONSOLIDATED FINANCIALS, REMOVED FOR TAX RETURN 430,645 TOTAL 15,410,287 |
| SCHEDULE D, PART X, LINE 2 | UNCERTAIN 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,471,762 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,471,762 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $56,998,563 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,326,645 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $39,671,918 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14690 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $58,470,325 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,326,645 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $41,143,680 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15240 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $871,843 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $871,843 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,190,669 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,092,063 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$901,394 | NetCommunityBenefitExpnsAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $497,376 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $497,376 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,559,888 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,092,063 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $467,825 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $63,030,213 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,418,708 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $41,611,505 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15740 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $14,979,642 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $68,652,853 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $68,811,069 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$158,216 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KINGMAN REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3269 STOCKTON HILL ROAD | AddressLine1Txt |
| City | KINGMAN | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86409 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.AZKRMC.COM | WebsiteAddressTxt |
| State License | H-0010 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | CANCER CENTER CARDIAC CATH LAB ACUTE REHAB UNIT | OtherDesc |
| Facility Reporting Group | 1 | FacilityReportingGroupCd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KINGMAN REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | see part V, Section C for URL | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | see part V, Section C for URL | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | see part v, section C for URL | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | see part v, section C for URL | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | Part V, section for URL | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | AS 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 6B | THE CHNA FOR KINGMAN HOSPITAL INC. WAS CONDUCTED WITH MOHAVE COUNTY, ARIZONA. |
| SCHEDULE H, PART V, SECTION B, LINE 7A | DIRECT 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 10A | DIRECT 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 11 | In 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 health |
| SCHEDULE H, PART V, SECTION B, LINE 16A - 16C | DIRECT URL FOR FAP POLICY, AND PLAN 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 22D | Kingman 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 31 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (31 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Outpatient Imaging Center | ||||
| 1033 Sycamore | Kingman | AZ | 86409 | imaging center |
| Kingman Cardiovascular Assoc | ||||
| 1739 Beverly Ave Suite 217 | Kingman | AZ | 86409 | Cardiology Physicians |
| Kingman Urology Clinic | ||||
| 1739 Beverly Ave Suite 106 | Kingman | AZ | 86409 | Urologist |
| GME Resident Clinic | ||||
| 2202 Stockton Hill Rd Suite 101 | Kingman | AZ | 86401 | Family Medicine |
| Kingman ENT Clinic | ||||
| 3116 Stockton Hill Road | Kingman | AZ | 86401 | Ear, Nose & Throat Physicians |
| Kingman Pulmonary Clinic | ||||
| 1739 Beverly AveSuite 203 | Kingman | AZ | 86409 | Pulmonary Medicine |
| Mohave Surgical Specialists | ||||
| 3104 Stockton Hill Road | Kingman | AZ | 86401 | General Surgeon |
| KRMC CARDIOTHORACIC SURGERY | ||||
| 1739 BEVERLY AVE SUITE 218 | Kingman | AZ | 86409 | Cardiothoracic Surgeon |
| Kingman Orthopedics | ||||
| 1739 BEVERLY AVE SUITE 102 | Kingman | AZ | 86409 | Orthopedic Physicians |
| High Desert Gastroenterolgy | ||||
| 1739 BEVERLY AVE SUITE 101 | Kingman | AZ | 86409 | Gastroenterologist |
| Orthopedic Surgery Clinic | ||||
| 1739 BEVERLY AVE SUITE 102 | Kingman | AZ | 86409 | Orthopedic Surgeons |
| Kingman Family Practice | ||||
| 1739 Beverly Ave Suite 209 | Kingman | AZ | 86409 | Family Medicine |
| Hillcrest Surgical | ||||
| 3939 Stockton Hill Road | Kingman | AZ | 86409 | General Surgeon |
| Mohave Pain Management | ||||
| 3801 SANTA ROSA | Kingman | AZ | 86401 | Pain Management Physicians |
| EMPLOYEE & OCCUPATIONAL HEALTH | ||||
| 1739 Beverly Ave Suite 118 | Kingman | AZ | 86409 | Occupational Medicine |
| KRMC PRIMARY CARE | ||||
| 2226 HUALAPAI MTN ROAD | Kingman | AZ | 86401 | PRIMARY CARE PHYSICIANS |
| Golden Valley Clinic | ||||
| 4995 W Hwy 68 | Golden Valley | AZ | 86413 | Family Medicine |
| Sunshine Canyon Healthcare | ||||
| 2202 Stockton Hill Rd Suite 100 | Kingman | AZ | 86401 | Family Medicine |
| Kingman OBGYN Associates | ||||
| 1739 Beverly Ave Suite 200 | Kingman | AZ | 86409 | Obstetrics/Gynecology |
| FASTRAX URGENT CARE | ||||
| 1726 BEVERLY AVE | Kingman | AZ | 86401 | Urgent Care |
| KRMC PRE-OP CLINIC | ||||
| 1739 Beverly Ave Suite 103 | Kingman | AZ | 86409 | Pre-op Care Facility |
| POST HOSPITAL CARE CLINIC | ||||
| 1726 BEVERLY AVE | Kingman | AZ | 86409 | POST HOSPITAL CARE |
| DESERT VIEW HEALTHCARE | ||||
| 1871 GATES AVE | KINGMAN | AZ | 86401 | FAMILY MEDICINE |
| KRMC PHYSIATRY | ||||
| 3801 SANTA ROSA | Kingman | AZ | 86401 | Physical Medicine & Rehab |
| Meadview Medical Services | ||||
| 330 E Meadview | Meadview | AZ | 86444 | FAMILY MEDICINE |
| Kingman Rheumatology | ||||
| 1739 BEVERLY AVE SUITE 209 | Kingman | AZ | 86409 | Rheumatologist |
| Joshua Tree Pediatrics | ||||
| 1739 BEVERLY AVE SUITE 204 | Kingman | AZ | 86409 | PEDIATRICIAN |
| KRMC DISEASE MANAGEMENT CLINIC | ||||
| 1739 BEVERLY AVE SUITE 107 | KINGMAN | AZ | 86409 | DISEASE MANAGEMENT |
| PAIN MANAGEMENT CLINIC | ||||
| 1739 BEVERLY AVE SUITE 221 | KINGMAN | AZ | 86409 | PAIN MANAGEMENT |
| KRMC HOSPICE | ||||
| 3269 STOCKTON HILL ROAD | KINGMAN | AZ | 86409 | HOSPICE SERVICES |
| KRMC HUALAPAI CAMPUS | ||||
| 3801 SANTA ROSA | KINGMAN | AZ | 86401 | ACUTE REHABILITATION |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7 | THE 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 $14,979,642. |
| SCHEDULE H, PART III, Section A, LINE 2 | THE 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 4 | THE 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 8 | The 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. Medicare shortfalls in rural settings reflect the excess cost of required care over the calculated average expected cost for participants in the Medicare program. For these reasons, Medicare shortfalls should be considered part of the community benefit provided. |
| SCHEDULE H, PART III, Section C, LINE 9b | ONCE 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 2 | NEEDS 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 3 | PATIENT 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 4 | COMMUNITY 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 5 | PROMOTION 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 I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| BOYS & GIRLS CLUB OF KINGMAN | |||||||
| 301 N 1ST STREET | KINGMAN | AZ | 86401 | 860743950 | 501(C)(3) | $15,000 | PROVIDES EDUCATION & MEALS TO CHILDREN |
| CORNERSTONE MISSION | |||||||
| 3049 SYCAMORE | KINGMAN | AZ | 86409 | 860960036 | 501(C)(3) | $16,000 | HOMELESS SHELTER FOR MEN |
| KINGMAN AID TO ABUSED PEOPLE | |||||||
| 1770 AIRWAY AVE | KINGMAN | AZ | 86409 | 860601113 | 501(C)(3) | $24,000 | SUPPORT FOR SHELTER FOR ABUSED PEOPLE |
| KINGMAN CANCER CARE | |||||||
| PO BOX 3014 | KINGMAN | AZ | 86402 | 860753651 | 501(C)(3) | $10,000 | ASSISTS CANCER PATIENTS IN KINGMAN AREA |
| KATHERINE HEIDENREICH ADULT CENTER | |||||||
| 1776 AIRWAY AVE | KINGMAN | AZ | 86401 | 860397271 | 501(C)(3) | $15,000 | TRANSPORTATION TO PHYSICIANS, MEALS FOR ELDERLY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 77 | RecipientCnt |
| Cash Grant | $297,511 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | ORGANIZATION'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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (true) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT MATHENEY | ||||||||||||||
| DIRECTOR | $642,344 | $0 | $26,203 | $0 | $52,064 | $0 | $28,452 | $0 | $26,911 | $0 | $775,974 | $0 | $0 | $0 |
| DENNIS DUNNING | ||||||||||||||
| PHYSICIAN | $619,594 | $0 | $360,289 | $0 | $0 | $0 | $10,460 | $0 | $20,741 | $0 | $1,011,084 | $0 | $0 | $0 |
| ALAIN ASHER | ||||||||||||||
| PHYSICIAN | $748,851 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,602 | $0 | $768,453 | $0 | $0 | $0 |
| JACOB OLDHAM | ||||||||||||||
| PHYSICIAN | $688,638 | $0 | $0 | $0 | $15,429 | $0 | $0 | $0 | $1,487 | $0 | $705,554 | $0 | $0 | $0 |
| HAVEN MALISH | ||||||||||||||
| PHYSICIAN | $636,911 | $0 | $24,237 | $0 | $26,615 | $0 | $7,863 | $0 | $26,922 | $0 | $722,548 | $0 | $0 | $0 |
| JEFFREY LUNN | ||||||||||||||
| PHYSICIAN | $597,052 | $0 | $0 | $0 | $89,343 | $0 | $13,250 | $0 | $20,317 | $0 | $719,962 | $0 | $0 | $0 |
| BRIAN TURNEY | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $526,376 | $0 | $0 | $0 | $35,129 | $0 | $15,886 | $0 | $29,228 | $0 | $606,619 | $0 | $0 | $0 |
| KIM MIYAUCHI | ||||||||||||||
| CHIEF NURSING OFFICER | $190,708 | $0 | $0 | $0 | $15,994 | $0 | $12,597 | $0 | $15,250 | $0 | $234,549 | $0 | $0 | $0 |
| RYAN KENNEDY | ||||||||||||||
| CHIEF OPERATING OFFICER | $235,100 | $0 | $0 | $0 | $7,628 | $0 | $14,941 | $0 | $28,548 | $0 | $286,217 | $0 | $0 | $0 |
| THOMAS GAUGHAN | ||||||||||||||
| CHIEF MEDICAL OFFICER | $351,285 | $0 | $0 | $0 | $10,500 | $0 | $5,027 | $0 | $20,175 | $0 | $386,987 | $0 | $0 | $0 |
| TIMOTHY BLANCHARD | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $282,682 | $0 | $0 | $0 | $0 | $0 | $10,600 | $0 | $28,508 | $0 | $321,790 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, line 6a | FormAndLineReferenceDesc |
| Explanation | Compensation 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 M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp | |
| Drugs And Medical Supplies | DrugsAndMedicalSuppliesGrp | |
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | SIMULATION MANNEQUIN | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $61,163 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | fair market value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PART I, COLUMN B | FormAndLineReferenceDesc |
| Explanation | Number of contributions or items contributed: THE NUMBER IN COLUMN B REPRESENTS THE TOTAL NUMBER OF CONTRIBUTIONS RECEIVED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | Process 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 12C | Process 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 15A | Review 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 15B | Review 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 19 | Describe 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 9 | OTHER CHANGES IN NET ASSETS: CHANGE IN NET ASSETS OF KRMC FOUNDATION 55,522 |
| Form 990, Part VI, Section A, Line 4 | Changes to Organizational Documents since Prior 990: THE ORGANIZATION AMENDED ITS BYLAWS DURING THE YEAR TO INCLUDE THE FOLLOWING: - EX-OFFICIO VOTING MEMBERS SHALL NOT HAVE A VOTE IN THE ELECTION OF BOARD MEMBERS OR OFFICERS - EFFECTIVE JULY 1, 2016, CHIEF OF STAFF OF KRMC SHALL NOT ALSO HOLD SEPARATE ELECTIVE OFFICE AS A DIRECTOR - ELECTIONS FOR CANDIDACY CAN NOW BE MADE ELECTRONICALLY |
| FORM 990 PART IX LINE 11G | DESCRIPTION:COLLECTIONS/CLAIMS ASSIST TOTAL FEES:931948 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING TOTAL FEES:1625831 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT SERVICES TOTAL FEES:10111220 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:EQUIPMENT SVC CONTRACTS TOTAL FEES:2602357 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:INSTRUCTOR FEES TOTAL FEES:76154 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:NURSE REGISTRY TOTAL FEES:4942764 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIANS TOTAL FEES:14532642 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:RELAY HEALTH FEES TOTAL FEES:330147 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:RECRUITING TOTAL FEES:638853 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BILLING TOTAL FEES:208387 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWESTERN ARIZONA REGIONAL INSURANCE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4041 N CENTRAL AVE | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85012 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208081486 | EIN |
| Primary Activities | INSURER | PrimaryActivitiesTxt |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 11a | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KRMC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NORTHWESTERN ARIZONA REGIONAL INSURANCE | ||
| D | $261,794 | interco amount |
| NORTHWESTERN ARIZONA REGIONAL INSURANCE | ||
| M & R | $2,287,789 | interco amount |
Comments