2014-11-10T11:25:21-08:00 2013-12-31 TCA Partners LLP 1111 East Herndon Avenue Suite 211 Fresno CA 93720 990 2013-01-01 860171900 White Mountain Communities Hospital Inc dba White Mountain Regional Medical Ctr WHIT 9283337142 118 South Mountain Ave Springerville AZ 85938 Greg Was CEO 2014-11-10 true Inger Sullenger CPA P01464277 5594317708 X 2013 2015-11-30 17:44:51Z Greg Was 118 South Mountain Ave Springerville AZ 859385104 17225594 false false X www.wmrmc.com X 1962 AZ WMRMC provides caring services & operates in a financially sound basis to ensure its continuing ability to meet the healthcare needs of patients & the communities it serves. 8 5 234 39 0 993420 697820 15416338 15537804 37193 1022 578134 984738 17025085 17221384 0 0 8978864 9823199 0 13655 7005570 7129937 15984434 16953136 1040651 268248 7075425 7376175 2213965 2246467 4861460 5129708 The board of directors and leadership at WMRMC recongnize the importance of healthcare as a service essential for the well-being of people in the region and as an important part of the community's economy. See also, Form 990, Part I, Ln 1. false false 10178801 16361941 The Board of Directors and Leadership at WMRMC recognize the importance of healthcare as a service essential for the well-being of people in the region and as an important part of the community's economy.Patient Services - The organization provides acute inpatient care, emergency health care and outpatient health care services to community members of Southern Apache County, Arizona and Catron County, New Mexico. Recent accomplishments include: implementation of a Swing Bed program; renovation of the Medical/Surgical Department and the Nurse call station.During 2013, the total number of visits was in excess of 15,000. 10178801 true true false false false false false false false false true false false false true false true false false false false false false false true false true true false false true false false false false false false false false false true false false false false false false false false false false false true 58 0 true 234 true false false false false false true true true true false 0 false false false false false false false false false false X 8 5 true false false false false false false true true false false true true true true true true true true false X X Finance Department 9283337142 118 South Mountain Ave Springerville AZ 859385104 Mary Nedrow President 1.00 0.00 X 0 0 0 Ryan Patterson Vice President 1.00 0.00 X 0 0 0 Nadia Comvaluis MD Secretary 1.00 0.00 X 0 0 0 John Fredericksen Treasurer 1.00 0.00 X 0 0 0 Veronica Dowling MD Board Member 1.00 0.00 X 16000 0 0 Gary Davis Board Member 1.00 0.00 X 0 0 0 Scott Hamblin MD Board Member 1.00 0.00 X 41693 0 0 Travis Udall Board Member 1.00 0.00 X 0 0 0 Samuel Grant CFO/CEO Pt yr 40.00 0.00 X 67205 0 9746 Jim Robertson CEO Pt yr 2013 40.00 0.00 X 0 0 16707 Greg Was CEO 40.00 0.00 X 0 0 1995 Karen Talamantes CNO 40.00 0.00 X 66194 0 4654 Sammie Finch DON 40.00 0.00 X 81323 0 16707 Carla Rotering MD Physician 40.00 0.00 X 239414 0 0 Michael Foote MD Physician 40.00 0.00 X 204008 0 0 Cristine Jackson Physician 40.00 0.00 X 124390 0 0 Greg Cluff Pharmacy Mgr 40.00 0.00 X 123145 0 0 Steven Hamblin Physical Therpist 40.00 0.00 X 111359 0 0 1074731 49809 5 false true false Round Valley Emergency Care 4141 W Thornton Showlow AZ 85901 ER Physicians/PA 1480440 Blue Cross 2444 W Las Palmaritas Dr Phoenix AZ 85069 EE Health Insurance 1390694 Amerisource Bergen 1825 S 43rd Ave Ste B Phoenix AZ 85009 Pharmacy Supplies 450349 LocumTenensCom 2655 Northwinds Parkway Alpharetta GA 30009 CRNA Coverage 300507 Philips Medical Capital 595 Miner Rd Cleveland OH 44143 Ultra-Sound Lease 219125 15 21455 525000 151365 697820 Net Patient Service Revs 15537804 15537804 15537804 1022 1022 0 0 18000 18000 18000 18000 0 21455 4210 -4210 -4210 0 0 Cafeteria, Childcare, etc 622000 146811 146811 Meaningful Use 622000 824137 824137 970948 17221384 16361941 161623 X 0 0 0 0 972536 972536 0 6998337 4580668 2410215 7454 0 1229375 610194 618352 829 622951 359361 262873 717 0 83315 83315 51155 51155 0 0 0 2477843 2419828 58015 401487 99927 301560 58606 20701 34329 3576 74047 13255 60650 142 69870 10791 59079 379551 2689 376862 72261 42621 29462 178 0 45271 23074 22154 43 89242 89242 0 649947 649947 189492 14147 175345 Supplies 1284150 1085702 197916 532 Equipment Rent & Maintenance 1036460 764270 272115 75 Licenses 67595 64450 3145 Dues & Subscriptions 55208 48743 6397 68 44437 18380 26016 41 16953136 10178801 6760680 13655 1230 1380 322308 916618 0 1586949 1560798 0 0 0 450571 493832 66510 99434 9872701 5737489 4474416 4135212 0 0 0 0 173441 168901 7075425 7376175 1051860 1100304 958547 635114 203558 511049 2213965 2246467 X 4861460 5129708 4861460 5129708 7075425 7376175 268248 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 26067 26067 5010981 2587415 2423566 4809877 3150074 1659803 25776 25776 4135212 Estimated third party payor settlements 511049 511049 17225594 4210 4210 17221384 17221384 16957346 4210 4210 16953136 16953136 Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990 Special Events Reclassifications $4210 Part XII, Line 2d: Other expenses and losses per audited F/S Special Events Reclassifications $4210 false Fall Into the Wild 21455 21455 4210 21455 21455 4210 4210 -4210 true true X true X true X 100.000000000 true true false false false false 110 479751 479751 0.02830 3137444 3137444 0.18510 6184930 6184930 0.36480 110 9802125 9802125 0.57820 110 9802125 9802125 0.57820 true 2184590 1182300 15505925 8391807 7114118 X true false 1 1 White Mountain Commun Hosp 118 South Mountain Ave Springerville AZ 859385104 www.wmrmc.com H2530 X X X X White Mountain Commun Hosp 1 true X X X X X X X 12 true false true X X false false false true true 100.0000 true 300.0000 true X X X X X X true true X true X true X X X true X false false Part V, Line 3 - Account Input from Person Who Represent the Community Community Survey Part V, Line 6i - Describe Other Needs Identified Needs will be addressed as Hospital finances permit. Part V, Line 7 - Explanation of Needs Not Addressed and Reasons Why Addressing all needs is not possible at this time due to the overall cost, and financial impact on White Mountain Communities Hospital as a Critical Access Hospital. Part V, Line 20d - Other Billing Determination of Individuals Without Insurance 20% Discount 2 White Mtn Reg RehabWellness 118 South Mountain Ave Springerville AZ 85938 Rehab/Wellness Center White Mtn Reg Specialty Clinic 118 South Mountain Ave Springerville AZ 85938 Specialty Clinic Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Based on a sliding scale of family size. Example family of 1 income of $10,890= 100% write-off, Family of 8 with income of $105,364=10 % discount.. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Bad Debt attributable to patient accounts is equal to actual charges written off. Estimated amount of bad debt expense attributable to charity care policy is the cost incurred based on cost to charge ratio. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit Bad Debt attributable to patient accounts is equal to actual charges written off. Estimated amount of bad debt expense attributable to charity care policy is the cost incurred based on cost to charge ratio. Part III, Line 4 - Bad Debt Expense Bad Debt ExpenseThe Hospital does not include a bad debt expense note in their Financial Statements, but the organization does have a Bad Debt Policy.POLICY: It is the policy of White Mountain Regional Medical Center to establish a consistent procedure to identify and process bad debt accounts. Definition: Bad debt is defined as an uncollectible account.Procedure: The process to determine an uncollectible account will include the patient receiving an initial statement, a follow up statement will be sent in 30 days, a follow up telephone call within the next 30 days with verbal notification of 10 day notice to pay (pre collection notice). A final call will then be made 10 days later with verbal notification of the account pending collection before determining if the account is bad debt. If no payment is received by the time all of the above steps have been taken, the account is then sent to a collection agency and written off as bad debt.The Patient Account Supervisor will keep a yearly spreadsheet and documentation on all bad debt accounts. Other Documentation/Equipment: Bad debt log; Medicare bad debt log.Charity CareThere are notes entitled "Charity Care" and "Charity Care and Community Benefit Expense" included in the Financial Statements:Charity Care: The Hospital accepts all patients regardless of their ability to pay. A patient is classified as a charity patient by reference to certain established policies of the Hospital. Essentially, these policies define charity services as those services for which no payment is anticipated. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as net patient service revenues. Services provided are recorded as gross patient service revenues and then written off entirely as an adjustment to net patient service revenues.CHARITY CARE AND COMMUNITY BENEFIT EXPENSEThe Hospital maintains records to identify and monitor the level of charity care and community service it provides. These records include: the amount of charges foregone, (based on established rates), for services and supplies furnished under its charity care and community service policies; the estimated cost of those services and supplies; and statistics quantifying the level of charity care as a percentage of expenses of the Hospital as a whole. The following is a summary of the Hospital's charity care and community benefit charges foregone for the years ended December 31, 2013 and 2012, in terms of services to the poor and benefits to the broader community: Benefits for the poor: Traditional charity care for 2013, and 2012, respectively: $479,751, $248,323. Unpaid Medicaid program charges for 2013, and 2012, respectively: $3,137,444, $3,207,348. Total quantifiable benefits for the poor, for 2013 and 2012, respectively: $3,617,195, $3,455,671. Benefits for the broader community: Unpaid Medicare program charges and total quantifiable benefits for the broader community, for 2013, and 2012, respectively: $6,184,930, $6,157,700. Total quantifiable community benefits combined, for 2013 and 2012, respectively: $ 9,802,125, $ 9,613,371. Part III, Line 8 - Explanation Of Shortfall As Community Benefit Any shortfall is attributable to community benefit. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Policy: It is the policy of White Mountain Regional Medical Center to establish a consistent policy to establish a procedure in determining "Charity Cases." Procedure: Charity Care is defined as an inability to pay. The patients indigence must be determined by the facility, not by the patient. This determination may occur at any time prior to the patients account achieving zero balance; prior to admission, at admission, after discharge or during the billing and collection process.The charity determination is to be made based on the patient/responsible partys net worth, net income and the number of members in the household. White Mountain Regional Medical Center bases their charity care on the Federal Poverty Income Guidelines. The facility must determine that no source other than the patient/responsible party would be legally responsible for the patients medical bill. This includes federal, state or local financial programs and/or legal guardians.The patients business office file will contain documentation of the method by which indigence was determined along with all supporting documentation to substantiate the decision. The final determination will be made by the CFO, with the recommendation of the Patient Account Supervisor. Part VI - Needs Assessment Since the organization is the only Hospital for over 50 miles, it provides services that are not otherwise offered in the community. Part VI - Patient Education of Eligibility for Assistance All hospital patients are advised of available options, if an inability to pay is expressed. Part VI - Community Information The Hospital serves Southern Apache County, Arizona, as well as: Catron County, New Mexico. Both are high poverty level areas. Part VI - Community Building Activities N/A Part VI - Explanation Of How Organization Furthers Its Exempt Purpose N/A Part VI - Affilated Health Care System Roles and Promotion N/A Part VI - States Where Community Benefit Report Filed AZ Part V - Explanation of Number of Facility Type Besides the main Hospital, there is a rehabilitation/wellness center, and a specialty clinic. Part VI - Additional Information N/A X X false false false false false false false false false false Carla Rotering MD Physician 239414 239414 Michael Foote MD Physician 204008 204008 Part III, Additional Information Schedule J, Part 1, Line 3: The organization utilizes Wage Watch for comparison salary data, the CEO salary is approved by the Board and the other officers and staff are approved by the CEO and CFO. Steve Hamblin Fam, Brd Mem 111359 Employed Phys Therap false Tom Hunt Fam, Brd Mem 79151 Employed Phys Therap false Robert Martin Fam, Brd Mem 74734 Employed as IT Mgr false Schedule L, Part V Supplemental Information Please see explanation of family relationships on Schedule O, as a response to Form 990 Part VI, Line 2: Business or Family Relationship of Officers, Directors, etc. Form 990, Part VI, Line 1a: Explanation of Delegated Broad Authority to Committee There is no Board delegation of authority to any committees. Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et The following describes some family relationships: WMRMC employs Board Member Gary Davis' son in law (Tom Hunt) as a physical therapist and his wife (Kathleen Davis) as a PT Transcriptionist; WMRMC employs Board Member Scott Hamblin as a physician, and his brother Steve Hamblin as a physical therapist (Scott Hamblin is not currently a Board Member in 2014, so relationship will cease to be an issue in future); WMRMC employs Board Member Mary Nedrow's son-in-law (Robert Martin)as an IT Manager. The family relationships of Gary Davis; Scott Hamblin; and Mary Nedrow were deemed business relationships (thus reportable as business transactions on Schedule L), due to the value of the transactions exceeding the $10,000 threshold. The requirement to report these family transactions on Schedule L, results in the loss of independence of these board members in voting: per Form 990 instructions. Form 990, Part VI, Line 11b: Form 990 Review Process The Form 990 is reviewed by all voting Board Members at a Board Meeting prior to filing. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts Done on an annual basis, and the individual signs acknowledgement of policy. Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management The organization utilizes Wage Watch for comparison salary data, the CEO salary is approved by the Board and the other officers and staff are approved by the CEO and CFO. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The organization utilizes Wage Watch for comparison salary data, the CEO salary is approved by the Board and the other officers and staff are approved by the CEO and CFO. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Available upon request