2014-05-15T11:07:59-05:00 2013-06-30 910189318 MOSS ADAMS LLP 3121 WEST MARCH LANE SUITE 100 STOCKTON CA 952192303 990 2012-07-01 860427850 CASA GRANDE COMMUNITY HOSPITAL CASA 5203816300 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 KAREN FRANCIS 5203816300 2014-05-13 1 TRACY S PAGLIA P00366884 2099556100 2012 2015-11-30 17:44:51Z CASA GRANDE REGIONAL MED CTR RONA CURPHY 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 141928958 0 X WWW.CASAGRANDEHOSPITAL.COM X 1982 AZ HEALTH CARE AND HEALTH CARE MANAGEMENT SERVICES THROUGH ACUTE CARE AND SPECIALTY CARE PROGRAMS. 9 6 990 370 0 0 445040 516467 132877547 140446405 256486 206380 405022 758877 133984095 141928129 6153 6430 0 0 57223652 59824236 0 0 91857 75392726 93158746 132622531 152989412 1361564 -11061283 93540561 79849467 88640236 87178263 4900325 -7328796 X CASA GRANDE REGIONAL MEDICAL CENTER PROVIDES ACUTE INPATIENT AND OUTPATIENT HEALTHCARE SERVICES INCLUDING URGENT CARE AND EMERGENCY SERVICES FOR PATIENTS. IT ALSO PROMOTES HEALTH AWARENESS TO THE CASA GRANDE COMMUNITY THROUGH EVENTS, PROGRAMS, AND SERVICES SUCH AS NUTRITIONAL EDUCATION, PHYSICIANS LUNCH AND LEARN TALKS, LAB DRAWS, SAFETY AND HEALTH FAIRS, AND A CARDIAC INTERVENTIONAL PROGRAM. 0 0 148328612 6430 140446405 CASA GRANDE REGIONAL MEDICAL CENTER PROVIDES ACUTE INPATIENT AND OUTPATIENT HEALTHCARE SERVICES AND EMERGENCY ROOM MEDICAL CARE SERVICES FOR PATIENTS. IT ALSO PROMOTES HEALTH AWARENESS TO THE CASA GRANDE COMMUNITY THROUGH EVENTS AND PROGRAMS SUCH AS DIABETES EDUCATION, LAB DRAWS, SAFETY AND HEALTH FAIRS, AND A CARDIAC INTERVENTIONAL PROGRAM. 148328612 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 0 1 52 0 1 990 1 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 0 1 1 1 0 AZ X LESA ABBEY 5203816913 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 CHERIE MCGLYNN 2.00 2.10 X X 0 0 0 THOMAS ERICKSON MD 1.00 0.50 X X 0 0 0 DAVID FITZGIBBONS 2.00 2.10 X X 0 0 0 HENRY GIVRE MD 2.00 1.60 X 38500 0 0 CHARIE WALLACE 1.00 X 0 0 0 JR MCEVOY 2.00 2.10 X X 0 0 0 CHUCK GOODMILLER 1.00 0.50 X 0 0 0 RAJEESH PUNNAKKATTU MD 1.00 X 96129 0 0 EVELYN CASUGA 2.00 1.50 X 0 0 0 RONA CURPHY 56.00 4.00 X 0 390106 8151 KAREN FRANCIS 51.00 4.00 X 0 289182 16661 CHERYSE AUSTIN 36.00 4.00 X 0 164277 10068 WILLIAM STUBBS MD 40.00 X 265546 0 5922 PAUL MADEJSKI MD 40.00 X 270005 0 11016 AMANPREET SINGH MD 40.00 X 272644 0 5922 SUNIL KURUP MD 40.00 X 146402 0 3416 AMELITA HITSMAN 40.00 X 159316 0 11016 1248542 843565 72172 70 0 1 0 CERNER CORPORATION PO BOX 730112 KANSAS CITY MO 64141 CLINICAL SYSTEMS 7558478 O GRADY PEYTON INTL 4441 COLLECTIONS CENTER DR CHICAGO IL 60693 NURSING REGISTRY 2190345 HEART HEALTH ORGANIZATION 333 N DOBSON RD STE 11 CHANDLER AZ 85224 CARDIOLOGY SERVICES 1443960 SONORAN DESERT ANESTHESIA INC PO BOX 93173 PHOENIX AZ 95070 ANESTHESIA SERVICES 1085448 ANGELICA CORPORATION PO BOX 846777 LOS ANGELES CA 90084 LINEN SERVICES 530160 24 200000 176784 139683 516467 NET PATIENT SERVICES 621990 138577603 138577603 RENTAL INCOME 531120 1038343 1038343 EHR REIMBURSEMENT 621500 601114 601114 LAB TESTS 621500 126541 126541 102804 102804 140446405 194274 194274 12935 829 12106 12106 12106 CAFETERIA 722210 358435 358435 CATERING & VENDING 722320 23247 23247 PARKING 812930 17036 17036 360159 360159 758877 141928129 140446405 0 965257 6430 6430 133500 133500 50094402 48260983 1763288 70131 6327093 6095521 222714 8858 3269241 3149587 115077 4577 448713 448713 142115 142115 118812 118812 12856011 12005774 850237 648975 625222 22844 909 4058576 3910032 142862 5682 1522480 1317491 204989 3432 1932 1000 500 138489 134889 2400 1200 5238185 5238185 5674986 5674986 1127867 1127867 BAD DEBT 42094261 42094261 PATIENT USE CHARGEABLES 5704376 5704376 PHARMACEUTICALS 3452408 3452408 MEDICAL SUPPLIES 3415414 3415414 6513646 5979754 533892 152989412 148328612 4568943 91857 17814750 9573379 15305388 13787180 2782681 2713616 1090403 851753 111084294 75629882 39668842 35454412 9345747 9369457 85471 18979 7447279 8080691 93540561 79849467 9096882 11387093 4727763 4618510 66536616 65011177 5901133 4539356 2377842 1622127 88640236 87178263 X 4900325 -7328796 4900325 -7328796 93540561 79849467 X -11061283 2705 -1170543 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3363312 3363312 55125829 30417994 24707835 46017399 40557094 5460305 6577754 4654794 1922960 35454412 DEFERRED COSTS, NET OF AMORTIZATION 1100649 THIRD PARTY SETTLEMENT RECEIVABLE 738948 DUE FROM AFFILIATES 6241094 8080691 ESTIMATED SELF-INSURANCE COSTS 1539570 DEPOSITS 2603 DERIVATIVE INSTRUMENTS 79954 1622127 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE COMPANY HAS ADOPTED THE PROVISIONS OF ASC 740 RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS THAT REQUIRE THE APPLICATION OF MORE-LIKELY-THAN-NOT RECOGNITION CRITERION. THE COMPANY RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE-LIKELY-THAN-NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE COMPANY RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. AS OF JUNE 30, 2013 AND 2012, RCSC HAS NO TAX POSITIONS IT BELIEVES TO BE UNCERTAIN. 1 1 1 X 1 X 1 1 1 0 1 1 910620 910620 0.00820 23018636 17187753 5830883 0.05260 23929256 17187753 6741503 0.06080 23929256 17187753 6741503 0.06080 1 42094261 3655437 28798244 29238021 -439777 X 1 1 1 1 CASA GRANDE REGIONAL MEDICAL CENTER

1800 E FLORENCE BLVD CASA GRANDE AZ 85122

X X X CASA GRANDE REGIONAL MEDICAL CENTER 1 1 X X X X X X X X X 12 1 0 1 X X X X 0 0 1 1 100.000000000000 1 200.000000000000 1 X X 1 1 X 1 0 1 X 0 0 PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 42094261. PART III, LINE 4: AUDITED FINANCIAL STATEMENTS, NOTE 3 - THE COMPANY REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS DUE FROM THIRD-PARTY PAYORS, PATIENTS, AND OTHERS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE COMPANY ANALYZES ITS HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS, AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS, AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. AS A SERVICE TO THE PATIENT, THE COMPANY BILLS THIRD-PARTY PAYORS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE COMPANY ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE COMPANY RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PATIENT ACCOUNTS RECEIVABLE BALANCES PAST DUE MORE THAN 150 DAYS ARE CONSIDERED DELINQUENT. DELINQUENT RECEIVABLES ARE CHARGED OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT OR THIRD-PARTY PAYOR. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE COMPANY'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS INCREASED FROM 86% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2012, TO 87% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2013. IN ADDITION, THE COMPANY'S SELF-PAY NET CHARGE OFFS INCREASED $25,215,000 FROM APPROXIMATELY $19,165,000 FOR FISCAL YEAR 2012, TO APPROXIMATELY $44,380,000 FOR FISCAL YEAR 2013. BOTH INCREASES WERE THE RESULT OF NEGATIVE TRENDS EXPERIENCED IN THE COLLECTION OF AMOUNTS FROM SELF-PAY PATIENTS IN FISCAL YEAR 2013 AND AS A RESULT OF THE ARIZONA MEDICAID (AHCCCS) PROGRAM CHANGES. THE COMPANY HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2012 OR 2013. THE COMPANY DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT CHARGE OFFS FROM THIRD-PARTY PAYORS.THERE IS NO COSTING METHODOLOGY IN DETERMINING BAD DEBTS. THE ACTUALWRITE OFF METHOD IS USED. THE AMOUNT REPORTED OF $3,655,437 IS THE ACTUAL CHARITY WRITE OFFS ACCORDING TO THE POLICY. PART III, LINE 8: THE COMPANY HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE COMPANY AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. THESE PAYMENT ARRANGEMENTS INCLUDE:MEDICARE - INPATIENT ACUTE CARE SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES PER DISCHARGE. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC AND OTHER FACTORS. OUTPATIENT SERVICES RELATED TO MEDICARE BENEFICIARIES ARE PAID BASED ON AMBULATORY PATIENT CLASSIFICATION (APC) RATES, WHICH VARY WITH THE CLINICAL INDICATORS FOR EACH PATIENT. THE HOSPITAL IS REIMBURSED FOR CERTAIN SERVICES AT TENTATIVE RATES WITH FINAL SETTLEMENT DETERMINED AFTER SUBMISSION OF ANNUAL COST REPORTS BY THE COMPANY AND AUDITS THEREOF BY THE MEDICARE ADMINISTRATIVE CONTRACTOR. THE HOSPITAL'S MEDICARE COST REPORTS HAVE BEEN AUDITED BY THE MEDICARE FISCAL INTERMEDIARY THROUGH 2010. THE HOSPITAL'S CLASSIFICATION OF PATIENTS UNDER THE MEDICARE PROGRAM AND THE APPROPRIATENESS OF THEIR ADMISSION ARE SUBJECT TO AN INDEPENDENT REVIEW BY A PEER REVIEW ORGANIZATION.ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM (AHCCCS) - HEALTH CARE SERVICES TO MEDICAID AND INDIGENT PATIENTS ARE PROVIDED AT RATES PUBLISHED BY THE STATE OF ARIZONA UNDER THE STATE'S AHCCCS PROGRAM. APPROXIMATELY 21% OF THE HOSPITAL'S NET PATIENT SERVICE REVENUE IS PAID BY THE AHCCCS PROGRAM. THE COMPANY HAS ALSO ENTERED INTO PAYMENT AGREEMENTS WITH CERTAIN COMMERCIAL INSURANCE CARRIERS, HEALTH MAINTENANCE ORGANIZATIONS AND PREFERRED PROVIDER ORGANIZATIONS. THE BASIS FOR PAYMENT TO THE COMPANY UNDER THESE AGREEMENTS INCLUDES PROSPECTIVELY DETERMINED RATES PER DISCHARGE, DISCOUNTS FROM ESTABLISHED CHARGES AND PROSPECTIVELY DETERMINED DAILY RATES.THE COMPANY RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE COMPANY RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE COMPANY'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE COMPANY RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. PART III, LINE 9B: THE COMPANY PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES TO PATIENTS MEETING CERTAIN CRITERIA UNDER THEIR CHARITY CARE POLICY. BECAUSE THE COMPANY DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THE AMOUNT OF CHARITY CARE PROVIDED FLUCTUATES DEPENDING ON CHANGES IN PATIENT DEMOGRAPHICS AND ECONOMIC CONDITIONS. CHARGES, AT COST, EXCLUDED FROM REVENUE UNDER THE COMPANY'S CHARITY CARE POLICY FOR THE YEARS ENDED JUNE 30, 2013 AND 2012 WERE APPROXIMATELY $3,663,000 AND 3,083,000, RESPECTIVELY. CASA GRANDE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 3: SEE PART V, SECTION B, LINE 7 EXPLANATION. CASA GRANDE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 7: FROM THE TOP 3 NEEDS THAT WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS THAT WAS COMPLETED IN MARCH 2013. THE TOP PRIORITY WAS OBESITY WHICH HAS HAD SIGNIFICANT WORK ON ADDRESSING THIS NEED. WE ARE ADDRESSING THIS THROUGH A COMMUNITY COMMITTEE THAT IS MADE UP OF COMMUNITY BUSINESS LEADERS, SUN LIFE FAMILY HEALTH CENTER AND CASA GRANDE REGIONAL MEDICAL CENTER WHO CHAIRS THIS EFFORT. WE HAVE APPLIED FOR A GRANT TO ASSIST US IN THIS WORK. WE IDENTIFIED 3 NEEDS AND OUR MAJOR FOCUS HAS BEEN ON OBESITY PREVENTION. THE OTHER TWO ARE: CHRONIC DISEASE AND SUBSTANCE ABUSE AND MENTAL HEALTH NEEDS. PART VI, LINE 2: THE ORGANIZATION CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT ON MARCH 1, 2013. SEE SCHEDULE H, PART V, SECTION B FOR MORE INFORMATION. PART VI, LINE 3: PATIENT COMPLETION OF A CONFIDENTIAL FINANCIAL DISCLOSURE FORM IS REQUIRED BEFORE CGRMC CAN MAKE AN ELIGIBILITY DETERMINATION. CGRMC STAFF WILL PROVIDE ASSISTANCE TO THOSE INDIVIDUALS WHO NEED HELP TO COMPLETE THE FORM, WHICH CAN BE OBTAINED IN THE ADMISSIONS OFFICE OR PATIENT BILLING. PATIENTS ARE ENCOURAGED TO COMPLETE THE APPLICATION PRIOR TO TREATMENT WHENEVER POSSIBLE. PATIENTS WORKING WITH OUR ELIGIBILITY VENDOR TO DETERMINE ELIGIBILITY FOR AHCCCS, SECTION 1011, CRIME VICTIM ASSISTANCE OR OTHER RESOURCES MAY ALSO APPLY FOR FINANCIAL ASSISTANCE, HOWEVER, HOSPITAL FINANCIAL ASSISTANCE IS CONSIDERED LAST, ONCE ALL OTHER RESOURCES HAVE BEEN EXHAUSTED. PART VI, LINE 4: CASA GRANDE IS A DYNAMIC, INVOLVED COMMUNITY, A MODERN CITY WITH RURAL HERITAGE AND OLD-FASHIONED VALUES. ITS ECONOMIC BASE IS A MIX OF RETAIL TRADE, MANUFACTURING AND AGRICULTURE. FOUNDED IN 1879, CASA GRANDE WAS NAMED FOR THE FAMOUS HOHOKAM INDIAN RUINS 20 MILES TO THE NORTHEAST. MIDWAY BETWEEN PHOENIX AND TUCSON, THE CITY HAS GROWN TO BE THE LARGEST COMMUNITY IN WESTERN PINAL COUNTY SINCE ITS INCORPORATION IN 1915. ONCE DEPENDENT ON AGRICULTURE AND MINING, THE COMMUNITY HAS EVOLVED INTO A DIVERSIFIED FULL-SERVICE AREA WITH MANUFACTURING, RETAIL TRADE, GOVERNMENT AND TOURIST-RELATED EMPLOYMENT. ALL OF PINAL COUNTY IS A DESIGNATED ENTERPRISE ZONE. PART VI, LINE 5: IN ADDITION TO PROVIDING PATIENT CARE WITHIN ITS 177 PRIVATE ROOMS, THERE IS AN IMPRESSIVE LINEUP OF ADDITIONAL SERVICES AVAILABLE AT CGRMC. THESE SERVICES PROVIDE THE COMMUNITY WITH MORE CONVENIENT ACCESS TO THE LATEST PROCEDURES AND EQUIPMENT AVAILABLE IN INTERVENTIONAL CARDIOLOGY, MEDICAL IMAGING, AND OUTPATIENT SURGERY. A WOUND CARE CENTER FEATURES TWO HYPERBARIC OXYGEN CHAMBERS. THERE IS ALSO A SLEEP LAB, OUTPATIENT PHYSICAL THERAPY, FULL SERVICE LABORATORY AND AN URGENT CARE CENTER.CGRMC IS PROUD TO SERVE AS A BASE STATION, PROVIDING MEDICAL DIRECTION TO MORE THAN 12 EMERGENCY MEDICAL SERVICE PROVIDERS IN PINAL COUNTY. AN AIREVAC HELICOPTER IS BASED AT THE CGRMC CAMPUS.THERE ARE MORE THAN 170 PHYSICIANS WHO ARE MEMBERS OF THE CGRMC MEDICAL STAFF. A FEW OF THE MEDICAL SPECIALTIES OFFERED INCLUDE: CARDIOLOGY, GASTROENTEROLOGY, GYNECOLOGY, NEUROLOGY, ONCOLOGY, PEDIATRICS, AND UROLOGY.CGRMC IS FORTUNATE TO HAVE DESERT REFLECTIONS IMAGING CENTER (DRIC) LOCATED ON CAMPUS. DRIC PROVIDES THE MOST UP-TO-DATE EQUIPMENT WITH PET CT, BREAST STEREOTACTIC SYSTEM, BONE DENSITOMETRY, HIGH-DEFINITION MRI, MULTI-SLICE CT SCANS, DIGITAL RADIOLOGY, DIGITAL MAMMOGRAPHY INCLUDING HIGH-DEFINITION BREAST MRI AND ULTRASOUND. BY UTILIZING THEIR STATE-OF-THE-ART VOICE RECOGNITION SYSTEM, TEST RESULTS CAN BE MADE AVAILABLE WITHIN ONE HOUR.CGRMC OPERATES AN URGENT CARE CENTER IN AN EFFORT TO BETTER MEET THE DEMANDS OF THE COMMUNITY FOR AFTER-HOURS, NON-EMERGENT MEDICAL CARE. THE URGENT CARE IS STAFFED WITH BOTH A PHYSICIAN AND PHYSICIAN ASSISTANT SEVEN DAYS A WEEK. PART VI, LINE 6: N/APART VI, LINE 7: N/A 0 0 0 0 0 0 0 0 0 0 RONA CURPHY 0 390106 0 0 0 0 0 0 0 8151 0 398257 0 0 KAREN FRANCIS 0 289182 0 0 0 0 0 0 0 16661 0 305843 0 0 CHERYSE AUSTIN 0 164277 0 0 0 0 0 0 0 10068 0 174345 0 0 WILLIAM STUBBS MD 265546 0 0 0 0 0 0 0 5922 0 271468 0 0 0 PAUL MADEJSKI MD 270005 0 0 0 0 0 0 0 11016 0 281021 0 0 0 AMANPREET SINGH MD 272644 0 0 0 0 0 0 0 5922 0 278566 0 0 0 AMELITA HITSMAN 159316 0 0 0 0 0 0 0 11016 0 170332 0 0 0 SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THE METHODS LISTED TO ESTABLISH TOP MANAGEMENT OFFICIAL'S COMPENSATION. JR MCEVOY OFFICER OF THE ORG. 1285866 INSURANCE 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER IS REGIONAL CARE SERVICES CORPORATION, AN ARIZONA NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE RIGHT TO APPOINT OR REMOVE TRUSTEES TO OR FROM THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION CANNOT AMEND OR MODIFY THE ARTICLES OF INCORPORATION WITHOUT THE CONSENT OF THE MEMBER. ADDITIONAL POWERS, AUTHORITY AND PREROGATIVES MAY BE GRANTED AND RESERVED TO THE MEMBER AS SET FORTH IN THE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THE CEO, CFO, AND THE DIRECTOR OF FINANCE REVIEWED THE FORM 990 PRIOR TO FILING. THE CEO AND CFO WILL PROVIDE AN OVERVIEW AFTER FILING TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A POLICY FOR EMPLOYEES TO DISCLOSE ANY CONFLICTS OF INTEREST BY REPORTING TO HR OR THE CEO. THIS WILL PRECLUDE THE STAFF MEMBER FROM PARTICIPATING IN ANY ACTIVITY WHICH CONFLICT. AT THE BOARD LEVEL EACH BOARD MEMBER AND SR. STAFF SIGN AN ANNUAL CONFLICT OF INTEREST STATEMENT THAT REQUIRES THEM TO DISCLOSE AND CONFLICT. WHEN THIS HAS OCCURRED WE GENERALLY EXCUSE THEM FROM ANY DELIBERATIONS OR DECISION MAKING ON THAT ISSUE. IF SOMETHING WOULD BE DISCOVERED AFTER THE FACT THAT WOULD GO BEFORE THE BOARD CHAIRPERSON TO ASSESS THE CONFLICT AND IF ANYTHING NEEDS TO BE DONE AT THAT POINT. THERE WERE NO IDENTIFIED CONFLICTS AFTER THE FACT DISCOVERED IN 2012. FORM 990, PART VI, SECTION B, LINE 15 THIS FILING ORGANIZATION DOES NOT SET OR PAY COMPENSATION TO THE CEO. OTHER OFFICERS, BEING CFO AND CNO, AND OTHER TOP OFFICIALS OF THE ORGANIZATION THE COMPENSATION IS SET BY THE CEO IN CONSULTATION WITH THE BOARD CHAIRPERSON WHICH INCLUDED BASE SALARY AND ANY BONUS THAT WAS GIVEN. THE REVIEW OF COMPENSATION WAS DONE UTILIZING OTHER ORGANIZATIONS 990, OTHER SURVEYS AND AN INDEPENDENT CONSULTATION IN 2009 AND 2012. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST, ARE UPLOADED TO EMMA SITE ON THE INTERNET, AND ARE FILED WITH THE STATE OF ARIZONA AS REQUIRED BY STATE STATUTE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -970,543. CONTRIBUTION FROM RHV NOT RECORDED ON BOOKS -200,000. REGIONAL CARE PHYSICIANS GROUP INC 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 263096262 HEALTHCARE AZ 501(C)(3) 9 REGIONAL CARE SERVICES CORPORATION 1 CASA GRANDE REGIONAL RETIREMENT COMMUNITY 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 742558095 HEALTHCARE AZ 501(C)(3) 11A, I REGIONAL CARE SERVICES CORPORATION 1 REGIONAL CARE SERVICES CORPORATION 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 860919714 HEALTHCARE AZ 501(C)(3) 11A, I N/A 0 CASA GRANDE COMMUNITY HOSPITAL FOUNDATION INC 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 311726569 HEALTHCARE AZ 501(C)(3) 7 REGIONAL CARE SERVICES CORPORATION 1 REGIONAL HEALTHCARE VENTURES 1800 E FLORENCE BLVD CASA GRANDE AZ 85122 262199660 HEALTHCARE AZ N/A C 0 0 0 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 REGIONAL HEALTHCARE VENTURES C 200000 CASH VALUE REGIONAL CARE PHYSICIANS GROUP INC N 109449 CASH VALUE REGIONAL CARE PHYSICIANS GROUP INC O 1583241 CASH VALUE REGIONAL CARE PHYSICIANS GROUP INC Q 116690 CASH VALUE REGIONAL CARE PHYSICIANS GROUP INC D 5835780 LOAN BALANCE