2013-11-12T06:33:10-08:00 2013-03-31 TCA Partners LLP 1111 East Herndon Avenue Suite 211 Fresno CA 93720 990 2012-04-01 311750849 Colusa Regional Medical Center COLU 5304585821 199 East Webster Street Colusa CA 95932 Tish Miller 2013-11-12 true Inger Sullenger CPA P01464277 5595938767 X 2012 2016-02-25 16:41:14Z Dale Kirby 199 East Webster Street Colusa CA 959322954 22791366 false false X www.colusamedicalcenter.org X 2001 CA Not-for-profit General Acute Care Hospital, with outlying primary care Rural Health Clinics 9 8 220 30 0 133830 104852 21107944 21343119 27672 42755 1033015 1300640 22302461 22791366 0 0 11458591 11682902 0 0 10405504 8412751 21864095 20095653 438366 2695713 11086891 13647776 6147169 6012341 4939722 7635435 Not-for-profit General Acute Care Hospital, with outlying primary care Rural Health Clinics false false 16034475 22369596 The Hospital provides inpatient, outpatient, and emergency care services to patients in the surrounding community regardless of age, sex, religion, or ability to pay.The Hospital had 968 inpatient visits including skilled nursing, and 45,230 outpatient visits. 16034475 true true false false false false false false false false true false false false false false true false false false false false false false false false true true false false true false false false false false false false false true false false false false false false false false false false false false true 39 0 true 220 true false false false false false false false false 0 false false false false false false false false false false X 9 8 true false false false false false false true true false false true true true false true true true true false X Tish Miller CFO 5304585821 199 East Webster Street Colusa CA 959322954 D'Ann Bressler 2.00 0.00 X 0 0 0 Michael Goodman MD 2.00 0.00 X 0 0 0 Marilyn Davison 2.00 0.00 X 0 0 0 Jan Gomes 2.00 0.00 X 0 0 0 Gary Teragawa 2.00 0.00 X 0 0 0 Nancy Newlin 2.00 0.00 X 0 0 0 Bob Kessinger 2.00 0.00 X 0 0 0 Ray Krause 2.00 0.00 X 0 0 0 Brady Myers 2.00 0.00 X 0 0 0 Terrence Deak 50.00 0.00 X 165043 0 24676 Katherine Hughes 50.00 0.00 X 150485 0 12028 Dale Kirby 50.00 0.00 X 228604 0 19212 Deborah Santivanez 40.00 0.00 X 150298 0 8505 Paul O'Rourke-Babb 40.00 0.00 X 139736 0 14633 Christine Gregory 40.00 0.00 X 129429 0 14735 Shirley Barnett 40.00 0.00 X 126624 0 11392 Addie McFadden 40.00 0.00 X 125888 0 7506 1216107 112687 18 false true false Herbert Gladen MD 428 Sioc Street Colusa CA 95932 General Surgeon 356000 Sodexho Dept 43283 Los Angeles CA 90088 Dietary Svcs 395381 NPH Medical Services 2639 Forest Ave Ste 110 Chico CA 95928 Registry Services 208234 Burger Rehabilitation Services 1301 E Bidwell St Folsom CA 95630 Therapy Svcs 605810 Anesthesia IAG Services 1333 Cabana Way Victorville CA 92392 CRNA Anesthesia Svcs 418051 11 45486 59366 104852 Net Patient Service Rev 21343119 21343119 21343119 42755 42755 0 0 144265 144265 144265 144265 0 0 0 0 Miscelleanous Operating 17277 17277 EMR Incentive Payment 1009200 1009200 Dietary,Pharm,Educ, Etc 129898 129898 1156375 22791366 22369596 316918 X 0 0 0 0 544132 434167 109965 0 8521244 6799166 1722078 118660 94680 23980 1762900 1406631 356269 735966 587233 148733 0 39577 31579 7998 49908 39822 10086 0 0 0 2289007 1826416 462591 35182 28072 7110 82065 65480 16585 0 0 677088 540254 136834 10051 8020 2031 0 14105 11254 2851 212512 169565 42947 0 632186 504426 127760 145295 115932 29363 Miscellaneous 165424 131993 33431 Equipment Rent & Maintenance 285409 227730 57679 Supplies 1648626 1315451 333175 Professional Fees 1956477 1561088 395389 169839 135516 34323 20095653 16034475 4061178 0 1346787 3187940 2135023 2402444 0 2374673 2182246 0 0 0 357019 354052 75219 85483 9940067 4658544 4798170 5281523 0 0 0 0 154088 11086891 13647776 1846598 1503426 4300571 4508915 6147169 6012341 X 4939722 7635435 4939722 7635435 11086891 13647776 2695713 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5177745 1211115 3966630 4762322 3447429 1314893 5281523 22791366 22791366 22791366 20095653 20095653 20095653 true true X true X 125.000000000 true X true true false false false false 2115215 2115215 0.10530 2115215 2115215 0.10530 2115215 2115215 0.10530 7500 7500 0.00040 4250 4250 0.00020 6400 6400 0.00030 18150 18150 0.00090 true 2089274 267525 7001210 7629528 -628318 X true true 1 1 Colusa Regional Medical Center

199 East Webster Street Colusa CA 959322954

X X X Colusa Regional Medical Center 1 true X X X X X X X X X 12 true true true X X X X X X X X false false false true true 125.0000 true 200.0000 true X X X X X X true true X X X X true X X X true X X X X X true X false false 5 Colusa Specialty Clinic

2967 Davison Ct Ste A Colusa CA 95932

Outpatient Specialty & Indust Med Clinic Williams Urgent Care & Med Ctr

501 E St Ste B Williams CA 95987

Rural Health Clinic Stonyford Rural Health Clinic

5080 Stonyford-Lodoga Rd Stonyford CA 95979

Rural Health Clinic Colusa Health Clinic

151 E Webster St Colusa CA 95932

Rural Health Clinic Arbuckle Medical Office

900 King St Arbuckle CA 95912

Rural Health Clinic Part VI - Additional Information N/A Part V - Explanation of Number of Facility Type Besides the main hospital consisting of 42 beds, we also operate a 6 bed skilled nursing facility on our main campus; as well as 4 licensed rural health clinics; and a specialty and industrial medicine clinic, in surrounding communities throughout Colusa County. Part VI - Affilated Health Care System Roles and Promotion N/A Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Our community board and management is committed to using surplus funds to improve access to care and improve or expand services offered throughout Colusa County. Our Community Board is open to all members of the public who wish to join. Part VI - Community Building Activities Community building activities are generally provided to educate the community on health related issues, illness prevention, and free/discounted services to assess health and patient needs. Part VI - Community Information Colusa Regional Medical Center serves the healthcare needs of the residents of Colusa County. We are largely a farming community, with about 30% of the population being Hispanic. A focus of the services we offer is to provide the medical services for this underserved population in our County. Part VI - Patient Education of Eligibility for Assistance Patients are educated and informed about their eligibility for assistance through the prominent posting in each registration area, printing on the bill that is sent to patients, and other posted notices about the counseling available at the Hospital. Part VI - Needs Assessment Mailed 800 stratified randomly sampled surveys, with 134 surveys returned for an 18% response rate. Conducted 4 focus groups: business/community leaders; health care providers; seniors; and, young parents. Also administered secondary data analysis and compared Colusa County to Glenn County and Lake County, California and the Nation on population rates, education and workforce rates, income rates, behavioral rist factors of adults and Hospital Compare.Other input is received on an ongoing basis through patient and physician surveys, and input from community leaders, our community Board members, and members of the community. Number of Hospital Faciltiy - 1 Part V, Line 7 - Explanation of Needs Not Addressed and Reasons Why Many of the needs have been and/or are being addressed in our strategic plan, goals and objectives for the current year. The needs were prioritized, and those with a high priority rose to the top to be addressed. Some needs are not currently being addressed due to: determined not to be a priority; lack of urgency; lack of hospital resources to sufficiently address; or financially unfeasible at this time. Number of Hospital Faciltiy - 1 Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment N/A Number of Hospital Faciltiy - 1 Part V, Line 3 - Account Input from Person Who Represent the Community Mailed 800 stratified randomly sampled surveys, with 134 surveys returned for an 18% response rate. Conducted 4 focus groups: business/community leaders; health care providers; seniors; and, young parents. Also administered secondary data analysis and compared Colusa County to Glenn County and Lake County, California and the Nation on population rates, education and workforce rates, income rates, behavioral rist factors of adults and Hospital Compare. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Policies state that collection efforts are to cease when a patient has qualified, or is in process of being qualified, for charity care. Part III, Line 8 - Explanation Of Shortfall As Community Benefit Entire shortfall is attributable to community benefit, as the payments received from Medicare fell short of covering the actual cost of providing care. X X X false false false false false false false false false false Terrence Deak 150907 14136 4433 20243 189719 Paul O'Rourke-Babb 139736 14633 154369 Katherine Hughes 147485 3000 4229 7799 162513 Deborah Santivanez 150298 650 7855 158803 Dale Kirby 198313 30291 5679 13533 247816 Sch J, Part III, Additional Information Part III, Additional Information Bonus compensation was paid in accordance with employment agreements, based on benchmarks reached. Compensation surveys are reviewed to ensure that overall compensation levels are comparable with salaries paid in the healthcare industry. Brady Myers Brd Mbr/Ins Broker 104377 Brokered Ins to Hospital false Brady Myers is a Board member of the Hospital, whom also brokers insurance to the Hospital. Although, he is paid nothing from the Hospital, he does receive a commission on the brokering of Hospital insurance via Insurance companies. The commission received from insurance companies related to the brokerage of insurance to the Hospital for 2012/2013 fiscal, was: $104,377. Therefore, Brady Myers was considered a non-independent voting member of the Board and listed as such on Form 990, part I. Form 990, Part IX, Column (D), Fundraising Exps The Hospital has both a Foundation and Auxiliary that generate some contribution revenue. They in turn donate their monies to Colusa Regional Medical Center (CRMC). Both the Foundation and Auxiliary are totally separate 501c3 entities from CRMC, and the Hospital does not pay any salaries or expenses for them. The Hospital has no staff or expenses currently, who are dedicated to supporting fundraising efforts or functions. Thus, there are no expenses that have been classified as "fundraising." Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Documents are all housed in Hospital Administration, and available upon request to the public. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The CEO reviews compensation surveys before adjusting salaries of officers of the organization. Form 990, Part VI, Line 15a Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management Comparative Hospital compensation data is provided to the Board prior to determining adjustments to the CEO salary. Form 990, Part VI, Line 11b Form 990, Part VI, Line 11b: Form 990 Review Process The 990 is reviewed and approved by management before filing, and a copy is available for the Board to review. Form 990, Part VI, Line 2 Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Brady Myers is a Board member of the Hospital, whom also brokers insurance to the Hospital. Although, he is paid nothing from the Hospital, he does receive a commission on the brokering of Hospital insurance via Insurance companies. Therefore, he was considered a non-independent voting member of the Board and listed as such on Form 990, part I.