COBRE VALLEY REGIONAL MEDICAL CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- COBRE VALLEY REGIONAL MEDICAL CENTER (EIN 86-0732836)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-09
- IRS object ID
- 201213149349302396
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-09T18:27:16-08:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TCA Partners LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 East Herndon Avenue Suite 211 | AddressLine1 |
| City | Fresno | City |
| State | CA | State |
| ZIP Code | 93720 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860732836 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cobre Valley Regional Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COBR | NameControl |
| Phone | 9284253261 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5880 S Hospital Drive | AddressLine1 |
| City | Globe | City |
| State | AZ | State |
| ZIP Code | 85501 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Neal Jensen | Name |
| Title | CEO | Title |
| Date Signed | 2012-11-09 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Inger Sullenger CPA | Name |
| Phone | 5594317708 | Phone |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Neal Jensen | NameOfPrincipalOfficerPerson |
| Gross Receipts | 39761268 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | cvrmc.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1993 | YearFormation |
| State Legal Domicile | AZ | StateLegalDomicile |
| Activity Or Mission Description | The organization will provide medical services which will be competitive with those charged for similar services by comparable facilities. The organization will also allow a portion of its services and facilities to be used for charity patients. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 338 | TotalNbrEmployees |
| Total Nbr Volunteers | 40 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 115523 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 18949 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 35011060 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 39131569 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 321760 | InvestmentIncomePriorYear |
| Investment Income Current Year | 270397 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 218134 | OtherRevenuePriorYear |
| Other Revenue Current Year | 340353 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 35666477 | TotalRevenuePriorYear |
| Total Revenue Current Year | 39761268 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 15636820 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 19402028 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 17844563 | OtherExpensePriorYear |
| Other Expenses Current Year | 16715774 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 33481383 | TotalExpensesPriorYear |
| Total Expenses Current Year | 36117802 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2185094 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3643466 | RevenuesLessExpensesCY |
| Total Assets BOY | 38158425 | TotalAssetsBOY |
| Total Assets EOY | 42109294 | TotalAssetsEOY |
| Total Liabilities BOY | 14134613 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 14752678 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 24023812 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 27356616 | NetAssetsOrFundBalancesEOY |
| Mission Description | The organization will provide medical services which will be competitive with those charged for similar services by comparable facilities. The organization will also allow a portion of its services and facilities to be used for charity patients. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 30615480 | Expense |
| Revenue | 39370741 | Revenue |
| Description | The Organization will provide medical services which will be competitive with those charges for similar services by comparable facilities. The organization will also allow a portion of its services and facilities to be used for charity patients. Along with providing acute health care services to the community as not for profit entity, Cobre Valley Regional Medical Center (CVRMC) hosts many educational programs available to the residents in the service area. The hospital and staff host and sponsor an annual health fair working with other area agencies to distribute and disseminate health, wellness, and information. The hospital also sponsors diabetic workshops, birthing and new baby care classes. The Emergency Department (ED) at CVRMC is the base station for the three Fire/EMS Departments in the service area. The hospital sponsors monthly training to firefighters and paramedics as well as medical supervision at no cost to the departments. The ED also is a clinical training site for Paramedics and Physician Assistants to fulfill clinical internship requirements in their curriculum. CVRMC is also the clinical training site for students attending nursing programs at Gila Community College and Eastern Arizona Community College. | Description |
| Total Program Service Expense | 30615480 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 114 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 338 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | AZ | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | James R Childers | NamePerson |
| Telephone Number | 9284021123 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5880 S Hospital Drive | AddressLine1 |
| City | Globe | City |
| State | AZ | State |
| ZIP Code | 85501 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|
| Brad Werrell DO | ||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |
| Jendean Sartain | ||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |
| Janice Cook | ||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |
| Gary Gustason MD | ||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |
| Fernando Shipley | ||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |
| James Rasmussen | ||||||
| Treasurer | 1.00 | X | 0 | 0 | 0 | |
| K Kane Graves | ||||||
| Secretary | 1.00 | X | 0 | 0 | 0 | |
| Byron Belew | ||||||
| Vice Chairman | 1.00 | X | 0 | 0 | 0 | |
| Ed Carpenter | ||||||
| Chairman | 1.00 | X | 0 | 0 | 0 | |
| Dana Miller | ||||||
| Physician | 40.00 | 380006 | 0 | 14003 | X | |
| Werner Andrade-Ortiz | ||||||
| Physician | 40.00 | 381972 | 0 | 6571 | X | |
| Binoy Chandra | ||||||
| Physician | 40.00 | 329451 | 0 | 304 | X | |
| Phuong Nguyen | ||||||
| Physician | 40.00 | 280912 | 0 | 425 | X | |
| Peter Peifer | ||||||
| PA | 40.00 | 198112 | 0 | 10342 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1570453 | TotalReportableCompFromOrg |
| Total Other Compensation | 31645 | TotalOtherCompensation |
| Number Individuals GT100 K | 28 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Health Tech Mangement Svcs Inc | |||||
| 405 Duke Dr Ste 210 | Franklin | TN | 37067 | Mangement Services | 836059 |
| Crossroads OBGYN | |||||
| 5885 S Hospital Dr Ste 1 | Globe | AZ | 85501 | OB/GYN Svcs | 252991 |
| Critical Nursing Solutions Inc | |||||
| 2200 East Camelback Rd Ste 230 | Phoenix | AZ | 85016 | Traveling Nurse Svcs | 619576 |
| Cobre Properties LLC co Ensemble Real Estat | |||||
| 4722 N 24th St Ste 400 | Phoenix | AZ | 85016 | Office Space Rent | 340568 |
| Aramark | |||||
| 1101 Market St | Philadelphia | PA | 19107 | Dietary/Hskpg Mgmt | 395990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 15 | NumberOfContractorsGT100K |
| All Other Contributions | 18949 | AllOtherContributions |
| Total Contributions | 18949 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Service | Description |
| Total Revenue Column | 39131569 | TotalRevenueColumn |
| Related Or Exempt Function Income | 39131569 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 39131569 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 269397 | TotalRevenueColumn |
| Exclusion | $269,397 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 101181 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 101181 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 101181 | TotalRevenueColumn |
| Exclusion | $101,181 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1000 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1000 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1000 | TotalRevenueColumn |
| Exclusion | $1,000 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| Rebates/Discounts | 67264 | 67264 |
| Other Revenue | 16798 | 16798 |
| Cafeteria Revenue | 155110 | 155110 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 239172 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 39761268 | TotalRevenueColumn |
| Related Or Exempt Function Income | 39370741 | RelatedOrExemptFunctionIncome |
| Exclusion | $371,578 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16302868 | Total |
| Program Services | 12898829 | ProgramServices |
| Management And General | 3404039 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 409882 | Total |
| Program Services | 324299 | ProgramServices |
| Management And General | 85583 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1708889 | Total |
| Program Services | 1352073 | ProgramServices |
| Management And General | 356816 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 980389 | Total |
| Program Services | 775684 | ProgramServices |
| Management And General | 204705 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 251448 | Total |
| Program Services | 198946 | ProgramServices |
| Management And General | 52502 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78405 | Total |
| Program Services | 62034 | ProgramServices |
| Management And General | 16371 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37450 | Total |
| Program Services | 29630 | ProgramServices |
| Management And General | 7820 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3535750 | Total |
| Program Services | 3535750 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150120 | Total |
| Program Services | 118775 | ProgramServices |
| Management And General | 31345 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 430027 | Total |
| Program Services | 340237 | ProgramServices |
| Management And General | 89790 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2002676 | Total |
| Program Services | 1584517 | ProgramServices |
| Management And General | 418159 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 432894 | Total |
| Program Services | 342506 | ProgramServices |
| Management And General | 90388 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Utilities | 567335 | 448875 | 118460 |
| Supplies | 6461002 | 6461002 | |
| Repairs & Maintenance | 731130 | 578470 | 152660 |
| Equip Rent & Maintenance | 301151 | 301151 | |
| Bad Debt | 1528974 | 1209724 | 319250 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207412 | Total |
| Program Services | 52978 | ProgramServices |
| Management And General | 154434 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36117802 | Total |
| Program Services | 30615480 | ProgramServices |
| Management And General | 5502322 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 358763 | BOY |
| EOY | 294210 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17580939 | BOY |
| EOY | 19787605 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4386200 | BOY |
| EOY | 4978930 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1033776 | BOY |
| EOY | 1210789 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 224240 | BOY |
| EOY | 76984 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 37634512 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 23765388 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12859391 | BOY |
| EOY | 13869124 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1715116 | BOY |
| EOY | 1891652 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38158425 | BOY |
| EOY | 42109294 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5341810 | BOY |
| EOY | 5523891 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6655000 | BOY |
| EOY | 6370000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1126873 | BOY |
| EOY | 1904857 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1010930 | BOY |
| EOY | 953930 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14134613 | BOY |
| EOY | 14752678 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23678193 | BOY |
| EOY | 27014174 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 345619 | BOY |
| EOY | 342442 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24023812 | BOY |
| EOY | 27356616 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38158425 | BOY |
| EOY | 42109294 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3643466 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -310662 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 904177 | OtherCostOrOtherBasis |
| Book Value | 904177 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15307846 | OtherCostOrOtherBasis |
| Depreciation | 9657907 | Depreciation |
| Book Value | 5649939 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1644757 | OtherCostOrOtherBasis |
| Depreciation | 1312880 | Depreciation |
| Book Value | 331877 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17316193 | OtherCostOrOtherBasis |
| Depreciation | 12794601 | Depreciation |
| Book Value | 4521592 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2461539 | OtherCostOrOtherBasis |
| Book Value | 2461539 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 13869124 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Accrued Retiree Health | Description |
| Amount | $953,930 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 953930 | TotalOfAmounts |
| Total Revenue | 39761268 | TotalRevenue |
| Total Expenses | 36117802 | TotalExpenses |
| Excess Or Deficit For Year | 3643466 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -310662 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -310662 | TotalAdjustments |
| Excess Or Deficit Per FS | 3332804 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 39761268 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 39761268 | RevenueSubtotal |
| Total Revenue Per Form990 | 39761268 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 36428464 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 310662 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 310662 | ExpensesNotRptdF990 |
| Expenses Subtotal | 36117802 | ExpensesSubtotal |
| Total Expenses Per Form990 | 36117802 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part XIII, Line 2d | Identifier |
| Return Reference | Part XIII, Line 2d: Other expenses and losses per audited F/S | ReturnReference |
| Explanation | Special Events Reclassifications $0 Unrealized losses on investments $310662 | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 400.000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8065588 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8065588 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.22330 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8065588 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8065588 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.22330 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 13 | NumberOfActivitiesOrPrograms |
| Persons Served | 2587849 | PersonsServed |
| Total Community Benefit Expense | 88145 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 88145 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 9 | NumberOfActivitiesOrPrograms |
| Persons Served | 122014 | PersonsServed |
| Total Community Benefit Expense | 916134 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 916134 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02540 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 25713 | PersonsServed |
| Total Community Benefit Expense | 24184 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 24184 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 26 | NumberOfActivitiesOrPrograms |
| Persons Served | 2735576 | PersonsServed |
| Total Community Benefit Expense | 1028463 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1028463 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02850 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 26 | NumberOfActivitiesOrPrograms |
| Persons Served | 2735576 | PersonsServed |
| Total Community Benefit Expense | 9094051 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 9094051 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.25180 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 223788 | PersonsServed |
| Total Community Building Expense | 6962 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6962 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 365300 | PersonsServed |
| Total Community Building Expense | 32174 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 32174 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 589088 | PersonsServed |
| Total Community Building Expense | 39136 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 39136 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,528,974 | BadDebtExpenseAmount |
| Amount Attributable To | 1528974 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 9322443 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 14389994 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -5067551 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 0 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cobre Valley Regional Med Ctr | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5880 South Hospital Drive | AddressLine1 |
| City | Globe | City |
| State | AZ | State |
| ZIP Code | 85501 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cobre Valley Regional Med Ctr | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | true | AllNeedsAddressed |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 400.0000 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 400.0000 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part VI - Additional Information | N/A | |
| Part V - Explanation of Number of Facility Type | Besides the main hospital, the organization operates three rural health clinics. Additional detail is provided in the response to Part VI, Question 6: how the organization has furthered its exempt purpose. | |
| Part VI - States Where Community Benefit Report Filed | AZ | |
| Part VI - Affilated Health Care System Roles and Promotion | N/A | |
| Part VI - Explanation Of How Organization Furthers Its Exempt Purpose | Please refer to PDF attachment of Schedule H Part VI narrative responses. | |
| Part VI - Community Building Activities | Please refer to PDF attachment of Schedule H Part VI narrative responses. | |
| Part VI - Community Information | Please refer to PDF attachment of Schedule H Part VI narrative responses. | |
| Part VI - Patient Education of Eligibility for Assistance | Please refer to PDF attachment of Schedule H Part VI narrative responses. | |
| Part VI - Needs Assessment | Please refer to PDF attachment of Schedule H Part VI narrative responses. | |
| Part V, Line 18c - Limited Eligibility for Emergency Medical Conditions Eligibility | Please refer to narratives in Schedule H, Part VI. | Number of Hospital Faciltiy - 0 |
| Part V, Line 3 - Account Input from Person Who Represent the Community | Please refer to Needs assessment narrative under Schedule H, Part VI. | Number of Hospital Faciltiy - 0 |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | Please refer to the Patient education and eligibility for assistance narrative provided in Part VI. | |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | Deductibles and co-payments from Medicare patients were $3,333,448, collected in addition to the $9,322,443 in Medicare revenue. Thus, the shortfall attributable to community benefit was: $1,734,103. | |
| Part III, Line 4 - Bad Debt Expense | Bad Debt Expense is described in the response to Part VI, question 3, PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. Please refer to that response. | |
| Part I, Line 7, Column F - Explanation of Bad Debt Expense | Bad Debt Expense is described in the response to Part VI, question 3, PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. Please refer to that response. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|
| Werner Andrade-Ortiz | |||
| 381972 | 6571 | 388543 | |
| Phuong Nguyen | |||
| 280912 | 425 | 281337 | 241258 |
| Peter Peifer | |||
| 198112 | 10342 | 208454 | |
| Dana Miller | |||
| 380006 | 14003 | 394009 | 326535 |
| Binoy Chandra | |||
| 329451 | 304 | 329755 | 232264 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Schedule K | Cobre Valley Regional Medical Center is not required to complete the Schedule K. The Hospital's bonds were issued in the year 2000. The Schedule K is required to be completed for bonds issued after 12/31/2002. | |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Documents are readily available in the administrative office, upon request. | Form 990, Part VI, Line 19 |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Salary surveys of other similarly sized hopitals with equivalent services and scope of operations, are used to set compensation levels. | Form 990, Part VI, Line 15b |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Annual review is monitored by the Executive Assistant and CEO. | Form 990, Part VI, Line 12c |
| Form 990, Part VI, Line 11: Form 990 Review Process | Management prepares with third party assistance and distributes and discusses copy with entire Board prior to issuance/submission to IRS. | Form 990, Part VI, Line 11 |
| Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company | The duties of the CEO and CFO are carried out by employees of an outside management company. | Form 990, Part VI, Line 3 |
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