2026-05-07T17:03:36-05:00 2025-09-30 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2024-10-01 860107344 LITTLE COLORADO MEDICAL CENTER LITT 9282894691 1501 N WILLIAMSON AVE WINSLOW AZ 86047 LONA KING CFO 9282894691 2026-05-07 1 1 MEGAN L KOZIOL CPA P01544037 4023302660 2026-04-22 2024 2025-03-06 01:10:19Z X LITTLE COLORADO MEDICAL CENTER TRAVIS UDALL 1501 N WILLIAMSON AVE WINSLOW AZ 86047 49289898 0 X LCMCWMH.COM X 1951 AZ COMPASSIONATE CARE FOR NORTHEASTERN ARIZONA. 12 12 334 51 0 0 91000 1825429 41958654 45461435 676603 809834 34625 35198 42760882 48131896 1136 3639 0 0 22164209 24358860 0 0 0 20259840 22101909 42425185 46464408 335697 1667488 45870019 50718927 18418445 21420325 27451574 29298602 X TO BE A HEALTHCARE ORGANIZATION TRUSTED BY ITS COMMUNITY THAT PROVIDES APPROPRIATE, SUSTAINABLE MEDICAL AND HOSPITAL SERVICES IN COLLABORATION WITH OTHER REGIONAL CARE PARTNERS. 0 0 42227664 3639 45461435 WINSLOW MEMORIAL HOSPITAL D/B/A LITTLE COLORADO MEDICAL CENTER (LCMC) GENERAL MEDICAL & SURGICAL HOSPITAL - PRIMARILY ENGAGED IN PROVIDING DIAGNOSTIC, MEDICAL TREATMENT (BOTH SURGICAL AND NONSURGICAL) TO PATIENTS WITH A WIDE VARIETY OF MEDICAL CONDITIONS. LCMC MAINTAINED 25-BEDS, PROVIDED INPATIENTS WITH FOOD SERVICES THAT MET THEIR NUTRITIONAL REQUIREMENTS, AND USED AN ORGANIZED STAFF OF PHYSICIANS AND OTHER MEDICAL STAFF TO PROVIDE PROFESSIONAL CARE SERVICES AS WELL AS OTHER SERVICES. THESE SERVICES INCLUDE OUTPATIENT SERVICES, ANATOMICAL PATHOLOGY SERVICES, DIAGNOSTIC X-RAY SERVICES, CLINICAL LABORATORY SERVICES, OPERATING ROOM SERVICES FOR A VARIETY OF PROCEDURES, AND PHARMACY SERVICES IN THE CITY OF WINSLOW, NAVAJO COUNTY, ARIZONA. LCMC MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES WHICH INCLUDE THE COST OF SUPPLIES AND SERVICES FURNISHED UNDER THE CHARITY CARE POLICY ALONG WITH ASSOCIATED EQUIVALENT SERVICE STATISTICS. 42227664 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 1 64 0 1 334 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 1 0 X LONA KING 9282894691 1501 NORTH WILLIAMSON AVENUE WINSLOW AZ 86047 THOMAS GREENWOOD MD DIRECTOR, CHIEF OF STAFF UNTIL 6/2025 40.00 0.50 X 238221 0 54761 GREG HACKLER CHAIRPERSON 5.00 0.50 X X 0 0 0 FRANK ARMAO MD SECRETARY/TREASURER 1.00 0.50 X X 0 0 0 JR DESPAIN CHAIRPERSON UNTIL 04/2025 5.00 0.50 X X 0 0 0 RHONDA GREER DIRECTOR 1.00 0.50 X 0 0 0 SARAH COLEMAN MD DIRECTOR, CHIEF OF STAFF 40.00 0.50 X 0 0 0 CHRIS BAVASI DIRECTOR 1.00 0.50 X 0 0 0 ROBERT SALABYE DIRECTOR 1.00 0.50 X 0 0 0 ROBERTA CANO DIRECTOR 1.00 0.50 X 0 0 0 DARRIN FRY DIRECTOR 1.00 0.50 X 0 0 0 ELIZABETH MCKEY DIRECTOR 1.00 0.50 X 0 0 0 ALLYSEN KELLY DIRECTOR 1.00 0.00 X 0 0 0 SAGE WHITE MD DIRECTOR 1.00 0.50 X 0 0 0 KATHLEEN SMITH DIRECTOR 1.00 0.50 X 0 0 0 LONA KING CFO 40.00 0.00 X 202562 0 24861 TRAVIS UDALL CEO 40.00 0.50 X 179340 0 28365 BRIAN BUCINA MD SURGEON 40.00 0.00 X 509353 0 45496 RANDALL REID MD OB/GYN 40.00 0.00 X 302161 0 57391 LYDIA EHLENBERGER OB/GYN 40.00 0.00 X 303218 0 8300 JAMES PAGE FAMILY PRACTICE MD 40.00 0.00 X 241109 0 51013 DOUGLAS UMLAH CHIEF OPERATIONS OFFICER 40.00 0.00 X 193531 0 26518 JOHN J DEMPSEY FORMER CEO 0.00 0.00 X 171608 0 40609 2341103 0 337314 47 1 1 0 MEDICAL SOLUTIONS 1010 N 102ND ST SUITE 300 OMAHA NE 68114 CONTRACTED HEALTHCARE 1269713 JG ANESTHESIA 2973 N KRISTEN DR FLAGSTAFF AZ 86001 ANESTHESIA 494711 XTEND 90 VOLUNTEER DR SUITE 150 HENDERSONVILLE TN 37075 COLLECTION SERVICES 482281 WINNCARE LLC 1031 N WARREN AVE WINSLOW AZ 86047 HOSPITALIST SERVICES 431813 PEAK ANESTHESIA 2880 N BOLDT DR FLAGSTAFF AZ 86001 ANESTHESIA 422811 15 1613460 211969 76668 1825429 PATIENT SERVICE REVENUE 621400 44241124 44241124 PHARMACY REVENUE 900099 282650 282650 MEAL & VENDING REVENUE 900099 64287 64287 873374 873374 45461435 800878 800878 35198 0 35198 35198 35198 1139820 27138 1093139 64863 46681 -37725 8956 8956 48131896 45461435 0 845032 X 3639 3639 931454 310284 621170 18605507 17831167 774340 613228 585504 27724 2844956 2691722 153234 1363715 1269402 94313 87042 87042 201057 201057 9894226 9731343 162883 83684 15528 68156 3530144 1915522 1614622 489224 489224 596049 590385 5664 7648 7648 188526 174806 13720 610162 481816 128346 1676583 1650032 26551 684032 565442 118590 SUPPLIES 3475228 3435224 40004 FOOD 227090 220629 6461 MISCELLANEOUS 217512 155740 61772 DUES & SUBSCRIPTIONS 133702 102607 31095 46464408 42227664 4236744 0 21761077 24046942 5419925 7408799 1182269 1261064 477726 509777 36575529 23866810 12709738 12708719 1658874 2098139 1894950 1897957 176809 148520 588651 639010 45870019 50718927 4077335 7441483 12860954 12488813 1480156 1490029 18418445 21420325 X 27451574 29298602 27451574 29298602 45870019 50718927 X 1667488 181279 -1739 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 207873 207873 21159287 12941622 8217665 14897232 10925188 3972044 311137 311137 12708719 ASSET RETIREMENT OBLIGATION 591293 SETTLEMENT AGREEMENT 66000 DEFERRED COMPENSATION 193725 OPERATING LEASE LIABILITIES 639011 1490029 X 48311436 181279 -1739 179540 48131896 0 48131896 46464408 0 46464408 0 46464408 PART X, LINE 2: THE HOSPITAL BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE HOSPITAL WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION -1,739. 1 1 X 1 X 125.000000000000 1 X 1 1 0 0 226000 226000 0.00490 15342815 15342815 15568815 15342815 226000 0.00490 2579 2579 0.00010 63365 63365 0.00140 540591 157268 383323 0.00820 3639 3639 0.00010 610174 157268 452906 0.00980 16178989 15500083 678906 0.01470 1 8016008 2084162 6601013 6616424 -15411 X 1 1 1 1 LITTLE COLORADO MEDICAL CENTER 1501 N WILLIAMSON AVE WINSLOW AZ 86047 LCMCWMH.COM RGH 0076 X X X X ONE PROVIDER BASED CLINIC LITTLE COLORADO MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X HTTPS://LCMCWMH.COM/PATIENTS-AND-VISITORS/ X 1 22 1 HTTPS://LCMCWMH.COM/PATIENTS-AND-VISITORS/ 0 1 X 125.000000000000 300.000000000000 X X X X X 1 1 X X X X 1 X HTTPS://LCMCWMH.COM/PATIENTS-AND-VISITORS/ X HTTPS://LCMCWMH.COM/PATIENTS-AND-VISITORS/ X HTTPS://LCMCWMH.COM/PATIENTS-AND-VISITORS/ X X X X X X X 1 X 0 X X X X 1 X 0 0 LITTLE COLORADO MEDICAL CENTER PART V, SECTION B, LINE 5: LCMC SOLICITED INPUT FROM MULTIPLE SOURCES IN THE COMMUNITY, INCLUDING GROUPS THAT WORK WITH DISADVANTAGED POPULATIONS. NAVAJO COUNTY PARTNERED WITH LCMC TO CONDUCT THE CHNA DURING THE YEAR ENDED 9/30/23. THIS EFFORT INCLUDED SOLICITED INPUT THROUGH FOCUS GROUPS, TOWN MEETINGS, COMMUNITY COALITIONS, COMMUNITY HEALTH SURVEYS, PUBLIC HEALTH AND HOSPITAL DATA, INTERVIEWS WITH MENTAL AND BEHAVIORAL HEALTH PROVIDERS, EMERGENCY SERVICES PERSONNEL, A COMMUNITY ADVISORY COMMITTEE, VOLUNTEER ORGANIZATIONS, AND INDIAN HEALTH SERVICES TO IDENTIFY THE NEEDS OF THE COMMUNITY. LITTLE COLORADO MEDICAL CENTER PART V, SECTION B, LINE 6B: NAVAJO COUNTY PUBLIC HEALTH SERVICES DISTRICT, SUMMIT HEALTHCARE, CARE1ST HEALTH PLAN ARIZONA, AZ@WORK, COMMUNITY BRIDGES, CHANGEPOINT INTEGRATED HEALTH, NAVAJO COUNTY CRIMINAL JUSTICE, NEXUS COALITION, AND MENTAL HEALTH ADVOCATE. LITTLE COLORADO MEDICAL CENTER PART V, SECTION B, LINE 11: NEEDS IDENTIFIED IN THE CHNA IMPLEMENTATION STRATEGY FOR FYE SEPTEMBER 30, 2023 INCLUDE THE FOLLOWING:1. SOCIAL DETERMINANTS OF HEALTH (SDOH)2. SUBSTANCE ABUSE3. MENTAL HEALTH4. SEXUALLY TRANSMITTED INFECTIONS (STI'S)5. CHRONIC DISEASESDURING THE IMPLEMENTATION PROCESS, WE DETERMINED THAT WE WOULD NOT BE ABLE TO MAKE A SIGNIFICANT IMPACT ON SDOH, AS WE ARE NOT EQUIPPED TO PROVIDE THOSE THINGS. HOWEVER, WE ARE WORKING WITH THE ENTIRE NAVAJO COUNTY TO ASSIST IN RESOURCES AND GETTING THE PATIENTS TO THEM. THE FOLLOWING ACTIONS WERE TAKEN DURING FYE 2025 (ENDING SEPTEMBER 30, 2025) AND PRIOR YEARS TO ADDRESS THE IDENTIFIED NEEDS:SDOH: WE WORKED WITH OUTSIDE AGENCIES AND VOLUNTEER PROGRAMS TO HELP PROVIDE FOOD BOXES. SUBSTANCE ABUSE: WE WORKED WITH THE DAWN NETWORK AND WITH THE OPIOID TASKFORCE TO OBTAIN GRANTS TO PROVIDE NARCAN AND EDUCATION FOR PATIENTS AND FAMILIES. WE ALSO WORKED ON IMPROVING OUR REFERRAL PROCESS FOR PATIENTS WHO NEED HELP WITH SUBSTANCE ABUSE. MENTAL HEALTH: WE ARE UTILIZING A TELE BEHAVIORAL HEALTH APPROACH TO PROVIDE BOTH ACCESS TO MEDICINE AND TALK THERAPY FOR BEHAVIORAL HEALTH. WE ARE ALSO WORKING WITH OUTSIDE AGENCIES TO STREAMLINE OUR REFERRAL PROCESS FOR BOTH INPATIENT AND OUTPATIENT THERAPY AS NEEDED. STI : WE HAVE WORKED TO INCREASE TESTING AND EDUCATION TO ALL PATIENTS REGARDING STI, TESTING AND TREATMENT.CHRONIC DISEASE: WE HAVE WORKED WITH A CONTRACTED COMPANY FOR CHRONIC CARE MANAGEMENT. THIS COMPANY DOES EDUCATION AND MANAGEMENT OF MEDICATIONS TO HELP STABILIZE AND IMPROVE THE QUALITY OF LIFE FOR PATIENTS WITH MULTIPLE CHRONIC DISEASES. LITTLE COLORADO MEDICAL CENTER PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON A CASE-BY-CASE BASIS. LITTLE COLORADO MEDICAL CENTER PART V, SECTION B, LINE 16J: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED IN THE EMERGENCY ROOM, WAITING ROOMS, ADMISSIONS OFFICE AND WAS MADE AVAILABLE UPON REQUEST.MORE THAN THE LESSER OF 5% OR 1,000 INDIVIDUALS IN THE SERVICE AREA ARE LEP. HOWEVER, THE LANGUAGE SPOKEN, NAVAJO, RECENTLY BECAME A WRITTEN LANGUAGE. THE FACILITY HAS STAFF WHO SPEAK NAVAJO AND ARE ABLE TO ASSIST PATIENTS IN COMPLETING FINANCIAL ASSISTANCE FORMS, BECAUSE THE FORMS ARE STILL PREDOMINATELY IN ENGLISH. LITTLE COLORADO MEDICAL CENTER PART V, SECTION B, LINE 24: THE HOSPITAL FINANCIAL ASSISTANCE POLICY DOES NOT COVER ELECTIVE PROCEDURES. THE HOSPITAL MAY HAVE CHARGED FAP ELIGIBLE PATIENTS GROSS CHARGES FOR SERVICES THAT ARE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY. PART I, LINE 3C: IN ADDITION TO UTILIZING FPG TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE, THE HOSPITAL CONSIDERED ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS OF PATIENTS. PRESUMPTIVE ELIGIBILITY MAY BE USED ON A CASE-BY-CASE BASIS. PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B, AND SUBSIDIZED HEALTH SERVICES, LINE 7G, WERE CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, LINE 7E, HEALTH PROFESSIONS EDUCATION, LINE 7F, AND CASH AND IN-KIND CONTRIBUTIONS, LINE 7I, WERE DETERMINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED UPON REVIEWING THE ACCOUNTS AND THE POVERTY LEVELS OF NAVAJO AND APACHE COUNTIES IN ARIZONA. IT WAS FOUND THAT ABOUT 26% OF THE OUTSTANDING BALANCES MAY HAVE BEEN ELIGIBLE UNDER THE FACILITY'S CHARITY CARE POLICY. ALSO FOR THIS REVIEW PROCESS, ANY FAMILIES WITH PRIOR APPLICATIONS FOR CHARITY CARE WERE GIVEN CONSIDERATION. PART III, LINE 4: THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSION IS LOCATED IN FOOTNOTE 1 ON PAGES 12 & 13 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE ENTIRE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. SERVICES ARE PROVIDED TO PATIENTS UNDER THE MEDICARE PROGRAM EVEN THOUGH THE HOSPITAL KNOWS THEY WILL NOT RECOVER ALL OF THE COSTS FROM PROVIDING THE SERVICES. THIS PROGRAM IS CONSIDERED SUBSIDIZED BY THE HOSPITAL AND OTHER PAYORS. PATIENTS RELY ON THESE SERVICES FOR THEIR HEALTH AND WELL-BEING AND ARE ESSENTIAL FOR THEIR ACCESS TO HEALTHCARE. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES.HOSPITAL SERVICES RENDERED ON A FEE SCHEDULE ARE NOT INCLUDED IN THE MEDICARE CALCULATIONS PER THE 990 INSTRUCTIONS. HAD THIS BEEN REPORTED THE HOSPITAL WOULD HAVE HAD A GREATER LOSS FROM MEDICARE SERVICES OF $55,434.MEDICARE FEE SCHEDULE REVENUE: $41,273MEDICARE ESTIMATED COSTS OF CARE RELATING TO PAYMENTS: $96,708NET (SHORTAGE): $(55,434) PART III, LINE 9B: ACCOUNTS THAT MEET THE CRITERIA FOR THE FINANCIAL ASSISTANCE POLICY WILL BE WRITTEN OFF IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS THAT DO NOT MEET THE CRITERIA FOR FINANCIAL ASSISTANCE WILL PROCEED THROUGH THE COLLECTION PROCESS. IF, DURING THE COLLECTION PROCESS, IT IS DETERMINED THAT AN ACCOUNT IN COLLECTION BELONGS TO A PATIENT WHO IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE ACCOUNT WILL BE REMOVED FROM COLLECTION AND RETURNED TO THE HOSPITAL FOR RESOLUTION. PART VI, LINE 2: LCMC ASSESSES HEALTH NEEDS BY EVALUATING THE PATIENTS SERVED IN THE CLINICS AND HOSPITAL. LCMC HAS STAFF THAT PARTICIPATE IN VARIOUS ORGANIZATIONS INCLUDING THE COUNCIL FOR AGING, ALICE'S PLACE, THE WINSLOW ROTARY, ETC. STAFF ARE MADE AWARE OF NEEDS OF THE COMMUNITY THROUGH THEIR INVOLVEMENT WITH THESE ORGANIZATIONS. ADDITIONALLY, LCMC HAS MONTHLY MEDICAL EXECUTIVE AND BI-ANNUAL MEDICAL STAFF MEETINGS TO DETERMINE THE HEALTH NEEDS OF THE COMMUNITY. PART VI, LINE 3: LCMC'S PATIENT BILLING STATEMENTS HAVE A NARRATIVE ATTACHED DESCRIBING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THE CONTACT INFORMATION FOR HOW TO OBTAIN ADDITIONAL INFORMATION. NOTICES OF FINANCIAL ASSISTANCE AVAILABILITY ARE POSTED IN THE ER, WAITING ROOMS, AND ADMISSIONS OFFICE. PART VI, LINE 4: LCMC IS LOCATED IN WINSLOW WHICH IS PART OF NAVAJO COUNTY, ARIZONA, AND SERVES THE HEALTHCARE NEEDS OF THE COMMUNITY AND SURROUNDING AREAS. THE SERVICE AREA IS MOSTLY RURAL WITH A POPULATION OF APPROXIMATELY 24,790 PEOPLE. THE AVERAGE HOUSEHOLD INCOME IS $43,918 WITH 31.6% OF THE POPULATION HAVING AN INCOME OF LESS THAN $35,000. MORE THAN 40% OF THE PATIENTS SERVED BY LCMC ARE ON THE ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM, AND MORE THAN 67% OF THE SERVICE AREA ARE OF NATIVE AMERICAN DESCENT. THE NEAREST HOSPITAL IS 60 MILES FROM WINSLOW. WINSLOW IS IN AN AREA FEDERALLY DESIGNATED AS A HEALTH PROFESSIONAL SHORTAGE AREA, A MEDICALLY UNDERSERVED AREA, AND A PERSISTENT POVERTY COUNTY. PART VI, LINE 5: LCMC'S BOARD OF DIRECTORS ALL RESIDE IN THE ORGANIZATION'S SERVICE AREA EXCEPT FOR FOUR MEMBERS, ONE RESIDES IN PHOENIX, AZ, ONE RESIDES IN PAYSON, AZ, AND TWO RESIDE IN FLAGSTAFF, AZ. IN ADDITION, NONE OF THE BOARD MEMBERS ARE RELATED TO THE ORGANIZATION. LCMC EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PROVIDERS IN ITS COMMUNITY AND SURROUNDING AREA FOR SOME OR ALL ITS DEPARTMENTS. LCMC REINVESTS SURPLUS FUNDS, IF ANY, TO IMPROVEMENTS IN PATIENT CARE, INCLUDING BUT NOT LIMITED TO EXPANSION OF SERVICES OFFERED, PATIENT EDUCATION, EMPLOYEE EDUCATION, AND EQUIPMENT AND FACILITY RENOVATIONS. X X X X X 0 1 0 0 0 0 0 1 0 BRIAN BUCINA MD SURGEON 474853 0 24000 0 10500 0 11359 0 34585 0 555297 0 0 0 RANDALL REID MD OB/GYN 296641 0 0 0 5520 0 13898 0 43932 0 359991 0 0 0 LYDIA EHLENBERGER OB/GYN 297143 0 0 0 6075 0 0 0 8300 0 311518 0 0 0 THOMAS GREENWOOD MD DIRECTOR, CHIEF OF STAFF UNTIL 6/202 238221 0 0 0 0 0 11093 0 44115 0 293429 0 0 0 JAMES PAGE FAMILY PRACTICE MD 209609 0 0 0 31500 0 10646 0 40788 0 292543 0 0 0 LONA KING CFO 202562 0 0 0 0 0 9385 0 15917 0 227864 0 0 0 DOUGLAS UMLAH CHIEF OPERATIONS OFFICER 193531 0 0 0 0 0 9034 0 17905 0 220470 0 0 0 JOHN J DEMPSEY FORMER CEO 136474 0 30750 0 4384 0 28280 0 12539 0 212427 0 0 0 TRAVIS UDALL CEO 175207 0 4133 0 0 0 2671 0 26037 0 208048 0 0 0 PART I, LINE 4B LCMC ENTERED INTO AN AGREEMENT WITH JOHN DEMPSEY TO PAY HIM A RETENTION BONUS WHICH VESTED ON 7/31/2020. THE FULL RETENTION BONUS WILL BE PAID OVER AN EIGHT-YEAR PERIOD. THIS DEFERRED COMPENSATION BENEFIT BECAME EFFECTIVE JANUARY 1, 2019. MONTHLY PAYMENTS BEGAN ON JULY 1, 2020. JOHN DEMPSEY WAS PAID $36,900 IN DEFERRED COMPENSATION IN CALENDAR YEAR 2024 AND WILL CONTINUE TO RECEIVE THE DEFERRED COMPENSATION UNTIL 2030. PART I, LINE 7 BONUSES WERE PROVIDED BASED ON COMPLETION OF TASKS DETERMINED AS PART OF EACH INDIVIDUALS PERFORMANCE PLANS. THOMAS GREENWOOD CHIEF OF STAFF AND OWNER OF WINNCARE, LLC 431813 PAYMENTS FOR HOSPITALIST SERVICES 0 X 1 76668 FMV 1 0 0 0 PART I, COLUMN (B): COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH BROAD AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S CEO AND CFO WILL REVIEW THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS REVIEWED ON AN ANNUAL BASIS. BOARD MEMBERS, OFFICERS, AND MANAGERS ARE COVERED UNDER LITTLE COLORADO MEDICAL CENTER'S CONFLICT OF INTEREST POLICY. WHEN A CONFLICT OF INTEREST ARISES, THE COVERED PERSON IS TO DISCLOSE THE CONFLICT TO HIS OR HER IMMEDIATE SUPERVISOR BEFORE A DECISION INVOLVING THE AREA OF CONFLICT IS MADE. MEMBERS WITH A CONFLICT OF INTEREST ARE ALSO NOT ALLOWED TO PARTICIPATE IN THE DECISION MAKING PROCESS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION REVIEWS AND DETERMINES THE CEO'S COMPENSATION EVERY FEW YEARS. THE ORGANIZATION BRINGS IN THE LEDBETTER LAW FIRM, PLC TO AID IN DETERMINING THE REASONABLENESS OF THE COMPENSATION. THE LAW FIRM CONSIDERS CEO COMPENSATION FROM OTHER HOSPITALS WITHIN THE CRITICAL ACCESS HOSPITALS IN ARIZONA, WHICH LCMC IS APART OF. THIS DATA IS COLLECTED THROUGH THE ARIZONA HOSPITAL ASSOCIATION. LEDBETTER LAW FIRM PLC WAS ENGAGED TO REVIEW AND ANALYZE THE COMPENSATION FOR THE CEO IN 2024. THE BOARD OF DIRECTORS APPROVED THE COMPENSATION RECOMMENDATION. NO PAY ADJUSTMENTS HAVE BEEN PROVIDED SINCE THAT TIME. THE BOARD AND OUTSIDE LEGAL COUNSEL REVIEW THE CEO'S COMPENSATION ANNUALLY. OTHER OFFICERS' COMPENSATION IS DETERMINED THROUGH MARKET ANALYSIS WITH FINAL DECISIONS TO BE MADE BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 3,050,607. MANAGEMENT AND GENERAL EXPENSES 84,959. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,135,566. PROFESSIONAL FEES - MEDICAL: PROGRAM SERVICE EXPENSES 3,998,700. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,998,700. PURCH SVCES-OTHER: PROGRAM SERVICE EXPENSES 2,682,036. MANAGEMENT AND GENERAL EXPENSES 77,924. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,759,960. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION -1,739. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. LITTLE COLORADO HEALTHCARE FOUNDATION 1501 NORTH WILLIAMSON AVENUE WINSLOW AZ 86047 208504703 FUNDRAISING ACTIVITES AZ LITTLE COLORADO MEDICAL CENTER C 7136 131423 1.00000 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0