2025-11-05T11:54:53-05:00 2024-12-31 200079326 DZA PLLC 12015 E MAIN AVE SPOKANE VALLEY WA 99206 990 2024-01-01 870543342 MOAB VALLEY HEALTHCARE INC MOAB 4357193500 450 WEST WILLIAMS WAY MOAB UT 845320998 JENNIFER SADOFF CEO 4357193503 2025-11-05 true true RIKKI PATCH P01472231 5092420874 2025-11-05 2024 2025-03-06 01:10:19Z MOAB REGIONAL HOSPITAL JENNIFER SADOFF 450 WEST WILLIAMS WAY MOAB UT 845320998 52552966 false X WWW.MRHMOAB.ORG X 1995 UT OUR DEDICATED TEAM PUTS THE PATIENT FIRST, DELIVERS QUALITY COST-EFFECTIVE HEALTHCARE AND PROMOTES WELLNESS TO ALL WE SERVE. 7 6 361 12 0 1286274 263283 49439659 50534168 964103 1211725 724595 478032 52414631 52487208 12060 20286 0 29348822 31207293 0 0 22244450 22654476 51605332 53882055 809299 -1394847 92790459 97035754 47823918 53317173 44966541 43718581 OUR DEDICATED TEAM PUTS THE PATIENT FIRST, DELIVERS QUALITY COST-EFFECTIVE HEALTHCARE AND PROMOTES WELLNESS TO ALL WE SERVE. false false 43577480 20286 49934196 MOAB REGIONAL HOSPITAL (MRH) OPERATES A 17-BED ACUTE CARE CRITICAL ACCESS HOSPITAL (CAH), WHICH PROVIDES EMERGENCY, INPATIENT, OUTPATIENT, ACUTE CARE AND SUBACUTE SERVICES IN HOSPITAL AND CLINIC SETTINGS. THE HOSPITAL PROVIDED 5,998 EMERGENCY DEPARTMENT VISITS, 1,419 DAYS OF INPATIENT SERVICES, 25,056 CLINIC VISITS, 1,112 HOSPICE DAYS, AND 92 BIRTHS DURING THE YEAR. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 1,606,383 FOR CHARITY CARE, 439,801 FOR MEDICAID, 17,070,400 FOR MEDICARE, AND 21,962,481 FOR OTHER THIRD-PARTY PAYERS DURING THE YEAR. 43577480 true true false true false false false false false false true false false false true true true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false true 55 0 true 361 true false false false false false false false false false false false false X 7 6 false false false false false false false true true false false true true true true true true true true false UT X ZACHARY WOJCIESZEK 4357193500 450 WEST WILLIAMS WAY MOAB UT 84532 DEIDRE FLANAGAN SURGEON 40.00 X 502960 0 72717 KIMBERLY FRANKE SURGEON 40.00 X 466308 0 33920 PHILLIP KOPELL PHYSICIAN 40.00 X 376045 0 72702 DYLAN COLE PHYSICIAN 40.00 X 374101 0 67117 WHITNEY MACK PHYSICIAN 40.00 X 387411 0 46088 ANGELA ALEXANDER TRUSTEE/PHYS 32.00 X 322136 0 0 JENNIFER SADOFF CEO 40.00 X 295038 0 48689 ZACHARY WOJCIESZEK CFO 40.00 X 203165 0 52087 HOLLY SLOAN CHAIR 1.00 X X 0 0 0 LYNDA SMIRZ VICE CHAIR 1.00 X X 0 0 0 DEE GULLEDGE TRUSTEE 1.00 X 0 0 0 BRENDON CAMERON TRUSTEE 1.00 X 0 0 0 KELLY VAGTS TRUSTEE 1.00 X 0 0 0 ALISON LING TRUSTEE 1.00 X 0 0 0 BETH LOGAN TRUSTEE TIL 1.00 X 0 0 0 2927164 393320 69 false true false PAUL ROBERT REAY PO BOX 487 MONTICELLO UT 84535 ER PHYSICIAN 515861 PATRICK SHERER 1575 OLD MAIL TRAIL MOAB UT 84532 ER PHYSICIAN 342780 ANGELA ALEXANDER 42172 DEER RD STEAMBOAT SPRINGS CO 80487 ER PHYSICIAN 322136 MK EDP PROFESSIONAL LLC 178 CHESTER CT RIDGWAY CO 81432 ER PHYSICIAN 263218 ERIC HANLY 2342 PROMONTARY COURT GRAND JUNCTION CO 81507 GEN. SURGERY 234292 9 220447 42836 263283 NET PATIENT SERVICE REVENUE 624100 49934196 49934196 MANAGEMENT FEES 561000 599972 599972 50534168 1235627 1235627 73479 73479 73479 73479 41856 43979 21779 -2123 -21779 -23902 -23902 CAFETERIA 722210 371591 371591 OTHER REVENUE 900099 32962 32962 404553 52487208 50534168 1689757 X 20286 20286 921115 322136 598979 23601130 19275534 4325596 791090 682289 108801 4122183 3341370 780813 1771775 1404162 367613 7399 7399 95659 95659 42164 42164 6549313 5756932 792381 93688 18948 74740 1058410 686114 372296 702223 335168 367055 621977 460161 161816 150272 144788 5484 92061 66085 25976 1548401 917284 631117 3929093 3162700 766393 689505 489400 200105 MEDICAL SUPPLIES & DRUGS 5112048 5112048 REPAIRS & MAINTENANCE 1622724 1292258 330466 DUES & SUBSCRIPTIONS 205978 54075 151903 133561 35742 97819 53882055 43577480 10304575 0 1670 2073 7895869 8889155 11250759 9614356 1031935 1300621 436349 622091 83375777 32405240 51108130 50970537 17636086 20603249 88891 88891 162500 130000 3178270 4814781 92790459 97035754 5957627 4136049 41866291 45904559 3276565 47823918 53317173 X 44966541 43718581 44966541 43718581 92790459 97035754 -1394847 146887 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4748 4748 false SCHEDULE C, PART II-B, LINE 1 THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. 2797195 2797195 61208347 20162667 41045680 16921446 10169321 6752125 2448789 2073252 375537 50970537 MALPRACTICE INSURANCE CLAIMS 2700000 THIRD-PARTY PAYOR SETTLEMENTS 576565 3276565 X 52591931 146887 146887 52445044 42164 42164 52487208 53839891 53839891 42164 42164 53882055 SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS ORGANIZED AS A UTAH NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOSPITAL IS REQUIRED TO FILE AN ANNUAL RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE HOSPITAL IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE HOSPITAL HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN(FORM 990T) WITH THE IRS. 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. true true true X true X true true false false 915638 915638 0.01700 4549930 4549930 5465568 4549930 915638 0.01700 66870 66870 0.00120 4288679 2127803 2160876 0.04010 20286 20286 0.00040 4375835 2127803 2248032 0.04170 9841403 6677733 3163670 0.05870 true 1963319 314131 13501408 13579960 -78552 X true true 1 1 MOAB VALLEY HEALTHCARE INC 450 WEST WILLIAMS WAY MOAB UT 845320998 WWW.MRHMOAB.ORG 2013-HOSP-45117 X X X X MOAB VALLEY HEALTHCARE INC 1 false false true X X X X X X X X X X 22 true false true true X WWW.MRHMOAB.ORG X X true 22 true SEE PART V, LINE 7D FOR FULL URL false true X 100.000000000000 400.000000000000 X X X X true true X X X X true X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X true X false X X X X true X false false FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 3E IDENTIFICATION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS BEGIN ON PAGE 42 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 5 MOAB REGIONAL HOSPITAL (MRH) PARTICIPATED IN COMMUNITY HEALTH NEEDS ASSESSMENT SERVICES ADMINISTRATED BY RURAL HEALTH INNOVATIONS, LLC (RHI), A SUBSIDIARY OF THE NATIONAL RURAL HEALTH RESOURCE CENTER (NRHRC) TO CONDUCT ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY BY MAILING OUT 800 SURVEYS TO A RANDOM STRATIFIED SAMPLE OF COMMUNITY MEMBERS, HOLDING A SERIES OF FOCUS GROUPS, AND KEY STAKEHOLDER INTERVIEWS. RHI FACILITATED A SERIES OF FOCUS GROUPS MADE UP OF A DIVERSE GROUP OF COMMUNITY MEMBERS, REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY TO SUPPLEMENT THE ASSESSMENT WITH QUALITATIVE DATA. THE FOCUS GROUPS INCLUDED: HEALTHCARE PROFESSIONALS; COMMUNITY LEADERS; YOUTH ORGANIZATIONS AND PARENTS; SENIORS; AND MULTICULTURAL GROUPS. AN EXTENSIVE LIST OF INVITEES WAS COMPILED BY THE MRH DIRECTOR OF COMMUNITY RELATIONS TO ENSURE QUALITY REPRESENTATION OF VARIOUS COMMUNITY ORGANIZATIONS, GOVERNMENT COUNCILS AND LOCAL RESIDENTS. FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 6B MOAB REGIONAL HOSPITAL PARTNERED WITH THE NATIONAL RURAL HEALTH RESOURCE CENTER TO CONDUCT ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT TO IMPROVE THE UNDERSTANDING OF THE HEALTH STATUS OF THE COMMUNITY IT SERVES. FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 7D THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS DISTRIBUTED TO LOCAL INTERESTED AGENCIES, INCLUDING THE SOUTH EASTERN UTAH HEALTH DEPARTMENT, THE MOAB FREE HEALTH CLINIC, AND ALL COMMUNITY LEADERS INVOLVED IN THE FOCUS GROUP. HARD COPIES OF THE LATEST COMMUNITY HEALTH NEEDS ASSESSMENT AND MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY ARE ALSO AVAILABLE UPON REQUEST WITHOUT CHARGE AND POSTED ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTPS://MRHMOAB.ORG/WP-CONTENT/UPLOADS/2023/02/MOAB-REGIONAL-HOSPITAL- CHNA-REPORT-FINAL.PDF FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 11 AFTER RECEIVING THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS, COMMUNITY AND HOSPITAL LEADERS WERE INVITED TO PARTICIPATE IN A STRATEGIC PLANNING SESSION TO PRIORITIZE TARGET AREAS FOR THE COMMUNITY HEALTH ASSESSMENT ACTION PLAN. THE TOP THREE IDENTIFIED HEALTH NEEDS INCLUDE: 1) MENTAL HEALTH 2) SUICIDE, AND 3) SUBSTANCE USE DISORDERS MOAB REGIONAL HOSPITAL HAS MADE STRIDES SINCE THE LAST CHNA TO BRING MORE MENTAL HEALTH AND SUBSTANCE USE RESOURCES AND SERVICES TO THE AREA. THIS CONTINUES TO BE IDENTIFIED AS ONE OF THE TOP HEALTH NEEDS IN THE COMMUNITY. THIS IS AN AREA THAT THE HOSPITAL CANNOT ADDRESS ALONE. IT IS IMPORTANT TO PARTNER WITH AGENCIES, BUSINESSES, FAITH-BASED ORGANIZATIONS, AND CONSUMERS TO IMPACT THIS. A MULTIPRONGED APPROACH WOULD INCLUDE EDUCATION IN THE COMMUNITY WHICH INCLUDES ALL AGE GROUPS, RACES, AND ETHNIC GROUPS; PROGRAMS FOCUSED ON PREVENTION; AND A VERY INTENTIONAL CONNECTION WITH ATRISK GROUPS. INCLUDED IN THIS WOULD BE A FOCUS ON SUICIDE PREVENTION AND ADDRESSING STIGMA. MRH IS CONTINUALLY ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 16J THE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS PROVIDED IN THE EMERGENCY AND WAITING ROOMS. PATIENTS ARE PROVIDED FINANCIAL AID INFORMATION AND AN APPLICATION AT THE TIME OF SERVICE. THE HOSPITAL ALSO INFORMS PATIENTS THAT FINANCIAL AID IS AVAILABLE IN ALL INVOICES. IN ADDITION, THE HOSPITAL PUBLICIZED THE FINANCIAL ASSISTANCE POLICY THROUGH NEWSPAPER ARTICLES AND EDUCATIONAL SEMINARS WITH THE COMMUNITY SENIOR CITIZENS AND MINORITY POPULATIONS. THE LATEST FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON THE HOSPITAL WEBSITE AS FOLLOWS. FAP: HTTPS://MRHMOAB.ORG/WP-CONTENT/UPLOADS/2023/04/MRH-FINANCIAL-AID- POLICY-REVISED-04.28.23.PDF FAP APPLICATION: HTTPS://MRHMOAB.ORG/WP-CONTENT/UPLOADS/2023/04/FINANCIAL- ASSISTANCE-PROGRAM-CHECKLIST-APPLICATION-04.27.2023.PDF FAP PLAIN LANGUAGE SUMMARY: HTTPS://MRHMOAB.ORG/WP- CONTENT/UPLOADS/2023/04/FINANCIAL-ASSISTANCE-PROGRAM-SUMMARY-04.28.2023.PDF SCHEDULE H, PART I, LINE 7G THE HOSPITAL HAS INCLUDED COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES IN PART I, LINE 7G IN THE AMOUNT OF 4,288,679 IN COLUMN C AND 2,127,803 IN COLUMN D. SCHEDULE H, PART I, LINE 7 THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES FOR FIGURES REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, TOTAL COMMUNITY BENEFIT, AND TOTAL COMMUNITY BUILDING EXPENSES). SCHEDULE H, PART II GRAND COUNTY IS DESIGNATED AS MEDICALLY UNDERSERVED AREA AND HAS A SHORTAGE OF HEALTH PROFESSIONALS. THE HOSPITAL IS CONTINUALLY RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ITS RURAL SERVICE AREA TO HELP IMPROVE ACCESS TO HEALTHCARE SERVICES AS IDENTIFIED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT. SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE ON LINE 2 IS REPORTED AT CHARGES. SCHEDULE H, PART III, LINE 3 THE HOSPITAL DETERMINED THE ESTIMATED AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE BY REVIEWING THEIR RECORDS FOR THE PERCENTAGE OF PATIENTS THAT WOULD HAVE BEEN ELIGIBLE HAD THEY COMPLETED THE FINANCIAL ASSISTANCE PROCESS. THE HOSPITAL ESTIMATED 16% OF ITS BAD DEBTS WOULD HAVE QUALIFIED. SCHEDULE H, PART III, LINE 4 THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 5 ON PAGE 15 OF THE AUDITED FINANCIAL STATEMENTS ATTACHED. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 10 BEGINNING ON PAGE 18 OF THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8 SERVICES ARE PROVIDED TO PATIENTS UNDER THE MEDICARE PROGRAM KNOWING THAT NOT ALL COSTS ASSOCIATED WITH PROVIDING THESE SERVICES WILL BE RECOVERED. PROVIDING THESE SERVICES IS ESSENTIAL TO THESE PATIENTS AND THE COMMUNITY AND INCREASES THEIR ACCESS TO HEALTHCARE SERVICES. THEREFORE, ANY MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES & REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. SCHEDULE H, PART III, LINE 9B IT IS THE POLICY OF MOAB REGIONAL HOSPITAL TO UTILIZE A COLLECTION AGENCY AS A RESOURCE FOR COLLECTING BAD DEBT. ALL PATIENTS WILL RECEIVE A MONTHLY STATEMENT REGARDING ANY OPEN BALANCES ON THEIR ACCOUNTS. THE PATIENT WILL RECEIVE TWO STATEMENTS APPROXIMATELY 30 DAYS APART. THE THIRD STATEMENT AT 90 DAYS WILL BE STAMPED FINAL NOTICE. AT 120 DAYS AFTER THE FIRST BILLING IF THE OPEN BALANCE HAS NOT BEEN ADDRESSED BY THE PATIENT THESE ACCOUNTS WILL BE FORWARDED ON TO THE COLLECTION AGENCY FOR ADDITIONAL ACTION (E.G. ACCRUING INTEREST, GARNISHING OF WAGES AND LEGAL ACTION) IF NECESSARY. IF AT ANY TIME DURING THE COLLECTION ACTIONS THE COLLECTION AGENCY DETERMINES THE PATIENT WOULD BE POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE, THE AGENCY WILL ENCOURAGE THE PATIENT TO CONTACT THE HOSPITAL TO APPLY FOR FINANCIAL ASSISTANCE. ONCE THE PATIENT CONTACTS THE HOSPITAL, THE ACCOUNT IS IMMEDIATELY MOVED TO "APPLYING FOR ASSISTANCE" STATUS AND NO FURTHER COLLECTION ACTIONS ARE TAKEN. THE PATIENT THEN HAS AN ADDITIONAL 120 DAYS TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. IF THE INDIVIDUAL RECEIVES DISCOUNTED CARE, THE REMAINING SELF-PAY PORTION IS MOVED TO AN INTEREST-FREE MONTHLY PAYMENT PLAN. IF AFTER SIX MONTHS THERE ARE NO FURTHER PAYMENTS MADE, THE HOSPITAL CONTACTS THE PATIENT TO DETERMINE IF THE PATIENT NEEDS TO LOWER THEIR MONTHLY PAYMENT AND INCREASE THE PAYMENT TIMELINE. SCHEDULE H, PART VI, LINE 2 IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED EVERY THREE YEARS, THE HOSPITAL REVIEWS LOCAL THIRD PARTY HEALTH DATA, SUCH AS DATA FROM THE HEALTH DEPARTMENT AND THE UTAH STUDENT HEALTH RISK AND POPULATION (SHARP) SURVEY. THE HOSPITAL ALSO COLLECTS FEEDBACK FROM PATIENTS TO HELP IMPROVE SERVICES. THE MOST RECENT COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE AVAILABLE UPON REQUEST OR A COPY CAN BE FOUND ON THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTPS://MRHMOAB.ORG/COMMUNITY-HEALTH/ SCHEDULE H, PART VI, LINE 3 THE HOSPITAL POSTS ITS CHARITY CARE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. IT ALSO PROVIDES A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ITS ADMISSION PACKET AS PART OF THE INTAKE PROCESS. A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS ARE ALSO INCLUDED WITH DISCHARGE MATERIALS. ASSIGNED HOSPITAL STAFF ALSO DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, AS APPLICABLE. SCHEDULE H, PART VI, LINE 4 THE HOSPITAL'S DEFINED SERVICE AREA EXTENDS OUT APPROXIMATELY 70 MILES IN ALL DIRECTIONS, CAPTURING A SERVICE AREA POPULATION OF APPROXIMATELY 16,000. THE ENTIRE SERVICE AREA (SOUTHEAST UTAH) IS RURAL OR FRONTIER IN NATURE. IT INCLUDES ALL OF GRAND COUNTY (9,700) AND THE SETTLEMENTS OF GREEN RIVER (800), LA SAL (250), MONTICELLO (1,900), AND BLANDING (3,300). SMALL HOSPITALS SERVE MONTICELLO AND BLANDING, BUT MOAB REGIONAL HOSPITAL PROVIDES MAJOR SURGICAL AND ANCILLARY SERVICES. LARGER COMMUNITIES IN COLORADO (CORTEZ AND GRAND JUNCTION) OFFER TERTIARY CARE HOSPITALS BUT ARE MORE THAN 100 MILES AWAY FROM ANY OF THE COMMUNITIES DESCRIBED. RECREATION-BASED TOURISM, FUELED BY OVER 3 MILLION VISITORS ANNUALLY, DRIVES THE ECONOMY OF GRAND COUNTY. THE MEDIAN HOUSEHOLD INCOME FOR GRAND COUNTY IS 62,521, COMPARED WITH 91,750 FOR UTAH AND 78,538 NATIONALLY. 17% OF PERSONS IN GRAND COUNTY FALL BELOW THE POVERTY LINE. APPROXIMATELY 35.6% OF THE HOSPITAL'S PATIENT MIX IS MEDICARE, WITH 15.5% COVERED BY THE MEDICAID PROGRAM. SCHEDULE H, PART VI, LINE 5 THE HOSPITAL'S GOVERNING BODY IS A VOLUNTEER BOARD OF DIRECTORS AND COMPRISES INDIVIDUALS WHO LIVE IN THE REGION, MOST OF WHOM HAVE BEEN RESIDENTS FOR DECADES. THEY BRING AN EXCELLENT MIX OF SKILLS AND EXPERIENCE AND INCLUDE A LICENSED CLINICAL SOCIAL WORKER, A VA NURSE, A FORMER GRAND COUNTY SCHOOL DISTRICT ADMINISTRATOR, PHYSICIANS, AND BUSINESS OWNERS. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. AS A NON-PROFIT CORPORATION, THE HOSPITAL DOES NOT HAVE ANY SHAREHOLDERS. THEREFORE, ALL SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN THE FACILITY, EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, AND EDUCATION. THE HOSPITAL SPONSORS EDUCATIONAL PROGRAMS TO ADDRESS SPECIFIC COMMUNITY HEALTH CONCERNS, SUCH AS SUBSTANCE USE DISORDER, MENTAL HEALTH, PARENTING, CHILDBIRTH, AND OTHERS. THE HOSPITAL ALSO PARTICIPATES IN ACTIVITIES TO PROMOTE THE COMMUNITY'S HEALTH, INCLUDING MAKING CASH AND IN-KIND DONATIONS THAT PROVIDE CRUCIAL PROGRAM SUPPORT TO ORGANIZATIONS THAT IMPACT THE LOCAL COMMUNITY. THESE INCLUDE YOUTH-ORIENTED ORGANIZATIONS, ADVOCATES FOR RECOVERY AWARENESS, A LOCAL DOMESTIC VIOLENCE SHELTER, AND OTHERS. THE HOSPITAL REGULARLY PARTNERS WITH AND SUPPORTS THE LOCAL FREE HEALTH CLINIC, HOSTS REGULAR BLOOD DRIVES, AND PROVIDES MATURATION EDUCATION TO 5TH-GRADE STUDENTS. X X false false false false false false false false false DEIDRE FLANAGAN SURGEON 497460 5500 41800 30917 575677 KIMBERLY FRANKE SURGEON 457065 9243 13200 20720 500228 PHILLIP KOPELL PHYSICIAN 370419 5626 43700 29002 448747 DYLAN COLE PHYSICIAN 363601 10500 36200 30917 441218 WHITNEY MACK PHYSICIAN 386655 756 36200 9888 433499 ANGELA ALEXANDER TRUSTEE/PHYSICIAN 322136 322136 JENNIFER SADOFF CEO 289538 5500 27772 20917 343727 ZACHARY WOJCIESZEK CFO 202114 1051 31367 20720 255252 FORM 990 FORM 990, PART III, LINE 4A - FIRST ACCOMPLISHMENT - CONTINUATION THE HOSPITAL IS THE LEADING HEALTHCARE FACILITY IN SOUTHEASTERN UTAH AND THE LARGEST PRIVATE EMPLOYER IN GRAND COUNTY. THE DEMAND FOR BOTH INPATIENT AND OUTPATIENT SERVICES HAS INCREASED SIGNIFICANTLY AS THE NEAREST TERTIARY HOSPITAL IS OVER 100 MILES AWAY, MAKING THE HOSPITAL A KEY COMPONENT TO THE HEALTH AND WELL-BEING OF THE 9,700 GRAND COUNTY RESIDENTS WHO CALL THE REGION HOME AND 3+ MILLION ANNUAL VISITORS TO THE REGION. ALL OF THE HOSPITAL'S 17 ACUTE CARE BEDS ARE ALSO LICENSED AS SWING BEDS. THE EMERGENCY DEPARTMENT IS VERY BUSY DUE TO THE EXTREME NATURE OF THE RECREATIONAL ACTIVITIES MOAB IS KNOWN FOR, AS IS THE ORTHOPEDIC DEPARTMENT THAT CAN ACCOMMODATE MOST INJURIES AND ELECTIVE PROCEDURES LOCALLY. THE HOSPITAL OWNS AND OPERATES THE MOAB REGIONAL HEALTH CENTER, A MULTI- SPECIALTY CLINIC LOCATED ADJACENT TO MOAB REGIONAL HOSPITAL. THE CLINIC MEDICAL STAFF INCLUDES SEVEN PRIMARY CARE PHYSICIANS, ONE GENERAL SURGEON, TWO ORTHOPEDIC SURGEONS, AND FOUR MENTAL/BEHAVIORAL HEALTH PROVIDERS; URGENT CARE SERVICES, AS WELL AS ADDITIONAL PRIMARY CARE AND WOMEN'S HEALTH SERVICES, ARE PROVIDED BY THREE PHYSICIAN'S ASSISTANTS. THE CLINIC ALSO SUPPORTS A VARIETY OF VISITING MEDICAL SPECIALISTS, INCLUDING AUDIOLOGY, DERMATOLOGY, CARDIOLOGY, GYNECOLOGY, NEUROLOGY, ONCOLOGY, PLASTIC SURGERY, PAIN MANAGEMENT, PODIATRY, AND UROLOGY. GRAND COUNTY HOSPICE, AN AFFILIATE OF MRH, PROVIDES COMPREHENSIVE END-OF LIFE CARE FOR INDIVIDUALS IN THE AREA. MOAB REGIONAL HOSPITAL'S ADDITIONAL PATIENT SERVICES INCLUDE INFUSION THERAPY SERVICES. UNDER THE DIRECTION OF LOCAL CHEMOTHERAPY CERTIFIED NURSES, AND WITH OVERSIGHT BY VISITING ONCOLOGISTS FROM GRAND JUNCTION, COLORADO, LOCAL AND REGIONAL CANCER PATIENTS ARE SPARED THE DIFFICULT EXPERIENCE OF HAVING TO DRIVE TWO TO FOUR HOURS ONE WAY TO LARGER FACILITIES FOR THEIR CHEMOTHERAPY AND OTHER INTRAVENOUS TREATMENTS. FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE CFO AND BOARD FINANCE COMMITTEE WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PROVIDED TO THE BOARD WHO THEN APPROVE THE 990. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS THE FORM 8879-TE AUTHORIZING THE PREPARER TO E-FILE THE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C THE HOSPITAL REQUIRES BOARD MEMBERS AND OFFICERS OF THE ORGANIZATION TO REVIEW THE POLICY ANNUALLY AND TO DISCLOSE POTENTIAL CONFLICTS. IF A CONFLICT EXISTS THEY ARE REVIEWED BY THE BOARD AND THE INDIVIDUAL WITH THE CONFLICT ABSTAINS FROM VOTING ON THE ISSUE. FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION OF THE CEO IS SET BY THE INDEPENDENT, VOLUNTEER BOARD OF DIRECTORS. CEO COMPENSATION RANGE IS DERIVED FROM THE UTAH HOSPITAL ASSOCIATION SALARY SURVEYS AND OTHER REGIONAL COMPENSATION SURVEYS. ADDITIONALLY, CEO COMPENSATION IS DETERMINED UNDER A YEARLY PERFORMANCE EVALUATION. THIS PRACTICE IS ALSO FOLLOWED FOR THE CFO POSITION AND FOR OTHER COMPENSATED OFFICERS AND KEY EMPLOYEES. THE ANNUAL DELIBERATION AND DECISION PROCESS IS SUBSTANTIATED. FORM 990, PAGE 6, PART VI, LINE 15B SEE FORM 990, PART VI, LINE 15A ABOVE. FORM 990, PAGE 6, PART VI, LINE 19 THE HOSPITAL MAKES GOVERNING DOCUMENTS AND ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE PUBLIC DISCLOSURE COPY OF THE FORM 990. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES 5,756,932 792,381 0