2025-05-13T14:51:10-05:00 2024-06-30 910189318 MOSS ADAMS LLP 5415 E HIGH STREET STE 350 PHOENIX AZ 85054 990 2023-07-01 942916102 KINGMAN HEALTHCARE INC KING 9287572101 3269 STOCKTON HILL ROAD KINGMAN AZ 86409 JOSHUA HOFFMAN CFO 9287572101 2025-05-12 1 1 LAUREN A HAVERLOCK P00545829 4804443424 2023 2025-03-06 01:10:19Z KINGMAN REGIONAL MEDICAL CENTER HEATH EVANS 3269 STOCKTON HILL ROAD KINGMAN AZ 86409 538974993 0 X AZKRMC.COM X 1980 AZ OUR VISION IS TO BE ONE OF THE KINDEST, HIGHEST QUALITY HEALTH SYSTEMS IN THE COUNTRY. 13 7 2412 150 0 0 5600063 6627738 378262586 376161190 1673810 14396155 12129554 9982086 397666013 407167169 522840 415292 0 0 188825639 192390110 0 0 0 202084948 194003067 391433427 386808469 6232586 20358700 414114244 413771141 97839507 80846270 316274737 332924871 TO INSPIRE AND PARTNER WITH OUR COMMUNITY TO ACHIEVE OPTIMAL HEALTH MIND, BODY AND SPIRIT. 0 0 319674503 415292 376161190 KINGMAN REGIONAL MEDICAL CENTER (KRMC) IS THE LARGEST HEALTHCARE PROVIDER IN NORTHWEST ARIZONA AND THE ONLY REMAINING NOT-FOR-PROFIT HOSPITAL IN MOHAVE COUNTY, ARIZONA. AS A 235-BED MULTICAMPUS HEALTHCARE SYSTEM, KINGMAN REGIONAL MEDICAL CENTER INCLUDES MORE THAN 1,900 EMPLOYEES, 270 PHYSICIANS/ALLIED HEALTH PROFESSIONALS, AND 150 VOLUNTEERS WHO CARE FOR THE HEALTH NEEDS OF THE COMMUNITY. THE THREE LARGEST PROGRAM SERVICES OF THE ORGANIZATION ARE ACUTE CARE SERVICES, OUTPATIENT PHYSICIAN SERVICES, AND HOME HEALTH SERVICES. WITHIN THESE SERVICE LINES, THE ORGANIZATION OPERATES AN AWARD-WINNING CANCER CENTER, GENERAL SURGERY, PRIMARY AND SPECIALTY CARE SERVICES, INTERVENTIONAL CARDIOLOGY, EMERGENCY MEDICAL AND URGENT CARE SERVICES. 319674503 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 1 172 0 1 2412 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 7 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X KINGMAN HEALTHCARE INC 9287572101 3269 STOCKTON HILL ROAD KINGMAN AZ 86409 HEATH EVANS CEO 40.00 X X 570367 0 25468 KRYSTAL BURGE CHAIRMAN 1.00 X X 0 0 0 JAMES BAKER VICE CHAIRMAN 1.00 X X 0 0 0 ROBERT DEVRIES SECRETARY 1.00 X X 0 0 0 SUSAN CHAN TREASURER 1.00 X X 0 0 0 BRENT BEDKE MD DIRECTOR 1.00 X 0 0 0 DAN DEL MONACO DIRECTOR 1.00 X 0 0 0 CATHY OTT DIRECTOR 1.00 X 0 0 0 LYNNE PETERSEN DIRECTOR 1.00 X 0 0 0 SAM ELTERS DIRECTOR 1.00 X 0 0 0 KALE BODILY MD DIRECTOR 1.00 X 0 0 0 JOSEPH DORNER DIRECTOR 1.00 X 0 0 0 RYAN SWAPP MD DIRECTOR 1.00 X 0 0 0 JOSHUA HOFFMAN CFO 40.00 X 307139 0 37058 DAVID SCHOTT CAO 40.00 X 311375 0 6776 LESLIE MARTIN CNO 40.00 X 265267 0 32326 JEREMY KAPLAN PHYSICIAN 40.00 X 1180673 0 45829 MARK DAVIS PHYSICIAN 40.00 X 877291 0 34406 ADAM BRAZE PHYSICIAN 40.00 X 826727 0 58918 ABHINAV OHRI PHYSICIAN 40.00 X 825911 0 26239 EDGARDO RIVERA PHYSICIAN 40.00 X 815812 0 54905 CHRISTINA DIMAMBRO FORMER CFO 0.00 X 383485 0 22145 JAMES WELLS FORMER CNO 0.00 X 318876 0 18829 6682923 0 362899 273 1 1 0 MONOLITH DIAGNOSTICS PO BOX 6024 KINGMAN AZ 86402 CONTRACT PATHOLOGISTS 2240513 J ROAD LLC 3169 20TH STREET N ARLINGTON VA 222015135 CONTRACT PHYSICIAN 836308 GHILONI PLLC 1404 FOOTHILLS MILLS STREET HENDERSON NV 89012 CONTRACT PHYSICIAN 577850 BRYAN A FICARRA JR 4126 W SANDRA TERRACE PHOENIX AZ 85053 CONTRACT PHYSICIAN 398596 DAVID ELKINS MD 336 SKYLINE DRIVE VISTA CA 92084 CONTRACT PHYSICIAN 379500 13 95934 6530245 1559 14944 6627738 PATIENT SERVICE REVENUE 622110 372015075 372015075 EHR/PQRS/MEANINGFUL USE PAYMENTS 621100 2194757 2194757 WELLNESS CENTER REVENUE 900099 1692349 1692349 HPSA MEDICARE PAYMENT 524114 230426 230426 28583 28583 376161190 5110474 5110474 330090 0 330090 330090 330090 137441150 39870 128195339 0 9245811 39870 9285681 9285681 8620776 3612485 5008291 5008291 CAFETERIA 722514 3244323 3244323 300B PHARMACY 446110 285361 285361 1114021 1114021 4643705 407167169 376161190 0 24378241 X 136550 136550 278742 278742 1706840 1706840 721041 721041 101349854 81706954 19642900 8968815 7717283 1251532 30892067 26581307 4310760 48751493 47325814 1425679 4395 4395 209355 209355 11358 11358 130344 130344 63602104 56161903 7440201 564301 2914 561387 4074690 1967430 2107260 10813402 5337 10808065 4448857 2611761 1837096 683163 624312 58851 1166444 615384 551060 15961929 9248738 6713191 959441 959441 MEDICAL SUPPLIES AND MA 62613649 55396195 7217454 AHCCS - PROVIDER ASSESS 19067122 19067122 DUES AND SUBSRIPTIONS 713047 344815 368232 LICENSE AND PERMITS 235930 174570 61360 8743536 8743536 386808469 319674503 67133966 0 10648891 40576030 14298651 90734117 88842459 66431258 8431745 8337455 6078124 6375690 350800073 220527279 138746171 130272794 116447105 28985435 11429993 8245621 2632766 12920255 0 718950 16558339 20173536 414114244 413771141 40851507 26741261 34706969 0 1745382 27862927 0 12156249 20535649 14085833 97839507 80846270 X 313519583 329985789 2755154 2939082 316274737 332924871 414114244 413771141 X 20358700 -1075800 -2632766 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 1 11358 11358 0 PART II-B, LINE 1: KINGMAN HOSPITAL PAYS ANNUAL DUES IN WHICH A PERCENTAGE OF THEIR DUES IS ATTRIBUTABLE TO LOBBYING. THE AMOUNT SHOWN ON THE LINE ABOVE REPRESENTS THAT PERCENTAGE. 21698675 21698675 153276825 93427293 59849532 172232546 127099986 45132560 3592027 3592027 130272794 LEASE LIABILITY 12758330 DEFERRED COMPENSATION 1327503 14085833 409739210 -1075800 3778185 2702385 407036825 130344 130344 407167169 390290610 3612485 3612485 386678125 130344 130344 386808469 PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 3,612,485. CHANGE IN NET ASSETS OF KRMC FOUNDATION 165,700. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 3,612,485. 1 1 1 X 1 X 1 1 0 1 1 596210 596210 0.00150 60380301 41232019 19148282 0.04950 19067121 39428638 0 0.00000 80043632 80660657 19744492 0.05100 216445 216445 0.00060 5758012 6323086 0 0.00000 986360 986360 0.00250 6960817 6323086 1202805 0.00310 87004449 86983743 20947297 0.05410 1 32278038 0 57918857 59249831 -1330974 X 1 1 1 1 KINGMAN REGIONAL MEDICAL CENTER 3269 STOCKTON HILL ROAD KINGMAN AZ 86409 WWW.AZKRMC.COM H-0010 X X X X CANCER CENTER CARDIAC CATH LAB ACUTE REHAB UNIT KINGMAN REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 0 1 1 X SEE PART V, SECTION C FOR URL 1 21 1 SEE PART V, SECTION C FOR URL 0 1 X 150.000000000000 350.000000000000 X X X X 1 1 X X X X 1 X HTTPS://WWW.AZKRMC.COM/PATIENTS-VISITORS/KRMC-PRICING-FINANCIAL-SERVICES X HTTPS://WWW.AZKRMC.COM/PATIENTS-VISITORS/KRMC-PRICING-FINANCIAL-SERVICES X HTTPS://WWW.AZKRMC.COM/PATIENTS-VISITORS/KRMC-PRICING-FINANCIAL-SERVICES X X X X X X 1 X 0 X X X X 1 X 0 0 KINGMAN REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: AS PART OF THE COMMUNITY HEALTH ASSESSMENT PROCESS, MEMBERS OF THE MOHAVE COUNTY COMMUNITY HEALTH COALITION CONDUCTED INTERVIEWS WITH INDIVIDUALS WHO REPRESENT:A) BROAD INTERESTS OF THE COMMUNITY,B) POPULATIONS OF NEED, ANDC) PERSONS WITH SPECIALIZED KNOWLEDGE IN PUBLIC HEALTH.THESE INDIVIDUALS CAME FROM THE FOLLOWING COMMUNITY SECTORS:- SOCIAL SERVICE AGENCIES- LOCAL SCHOOL SYSTEM AND COMMUNITY COLLEGE- LOCAL CITY AND COUNTY GOVERNMENT- PUBLIC HEALTH AGENCIES- INDUSTRY- FAITH COMMUNITY- MEDICAL PROVIDERS KINGMAN REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: THE CHNA FOR KINGMAN HOSPITAL INC. WAS CONDUCTED WITH MOHAVE COUNTY, ARIZONA. KINGMAN REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: COMMUNITY HEALTH IMPROVEMENT PLAN DISCLOSURE STATEMENT KINGMAN HEALTHCARE INC. (KHI), IN PARTNERSHIP WITH THE MOHAVE COUNTY DEPARTMENT OF PUBLIC HEALTH (MCDPH) LEADS A BROAD COMMUNITY INITIATIVE TO IMPROVE HEALTH AND QUALITY-OF-LIFE IN MOHAVE COUNTY COMMUNITIES. THE INITIATIVE ENGAGES COMMUNITY STAKEHOLDERS AND THE PUBLIC TO MAKE MEASURABLE IMPROVEMENTS IN COMMUNITY HEALTH. IT INVOLVES THE FOLLOWING PROCESS, WHICH IS CONDUCTED ON A THREE-YEAR CYCLE:1. RESEARCHERS COLLECT FACTS AND STATISTICS REGARDING HEALTH AND QUALITY-OF-LIFE IN MOHAVE COUNTY. THIS PROCESS INCLUDES SPEAKING TO MOHAVE COUNTY RESIDENTS TO OBTAIN THEIR INSIGHTS. THE INFORMATION IS THEN PUBLISHED IN A REPORT CALLED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA).2. BASED ON THE INFORMATION IN THE CHNA, KHI AND MCDPH WORK WITH COMMUNITY MEMBERS AND STAKEHOLDERS TO IDENTIFY PRIORITY HEALTH ISSUES. THOSE GROUPS DEVELOP A PLAN TO ADDRESS THE CHOSEN PRIORITIES IN THREE MOHAVE COUNTY REGIONS: KINGMAN, BULLHEAD CITY, AND LAKE HAVASU CITY. WE DOCUMENT THE RESULTS OF THESE PLANNING EFFORTS IN A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR EACH REGION.3. GUIDED BY THE PRIORITIES AND STRATEGIES OUTLINED IN EACH COMMUNITY'S RESPECTIVE CHIP, COMMUNITY PARTICIPANTS COLLABORATE TO IMPLEMENT EACH REGION'S HEALTH IMPROVEMENT PLAN. KHI PLANS TO ADDRESS SIGNIFICANT NEEDS IDENTIFIED IN THE 2022 CHNA AS FOLLOWS:- MENTAL HEALTH - KHI CONTINUES TO IMPLEMENT STRATEGIES TO INTEGRATE BEHAVIORAL HEALTH SERVICES IN ALL KHI PRIMARY CARE CLINICS AND CERTAIN SPECIALTY CLINICS (PAIN CLINIC, CANCER CENTER, ETC.). THE PROGRAM EDUCATES STAFF AND IMPLEMENTS PROCESSES FOR IDENTIFYING AND TREATINGPATIENTS WHO ARE STRUGGLING WITH DEPRESSION OR WHO ARE OTHERWISE AT HIGH RISK FOR SELF-HARM.THE FOLLOWING ACTIONS WERE TAKEN DURING FY21 TO ADDRESS MENTAL HEALTH:- EXPANDED KHI'S INTEGRATED BEHAVIORAL HEALTH PROGRAM. SPECIFICALLY, IN FY21, WE HIRED ADDITIONAL STAFF TO PROVIDE PROGRAM SERVICES.- CONTINUED TO PROVIDE INPATIENT PSYCHIATRIC SERVICES.- CONTINUED TO COLLABORATE WITH COMMUNITY STAKEHOLDERS AND MENTAL HEALTH EXPERTS THROUGH THE MOHAVE COUNTY MENTAL HEALTH RESOURCE TEAM (MHRT) TO ADDRESS MENTAL HEALTH NEEDS IN THE COMMUNITY.- CONTINUED TO PROVIDE FINANCIAL SUPPORT FOR COMMUNITY INITIATIVES THAT ADDRESS MENTAL HEALTH NEEDS IN OUR COMMUNITY.- SUBSTANCE ABUSE- KHI CONTINUES TO IMPLEMENT STRATEGIES TO ADDRESS THE OPIOID CRISES AND OTHER SUBSTANCE ABUSE ISSUES. THESE STRATEGIES INCLUDE IMPLEMENTING AN EVIDENCE-BASED PROGRAM IN THE KHI EMERGENCY DEPARTMENT, ACUTE CARE AREAS, AND OUTPATIENT CLINICS FOR IDENTIFYING PATIENTS WHOHAVE ADDICTION RISKS OR CURRENT ADDICTION ISSUES. WE ARE NOW SCREENING MOST PATIENTS FOR THESE RISK FACTORS. ONCE IDENTIFIED, BEHAVIORAL HEALTH SPECIALISTS WORK WITH THEM TO ENSURE THEY HAVE RESOURCES, EDUCATION, SUPPORT AND TREATMENT WHEN APPROPRIATE. ADDITIONALLY, KHI'S TEAM OF SUBSTANCE COUNSELORS, PSYCHOLOGY NURSES, AND PSYCHIATRISTS PROVIDE MAT (MEDICATION ASSISTED TREATMENT) FOR OPIOID ADDICTION. THE FOLLOWING ACTIONS WERE TAKEN DURING FY21 TO ADDRESS SUBSTANCE ABUSE:- THROUGH KHI'S INTEGRATED BEHAVIORAL HEALTH PROGRAM, CONTINUED TO SCREEN PATIENTS WHO HAVE ADDICTION RISKS OR CURRENT ADDICTION ISSUES IN THE KRMC EMERGENCY DEPARTMENT, ACUTE CARE AREAS, AND OUTPATIENT CLINICS AND REFER PATIENTS TO APPROPRIATE RESOURCES FOR EDUCATION, TREATMENT, AND SUPPORT.- CONTINUED TO PROVIDE MEDICATION ASSISTED TREATMENT (MAT) FOR OPIOID ADDICTION.- CONTINUED TO COLLABORATE WITH COMMUNITY STAKEHOLDERS AND MENTAL HEALTH EXPERTS THROUGH THE MOHAVE SUBSTANCE TREATMENT EDUCATION & PREVENTION PARTNERSHIP (MSTEPP) TO ADDRESS SUBSTANCE ABUSE IN THE COMMUNITY.- CONTINUED TO PROVIDE FINANCIAL SUPPORT FOR COMMUNITY INITIATIVES THAT ADDRESS SUBSTANCE ABUSE IN OUR COMMUNITY.- HEALTH CARE NEEDS - KHI CONTINUES TO IMPLEMENT STRATEGIES TO MEET IDENTIFIED HEALTH AND WELLNESS NEEDS OF OUR COMMUNITY. OUR OVERALL AIM IS TO PROVIDE A FULL RANGE OF HIGH-QUALITY MEDICAL SERVICES IN OUR RURAL HEALTHCARE SYSTEM THAT MEET OR EXCEED THOSE FOUND IN LARGER URBAN AREAS. OUR SUCCESS IS MEASURED BY THE NUMBER OF RESIDENTS WHO CAN AVOID TRAVEL TO OTHER AREAS AND RECEIVE THE MEDICAL SERVICES THEY NEED CLOSE TO HOME. TO THIS AIM, KHI'S IS IMPLEMENTING STRATEGIES TO CONTINUE RECRUITING MEDICAL TALENT AND IMPLEMENTING STATE-OF-THE-ART TECHNOLOGIES FOR DELIVERING HIGH-QUALITY CARE. FOR EXAMPLE WE PLAN TO CONTINUE BUILDING OUR MEDICAL IMAGING, DIAGNOSTIC, AND SURGICAL CAPABILITIES FOR ADDRESSING COMMON CHRONIC DISEASE CONDITIONS. ADDITIONALLY, TO MEET IDENTIFIED COMMUNITY NEEDS, KHI CONTINUES TO FOCUS ON PROVIDING ADVANCED CAPABILITIES IN CARDIAC CARE, WOUND CARE, CANCER CARE, ALONG WITH REHABILITATION AND PAIN MANAGEMENT THERAPIES.THE FOLLOWING ACTIONS WERE TAKEN DURING FY21 TO ADDRESS HEALTHCARE NEEDS:- CONTINUED TO IMPLEMENT IMPROVEMENTS TO CARE DELIVERY TO INCREASE PATIENT THROUGHPUT AND REDUCE WAIT TIMES FOR APPOINTMENTS.- CONTINUED TO PROVIDE VIRTUAL HEALTHCARE OPTIONS TO INCREASE ACCESS TO HEALTHCARE IN OUR COMMUNITY.- EXPANDED CLINICAL TRIALS AT THE KHI WL NUGENT CANCER CENTER, WHICH GIVES LOCAL CANCER PATIENTS ACCESS TO ADDITIONAL ADVANCED CANCER TREATMENTS CLOSE TO HOME.- CONTINUED TO COLLABORATE WITH MAYO CLINIC TO FOR MEDICAL EXPERTISE AND RESEARCH, WHICH ENABLES KHI TO ADDRESS MORE TYPES OF MEDICAL CONDITIONS AT A LOCAL LEVEL AND PROVIDES COMMUNITY MEMBERS FURTHER OPTIONS FOR RECEIVING QUALITY CARE CLOSE TO HOME.- PROVIDER SHORTAGES - ATTRACTING ADEQUATE NUMBERS OF HEALTHCARE PROVIDERS IS ONE OF KHI'S BIGGEST CHALLENGES, BOTH NOW AND FOR THE FORESEEABLE FUTURE. LIKE THE REST OF THE COUNTRY, WE NEED MORE PROVIDERS TO MEET HEALTHCARE NEEDS IN OUR COMMUNITY. BUT, THE NATIONWIDE SHORTAGE OF DOCTORS AND OTHER HEALTHCARE PROVIDERS CONTINUES TO INTENSIFY. ONE KEY KHI STRATEGY FOR ALLEVIATING THE PROBLEM IS TO CONTINUE BUILDING AND STRENGTHENING KHI'S MEDICAL RESIDENCY PROGRAM. THE CURRENT PRIORITY IS CHOOSING STRONG CANDIDATES WHO WOULD CONSIDER STAYING IN KINGMAN AFTER COMPLETING THEIR TRAINING. IN ADDITION TO ITS PHYSICIAN TRAINING PROGRAMS, KHI STRATEGIES INCLUDE EMPLOYING MORE NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS TO PROVIDE GENERAL MEDICAL CARE. ADDITIONALLY, KHI IS WORKING TO IMPLEMENT TELEMEDICINE TECHNOLOGY FOR EVALUATING, DIAGNOSING, AND TREATING CERTAIN HEALTH CONDITIONS.THE FOLLOWING ACTIONS WERE TAKEN DURING FY21 TO ADDRESS PROVIDER SHORTAGES:- INTENSIFIED NATIONWIDE RECRUITING EFFORTS FOR HEALTHCARE PROVIDERS.- DEVELOPED SPECIFIC INITIATIVES WITHIN KHI'S NEW STRATEGIC PLAN AIMED ATENHANCING KRMC'S WORK CULTURE FOR ATTRACTING AND RETAINING HEALTHCARE STAFF.- CONTINUED TO UTILIZE MID-LEVEL HEALTHCARE PROVIDERS FOR GENERAL MEDICAL CARE.- CONTINUED TO STRENGTHEN KHI'S MEDICAL RESIDENCY PROGRAM TO ENCOURAGE MEDICAL STUDENTS WHO GRADUATE THE PROGRAM TO STAY IN KINGMAN.- HEALTH CARE COSTS - KHI CONTINUES TO IMPLEMENT STRATEGIES TO ASSIST RESIDENTS IN REDUCING THEIR HEALTHCARE COSTS. CHIEF AMONG OUR STRATEGIES IS TO EDUCATE THE COMMUNITY ON HOW TO REDUCE THEIR RISK OF CHRONIC DISEASE THROUGH HEALTHY LIFESTYLE CHOICES (PROPER DIET, EXERCISE, NOT SMOKING, ETC.). WE CONTINUE TO PROMOTE HEALTHY LIFESTYLE MESSAGING IN OUR PUBLICATIONS, ADVERTISING, HEALTH FAIRS, HEALTH LECTURES, AND OTHER PUBLIC COMMUNICATIONS. ADDITIONALLY, SPECIFIC INFORMATION IS PROVIDED TO PATIENTS DURING VISITS WITH THEIR PRIMARY CARE PROVIDER. OTHER KHI STRATEGIES FOR REDUCING HEALTHCARE COSTS INVOLVE STRICT FISCAL MANAGEMENT ALONG WITH COST TRANSPARENCY TO THE PUBLIC FOR MAKING INFORMED HEALTHCARE COST DECISIONS.THE FOLLOWING ACTIONS WERE TAKEN DURING FY21 TO ADDRESS HEALTHCARE COSTS:- CONTINUED TO PROMOTE HEALTHY LIFESTYLE MESSAGING ON SOCIAL MEDIA AND IN VARIOUS KHI PUBLICATIONS TO EDUCATE THE COMMUNITY ON HOW TO REDUCE THEIR HEALTHCARE COSTS BY REDUCING THEIR RISK OF CHRONIC DISEASE THROUGH HEALTHY LIFESTYLE CHOICES (PROPER DIET, EXERCISE, ETC.).- CONTINUED TO PUBLISH PRICING FOR VARIOUS MEDICAL SERVICES AND PROCEDURES ON KRMC'S WEBSITE SO THAT INDIVIDUALS CAN MAKE INFORMED DECISIONS ABOUT THEIR HEALTHCARE COSTS.- PROVIDED FREE TELEMEDICINE SERVICES FOR MINOR HEALTH CONDITIONS ON KHI'S "CARE ANYWHERE" PLATFORM (KHI BEGAN WAIVING THE $15 FEE FOR CARE ANYWHERE AT THE START OF THE COVID PANDEMIC).- CONTINUED TO PROVIDE CHARITY CARE TO LOW-INCOME PATIENTS WITH NO HEALTH INSURANCE AND FINANCIAL ASSISTANCE TO UNDERINSURED RESIDENTS OF MOHAVE COUNTY WHO REQUIRE EMERGENCY CARE, HOSPITALIZATION, OR OTHER MEDICALLY NECESSARY TESTS OR TREATMENTS.- CONTINUED TO PROVIDE FREE (NO OUT-OF-POCKET COST) SCREENING MAMMOGRAMS TO ALL MOHAVE COUNTY RESIDENTS THROUGH KHI'S "CATCH IT EARLY" PROGRAM; ALSO PROVIDED FREE OR REDUCED COST DIAGNOSTIC SERVICES TO LOW-INCOME PATIENTS WHO HAVE AN ABNORMAL SCREENING RESULT. SCHEDULE H, PART V, SECTION B, LINE 7A DIRECT URL WHERE CHNA REPORT IS MADE AVAILABLE TO THE ORGANIZATION'S WEBSITE:HTTPS://WWW.AZKRMC.COM/NEWSROOM/COMMUNITY-HEALTH-ASSESSMENT-COMMUNITY-HEALTH-IMPROVEMENT-PLAN SCHEDULE H, PART V, SECTION B, LINE 10A DIRECT URL WHERE IMPLEMENTATION PLAN IS MADE AVAILABLE :HTTPS://WWW.AZKRMC.COM/SITES/DEFAULT/FILES/2022-06/KINGMAN%20REGIONAL%20MEDICAL%20CENTER%20COMMUNITY%20HEALTH%20NEEDS%20IMPLEMENTATION%20STRATEGIES%20(2022-2025)%20FINAL%20DRAFT%5B2%5D.PDF CONTINUATION OF SCHEDULE H, PART V, SECTION B, LINE 11 - CONTINUED TO PROVIDE SCHOLARSHIPS FOR MEMBERSHIPS TO KHI'S DEL. E. WEBB WELLNESS CENTER TO QUALIFIED LOW-INCOME PATIENTS WHO NEED TO IMPROVE A HEALTH CONDITION WITH EXERCISE AND ARE UNABLE TO AFFORD A MEMBERSHIP. KHI FUTURE STRATEGIES DO NOT SPECIFICALLY ADDRESS THE FOLLOWING ISSUES IDENTIFIED IN THE 2019 CHNA BECAUSE THEY ARE OUTSIDE THE SCOPE OF OUR CURRENT OPERATIONS.- FOOD INSECURITY- EXCESSIVE HOUSING COST- HIGH RESIDENTIAL SEGREGATION- COST OF TRANSPORTATION FOR LOW-INCOME RESIDENTSHOWEVER, KRMC PROVIDES MANY PROGRAMS AND SERVICES THAT DIRECTLY OR INDIRECTLY HELP TO IMPROVE OUTCOMES IN THESE HEALTH AREAS. ADDITIONALLY, THROUGH OUR COMMUNITY BENEFIT PROGRAM, WE FINANCIALLY SUPPORT COMMUNITY ORGANIZATIONS THAT DIRECTLY SUPPORT AND ADDRESS THE COMMUNITY NEEDS IDENTIFIED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT. SCHEDULE H, PART V, SECTION B, LINE 14 THE FACILITY UNDER THE FINANCIAL ASSISTANCE POLICY CALCULATES THE AVERAGE DISCOUNT GIVEN TO MEDICARE AND COMMERCIAL PATIENTS AND THE COMBINED RESULT IS USED TO PROVIDE THAT DISCOUNT TO THE UNINSURED POPULATION. SCHEDULE H, PART V, SECTION B, LINE 16I TRANSLATION OF FAP INTO PRIMARY LANGUAGE SPOKEN BY LEP POPULATIONS: KINGMAN HOSPITAL, INC., HAS TRANSLATED THE FAP INTO SPANISH AND HAS PROVIDED THE POLICY IN PAPER AND ON THEIR WEBSITE. KINGMAN HOSPITAL, INC., WOULD CONSIDER TRANSLATING INTO ANOTHER LANGUAGE WHEN IT IS KNOWN THAT PATIENTS WILL NEED THE TRANSLATION AND ARE NOT SERVED BY THE CURRENT FORMS AND STATEMENETS. KINGMAN HOSPITAL, INC. USES DEMOGRAPHIC DATA FROM THEIR SYSTEM AND THE COUNTIES TO DETERMINE IF A PATIENT POPULATION EXISTS THAT IS OVER 1,000 INDIVIDUALS THAT DO NOT SPEAK ENGLISH OR SPANISH. 27 1 - KRMC URGENT CARE 1726 BEVERLY AVENUE KINGMAN AZ 86401 URGENT CARE 2 - OUTPATIENT IMAGING CENTER 1033 SYCAMORE KINGMAN AZ 86409 IMAGING CENTER 3 - KINGMAN PULMONARY CLINIC 1739 BEVERLY AVENUE SUITE 203 KINGMAN AZ 86409 PULMONARY MEDICINE 4 - KINGMAN OBGYN ASSOCIATES 1739 BEVERLY AVENUE SUITE 200 KINGMAN AZ 86409 OBSTETRICS/GYNECOLOGY 5 - KRMC PRIMARY CARE 2226 HUALAPAI MOUNTAIN ROAD KINGMAN AZ 86401 PRIMARY CARE PHYSICIANS 6 - KINGMAN FP CLINIC 3801 SANTA ROSA 4TH FLOOR KINGMAN AZ 86401 FAMILY MEDICINE 7 - KRMC HOSPICE 3269 STOCKTON HILL ROAD KINGMAN AZ 86409 HOSPICE SERVICES 8 - KINGMAN ORTHOPEDICS 1739 BEVERLY AVENUE SUITE 102 KINGMAN AZ 86409 ORTHOPEDIC PHYSICIANS 9 - GOLDEN VALLEY CLINIC 4995 W HIGHWAY 68 KINGMAN AZ 86413 FAMILY MEDICINE 10 - KINGMAN CARDIOVASCULAR ASSOCIATES 1739 BEVERLY AVENUE SUITE 217 KINGMAN AZ 86409 CARDIOLOGY PHYSICIANS 11 - MOHAVE SURGICAL SPECIALISTS 3104 STOCKTON HILL ROAD KINGMAN AZ 86401 GENERAL SURGEON 12 - KRMC PAIN MANAGEMENT CLINIC 3801 SANTA ROSA DRIVE KINGMAN AZ 86401 PAIN MANAGEMENT 13 - JOSHUA TREE PEDIATRICS 1739 BEVERLY AVENUE SUITE 204 KINGMAN AZ 86409 PEDIATRICIAN 14 - EMPLOYEE AND OCCUPATIONAL HEALTH 1739 BEVERLY AVENUE SUITE 118 KINGMAN AZ 86409 OCCUPATIONAL MEDICINE 15 - KRMC NEUROLOGY 3801 SANTA ROSA DRIVE KINGMAN AZ 86401 NEUROLOGY 16 - KRMC DISEASE MANAGEMENT CLINIC 3801 SANTA ROSA DRIVE KINGMAN AZ 86401 DISEASE MANAGEMENT 17 - HIGH DESERT GASTROENTEROLGY 1739 BEVERLY AVENUE SUITE 101 KINGMAN AZ 86409 GASTROENTEROLOGIST 18 - KRMC ENDOCRINOLOGY 3801 SANTA ROSA DRIVE KINGMAN AZ 86401 ENDOCRINOLOGY 19 - KRMC PHYSIATRY 3801 SANTA ROSA DRIVE KINGMAN AZ 86401 PHYSICAL MEDICINE AND REHAB 20 - KRMC CARDIOTHORACIC SURGERY 1739 BEVERLY AVENUE SUITE 218 KINGMAN AZ 86409 CARDIOTHORACIC SURGEON 21 - KRMC PALLIATIVE CARE 3269 N STOCKTON HILL ROAD KINGMAN AZ 86409 PALLIATIVE CARE 22 - KINGMAN RHEUMATOLOGY AND PRIMARY CARE 1739 BEVERLY AVENUE SUITE 209 KINGMAN AZ 86409 RHEUMATOLOGIST 23 - KRMC ORTHOPEDIC-HMC 3801 SANTA ROSA DR KINGMAN AZ 86401 CHIROPRACTIC SERVICES 24 - KINGMAN UROLOGY CLINIC 1712 SYCAMORE KINGMAN AZ 86409 UROLOGIST 25 - KRMC PRE-OP CLINIC 1739 BEVERLY AVENUE SUITE 103 KINGMAN AZ 86401 PRE-OP CARE FACILITY 26 - BEHAVORIAL HEALTH INSTITUTIONS 3801 SANTA ROSA DRIVE KINGMAN AZ 86401 BEHAVORIAL HEALTH 27 - KRMC HIGH DESERT VEIN CENTER-KINGMAN 2002 STOCKTON HILL ROAD 103 KINGMAN AZ 76401 VEIN CENTER PART I, LINE 3C: DESCRIPTION OF OTHER FACTORS USED TO DETERMINE FINANCIAL ASSISTANCE: KINGMAN REGIONAL MEDICAL CENTER ALSO USES A PATIENTS ASSET LEVEL, MEDICAL INDIGENCY AND INSURANCE TO DETERMINE THE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. PART I, LINE 7: THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A AND 7B. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. THE INFORMATION FOR LINES 7E THROUGH 71 WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS. PART III, LINE 2: AFTER ALL THIRD-PARTY PAYERS ARE PROPERLY BILLED, PAYMENTS AND CONTRACTUAL ADJUSTMENTS ARE APPLIED TO THE ACCOUNTS ACCORDING TO THE CONTRACTS, AND THE REMAINING DEBT IS THE FINANCIAL RESPONSIBILITY OF THE PATIENT. ANY ELIGIBLE DISCOUNTS ARE APPLIED TO THE ACCOUNTS PRIOR TO DETERMINING PATIENT RESPONSIBILITY AMOUNTS. KINGMAN REGIONAL MEDICAL CENTER WILL NOT BILL A PATIENT FOR ANY AMOUNT THAT AN INSURANCE COMPANY IS OBLIGATED TO PAY. KINGMAN REGIONAL MEDICAL CENTER WILL NOT REFER ACCOUNTS FOR COLLECTION WHILE A CLAIM ON THE ACCOUNT IS STILL PENDING PAYER PAYMENT. KINGMAN REGIONAL MEDICAL CENTER WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE PATIENT HAS INITIALLY APPLIED FOR FINANCIAL ASSISTANCE AND KINGMAN REGIONAL MEDICAL CENTER HAS NOT YET NOTIFIED THE PATIENT OF FINAL DETERMINATION.THE KRMC UNCOMPENSATED CARE POLICY PROVIDES CHARITY CARE FOR ACCOUNTS WHERE PAYMENT IS NOT ANTICIPATED. CHARITY CARE IS SEPARATE AND DISTINCT FROM BAD DEBTS, WHICH ARE ACCOUNTS FOR WHICH CREDIT WAS EXTENDED AND PAYMENT IS ANTICIPATED, BUT NOT RECEIVED. THE HOSPITAL'S QUALIFYING DISCOUNT PROGRAM CAN INCLUDE THOSE PATIENTS WHOSE HOUSEHOLD INCOME IS UP TO 350% OF THE FEDERAL POVERTY LEVEL. THIS PROGRAM IS FOR ALL PATIENTS REGARDLESS OF THEIR PRIMARY INSURANCE STATUS AND IS BASED ON THEIR FAMILY SIZE AND INCOME FROM ALL SOURCES. PART III, LINE 3: THE ORGANIZATION DOES NOT CONSIDER ANY OF ITS BAD DEBT EXPENSE TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: REFER TO PAGE 20 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE ORGANIZATION IS A SOLE COMMUNITY NOT-FOR PROFIT HOSPITAL THAT PROVIDES HEALTHCARE SERVICES TO COMMUNITY RESIDENTS AND VISITORS IN A RURAL SETTING WITH LIMITED ACCESS TO SPECIALIST CARE. ACCESSIBLE, HIGH-QUALITY HEALTHCARE SERVICE IS IMPORTANT FOR THE OVERALL HEALTH OF ALL RESIDENTS AND NOT FULLY AVAILABLE IN MOST RURAL SETTINGS. WHERE MEDICARE IS CALCULATED TO PAY AT EXPECTED COST, RURAL CARE IS OFTEN MORE EXPENSIVE AS PATIENTS TEND TO HAVE A HIGHER THAN AVERAGE ACUITY AND LENGTH OF STAY DUE TO LIMITED SPECIALIST CARE IN THE TREATMENT AND PATIENT CARE FOLLOW UP PROCESS. ADDITIONALLY, PATIENT VOLUMES ARE MORE RESTRICTED AND SEASONALLY IMPACTED IN RURAL SETTINGS AS COMPARED TO METROPOLITAN SETTINGS, WHICH AFFECTS THE HOSPITAL'S OPPORTUNITY TO SPREAD THE FIXED COSTS OVER MORE PATIENT CARE EXPERIENCES. ALSO RELATIVE TO THE SEASONAL PATIENT FLUCTUATIONS, RURAL HOSPITALS TEND TO HAVE A HIGHER NEED FOR AGENCY TRAVEL NURSES TO SUPPLEMENT THE HIGHER CENSUS TIMES WHICH IS 40% HIGHER COSTS THAN EMPLOYED STAFF. PHYSICIAN RECRUITMENT IS ALSO A MAJOR CHALLENGE FOR SOLE COMMUNITY PROVIDERS AND THEREFORE MUST UTILIZE LOCUM TENENS PHYSICIANS AT A MUCH HIGHER COST THAN EMPLOYED PHYSICIANS. MEDICARE SHORTFALLS IN RURAL SETTINGS REFLECT THE EXCESS COST OF REQUIRED CARE OVER THE CALCULATED AVERAGE EXPECTED COST FOR PARTICIPANTS IN THE MEDICARE PROGRAM. FOR THESE REASONS, MEDICARE SHORTFALLS SHOULD BE CONSIDERED PART OF THE COMMUNITY BENEFIT PROVIDED. PART III, LINE 9B: ONCE THE PATIENT IS BILLED AND CONTACTED, THEY ARE INFORMED OF OPTIONS AND OF THE FINANCIAL ASSISTANCE POLICY (FAP). THE OTHER OPTIONS INCLUDE PAYING UP FRONT OR NO INTEREST PAYMENTS WITHIN A SCHEDULED NUMBER OF DAYS. A CASH DISCOUNT IS AVAILABLE TO THE PATIENT. IF QUALIFIED FOR THE FAP, THE APPROPRIATE QUALIFYING AMOUNT IS ADJUSTED TO CHARITY CARE. IF A BALANCE REMAINS THAT DOES NOT QUALIFY, THE PATIENT HAS CASH DISCOUNT AND NO INTEREST PAYMENT PLAN AS DESCRIBED ABOVE. FOR PATIENTS THAT THE HOSPITAL IS UNABLE TO CONTACT:- EIGHT ACCOUNT STATEMENTS ARE SENT.- THREE LETTERS EXPLAINING THAT IF THE PATIENT FAILS TO CONTACT PATIENT FINANCIAL SERVICES, COLLECTION EFFORTS WILL BE PASSED TO AN AGENCY. THE ABOVE IS A MINIMUM OF 120 DAY PROCESS FOR ALL PATIENT PAYER TYPES. ONCE THE PATIENT ACCOUNT IS SUBMITTED TO A COLLECTION AGENCY, IT IS ADJUSTED TO BAD DEBT. PART VI, LINE 2: SINCE 2011, KRMC, IN PARTNERSHIP WITH THE MOHAVE COUNTY DEPARTMENT OF PUBLIC HEALTH, HAS LED A MAJOR COMMUNITY HEALTH INITIATIVE TO IMPROVE HEALTH AND QUALITY OF LIFE IN MOHAVE COUNTY. A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), ALONG WITH A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS COMPLETED EVERY THREE YEARS. THE, MOST RECENT PLAN WAS COMPLETED AND REVIEWED BY THE KINGMAN HEALTHCARE, INC. BOARD IN 2022. THE FINDINGS ARE DOCUMENTED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT, WHICH DETAILS HEALTH AND WELLNESS STATISTICS AND IDENTIFIES COMMUNITY NEEDS FOR HEALTH SERVICES IN MOHAVE COUNTY. THE PLANS OF ACTION TO IMPROVE THE FINDINGS PER THE CHNA, CAN BE FOUND IN THE 2022-2025 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) REPORT. KRMC IS CURRENTLY COMPLETING THE 2025 VERSION OF THE CHNA AND CHIP REPORT WITH A RELEASE DATE EXPECTED IN SUMMER 2025. THE CHNA AND CHIP REPORTS ARE AVAILABLE FOR THE PUBLIC ON THE KRMC WEBSITE WWW.AZKRMC.COM. PART VI, LINE 3: WHEN PATIENTS INDICATE THEY MIGHT NEED ASSISTANCE WITH BILLING, KRMC HAS FINANCIAL COUNSELORS AVAILABLE TO DISCUSS THE HOSPITAL'S PATIENT ASSISTANCE PROGRAM. IN ADDITION, IN PATIENTS WHO ARE REGISTERED AS SELF PAY ARE PROACTIVELY VISITED BY HOSPITAL COUNSELORS TO DISCUSS OPTIONS, INCLUDING HELPING THE PATIENT ENROLL IN MEDICAID AND OTHER PATIENT BENEFIT PROGRAMS. KRMC HAS PROGRAM DESCRIPTIONS IN BOTH ENGLISH AND SPANISH ONLINE TO EXPLAIN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP) APPLICATION AS WELL AS A PRICE TRANSPARANCY ONLINE WEBPAGE. THE HOSPITAL WEBSITE ALSO INLCUDES SECTIONS ABOUT THE KRMC POLICY COMBATING SURPRISE BILLS AND A DESCPTION OF HOW TO UNDERSTAND THE BILLING. FURTHER INFORMATION ABOUT ASSISTANCE PROGRAMS AND THE AFFORDABLE CARE ACT ARE INCLUDED ON BILLING STATEMENT FROM KRMC. OTHER FORMS OF COMMUNICATION INLCUDE PUBLIC HEALTH FAIRS AND EDUCATIONAL OPPORTUNITIES, PUBLISHED HEALTHCARE ARTICLES AND POSTINGS ON VARIOUS SOCIAL MEDIA PLATFORMS. PART VI, LINE 4: AS A REGIONAL HEALTHCARE FACILITY, KRMC AND ITS CLINICAL PRACTICES PROVIDE HEALTHCARE SERVICES FOR THE COMMUNITIES IN MOHAVE COUNTY, ARIZONA (APPROXIMATELY 13,470 SQUARE MILES). KRMC, WHICH IS LOCATED IN THE CITY OF KINGMAN, ARIZONA (POPULATION OF 35,334 IN 2023), IS THE LARGEST HOSPITAL BETWEEN LAS VEGAS, NEVADA, AND PHOENIX, ARIZONA. OVERALL, THE ESTIMATED POPULATION IN RURAL MOHAVE COUNTY IS 220,816 WITH AN ESTIMATED 16.8 PERSONS PER SQUARE MILE. THE KRMC PAYOR MIX FOR THE MEDICAID AND THE UNINSURED POPULATION IS 21.5% WITH AN ADDITIONAL 55% PERCENT COMING FROM MEDICARE. ACCORDING TO THE CENSUS BUREAU, IN 2024 AN ESTIMATED 16.8% OF THE POPULATION IN MOHAVE COUNTY LIVED AT OR BELOW THE POVERTY LINE, WHICH IS HIGHER THAN THE NATIONAL AVERAGE OF 12.4%. THE MEDIAN INCOME IN 2023 FOR THE COUNTY WAS $55,799, A 4.12% INCREASE FROM 2022-23. EDUCATIONALLY, 88.2% OF PEOPLE 25 OR OLDER ARE HIGH SCHOOL GRADUATES WITH 14.9% HAVING EARNED A BACHELOR'S DEGREE OF HIGHER. IN DECEMBER 2024, THE UNEMPLOYMENT RATE FOR MOHAVE COUNTY WAS 4.2% WHILE THE HIGHEST RATE OF UNEMPLOYMENT IN ARIZONA IS YUMA COUNTY AT 11.9% DURING THE SAME TIME PERIOD. WITHIN MOHAVE COUNTY, THERE ARE THREE OTHER HOSPITALS PROVIDING HEALTHCARE SERVICES TO THE COMMUNITY. PART VI, LINE 5: KINGMAN HEALTHCARE, INC. IS ORGANIZED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES RELATING TO HEALTHCARE IN HOSPITAL DISTRICT #1 OF MOHAVE COUNTY. ITS PRIMARY FUNCTION IS TO OPERATE KINGMAN REGIONAL MEDICAL CENTER (KRMC). KRMC'S BOARD OF DIRECTORS CONSISTS OF 13 MEMBERS HOLDING TERMS OF THREE YEARS. ALL BOARD MEMBERS ARE COMMUNITY-MINDED INDIVIDUALS WHO DO NOT RECEIVE COMPENSATION FOR THEIR SERVICES ON THE KRMC BOARD. ALL EXCESS FUNDS ARE KEPT FOR THE BENEFIT AND DEVELOPMENT OF THE COMMUNITY'S HEALTH SERVICES AS DETERMINED BY OUR LOCAL BOARD. WITH THIS, OUR HOSPITAL AVERAGE INPATIENT CHARGES HAVE REMAINED SIGNIFICANTLY BELOW THE ARIZONA AVERAGE FOR THE SAME TYPES OF PATIENTS. ADDITIONALLY, EXCESS FUNDS ACCUMULATED SINCE KRMC WAS ORGANIZED, HAVE BEEN UTILIZED TO PAY CAMPUS EXPANSION AND IMPROVEMENTS, STATE-OF-THE-INDUSTRY TECHNOLOGY, AND COMPETITIVE SALARIES FOR EMPLOYEES. KRMC CONTINUALLY INVESTS IN ADVANCED MEDICAL TECHNOLOGIES. FROM SPECIALIZED DIAGNOSTIC CAPABILITIES TO ADVANCED TREATMENTS IN CARDIAC CARE AND CANCER, PATIENTS AT KRMC BENEFIT FROM SOME OF THE MOST SOPHISTICATED MEDICAL TECHNOLOGIES IN THE REGION. IN 2007, KRMC RECEIVED THE GOVERNOR'S ARIZONA INNOVATION AWARD IN RECOGNITION FOR ITS INVESTMENT IN TECHNOLOGY AND SERVICES NOT NORMALLY SEEN IN A RURAL COMMUNITY. KRMC IS A MAJOR COMMUNITY PARTNER DEDICATED TO ENHANCING THE OVERALL QUALITY-OF-LIFE IN NORTHWEST ARIZONA. WE OFFER MANY SERVICES AND PROGRAMS TO BENEFIT THE COMMUNITY, ESPECIALLY OUR MOST VULNERABLE CITIZENS - CHILDREN, ELDERLY, THOSE IN ILL HEALTH, AND THOSE IN SOCIO-ECONOMIC DISTRESS. EXAMPLES OF OUR COMMUNITY BUILDING ACTIVITIES INCLUDE:- CONDUCTING PUBLIC HEALTH LECTURES AT THE HOSPITAL AND AT AREA NURSING HOMES AND BUSINESSES (MONTHLY).- CONDUCTING HEALTH FAIRS, WHICH ARE FREE AND OPEN TO THE PUBLIC (8 HEALTH FAIRS PER YEAR).- OFFERING A VARIETY OF FREE SUPPORT GROUPS TO HELP PEOPLE WHO ARE WORKING TO CHANGE A BEHAVIOR OR WHO ARE DEALING WITH A LOSS, CONDITION, OR DISEASE.- SPONSORING PHYSICAL FITNESS PROGRAMS AT COMMUNITY ELEMENTARY SCHOOLS TO HELP KIDS BE ACTIVE, FIT, AND HEALTHY.- PLACING DEFIBULATORS IN OUR COMMUNITY'S HIGH TRAFFIC PUBLIC PLACES TO PROVIDE IMMEDIATE LIFESAVING TREATMENT TO SOMEONE WITH CARDIAC ARREST.- PROVIDING FREE OR LOW COST MAMMOGRAMS TO UNINSURED OR UNDERINSURED WOMEN RESIDING IN THE HOSPITAL DISTRICT OF MOHAVE COUNTY.- PROVIDING SCHOLARSHIPS FOR QUALIFIED INDIVIDUALS WHO CANNOT AFFORD A MEMBERSHIP TO KRMC'S DEL E. WEBB WELLNESS CENTER.- PROVIDING SCHOLARSHIPS TO HELP NURSING STUDENTS WITH THEIR EDUCATIONAL COSTS.- PROVIDING CASH CONTRIBUTIONS, FREE SERVICES, OR OTHER SUPPORT TO OVER 40 LOCAL ORGANIZATIONS THAT SERVE THE NEEDS OF OUR COMMUNITY (E.G, BOYS AND GIRLS CLUB, KINGMAN FOOD BANK, SARAH'S HOUSE, ETC.).- HELPING UNINSURED/UNDERINSURED PATIENTS WITH THEIR HEALTHCARE COSTS THROUGH KRMC'S CHARITY CARE PROGRAM. ADDITIONALLY, KRMC IS ONE OF THE AREA'S LARGEST CONTRIBUTORS TO THE LOCAL ECONOMY. WE EMPLOY OVER 1800 PEOPLE AND DURING THE PAST YEAR SPENT OVER $10,000,000 WITH LOCAL BUSINESSES. 1 MSTEPP 2730 E ANDY DEVINE AVENUE KINGMAN AZ 86401 262119427 501(C)(3) 35000 0 PROVIDES SOLUTIONS FOR SUBSTANCE ABUSE KINGMAN AID TO ABUSED PEOPLE 1770 AIRWAY AVENUE KINGMAN AZ 86409 860601113 501(C)(3) 22000 0 PROVIDES SHELTER & ASSISTANCE FOR ABUSED PERSONS IN THE KINGMAN AREA KATHERINE HEIDENREICH ADULT CENTER 1776 AIRWAY AVENUE KINGMAN AZ 86401 860397271 501(C)(3) 15000 0 PROVIDES ASSISTANCE TO THE ELDERLY, TRANSPORTATION TO PHYS. APPTS, MEALS TO HOMEBOUND PERSONS KINGMAN CANCER CARE UNIT PO BOX 3014 KINGMAN AZ 86402 860753651 501(C)(3) 13000 0 PROVDES ASSISTANCE FOR CANCER PATIENTS IN KINGMAN AREA, TRANSPORTATION, HEALTHCARE EQUIPMENT, ETC. CORNERSTONE MISSION 3049 SYCAMORE KINGMAN AZ 86409 860960036 501(C)(3) 11000 0 PROGRAM TO HELP HOMELESS MEN IN KINGMAN AREA, EDUCATION & JOB SKILLS KINGMAN AREA FOOD BANK 2930 E BUTLER AVENUE KINGMAN AZ 86409 860503686 501(C)(3) 10000 0 COMMUNITY FOOD BANK KINGMANS HEALING HOOVES 4390 N GLEN ROAD KINGMAN AZ 86409 352439100 501(C)(3) 8500 0 EAL/EAP, HORSEMANSHIP RIDING LESSONS, AND RIDERS WITH DISABILITIES RIDING LESSONS ARIZONA YOUTH PARTNERSHIP 1902 PACIFIC AVENUE KINGMAN AZ 86401 860669087 501(C)(3) 6500 0 TEACHES HOMELESS TEENAGE BOYS THE SKILLS TO REFUSE ALCOHOL, TOBACCO AND DRUGS YUCCA COMMUNITY FOOD PANTRY PO BOX 303 YUCCA AZ 86438 384139944 501(C)(3) 5550 0 COMMUNITY FOOD BANK 9 0 EMPLOYEE EDUCATION BENEFITS 74 278742 PART I, LINE 2: ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: KHI ACCOUNTING POLICIES AND PROCEDURES ARE FOLLOWED FOR GRANT FUNDS INCLUDING SPECIFIC REQUIREMENTS FOR GRANT PROGRAMS. X X X X 1 0 0 0 0 0 0 1 0 JEREMY KAPLAN PHYSICIAN 844533 0 336140 0 0 0 13200 0 32629 0 1226502 0 0 0 MARK DAVIS PHYSICIAN 498053 0 379238 0 0 0 9900 0 24506 0 911697 0 0 0 ADAM BRAZE PHYSICIAN 826727 0 0 0 0 0 19800 0 39118 0 885645 0 0 0 EDGARDO RIVERA PHYSICIAN 576274 0 239538 0 0 0 19800 0 35105 0 870717 0 0 0 ABHINAV OHRI PHYSICIAN 625648 0 200263 0 0 0 13200 0 13039 0 852150 0 0 0 HEATH EVANS CEO 569726 0 0 0 641 0 0 0 25468 0 595835 0 0 0 CHRISTINA DIMAMBRO FORMER CFO 174341 0 0 0 209144 0 0 0 22145 0 405630 0 0 0 JOSHUA HOFFMAN CFO 306857 0 0 0 282 0 2212 0 34846 0 344197 0 0 0 JAMES WELLS FORMER CNO 110216 0 0 0 208660 0 4957 0 13872 0 337705 0 0 0 DAVID SCHOTT CAO 311189 0 0 0 186 0 0 0 6776 0 318151 0 0 0 LESLIE MARTIN CNO 264053 0 0 0 1214 0 16011 0 16315 0 297593 0 0 0 PART I, LINE 4A TWO INDIVIDUALS REPORTED ON PART VII RECEIVED SEVERANCE PAYMENTS IN 2023. DETAILS OF THE AGREEMENTS ARE AVAILABLE UPON REQUEST. PART I, LINE 7 STRATEGICALLY IDENTIFIED ROLES WITHIN THE ORGANIZATION ARE ELIGIBLE FOR BONUSES BASED ON THE DISCRETION OF THE BOARD, INCLUDING THE ABILITY TO SET GOALS AND TARGETS FOR THOSE BONUSES. A ARIZONA INDUSTRIAL DEVELOPMENT AUTHORITY 813526584 2017-12-29 20000000 CAPITAL PROJECTS 0 0 0 B ARIZONA INDUSTRIAL DEVELOPMENT AUTHORITY 813526584 2021-09-28 30000000 CAPITAL PROJECTS 0 0 0 A 12463184 20000000 89500 19910500 2019 0 0 1 1 B 11416730 30000000 126564 22505036 7368400 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 FRANCESCO SINOPOLI FAMILY MEMBER OF JAMES BAKER, VICE CHAIRMAN OF THE BOARD 199315 EMPLOYEE PAY 0 SARAH SCHRITTER RELATIONSHIP WITH DAN DEL MONACO, DIRECTOR OF THE BOARD 168015 EMPLOYEE PAY 0 AMANDA BAKER FAMILY MEMBER OF JAMES BAKER, VICE CHAIRMAN OF THE BOARD 143536 EMPLOYEE PAY 0 MEAGAN FLUMMER FAMILY MEMBER OF DAN DEL MONACO, DIRECTOR OF THE BOARD 142149 EMPLOYEE PAY 0 KAREN WATERS FAMILY MEMBER OF JOSEPH DORNER, DIRECTOR OF THE BOARD 117709 EMPLOYEE PAY 0 KAITLYN DEL MONACO FAMILY MEMBER OF DAN DEL MONACO, DIRECTOR OF THE BOARD 44113 EMPLOYEE PAY 0 MONOLITH DIAGNOSTICS PC 100% CONTROLLED ENTITY OF BRENT BEDKE, MD AND RYAN SWAPP, MD 2263850 PAYMENTS FOR MEDICAL SERVICES 0 FORM 990, PART VI, SECTION A, LINE 2 BRENT BEDKE AND RYAN SWAPP HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY A THIRD-PARTY PREPARER WITH A DETAIL REVIEW BEING CONDUCTED BY THE CONTROLLER AND ACCOUNTANT OF THE ORGANIZATION. A FINAL COPY OF THE FORM 990 IS THEN E-MAILED TO THE BOARD OF DIRECTORS BEFORE THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE EXECUTIVE ASSISTANT TO THE CEO ANNUALLY DISTRIBUTES THE POLICY DOCUMENTS AND FORMS TO ALL MANAGERS AND BOARD MEMBERS. THE RELATED FORMS CONTAIN WRITTEN EXPLANATIONS BY MANAGERS AND BOARD MEMBERS. IF A POTENTIAL CONFLICT ARISES, THE SITUATION IS THEN REVIEWED BY THE CEO. IF A CONFLICT OF INTEREST COVERED BY THIS POLICY EXISTS, WHETHER OR NOT LISTED ON A DISCLOSURE FORM, THEN THE PERSON INVOLVED WITH THE POTENTIAL CONFLICT OF INTEREST RECUSES THEMSELF FROM VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE CHRO PREPARES A STUDY BASED ON EXTERNAL COMPARISONS OF SIMILAR POSITIONS IN SIMILAR SIZED ORGANIZATIONS IN THE INDUSTRY. THE STUDY IS REVIEWED BY AN INDEPENDENT COMPENSATION COMMITTEE THEN SUBMITTED TO THE EXECUTIVE BOARD FOR FINAL APPROVAL. CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION PROCESS ARE KEPT ON FILE. THIS STUDY IS CONDUCTED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR A VALID BUSINESS PURPOSE. FORM 990, PART VI, SECTION C, LINE 19 THE EXECUTIVE ASSISTANT TO THE CEO ANNUALLY DISTRIBUTES THE POLICY DOCUMENTS AND FORMS TO ALL MANAGERS AND BOARD MEMBERS. THE RELATED FORMS CONTAIN WRITTEN EXPLANATIONS BY MANAGERS AND BOARD MEMBERS. IF A POTENTIAL CONFLICT ARISES, THE SITUATION IS THEN REVIEWED BY THE CEO. IF A CONFLICT OF INTEREST COVERED BY THIS POLICY EXISTS, WHETHER OR NOT LISTED ON A DISCLOSURE FORM, THEN THE PERSON INVOLVED WITH THE POTENTIAL CONFLICT OF INTEREST RECUSES THEMSELF FROM VOTING ON THE MATTER. FORM 990, PART IX, LINE 11G NURSING AGENCY & CONTRACT LABOR, ETC: PROGRAM SERVICE EXPENSES 45,154,325. MANAGEMENT AND GENERAL EXPENSES 165,101. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 45,319,426. CONTRACT & EQUIPMENT SERVICES: PROGRAM SERVICE EXPENSES 10,955,578. MANAGEMENT AND GENERAL EXPENSES 5,936,441. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,892,019. CONSULTING FEES,PATIENT FINANCIAL SERVICES COLLECTION AGENCY, & NI2: PROGRAM SERVICE EXPENSES 52,000. MANAGEMENT AND GENERAL EXPENSES 1,338,659. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,390,659. FORM 990, PART XI, LINE 9: CHANGE IN NET ASSETS OF KRMC FOUNDATION 165,700. OTHER CHANGE -2,798,466. NORTHWEST ARIZONA REGIONAL INSURANCE 4041 N CENTRAL AVENUE PHOENIX AZ 85012 208081486 INSURER AZ 501(C)(3) LINE 12A, I KRMC 1 KINGMAN REGIONAL MEDICAL CENTER FOUNDATION 3269 STOCKTON HILL ROAD KINGMAN AZ 86409 742388735 COMMUNITY SUPPORT AZ 501(C)(3) LINE 7 N/A 1 KX VENTURES 3269 N STOCKTON HILL ROAD KINGMAN AZ 86409 843415074 LAND DEVELOPMENT AZ N/A LEASE 0 1 0.85000 0 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 NORTHWESTERN ARIZONA REGIONAL INSURANCE R 1934834 INTERCO AMOUNT NORTHWESTERN ARIZONA REGIONAL INSURANCE S 1000000 INTERCO AMOUNT