2026-06-09T21:16:04-05:00 2025-06-30 994625061 CRI ADVISORS LLC 2424 LOUISIANA BLVD NE STE 300 ALBUQUERQUE NM 87110 990 2024-07-01 850141285 CIBOLA GENERAL HOSPITAL CIBO 5052874446 1016 E ROOSEVELT AVENUE GRANTS NM 87020 LIZ SELLERS CEO 5052874446 2026-06-09 1 1 RHONDA G WILLIAMS P01752571 5058832727 2026-06-09 2024 2025-03-06 01:10:19Z LIZ SELLERS 1016 E ROOSEVELT AVENUE GRANTS NM 87020 83269089 0 X WWW.CIBOLAHOSPITAL.COM X 1959 NM TO PROVIDE HEALTH CARE SERVICES TO THE COMMUNITY WITHOUT REGARD TO ABILITY TO PAY BY UTILIZING STATE OF THE ART PRACTICES AND EQUIPMENT TO PROVIDE QUALITY CARE. 9 9 361 8 0 0 675658 5139234 52876561 77868627 64511 27328 199037 233900 53815767 83269089 0 0 0 0 29893802 32068340 0 0 0 28275871 31014710 58169673 63083050 -4353906 20186039 36477185 55340880 9431734 8127506 27045451 47213374 X TO PROVIDE EXCELLENT HEALTH CARE TO THE COMMUNITY BY COMMITTING TO SERVICE, QUALITY, FINANCIAL STABILITY, AND GROWTH. THE ORGANIZATION STRIVES TO PROVIDE PATIENTS AND FAMILIES WITH QUALITY SERVICE BY IMPLEMENTING NATIONAL BEST PRACTICES AS STANDARDS. IT ALSO MAINTAINS FINANCIAL STABILITY TO ENSURE ITS CONTINUANCE AND GROWTH SO THAT HEALTH CARE IS ACCESIBLE THROUGH THE HOSPITAL AND ITS PHYSICIAN PARTNERSHIPS. 0 0 47692485 78102527 THE ORGANIZATION PROVIDES PATIENT CARE TO THE RESIDENTS OF GRANTS, NEW MEXICO AND OUTLYING COMMUNITIES WITHOUT REGARD TO ABILITY TO PAY. THERE ARE APPOXIMATELY 27,000 RESIDENTS IN THE CIBOLA COUNTY, NM COMMUNITY. CIBOLA COUNTY HOSPITAL UTILIZES STATE OF THE ART EQUIPMENT AND THE HIGHEST HEALTH CARE STANDARDS TO PROVIDE QUALITY HEALTH CARE. DURING THE FISCAL YEAR, THE ORGANIZATION HAD ABOUT 755 INPATIENT ADMISSIONS SERVED IN ITS 25-BED FACILITY. THE HOSPITAL ALSO HAD ABOUT 24,058 OUTPATIENT VISITS, 14,578 EMERGENCY ROOM VISITS, AND ABOUT 28,362 CLINIC VISITS. THE ORGANIZATION'S STAFF WORK HARD TO MEET PATIENT NEEDS AND THEY FEEL EVERY PATIENT ENCOUNTER IS AN ACCOMPLISHMENT. 47692485 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 76 0 1 361 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NM X X CIBOLA GENERAL HOSPITAL 5052874446 1016 E ROOSEVELT AVE GRANTS NM 87020 EILEEN YARBOROUGH CHAIRMAN 2.00 X X 0 0 0 HARRY SHESHKI MD VICE CHAIRMAN 2.00 X X 0 0 0 DR STACEY DIMITT CHIEF OF MEDICAL STAFF/MEMBER 40.00 X X 489538 0 19854 KEVIN BRANUM TREASURER 2.00 X X 0 0 0 KENDRA BROWN MEMBER 2.00 X 0 0 0 CARLOS TAPIA MEMBER 2.00 X 0 0 0 VICTORIA GASTONGUAY MEMBER 2.00 X 0 0 0 RAY CARPENTER MEMBER 2.00 X 0 0 0 DR ARNOLD VALDIVIA MEMBER 2.00 X 0 0 0 MARIA ATENCIO ACTING CEO 40.00 X 212800 0 30500 JIM HERMES CFO 40.00 X 201457 0 10401 THOMAS WHELAN OUTGOING CEO 40.00 X 310557 0 28331 ALFREDO NEVAREZ PHYSICIAN 40.00 X 399893 0 23000 SNOW MARIKA PETERSEN PHYSICIAN 40.00 X 488393 0 20250 AMANDA YOUNG PHYSICIAN 40.00 X 443430 0 22865 SARA THORP PHYSICIAN 40.00 X 439841 0 23000 ANALISA VILLARREAL PHYSICIAN 40.00 X 402894 0 22139 3388803 0 200340 68 0 1 0 FEDKO EMERGENCY PHYSICIANS NM LLC 1202 HIGHWAY 60 SOCORRO NM 87801 EMERGENCY DEPT MANAGEMENT 2945417 TRICORE REFERENCE LABORATORY 1001 WOODARD PL NE ALBUQUERQUE NM 87102 PATHOLOGY REFERENCE LAB SVCS 856312 NETHERLANDS ANESTHESIA 104 LEGION DR LAS VEGAS NM 87701 ANESTHESIA SERVICES 819419 CARDIAC CARE CONSULTANTS OF NM PC 715 DR MARTIN LUTHER KING JR AVE N ALBUQUERQUE NM 87102 CARDIOLOGY SERVICES 345369 AB STAFFING SOLUTIONS 3451 MERCY RD 102 GILBERT AZ 85297 NURSE STAFFING AGENCY 312360 14 5139234 5139234 ACUTE CARE HOSPITAL SERVICES 622110 54022409 54022409 PATIENT SAFETY NET CARE POOL 622110 22105851 22105851 CIBOLA COUNTY MILL LEVY SUBSIDY 622110 1740332 1740332 OTHER PROGRAM REVENUE 622110 35 35 77868627 27328 27328 FOOD SERVICE INCOME 722514 233900 233900 233900 83269089 78102527 0 27328 1303437 376345 927092 25392001 19044001 6348000 735705 551779 183926 2684357 2013268 671089 1952840 1464630 488210 1363522 640855 722667 345739 345739 56297 56297 5737540 5737540 125210 125210 3201178 2721000 480178 732174 366087 366087 1184 1184 167820 167820 2760036 2070027 690009 4463754 3876044 587710 PURCHASED SERVICES 5479648 2741324 2738324 MEDICAL, RX & FOOD SUPP 4239214 3688116 551098 LICENSES & TAXES 2341394 2107255 234139 63083050 47692485 15390565 0 2328313 8393038 6491333 13591086 11183715 18875112 1366413 1646486 690660 1127325 28154516 16446683 14416751 11707833 36477185 55340880 4866784 4010359 4564950 4117147 9431734 8127506 X 27045451 47213374 27045451 47213374 36477185 55340880 X 20186039 209216 -227332 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6104792 3492675 2612117 3731265 153236 3578029 14146687 11347631 2799056 4171772 1453141 2718631 11707833 LONG-TERM LEASE LIABILITY 4117147 4117147 83310485 209216 209216 83101269 167820 167820 83269089 62915230 0 62915230 167820 167820 63083050 PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASS INTEREST EXPENSE PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS INTEREST EXPENSE SCHEDULE D, PART VI, LINE 1(E): THIS LINE CONTAINS THE ORGANIZATION'S SOFTWARE LICENSE. 1 1 1 X 350.000000000000 1 X 100.000000000000 1 1 0 0 454256 454256 0.00720 4121219 3856566 264653 0.00420 4575475 3856566 718909 0.01140 12564 12564 0.00020 12564 12564 0.00020 4588039 3856566 731473 0.01160 1 8558594 4164713 5257657 9065428 -3807771 X 1 1 1 1 CIBOLA GENERAL HOSPITAL INC 1016 E ROOSEVELT AVE GRANTS NM 87020 HTTPS://CIBOLAHOSPITAL.COM X CIBOLA GENERAL HOSPITAL INC 1 0 0 1 X X X X X X X X X 25 1 0 0 1 X HTTPS://CIBOLAHOSPITAL.COM 1 25 1 HTTPS://CIBOLAHOSPITAL.COM 0 1 X 350.000000000000 100.000000000000 X X X X 1 1 X X X X 1 X HTTPS://CIBOLAHOSPITAL.COM X HTTPS://CIBOLAHOSPITAL.COM X X X 1 X 1 X X X X 1 0 0 CIBOLA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 5: FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL SOUGHT INPUT FROM ALL PERSONS IN ITS SERVICE AREA, INCLUDING COUNTY GOVERNMENT AND LEADERS OF THE BUSINESS COMMUNITY. THE NEEDS ASSESSMENT WAS OFFERED ONLINE FROM A LINK TO IT IN THE HOSPITAL'S WEBSITE, AND WAS ALSO OFFERED IN A PAPER VERSION TO ANY WHO PREFERRED IT THAT WAY. THE PERSONS CONSULTED INCLUDED, BUT WERE NOT LIMITED TO, THE CEO, CFO, CCO, HR DIRECTOR, ALL MEMBERS OF THE BOARD, AND THE MEDICAL STAFF. THE NEEDS ASSESSMENT WAS HEAVILY ADVERTISED IN THE MEDIA. CIBOLA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 11: THE HOSPITAL AND ITS BOARD PRACTICE ONGOING PROMOTION OF HEALTH IMPROVEMENT. COMMUNITY HEALTH IS PROMOTED IN THE FOLLOWING WAY: (1) THE HOSPITAL BOARD IS A COMMUNITY-BASED, ALL VOLUNTEER GROUP; (2) SURPLUS FUNDS ARE USED TO REINVEST IN THE FACILITIES TO KEEP THEM STATE OF THE ART; (3) FINANCIAL SUPPORT TO THE LOCAL COLLEGE FUNDS THE SALARY OF THE NURSING PROGRAM DIRECTOR; (4) THE HOSPITAL CO-SPONSORS AN ANNUAL HEALTH FAIR TO EDUCATE THE COMMUNITY; (5) ANNUAL VACCINATION CLINICS ARE STAFFED BY HOSPITAL NURSES; AND (6) FREE CLASSES ARE SPONSORED IN DIABETES EDUCATION, CHILDBIRTH, AND BREASTFEEDING. CIBOLA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 18E: OUTSIDE COLLECTION AGENCIES ARE USED. THE RECOVERY RATES BY THESE AGENCIES ARE TYPICALLY UNDER 10%. CIBOLA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 20E: PATIENTS ARE NOTIFIED UPON ADMISSION AND DISCHARGE OF THE FINANCIAL ASSISTANCE PROGRAM. ALSO, THE ORGANIZATION DOCUMENTS ITS DETERMINATION OF ELIGIBILITY AND NOTIFIES PATIENTS OF THE POLICY IN COMMUNICATIONS WITH PATIENTS REGARDING THEIR BILLS. PART I, LINE 7: AMOUNT REPORTED ON LINE A, COLUMN C IS BASED ON THE ORGANIZATION'S COST TO CHARGE RATIO. LINE B, COLUMN D USES COST TO CHARGE RATIO OFFSET BY A CONTRACTUAL PERCENTAGE LEADING TO THE AMOUNT REPORTED IN COLUMN E. LINE E, COLUMN C IS BASED ON ACTUAL COST. PART I, LINE 3C THE APPLICANT FOR FINANCIAL ASSISTANCE MUST SUBMIT THE FOLLOWING AS PROOF OF INCOME: (1) COMPLETED FINANCIAL ANALYSIS FORM, INCLUDING NUMBER OF PERSONS IN THE HOUSEHOLD, LOCATION OF EMPLOYER AND LENGTH OF EMPLOYMENT, DISCLOSURE OF PROPERTY AND REAL ESTATE OWNED, INCOME OF RESPONSIBLE PARTY AND SPOUSE, BANK BALANCES, AND LISTING OF MONTHLY EXPENSES. (2) PROOF OF HOUSEHOLD INCOME. AND (3) DISCLOSURE OF ANY OTHER SUPPORT RECEIVED. PART III, LINE 4: THERE IS NO MENTION OF BAD DEBT EXPENSE NOR ITS CALCULATION METHODOLOGY WITHIN AUDITED FINANCIAL STATEMENT REPORT. PART III, LINE 8: THE ENTIRE MEDICARE SHORTFALL SHOULD BE REGARDED AS COMMUNITY BENEFIT. PART III, LINE 9B: PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE CONSIDERED IN THE PROCESS. PART VI, LINE 3: THE APPLICANT FOR FINANCIAL ASSISTANCE MUST SUBMIT THE FOLLOWING AS PROOF OF INCOME: (1) COMPLETED FINANCIAL ANALYSIS FORM, INCLUDING NUMBER OF PERSONS IN THE HOUSEHOLD, LOCATION OF EMPLOYER AND LENGTH OF EMPLOYMENT, DISCLOSURE OF PROPERTY AND REAL ESTATE OWNED, INCOME OF RESPONSIBLE PARTY AND SPOUSE, BANK BALANCES, AND LISTING OF MONTHLY EXPENSES. (2) PROOF OF HOUSEHOLD INCOME. AND (3) DISCLOSURE OF ANY OTHER SUPPORT RECEIVED. PART VI, LINE 7, REPORTS FILED WITH STATES NM PART VI, LINE 2: THE ORGANIZATION OBTAINS A GREAT AMOUNT OF INFORMAL FEEDBACK FROM PATIENTS AND VISITORS. PART VI, LINE 3: IF DURING THE PATIENT REGISTRATION PROCESS IT IS DETERMINED THAT THE PATIENT LACKS THE ABILITY TO PAY, THEN THE REGISTRATION PERSON WILL PRESENT THE PATIENT THE INFORMATION NEEDED FOR HIM/HER TO APPLY FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: CIBOLA GENERAL HOSPITAL PROVIDES MEDICAL SERVICES IN A COUNTY THAT REPRESENTS APPROXIMATELY 27,000 RESIDENTS. PART VI, LINE 5: A TRANSPARENT BOARD, INVOLVED MEDICAL STAFF, AND EMPLOYEES WHO ARE ALSO CITIZEN-STAKEHOLDERS HELP PROMOTE COMMUNITY HEALTH. PART VI, LINE 6: THE ORGANIZATION IS NOT A PART OF AN AFFILIATED HEALTH CARE SYSTEM. X X 0 0 0 0 0 0 0 0 0 DR STACEY DIMITT CHIEF OF MEDICAL STAFF/MEMBER 489538 0 0 0 0 0 0 0 19854 0 509392 0 0 0 SNOW MARIKA PETERSEN PHYSICIAN 488393 0 0 0 0 0 0 0 20250 0 508643 0 0 0 AMANDA YOUNG PHYSICIAN 443430 0 0 0 0 0 0 0 22865 0 466295 0 0 0 SARA THORP PHYSICIAN 439841 0 0 0 0 0 0 0 23000 0 462841 0 0 0 ANALISA VILLARREAL PHYSICIAN 402894 0 0 0 0 0 0 0 22139 0 425033 0 0 0 ALFREDO NEVAREZ PHYSICIAN 399893 0 0 0 0 0 0 0 23000 0 422893 0 0 0 THOMAS WHELAN OUTGOING CEO 310557 0 0 0 0 0 0 0 28331 0 338888 0 0 0 MARIA ATENCIO ACTING CEO 212800 0 0 0 0 0 0 0 30500 0 243300 0 0 0 JIM HERMES CFO 201457 0 0 0 0 0 0 0 10401 0 211858 0 0 0 FORM 990, PART VI, SECTION A, LINE 7B PER THE COUNTY FACILITIES CONTRACT WITH THE HOSPITAL, THE HOSPITAL SHALL NOT ACQUIRE REAL PROPERTY ADJACENT TO THE HOSPITAL OR CLINIC PREMISES WITHOUT THE CONSENT OF THE COUNTY. PER THAT CONTRACT, THE COUNTY SHALL APPOINT 4 BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 AND RELATED SCHEDULES ARE REVIEWED BY THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C ALL TRUSTEES, OFFICERS AND EMPLOYEES ARE REQUIRED ANNUALLY TO DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST IN WRITING. THE FORM IS SIGNED AND DATED, AND MONITORED BY THE COMPLIANCE COORDINATOR. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF OFFICERS AND HIGHLY PAID EMPLOYEES IS DETERMINED BY REVIEW OF COMPARABLE PAY FOR COMPARABLE DUTIES BY RECRUITERS, AND/OR OTHER CONSULTANTS. ALL AMOUNTS ARE APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS AND TAX FORMS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ALSO, THE CEO REPORTS REGULARLY TO THE COUNTY COMMISSION AT A PUBLIC MEETING AND THE BOARD HOLDS MONTHLY PUBLIC MEETINGS. FORM 990, PART XI, LINE 9: RESTATEMENT OF LIABILITIES PER AUDITED FINANCIALS -227,332. FORM 990, PART XII, LINE 2C: THE BOARD SELECTS THE AUDITORS AND OVERSEES THE AUDIT PROCESS; THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THIS IS THE FIRST TIME CIBOLA GENERAL HOSPITAL HAS FAILED TO FILE ITS TAX RETURN BY THE DUE DATE OR EXTENDED DUE DATE. WE HAVE AN EXCELLENT PAST COMPLIANCE RECORD. THE LATE FILING OF THIS RETURN WAS DUE TO UNFORESEEN CIRCUMSTANCES.IN 2024/2025, THE HOSPITAL EXPERIENCED A TURNOVER IN UPPER MANAGEMENT, AS WELL AS ACCOUNTING SERVICE PROVIDERS. AS A RESULT OF THIS TRANSITION, NO ONE FILED THE EXTENSION FOR THE 990 THAT WAS DUE BY NOVEMBER 15, 2025. WE ONLY BECAME AWARE OF THIS WHEN WE BEGAN SENDING OUR ACCOUNTANT THE INFORMATION TO PREPARE THE RETURN. THE INDEPENDENT AUDIT WAS COMPLETED IN MARCH OF 2026, PRIOR TO THE EXTENDED DUE DATE OF MAY 15. WE PROVIDED THE INFORMATION TO THE ACCOUNTANT AS QUICKLY AS POSSIBLE.CIBOLA GENERAL HOSPITAL IS THE SOLE HOSPITAL FOR CIBOLA COUNTY, MAKING IT THE PRIMARY HEALTHCARE PROVIDER FOR RESIDENTS IN THE REGION. CIBOLA COUNTY RESIDENTS HAVE VERY LITTLE ACCESS TO PRIMARY CARE PHYSICIANS AND MENTAL HEALTH PROVIDERS. APPROXIMATELY 26,859 PEOPLE LIVE IN CIBOLA COUNTY, OF WHICH 45% ARE AMERICAN INDIAN AND 63% LIVE IN RURAL AREAS. CIBOLA COUNTY HAS A LOWER HOUSEHOLD INCOME THAN THE NEW MEXICO AVERAGE. APPROXIMATELY 68% OF THE HOSPITAL'S NET REVENUE IS FROM MEDICARE AND MEDICAID PROGRAMS. THE HOSPITAL PROVIDES SERVICES TO MEDICALLY INDIGENT RESIDENTS OF CIBOLA COUNTY, AS WELL AS THE COUNTY'S PRISON INMATES, AT NO COST TO THE COUNTY.A LARGE LATE-FILING PENALTY WOULD SEVERELY AFFECT THE HOSPITAL'S ABILITY TO PROVIDE MUCH-NEEDED SERVICES TO RESIDENTS OF AN IMPOVERISHED AREA OF NEW MEXICO WHO ARE VERY MUCH DEPENDENT ON GOVERNMENT SUPPORT AND INDIGENT CARE PROGRAMS TO OBTAIN EVEN BASIC MEDICAL CARE.DUE TO THE ABOVE FACTORS, WE RESPECTFULLY REQUEST THAT YOU WAIVE THE LATE-FILING FEES FOR THIS RETURN.