2024-07-10T15:21:29-05:00 2023-09-30 910189318 Moss Adams LLP 5415 E High Street Ste 350 Phoenix AZ 85054 990 2022-10-01 866007596 Yuma Regional Medical Center YUMA 9283367000 2400 S Avenue A Yuma AZ 85364 Vernon Moore SVP/Chief Financial Officer 9283367000 2024-07-08 1 Vernon Moore 999009999 1 Lauren A Haverlock P00545829 4804443424 2024-06-27 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Dr Robert J Trenschel 2400 S Avenue A Yuma AZ 85364 1254254158 0 X www.yumaregional.org X 1964 AZ Through prudent use of resources, our 406-bed inpatient hospital, along with numerous outpatient clinics, serves as the healthcare hub for all of Yuma County. 8 5 3091 291 185398 0 4167312 532542 738063870 802510970 24193130 28447342 -518106 947135 765906206 832437989 282001 243427 0 0 325267383 347225029 0 0 0 366254087 425499727 691803471 772968183 74102735 59469806 1139108002 1307260079 379511582 438293571 759596420 868966508 X The mission of Yuma Regional Medical Center is to improve the health and wellbeing of individuals, families and the communities we serve through excellence, innovation and prudent use of resources. 0 0 673802991 243427 802691714 See Schedule O. 673802991 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 357 0 1 3091 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 8 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Vernon Moore SVPChief Financial O 9283367000 2400 S Avenue A Yuma AZ 85364 Robert J Trenschel DO MPH President/CEO 40.00 2.00 X X 1457735 0 347226 Simon Lavotshikin MD General Surgeon 40.00 X 1263833 0 12730 Nader Haddad MD Obstetrician/Gynecologist 40.00 X 1137972 0 40915 Abhinav Chandra Oncology Program Medical Director 40.00 X 1060381 0 40915 Robert Takesuye MD Radiation Oncologist 40.00 2.00 X 1057475 0 13461 Jon-Rene Suffern MD Anesthesiologist 40.00 X 1006157 0 40467 Bharat Magu MD SVP/Chief Medical Officer 40.00 X 629150 0 120408 David Willie - SVPChief Financial Officer (thru 10/22) 40.00 2.00 X 663322 0 30034 Diane Poirot SVP/Human Resources (thru 05/22) 40.00 X 611831 0 8389 Deborah Aders RN MS CIC SVP/Chief Nursing Officer 40.00 X 541614 0 21587 Trudie Milner SVP/Operations 40.00 X 463270 0 78613 Fred Peet SVP/Chief Information Officer 40.00 X 420655 0 93378 Machele Headington SVP/Marketing and Communications 36.00 4.00 X 330769 0 99672 Robert Seibel SVP/General Counsel (thru 09/22) 40.00 X 391910 0 29185 Matthew McElrath SVP/Human Resources 40.00 X 298186 0 85607 Vernon Moore SVP/Chief Financial Officer 40.00 2.00 X 303988 0 76249 James Adamson SVP/General Counsel 40.00 2.00 X 274830 0 67607 Ashvin Shah MD Board Member 5.00 X 73500 0 0 Claudia Dima MD Board Member 5.00 X 32600 0 0 Woody Martin Board Chair 8.00 X X 0 0 0 John Sternitzke Vice Chair 5.00 X X 0 0 0 Lora Dana Secretary/Treasurer 6.00 X X 0 0 0 Fred Earle Board Member 5.00 X 0 0 0 Julie Engel Board Member (thru 02/23) 5.00 X 0 0 0 Louie Gradias Board Member 5.00 X 0 0 0 12019178 0 1206443 416 0 1 0 Yuma Heart and Vascular LLC 2400 S Avenue A Yuma AZ 85364 Medical Healthcare Services 14836117 Hospitality Healthcare Serv 6929 West Southern Avenue Laveen AZ 85339 Custodial Services 7825679 Pat Walker Construction LLC PO BOX 26059 Yuma AZ 85367 Construction Services 6702705 SW Rehabilitation Assoc LTD 2281 West 24th Street Suite 10 Yuma AZ 85364 Rehab Services 3854376 Monolith Diagnostics 1740 Sycamore Avenue Suite C Kingman AZ 86401 Anatomic and Clinical Pathology Services 3527133 159 428067 104475 532542 Patient services 621110 786286348 786286348 Health education 611710 6695826 6695826 Inc from affiliates 523000 4415257 4229859 185398 Contract revenue 624100 1136964 1136964 Gift Shop/Snack Bar 459420 1006969 77444 929525 2969606 2969606 802510970 14694823 14694823 1598791 832400 766391 766391 766391 434722007 14281 420964325 19444 13757682 -5163 13752519 13752519 Research trial revenue 541900 180744 180744 180744 832437989 801576791 185398 30143258 X 243427 243427 6532168 6532168 299826 299826 281008425 258875152 22133273 10688669 9624078 1064591 33315680 29707514 3608166 15380261 13848387 1531874 2148134 2148134 13375532 13375532 326550 326550 24656 24656 3044177 3044177 105148849 92766729 12382120 1007412 1007412 8615415 5553069 3062346 23761148 21394824 2366324 9932898 7928430 2004468 2016711 2016711 308576 308576 11694678 9517162 2177516 34839348 28352361 6486987 8896005 6455109 2440896 Medical supplies 99430221 99430221 Bad debt expense 60142880 60142880 Operations & Other 40786537 29663822 11122715 772968183 673802991 99165192 0 90247071 46857380 27781537 14868781 77501217 145775481 12835363 13955839 12112774 13698819 932256150 515927554 387248272 416328596 460002098 554930090 24479177 27021623 36602666 36653488 10297827 37169982 1139108002 1307260079 67500160 83550696 2336313 1256347 187258566 175359061 12569966 34020087 109846577 144107380 379511582 438293571 X 759596420 868966508 759596420 868966508 1139108002 1307260079 X 59469806 34232792 15667490 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 24656 24656 0 Part II-B, Line 1: Yuma Regional Medical Center (YRMC) is a member of the American Hospital Association (AHA) and Arizona Hospital Association (AZHHA). YRMC paid a total of $236,852 to AHA for membership during FY2023. Of the amount reported, 10.41% or $24,656 of dues were expended by AHA for specific lobbying purposes. 15686283 617 1730745 188661 17228984 17050847 500 -1183917 181147 15686283 14025276 35001 3086808 80238 16000 17050847 12942714 400 1509032 240753 186117 14025276 9274083 3259188 487075 77631 12942715 0.38000 0.19000 0.43000 0 1 1 29034567 29034567 497151397 192012123 305139274 21155337 13930053 7225284 322702782 309985378 12717404 62212067 62212067 416328596 Interest rate swaps and CAP 1013725 Self-insurance liability 9392859 Minimum pension liability 3065476 Third party settlements 68565320 ROU financing liability 58622667 457(f) fund payable 3447333 144107380 Part V, Line 4: THE FOUNDATION OF YUMA REGIONAL MEDICAL CENTER HOLDS THE ENDOWMENT FUNDS: MCDANIEL ENDOWMENT FUND IS USED FOR VARIOUS PURPOSES RELATED TO CANCER CARE IN YUMA COUNTY. UNRESTRICTED ENDOWMENT FUNDS ARE USED TO SUPPORT SPECIAL PROJECTS, PROGRAMS, AND PRESSING NEEDS OF THE SUPPORTED ORGANIZATION, AS WELL AS COMMUNITY WELLNESS INITIATIVES AND SCHOLARSHIP SUPPORT FOR LOCAL STUDENTS. Central America and the Caribbean 0 0 Investment 9279726 0 0 0 0 0 0 9279726 0 9279726 1 0 1 1 1 0 Part III Accounting Method: 1 1 X 1 X 1 X 1 1 0 1 0 7283486 2933218 4350268 0.00610 224882590 188471521 36411069 0.05110 232166076 191404739 40761337 0.05720 19 18065 367657 119884 247773 0.00030 4 226 6841555 0 6841555 0.00960 4 894 181590 0 181590 0.00030 245061 0 245061 0.00030 27 19185 7635863 119884 7515979 0.01050 27 19185 239801939 191524623 48277316 0.06770 3 2182 23174 23174 0.00000 11 1000 22258 22258 0.00000 4 444 34742 34742 0.00000 18 3626 80174 80174 0.00000 0 60142880 0 250039657 341510490 -91470833 X 1 1 6 1 Yuma Regional Medical Center 2400 S Avenue A Yuma AZ 85364 www.yumaregional.org H0097 X X X A 2 Yuma Regional Medical Center - Foothills 11142 S Scottsdale Drive Yuma AZ 85367 www.yumaregional.org H0097 X A 3 Yuma Regional Medical Plaza 2460 Parkview Loop Yuma AZ 85364 www.yumaregional.org H0097 X OP Surgery, Imaging, Cardiac Rehab, Wound Care, Bariatric A 4 Yuma Regional Cancer Center 2375 Ridgeview Drive Yuma AZ 85364 www.yumaregional.org H0097 X Cancer Center, Oncology, Hematology, Radiation A 5 Yuma Rehabilitation Hospital 901 W 24th Street Yuma AZ 85364 www.encompasshealth.com SH3378 X B 6 Foothills Medical Plaza ER 11351 E South Frontage Road Yuma AZ 85367 www.yumaregional.org H0097 X X A Yuma Regional Medical Center 0 0 1 X X X X X X X X X 22 1 1 0 1 X See Part V X 1 22 1 See Part V 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X See Part V X See Part V X See Part V X X X X X X 1 X 0 X X X X 1 X 0 0 Yuma Rehabilitation Hospital 0 0 1 X X X X X X X X X 22 1 1 0 1 X See Part V X 1 22 1 See Part V 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See Part V X See Part V X See Part V X X X X X 1 X 0 X X X X 1 X 0 0 Schedule H, Part V, Section B. Facility Reporting Group A: Part V, Section B, Line 7a:The Hospital Facility's Website Where The CHNA Report Is Available:https://www.yumaregional.org/community/community-health-needs-assessment Schedule H, Part V, Section B. Facility Reporting Group B: Part V, Section B, Line 7a:The Hospital Facility's Website Where The CHNA Report Is Available:https://encompasshealth.com/-/media/healthsouth/project/healthsouth/locations/yumarehab-03016500/2022-prc-chna-report-sept-2022---yuma-county-az-pdf.pdf?la=en&hash=CE5D8D61F6BA97AC9490CBDDD1215D34D626B4DA Schedule H, Part V, Section B. Facility Reporting Group B: Part V, Section B, Line 7b:Other Website Where The CHNA Report Is Available:https://www.yumaregional.org/community/community-health-needs-assessment Schedule H, Part V, Section B. Facility Reporting Group A: Part V, Section B, Line 10:The Hospital's Most Recently Adopted Implementation Strategy:https://www.yumaregional.org/wp-content/uploads/2023/03/CHIP-2022-23.pdf Schedule H, Part V, Section B. Facility Reporting Group B: Part V, Section B, Line 10:The Hospital's Most Recently Adopted Implementation Strategy:https://encompasshealth.com/-/media/healthsouth/project/healthsouth/locations/yumarehab-03016500/yuma-rehabilitation-hospital-chip-pdf.pdf?la=en&hash=55AD1903F0938A360F24F5C0075532FE01DF1A98 Schedule H, Part V, Section B. Facility Reporting Group A: Part V, line 16a, FAP website:https://www.yumaregional.org/patients-and-visitors/patient-resources/patient-financial-services/ Schedule H, Part V, Section B. Facility Reporting Group B: Part V, line 16a, FAP website:https://encompasshealth.com/locations/yumarehab/financial-assistance Schedule H, Part V, Section B. Facility Reporting Group A: Part V, line 16b FAP Application Website:https://www.yumaregional.org/patients-and-visitors/patient-resources/patient-financial-services/ Schedule H, Part V, Section B. Facility Reporting Group B: Part V, line 16b FAP Application Website:https://encompasshealth.com/-/media/healthsouth/project/healthsouth/files/financial-assistance/instructions_applications/yuma-instructions-and-application.pdf?la=en&hash=4D6F409109401A5E28CC153B20C84171057E1923 Schedule H, Part V, Section B. Facility Reporting Group A; Part V, line 16c FAP Plain Language Summary Website:https://www.yumaregional.org/patients-and-visitors/patient-resources/patient-financial-services/ Schedule H, Part V, Section B. Facility Reporting Group B: Part V, line 16c FAP Plain Language Summary Website:https://encompasshealth.com/-/media/healthsouth/project/healthsouth/files/financial-assistance/plain_language/yuma-plain-language-summary.pdf?la=en&hash=56CCC3813DA31D8F0C11FEEF53C7CF54D3982EF6 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Yuma Regional Medical Center, - Facility 2: Yuma Regional Medical Center - Foothills, - Facility 3: Yuma Regional Medical Plaza, - Facility 4: Yuma Regional Cancer Center, - Facility 6: Foothills Medical Plaza ER Yuma Regional Medical Center Part V, Section B, line 5: Significant health needs of the community for Yuma Medical Center and Yuma Rehab Hospital:Yuma Regional Medical Center and Yuma Rehabilitation Hospital conducted a Community Health Needs Assessment in 2022. Working collaboratively with our Yuma County public health partners and Southwest Arizona town hall (formerly known as the Southwest Arizona futures forum, or SAFF), Yuma Regional Medical Center adopted the below-listed community health priorities as a working document and vision to address the top health concerns within our defined service area, Yuma County. In alignment with our mission, goals and strategic priorities, Yuma Regional Medical Center will focus on the below listed five (5) priorities:1. Mental health2. Substance use/abuse3. Access to healthcare services 4. Diabetes5. CancerStrategies for addressing these identified health priorities are outlined below. Yuma Regional Medical Center Part V, Section B, line 6a: Yuma Rehabilitation Hospital Yuma Regional Medical Center Part V, Section B, line 11: Yuma Regional Medical Center and Yuma Rehabilitation Hospital leaders, along with leaders and partners from various community stakeholder groups, have continued to address needs from the most recent 2022 CHNA. The following community health improvement plan results are shared:Priority Area: Mental HealthHigh incidence of those who reported fair or poor mental health. Symptoms of chronic depression. Suicide deaths (particularly in young adults), ratio of mental health providers. Of note, key informants rated mental health as a top concern. Goals:- Increase availability/access to behavioral health providers in community- Reduce ER holding times due to lack of inpatient psychiatric facility beds- Reduce ER transfers of psychiatric inpatients to facilities outside Yuma County- Increase awareness among adults and teens related to mental health wellness strategies and coping skillsStrategy #1: Recruit additional behavioral health providers to the community to expand access to care (increased providers means more appointments).Target population(s): Patients currently needing to travel for care due to no available providers and appointments.Actions:Recruited the following providers during the year:- Dr. Eyuel Terefe, psychiatry residency program director - Janelle Rudnick, NP, inpatient BHU- Full-time agency provider coverage for inpatient BHU - The onboarding of a psychiatry residency program director is instrumental in preparing for and establishing YRMC's psychiatry residency program to begin summer 2025, where we will train and retain psychiatry providers in Yuma County and increase access to care. The program director cares for patients in the outpatient setting. In addition, a child and adolescent psychiatrist for our psychiatry residency program has been recruited and will start August 25, 2024. This serves as an important step in meeting the identified need for expanded services for children. Strategy #2: Initiate community coalition to minimize duplication of resources and eliminate gaps in care. Target population(s): Community leaders, key stakeholders, social service organizations, law enforcement and those directly impacted (families and patients). Actions:- Launched collaboration with local law enforcement for education and training.- Expanded partnership with local law enforcement to accept direct voluntary referrals for evaluation. - Collaboration with outpatient community programs for potential referrals to inpatient behavioral health unit (BHU) and intensive outpatient program (IOP).- Initiated transport for patients at outpatient clinics to provide urgent assessments and admission to BHU minimizing unnecessary emergency department visits where appropriate.- Collaboration with local jail to provide court-ordered treatments for patients (April 2024).- YRMC serves as an active hub coordinating between agencies to minimize resource use.- Coordination of efforts with local military and law enforcement to minimize the need to transfer patients outside of the community for care.Strategy #3: Expand local availability of behavioral health services (acute inpatient and intensive outpatient) to reduce need to travel out of town for care.Target population(s): Yuma County service area. Patients and families seeking services.Actions:- YRMC opened a 24-bed inpatient adult behavioral health unit in February 2023. - Behavioral health crisis assessments are now provided on-site by crisis team. Additionally, YRMC assessment team is also now providing assessments in the YRMC emergency departments, meeting patients where the need is. -YRMC now accepts direct admits from local law enforcement minimizing wait times during crisis episodes.- YRMC also added a full series of needed intensive outpatient program/groups, including: -General Mood Disorders -Acute Disorders -Military, Veterans and First Responders -Spanish- New programs/groups starting 2024: - Senior (65+) Therapy - Post-partum Depression - Adolescent Emergency (11-17)-Recruited the following providers in 2023 to expand local availability to behavioral health services. - Dr. Eyuel Terefe, Psychiatry Residency Program Director - Janelle Rudnick, NP, Inpatient BHU - Full-time agency coverage provider for inpatient BHU- YRMC opened a 24-bed inpatient behavioral health unit in February 2023 to expand access to inpatient behavioral health. The IP BHU also established a robust iop for long-term treatment and management of behavioral health patients.Strategy #4: Partner to host behavioral health educational sessions to build community awareness and support.Target population(s): School systems, adult care facilities, caregivers, and directly impacted patients and families.Actions:- Partnership with Yuma County Anti-Drug Coalition to provide ongoing education and support to local schools with a heavy focus on high schools and parents.- YRMC serves as an active member of the Yuma County Anti-Drug Coalition current efforts include education and state-supported distribution of Narcan to patients and families who present to the emergency department with fentanyl overdose.- Ongoing collaborative efforts with local schools and adult facilities to provide education and support for identifying a person in crisis/need.- YRMC is currently in the process of developing geriatric behavioral health services and IOP for local long-term care facilities. Strategy #5: Develop and implement psychiatry residency program to grow and retain psychiatrists in our community.Target population(s): Yuma County service area.Actions:- Dr. Terefe recruited and hired in July 2023 to lead the psychiatry residency program. Residency application submitted, new building purchased and renovated to accommodate the residency program and increase space (access) to psychiatry services. ACGME site visit scheduled for May 2024.- YRMC psychiatry residency program is on track to open its doors to resident physicians in July 2025. - The following providers were recruited/started in development of the psychiatry residency program in 2023. - Dr. Eyuel Terefe, Psychiatry Residency Program DirectorDr. Terefe is instrumental in preparing for and establishing our psychiatry residency program starting summer 2025, where we will train and retain psychiatry physicians in Yuma County and improve/increase access to care. Dr. Terefe also cares for patients in the outpatient setting at YRMC Behavioral Health Center. The ACGME site visit is scheduled for May 2024 to gain approval/accreditation of our psychiatry residency program.- In addition, a child and adolescent psychiatrist for our psych residency program has been recruited and will start August 25, 2024.- Active recruitment is underway for additional faculty physicians to support and build the academic foundation for our psychiatry residency program. A number of candidates are in process and anticipated to finalize in 2024.Priority Area: Substance AbuseHigh incidence of cirrhosis, liver disease death, excessive drinking, unintentional drug-related deaths, illicit drug use. Key informants ranked substance use as a top concern a total of 24.1% of area adults are excessive drinkers (heavy and/or binge drinkers).Benchmark: Higher than found across Arizona.Trend: Marks a significant increase since 2019.Disparity: Highest in Yuma. More often reported among men, adults younger than 65, Hispanic.Barriers to access attributed: Lack of locally available detox and support groups.Goals: - Reduce number of patients needing to travel out of town for substance detox and treatment- Expand awareness and education among students and parentsStrategy #1: Develop acute medical detox and treatment services in Yuma CountyTarget population(s): Yuma County service areaActions:- Develop inpatient chemical dependency detox unit (2024).- Expand iop services for chemical dependency patients and families.- Initiate the ED Naloxone program for those identified in need and at high risk.- This is underway with the establishment of our psychiatry residency program and recruitment of an addiction psychiatrist. Active contract negotiations are underway with an addiction psychiatrist anticipated to start late summer 2024. Strategy #2: Partner with community leaders, schools and families to enhance awareness through outreach and educationTarget population(s): Yuma County service areaActions:- Family medicine resident physicians rotate through local elementary and middle schools to mentor and educate underserved students through a variety of activities and presentations. Part V, Section B Facility Reporting Group B Facility Reporting Group B consists of: - Facility 5: Yuma Rehabilitation Hospital Yuma Rehabilitation Hospital Part V, Section B, line 5: Please see the narrative response for Yuma Regional Medical Center (Reporting Group A) Yuma Rehabilitation Hospital Part V, Section B, line 6a: Yuma Regional Medical Center Yuma Rehabilitation Hospital Part V, Section B, line 11: Please see the narrative response for Yuma Regional Medical Center (Reporting Group A) For Yuma Rehabilitation Hospital (YRH):Priority Area: Potentially Disabling Conditions Approximately 36.8% of county residents report having three or more chronic health conditions. People with disabilities are less likely to get preventive health care services. Goals: -Increase independence in populations with chronic conditions.-Decrease risk for injuries related to chronic conditions Strategy 1: Educate community and partners on self and rapid admission program to help support individuals with chronic conditions being referred to YRH for inpatient rehabilitation Target Population(s): Yuma County service area Strategy 2: Yuma Rehabilitation Hospital therapy department education on fall prevention strategies for patients and community outreach Target Population(s): YRH patient population and Yuma County service area Yuma Rehabilitation Hospital Part V, Section B, line 16j: The FAP, FAP application form and plain language summary of the FAP were translated into the primary language(s) spoken by Limited English Proficiency (LEP) populations. Part V, Section B, Line 11, Continued: Strategy #3: Recruit a Hepatology practitionerTarget population(s): Yuma County service areaActions: - Recruited an internal medicine/Hepatology physician, Dr. Jinendra Satiya, who will start April 7, 2024.Strategy #4: Develop curriculum for family medicine residents in partnership with psychiatry program - to include detox medicine.Target population(s): Yuma County service areaActions:- Psychiatry program director has begun a quarterly behavioral health series presented to family medicine residents during their didactics. - The new behavioral health track just announced its first family medicine resident physician participant, who will begin their focused educational track in July 2024. Priority Area: Access to Health Care ServicesBarriers to access attributed to: Inconvenient office hours, lack of available appointments (wait time to get an appointment), primary care physician ratio well below national standard. Emergency department utilization burdened with high volume of non-acute care.Goals:- Expand availability of appointments and reduce wait time for appointments- Expand availability of primary care providers across community- Improve physician-to-population ratioStrategy #1: Expand family & community medicine residency program (growing our own)Target population(s): Medical students with strong interest in serving communityActions: - Family medicine residency program will welcome 11 residents in July 2024, as we expand our incoming class size by two and welcome a transfer PGY2 resident. - YRMC continues to welcome growing numbers of medical students who rotate through a variety of specialty clinical rotations. - Overall goal to expand program from 26 to 36 residents - 12 per class per year. For this year's match, the program was seeking 12 new residents and matched 11. Now completing soap week to work on filling the remaining open spot.Strategy #2: Expand clinic hours and location to serve more peopleTarget population(s): New graduate physicians serving Yuma County residents and visitorsActions:- New Foothills Medical Plaza opened in July 2023. Over 12,000 new patient appointments completed.- Acquired internal medicine and diabetes medical practice adding two providers specializing in diabetes care.- Increased pediatric and primary care appointments by nearly 4% by expanding hours and increasing efficiency.- In particular, FM, IM, PEDs and OB increased hours to see patients by staggering provider and staff schedules. Some work 7:00 am to 4:00 pm and others 9:00 am to 6:00 pm. This allows clinics to open earlier, close later and offer Saturday services.- Fall 2023, YRMC opened its Foothills Medical Plaza, adding a second emergency department location with the addition of primary care, PEDs, OB, and podiatry providers within that same location. This helps to improve access to care, even closer to patients' homes.- Increased transitional care hours by 10 hours per week by expanding hours (7:30am to 6:00pm Monday through Friday). Strategy #3: Recruit and retain additional providers to meet community needsTarget population(s): New graduate physicians serving Yuma County residents and visitorsActions:- Added 40 new providers in 2023 - Primary care added 6 providers in 2023 to include providers in San Luis, Yuma, Foothills - Erika Benitez, NP, May 2023 - YRMC Primary Care San Luis - Selina Villarreal, NP, Jul 2023 - YRMC FMC W. 24th Street - Cara Piotrowicz, NP, Jul 2023 - YRMC Foothills Medical Plaza - Dr. Stephen Gipson, Aug 2023 - YRMC Family Medicine Center - Wanda Garcia, NP, Jul 2023 - YRMC Transitional Care - Kaitlin Toner, PA, Feb 2023 - YRMC Transitional Care - Pediatrics added 1 new provider in 2023 expanding care in the Foothills - James Lurquin, NP, Feb 2023 YRMC Foothills Medical Plaza - Specialty care 12 additional providers recruited in 2023 - Bariatric Surgeon 2023 - Cardiac Electrophysiology 2023 - Endocrinologist 2023 - Gastro NP 2023 - General Surgeon 2023 - General Surgery PA 2023 - Ob/Gyn Women's Health NP 2023 - Psychiatrist 2023 - Psychiatry NP 2023- Two physicians from the class of 2023 YRMC family medicine residency are now serving the community as full-time providers. An additional three physicians from the class of 2024 have made a commitment to serving our Yuma community after residency. This speaks to our ongoing dedication to supporting a flourishing graduate medical education program where over 35% of graduates from our program are choosing to stay in Yuma following graduation. Priority Area: DiabetesHigh incidence of deaths attributed to diabetes. Overall prevalence of diabetes is high among adults. Kidney disease prevalence and deaths. Key informants ranked diabetes as a top concern.Goals:- Reduce incidence through diabetes education (inpatient and outpatient)- Recruit additional providers to include pediatric endocrinologyStrategy #1: Expand availability of diabetes support and education (inpatient and outpatient)Target population(s): Patients diagnosed as diabetic or borderlineActions: - Acquired internal medicine/diabetes medical practice adding two providers specializing in diabetes care.- Implemented chronic care management program focused specifically on keeping our diabetic patient population healthier.- Implemented nutrition counseling in our diabetes and primary care practices.- Develop (2024) national accreditation for best practice inpatient diabetes management program with standardization in treatment and follow-up.- Added registered dietician to transitional care services to help with diabetes management.- Pediatric endocrinologist coverage by Dr. Hassan through YRMC pediatrics subspecialty clinic.Strategy #2: Recruit additional specialists (adult endocrinology)Target population(s): Serving Yuma County residents and visitorsActions: Adult endocrinologist recruited and hired August 23. Pediatric endocrinologist coverage by Sr. Hassan through YRMC pediatrics subspecialty clinic.Priority Area: Cancer CareCancer is a leading cause of death in Yuma County. Identified high prevalence of cancer (non-skin) in Yuma County.Goals:- Improve lung cancer early detection and reduce deaths- Increase local availability of advanced clinical trials and treatmentsStrategy #1: Implement lung screening programTarget population(s): Yuma County service area - patients with history of smokingActions:- Put lung screening program into services in 2022 for patients with a history of smoking. Patients meeting criteria are scheduled for a low-dose cat lung scan. - 471 patients scanned with 14 patients receiving pre-symptom diagnoses and many others being actively monitored. Strategy #2: Invest in advanced clinical research facilities and programsTarget population(s): Yuma County service areaActions:- Increasing the number of clinical trials available to cancer patients. - Initiated an afflation with University of Arizona clinical trial network to have access to national co-op group trials. - Recognized as a top performing leader in the recruitment of minorities to clinical trials. - Lauded as a top recruiting site for a Novartis trial. Strategy #3: Recruit additional radiation oncology and palliative care providersTarget population(s): Yuma County service areaActions: - Recruited Ramon Perez, NP for palliative care who started January 14, 2024. - Actively recruiting two full-time medical oncologists. - Actively recruiting three palliative care advanced practice providers and one palliative care physician. Secondary Focus:It should be noted that the below-listed identified health needs will remain visible and may be addressed as resources allow - to include potential community partnerships that minimize duplication of effort: Nutrition, heart disease and stroke, respiratory disease, infant health & family planning, injury & violence, physical activity & weight, potentially disabling conditions, tobacco use, oral health. Part V, Section B, Line 11, Continued: In these areas, we have made progress by:- Starting a stroke support group (February 2024) for patients and their families/caregivers to provide support and resources.- Earning American Heart Association "get with the guidelines" award to include recognition for the addition of diabetes management in our stroke program for best practices.- Expanding cardiac rehab program in conjunction with pulmonologists to develop cardio-pulmonary rehab services.- Expanding stroke education into the local middle schools and high schools to increase awareness of signs and symptoms for early identification and treatment.- Hired a chest pain coordinator (December 2022) and applied for DNV chest pain/stemi certification (March 2024).- Offering new shockwave IVL procedure for coronaries and peripheral arteries new procedure.- Rolling out endobronchial ultrasound (EBUS) new procedure.- Bringing the new watchman left atrial appendage occluder (LAAO) procedure to the community.- Championing ventilator protocol implementation.- Supporting cath lab nurses, rad techs, echo techs and respiratory therapists who volunteer regularly at community events. 49 1 - Anticoagulation Clinic 2451 S Avenue A Suite B101 Yuma AZ 85364 Anticoagulation Clinic 2 - Anticoagulation Clinic - Foothills 11351 S Frontage Road Yuma AZ 85367 Anticoagulation Clinic 3 - Bariatric Clinic 2460 S Parkview Loop Suite 3 Yuma AZ 85364 Bariatric Clinic 4 - Tuscany Plaza 2851 S Avenue B Bldg 19 Yuma AZ 85364 Behavioral Health Clinic 5 - Behavioral Health Clinic 7201 E 31st Place Yuma AZ 85365 Behavioral Health Clinic 6 - Bone and Joint Tuscany Plaza 2851 S Avenue B Bldg 20 Suite 2001 Yuma AZ 85364 Bone and Joint Clinic 7 - Cardiology 1951 W 25th Street Suite F Yuma AZ 85364 Cardiology Clinic 8 - Cardiopulmonary Rehabilitation 2460 S Parkview Loop Suite 206 Yuma AZ 85364 Rehabilitation Clinic 9 - Cardiovascular and Thoracic Surgery Clinic 2460 S Parkview Loop Suite 203 Yuma AZ 85364 Surgery Center 10 - Center for Bone and Joint Health 2460 S Parkview Loop Suite 3 Yuma AZ 85364 Bone and Joint Clinic 11 - Children's Rehabilitative Services 2851 S Avenue B Bldg 25 Ste 2504 Yuma AZ 85364 Rehabilitation Clinic 12 - Diagnostic Imaging Parkview 2460 S Parkview Loop Suite 2 Yuma AZ 85364 Imaging Clinic 13 - Diagnostic Imaging Promed 2270 Ridgeview Drive Suite 127 Yuma AZ 85364 Imaging Clinic 14 - Ear Nose and Throat 2680 S Avenue B Yuma AZ 85364 ENT Clinic 15 - Emergency ResponseLab Annex 2451 S Avenue A Yuma AZ 85364 COVID testing site 16 - Endoscopy Center 2261 S Avenue B Yuma AZ 85364 Endoscopy Center 17 - Family Medicine Center 2500 S 8th Avenue Suite 200 Yuma AZ 85364 Family Medical Clinic 18 - Family Medicine Center - West 1965 W 24th Street Suite A Yuma AZ 85364 Family Medical Clinic 19 - Foot and Ankle 1881 W 24th Street Suite C Yuma AZ 85364 Foot and Ankle Clinic 20 - Foothills MOB 11351 E South Frontage Road Yuma AZ 85367 Foothills Health Campus 21 - Gastroenterology 1390 W 16th Street Yuma AZ 85364 Gastroenterology Clinic 22 - General Surgery 2270 Ridgeview Drive Suite 201 Yuma AZ 85364 Surgery Center 23 - General Surgery 2270 Ridgeview Drive Suite 128 Yuma AZ 85364 Surgery Center 24 - General Surgery 2270 Ridgeview Drive Suite 130 Yuma AZ 85364 Surgery Center 25 - Health Clinics 2851 S Avenue B Bldg 25 Ste 2503 Yuma AZ 85364 Health Clinic 26 - Internal Medicine & Diabetes Clinic 3800 W 24th Street Suite 1 Yuma AZ 85364 Internal Medicine & Diabetes Clinic 27 - Ophthalmology 2270 Ridgeview Drive Suite 303 Yuma AZ 85364 Ophthalmology Clinic 28 - Outpatient Laboratory Foothills 11282 N Frontage Road Yuma AZ 85367 Laboratory 29 - Outpatient Laboratory Parkview 2460 S Parkview Loop Suite 2 Yuma AZ 85364 Laboratory 30 - Outpatient Nutrition Services 2460 S Parkview Loop Yuma AZ 85364 Nutrition Education Services for Bariatric Pts 31 - Outpatient Services 1320 W 24th Street Yuma AZ 85364 Outpatient Center 32 - Outpatient Surgery 2460 S Parkview Loop Suite 1 Yuma AZ 85364 Surgery Center 33 - Pain Management 2460 S Parkview Loop Entrance 3 Yuma AZ 85364 Pain Management/PMR Clinic 34 - Pediatric Sub-Specialty Clinic 2851 S Avenue B Bldg 25 Ste 2504 Yuma AZ 85364 Pediatric Clinic 35 - Pediatrics Tuscany Plaza 2851 S Avenue B Bldg 25 Yuma AZ 85364 Pediatric Clinic 36 - Plastic and Reconstructive Surgery 2460 S Parkview Loop Suite 201 Yuma AZ 85364 Plastic and Reconstructive Surgery 37 - Walk-in Clinic Foothills 11142 S Scottsdale Drive Yuma AZ 85367 Primary Care Clinic 38 - Primary Care San Luis 845 E B Street San Luis AZ 85349 Primary Care Clinic 39 - Southwest PETCT Institute 1320 W 24th Street Yuma AZ 85364 Imaging Clinic 40 - Specialty Clinics 2851 S Avenue B Bldg 20 Ste 2001 Yuma AZ 85364 Specialty Clinic 41 - Sports Medicine 2851 S Avenue B Suite 201 Yuma AZ 85364 Sports Medicine/YRMC Bone & Joint Tuscany 42 - Surgical Specialties 2270 Ridgeview Drive Suite 302 Yuma AZ 85364 Urology Clinic 43 - Transitional Care ServicesPalliative Care 2451 S Avenue A Suite 104A Yuma AZ 85364 Transitional Care/Palliative Care Services 44 - Women's Health Center 2911 S 8th Avenue Yuma AZ 85364 Women's Clinic 45 - Women's Health Center Laborists 2911 S 8th Avenue Yuma AZ 85364 OB/GYN Laborists-WHC 46 - Women's Health Center Tuscany Plaza 2851 S Avenue B Bldg 6 Yuma AZ 85364 Perinatology Clinic 47 - Wound Care Center 2460 S Parkview Loop Suite 205 Yuma AZ 85364 Wound Care Center 48 - YRMC Pediatrics 2359 S 22nd Drive Suite 2 Yuma AZ 85364 Pediatric Clinic 49 - Yuma Regional Corporate Center 399 W 32nd Street Yuma AZ 85364 Administrative Services Part I, Line 7: Utilizing the worksheets included in the instructions for Schedule H, cost-to-charge ratios were calculated and used to determine amounts reported in the table. Part I, Ln 7 Col(f): The bad debt expense included on Form 990, Part IX, Line 25(a), but subtracted for purposes of calculating the percentage in this column is $60,142,880. Part II, Community Building Activities: Economic development:Leader/executive participation in greater Yuma economic development, chamber of commerce, Yuma Visitors Bureau, and Arizona Western College collaborative. In those activities, Yuma Regional Medical Center (YRMC) leadership plays an active role in supporting the business and economic drivers and workforce needs.Yuma Regional Medical Center actively supports tourism as a major economic driver for the community. With approximately 100,000 annual winter visitors, YRMC has actively partnered with the local Yuma Visitors Bureau (YVB) to ensure the medical needs of a high volume of visitors. YRMC leader Shay Andres serves on the YVB board of directors, contributing approximately 3-4 hours per month in professional leadership support. Tourism is a major industry for both Arizona and Yuma County. With proximity to California and Mexico, the area attracts large numbers of travelers and international shoppers. During the winter, Yuma's influx of seasonal visitors positively impacts the economy.Community Support:Yuma Regional Medical Center is involved in several community building activities that address the root causes of health problems. Through these activities, YRMC supports community assets by offering the expertise and resources of our healthcare organization. We encourage employees to be involved in the community through community boards, health advocacy programs, and physical improvement projects to continuously improve the quality of life for the community we serve. Community building activities include the following:Coalition Building:Hospital representation to community coalitions related to community health such as:- Yuma County Anti-drug Coalition- Yuma Community Food Bank- Yuma Drowning Prevention CoalitionCommunity Health Improvement Advocacy:Local, state, and national advocacy in areas such as access to healthcare, public health, transportation, and housing:Crossroads Mission- Financial support for drug/detox program- YRMC hosted the Southwest AZ Town Hall "mental health, substance use and homelessness"- School Health/Sports Physicals.- Healthy Kids Program (teaches family wellness, nutrition, exercise, etc.)- Amberly's Place - support and assistance for victims of sexual abuse Part III, Line 2: Note 4: Patients who are covered by third-party payors are responsible for related deductibles and coinsurance, which vary in amount. The Medical Center also provides services to uninsured patients and offers those uninsured patients a discount, either by policy or law, from standard charges. The Medical Center estimates the transaction price for patients with deductibles and coinsurance and from those who are uninsured based on historical experience and current market conditions. The initial estimate of the transaction price is determined by reducing the standard charge by any contractual adjustments, discounts, and implicit price concessions. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to patient service revenue in the period of the change. For the years ended September 30, 2023 and 2022, additional revenue of approximately $3,247,000 and $3,219,000, respectively, was recognized due to changes in its estimates of implicit price concessions, discounts, and contractual adjustments for performance obligations satisfied in prior years. Part III, Line 4: YRMC periodically reviews its collection rates for all self-pay accounts and estimates the anticipated collections on all outstanding self-pay balances. A reserve is established to estimate those account balances that are not expected to be collected based on those historical collection rates.See Note 2 on page 11 of the attached financial statements for the footnote "patient accounts receivable, net and Note 4 on page 16 for the footnote "net patient service revenue." Part III, Line 8: The organization provides acute medical care to all in need without regard to the patient's ability to pay and without regard to their payor source. The community benefits from the prompt provision of acute care services and, to the extent YRMC incurs a shortfall providing such services, this is clearly a benefit to the community.The organization utilizes the step-down method of cost allocation, as prescribed by CMS in the Medicare Cost Report. Part III, Line 9b: Patients may be eligible for full financial assistance or partial assistance. If partial, the remaining balance on the account will be subject to YRMC'S normal collection process and payment arrangements will be made. The balance will be turned over to a collection agency if any of the following events occur:1. Mail returned - not able to locate patient. Account goes to a collection agency after two consecutive mail returns.2. No telephone listing or disconnected.3. Regular sequence of statements and collection notices sent, including a final notice, with no response. Part VI, Line 2: Yuma Regional Medical Center (YRMC) has proactively developed several mechanisms for continuous evaluation of community health needs. A comprehensive Community Health Needs Assessments, funded by YRMC. The findings of that survey were shared during a Yuma County leadership plenary session designed for community feedback and community health needs. More recently, YRMC has conducted Community Health Needs Assessments in 2016, 2019 and 2022, as outlined in Part V of this Schedule H.Periodically, the YRMC board of directors conducts a comprehensive physician manpower review, then prepares a medical staff development plan (MSDP). YRMC then implements the plan to recruit those providers needed into the community. Part VI, Line 3: As each patient is registered for services, request for insurance information or payment is completed. If a patient states that they have no insurance, we will request payment in full or a deposit. If a balance remains, we will interview the patient and complete YRMC financial assistance forms. At this time the patient is given information about the AHCCCS application process, and the application is completed if the patient is eligible (based on residency and income, for example). The application process is an online web-based application called Health-E-AZ. This online process provides a tentative approval pending verification of information to determine if the patient might potentially qualify for AHCCCS. Once it is determined that the patient will not qualify for any government programs, then the financial counselor will visit with the patient and explain the financial assistance program and, if the patient wishes to apply, will retrieve all of the necessary proof of income to complete the financial assistance process. The completion of this process may continue after the patient leaves the hospital until the financial assistance process is completed by the staff in the patient accounting department.If the patient is an emergency room (ER) patient and does not qualify for completing an AHCCCS application, the patient is given a sheet of instructions explaining the financial assistance process, documents that are needed to complete the application, and phone numbers to call to make an appointment to complete the financial assistance process.The financial assistance process involves the collaboration of front-end registrars, financial counselors, med-assist employees, cashiers, and the patient accounting department. Part VI, Line 4: YRMC is the only hospital in Yuma County and also serves surrounding areas (towns on the California/Arizona border) and residents of Mexican border towns. The county has been designated as a medically underserved area.In Yuma County, approximately 65 percent of the population is Hispanic or Latino and, in the city of San Luis and the city of Somerton (both in Yuma County), over 90 percent of the population is Hispanic or Latino. Yuma County's population is about 208,000 and is expected to grow by 5-6 percent in the next five years.Over 75 percent of the population in Yuma County has a GED or high school diploma; 16 percent have a bachelor's degree or higher. Approximately five percent have a master's degree.The main industries in Yuma County are agriculture, tourism, and the military. There are two military bases here - Marine Corps Air Station Yuma and Yuma Proving Grounds (US Army).Approximately 17 percent of the population is below the poverty line. Part VI, Line 5: YRMC is involved in several community building activities that address the root causes of health problems. Through these activities, YRMC supports community assets by offering the expertise and resources of our healthcare organization. YRMC encourages employees to be involved in the community through community boards, health advocacy programs and physical improvement projects to continuously improve the quality of life for the communities we serve.See also community-building activities listed for Schedule H, Part II above. Part VI, Line 6: N/A Part VI, Line 7, Reports Filed With States AZ 1 Foundation of Yuma Regional Medical Center 2400 S Avenue A Yuma AZ 85364 510179146 501(c)(3) 243427 0 General operating grant 1 0 Part I, Line 2: Yuma Regional Medical Center exercises control over the Foundation of Yuma Regional Medical Center and monitors the use of grant funds through shared members of the Board of Directors of each organization. X 1 1 X X X X 1 1 0 1 0 1 0 1 0 Robert J Trenschel DO MPH President/CEO 1112519 0 319729 0 25487 0 325146 0 22080 0 1804961 0 0 0 Simon Lavotshikin MD General Surgeon 487227 0 775843 0 763 0 12200 0 530 0 1276563 0 0 0 Nader Haddad MD Obstetrician/Gynecologist 341182 0 796427 0 363 0 12200 0 28715 0 1178887 0 0 0 Abhinav Chandra Oncology Program Medical Director 570722 0 488849 0 810 0 12200 0 28715 0 1101296 0 0 0 Robert Takesuye MD Radiation Oncologist 527056 0 528097 0 2322 0 12200 0 1261 0 1070936 0 0 0 Jon-Rene Suffern MD Anesthesiologist 593994 0 411714 0 449 0 12200 0 28267 0 1046624 0 0 0 Bharat Magu MD SVP/Chief Medical Officer 478820 0 149084 0 1246 0 120144 0 264 0 749558 0 0 0 David Willie - SVPChief Financial Officer (thru 10/22) 398242 0 256414 0 8666 0 12200 0 17834 0 693356 0 0 0 Diane Poirot SVP/Human Resources (thru 05/22) 210938 0 0 0 400893 0 8041 0 348 0 620220 0 0 0 Deborah Aders RN MS CIC SVP/Chief Nursing Officer 417756 0 117000 0 6858 0 12200 0 9387 0 563201 0 0 0 Trudie Milner SVP/Operations 346306 0 113400 0 3564 0 78224 0 389 0 541883 0 0 0 Fred Peet SVP/Chief Information Officer 316933 0 101400 0 2322 0 92600 0 778 0 514033 0 0 0 Machele Headington SVP/Marketing and Communications 236947 0 91500 0 2322 0 77592 0 22080 0 430441 0 0 0 Robert Seibel SVP/General Counsel (thru 09/22) 250614 0 136021 0 5275 0 12200 0 16985 0 421095 0 0 0 Matthew McElrath SVP/Human Resources 228718 0 67275 0 2193 0 67936 0 17671 0 383793 0 0 0 Vernon Moore SVP/Chief Financial Officer 225709 0 75475 0 2804 0 75882 0 367 0 380237 0 0 0 James Adamson SVP/General Counsel 193253 0 80505 0 1072 0 57416 0 10191 0 342437 0 0 0 Part I, Line 1a The President/CEO is provided a monthly PERQ allowance which is treated as taxable compensation. Part I, Lines 4a-b Yuma Regional Medical Center established the "capital accumulation and in section 457(f) of the code (Internal Revenue Code of 1986) as approved retention plan" as a non-qualified deferred compensation plan as described by the Board of Directors. The purpose of this plan is to provide certain supplemental retirement benefits to eligible executives. The Board may only designate participants from among those employees who are part of a select group of management or highly compensated employees. YRMC will establish an initial vesting date for each participant and, within the Board's discretion, may offer to extend a participant's vesting date meeting specific criteria as set forth within the plan document. The following individuals participated in the plan and had contributions to the plan in 2022: James Adamson - $56,701 Machele Headington - $65,392 Bharat Magu - $107,944 Matthew McElrath - $56,814 Trudie Milner - $66,024 Vernon Moore - $66,054 Fred Peet - $80,400 Robert J. Trenschel - $312,946 There were no withdrawals from the plan in calendar year 2022. Severance payments were made in calendar year 2022 to the following individuals: Diane Poirot - $400,000 Part I, Line 5 Yuma Regional Medical Center has a pay-at-risk incentive program for certain executives. See Section II of the Schedule O disclosure for Form 990, Part VI, Lines 15a and 15b for a description of this program. Part I, Line 6 Yuma Regional Medical Center has a pay-at-risk incentive program for certain executives. See Section II of the Schedule O disclosure for Form 990, Part VI, Lines 15a and 15b for a description of this program. Part I, Line 7 Yuma Regional Medical Center has a pay-at-risk incentive program for certain executives. See Section II of the Schedule O disclosure for Form 990, Part VI, Lines 15a and 15b for a description of this program. A Industrial Development Authority of City of Yuma Arizona 860498547 988514CE3 2014-02-05 179884512 See Part VI 0 0 0 B Arizona Health Facilities Authority 860453292 2015-09-15 20000000 Facilities improvements 0 0 0 C Industrial Development Authority of City of Yuma Arizona 860498547 2017-03-14 20000000 See Part VI 0 0 0 D Industrial Development Authority of City of Yuma Arizona 860498547 2019-09-10 20000000 See Part VI 0 0 0 A 22470000 179901930 1127545 75002093 103375000 397292 2015 1 0 1 1 B 18901280 20000000 78870 19921130 2016 0 0 1 1 C 12552740 20097323 84500 20012823 2019 0 0 1 1 D 7488859 20126067 74000 20052387 2023 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 1 0 0 0 0 0 1 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: Industrial Development Authority of City of Yuma, Arizona Date the Rebate Computation was Performed: 03/14/2024 Issuer Name: Arizona Health Facilities Authority Date the Rebate Computation was Performed: 04/10/2023 Issuer Name: Industrial Development Authority of City of Yuma, Arizona Date the Rebate Computation was Performed: 04/10/2023 Part I, Bond A: Determined to be a single issue for tax purposes comprised of three series of tax-exempt bonds - Series 2014A, Series 2014B, and Series 2014C: (i) all three Series were sold fewer than 15 days apart (ii) all three Series were sold pursuant to a common plan of financing (iii) the source of repayment for all three Series is expected to be the same Part I, Column (c), Bond A: The CUSIP number reported is that assigned to the final maturity of the Series 2014A bonds; no CUSIP numbers were assigned to either Series 2014B or Series 2014C bonds. Part I, Column (f), Bond A: The complete purpose of these bonds is current refunding of tax-exempt bonds, facilities improvements, and equipment acquisitions. Part I, Column (f), Bonds C and D: The complete purpose of these bonds is to finance equipment and information systems acquisitions. Part II, Line 3, Bonds A, C and D: The amounts reported for the issue price (Part I, column (e)) and the figures on this Line 3 differ by accumulated earnings on undisbursed bond proceeds. Part II, Line 11, Bond A: The amount reported is the principal amount of tax-exempt bonds currently refunded. Part II, Line 12, Bond A: This amount was earmarked for issuance costs, but was unspent and transferred to the respective series' revenue funds in accordance with the respective series' bond indentures. Part IV, Line 2c, Bond A: The rebate calculation was performed on March 14, 2024 for the period March 14, 2024 through March 14, 2029. Part IV, Line 2c, Bond B: The rebate calculation was performed on April 10, 2023 for the period March 14, 2017 through March 14, 2022. Part IV, Line 2c, Bond C: The rebate calculation was performed on April 10, 2023 for the period September 15, 2015 through September 15, 2022. Part IV, Line 6, Bond D: Calculations demonstrate that the yield on the undisbursed Bond proceeds after the expiration of the available temporary period was less than the yield on the Bonds. This is expected to be confirmed when the rebate calculations are complete. Michael Headington Family member of Machele Headington, Key Employee 90540 Salaries & wages 0 Gary Aders Family member of Deborah Aders, Key Employee 118524 Salaries & wages 0 Form 990, Part I, Line 6: Services provided by volunteers: Volunteers are a vital part of Yuma Regional Medical Center (YRMC). YRMC offers opportunities for service that accommodate the schedules of working adults, students and retirees. Some of our volunteers work directly with patients, while others provide invaluable assistance in support areas or with special projects. In FY2023, 291 volunteers assisted in numerous service areas and contributed over 23,000 volunteer hours. Due to COVID-19 precautions, the number of volunteers was down compared to prior years; however, we are confident that the number of volunteers will return to previous levels with the easing of the pandemic. Volunteers are an essential part of YRMC performing a variety of services to help patients, visitors and staff. They offer support in clinical as well as non-clinical areas by performing such duties as information desk receptionist, transporting visitors as a cart driver, book and beverage cart services, patient visitor and wheelchair transporters, warehouse and office assistants, and soothing a crying baby in the NICU. In addition, volunteers support blood drives, hospital support groups, community outreach events, and the patient and family care center. Form 990, Part III, Line 4a: Program service accomplishments: Yuma Regional Medical Center (YRMC) will be recognized as the model regional medical center. We will work collaboratively to evolve the best system of integrated healthcare in our service area. Our Mission: To improve the health and wellbeing of individuals, families and the communities we serve through excellence, innovation and prudent use of resources. Our Vision: We strive to be recognized as the model regional medical center. We work collaboratively to evolve the best system of integrated healthcare in our service area. Overview: Yuma Regional Medical Center is a licensed 406-bed general acute care hospital that provides inpatient, outpatient, emergency room and other acute care and hospital related services to the people of Yuma, Arizona and the surrounding communities. Not-for-Profit Community Hospital: As a not-for-profit community hospital, Yuma Regional Medical Center is dedicated to meeting the healthcare needs of this community today, tomorrow and well into the future. Through this report, you will learn about many services and programs that we provide. The YRMC team consists of over 3,000 employees, some 600 physicians and over 250 volunteers. YRMC maintains the highest standards for our medical staff to help ensure you receive the quality care you expect. More than 90 percent of the physicians practicing at YRMC are board certified/eligible in one or more specialties. We pledge to serve as an active community partner while continuing our mission to improve the health and well-being of the communities we serve. YRMC Board of Directors: The Board of Yuma Regional Medical Center is composed of an array of professionals who bring their skills and talents together to work, without pay, so that you can receive the highest quality of medical care in your community. As we look to the future, the YRMC Board of Directors has again set the bar high. It is our vision to work collaboratively to evolve the best system of coordinated health care in our service area. As a non-profit community hospital, we reinvest funds remaining at the close of the year into new services and programs for the community. Our strategies moving forward include: the ongoing implementation of an electronic health record to improve patient safety and quality; improving patient access to services through recruitment of physicians in identified shortage areas; investment in new technologies; remaining financially sound; and providing the highest standard of care and patient safety. As a not-for-profit hospital, YRMC has no shareholders. Financial Stability, a Solid Future: As a not-for-profit hospital, Yuma Regional Medical Center relies almost entirely on patient revenues for funding. We do not receive local, state or federal funds through tax levies. There are no out-of-state corporations or private shareholders involved with YRMC - all funds remaining at the end of the year are reinvested for the people and communities we serve. Charity Care/Financial Assistance: At Yuma Regional Medical Center, we believe that all people have a right to medically necessary health care and equal access to diagnostic and therapeutic treatment regardless of financial status. Eligibility criteria for charity care or discounts are based on a percentage of the department of health and human service's annual "federal poverty guidelines." Eligibility criteria includes individual or family income, individual or family net worth, employment status, other financial obligations, amount and frequency of healthcare bills and other financial resources available to the patient. A copy of YRMC's charity care policy is available on the website www.yumaregional.org. Neonatal Care: In FY2023, 386 of our tiniest patients were admitted to and cared for by the specially trained staff in the Neonatal Intensive Care Unit (NICU). YRMC's NICU is licensed to care for infants who have achieved 28 weeks gestation and older. Gestation for a full-term infant is 40 weeks. Infants that are born at YRMC at less than 28 weeks are cared for in the NICU until they are stable enough to transport. Our youngest infants have been 22 weeks. By having a NICU, families are relieved of the expense of going out of town for extended periods of time to be near their sick infants and are able to have a support system nearby. Healthcare Education: Yuma Regional Medical Center is committed to the education of healthcare professionals by providing expanded learning opportunities. YRMC's support of health education and advancement includes a significant commitment to nursing education through partnerships with local community college Arizona Western College (AWC) as well as Northern Arizona University and others. From our education center and simulation lab to clinical rotations and learning in the inpatient and outpatient setting, YRMC provides ongoing support for the development of nurses. YRMC also serves as a primary partner with AWC for a successful radiology tech program. Clinical internships and teaching for radiology tech students provide both inpatient and outpatient internship opportunities for local students. AWC massage therapy students utilize space in our outpatient clinic (and cancer center) - a partnership that includes the ability to provide YRMC cancer patients with massage therapy services at no cost. YRMC also supports a growing family medicine residency program as well as rotations for other medical specialties including sports medicine. Our pharmacy serves as a clinical site for interns, a program that continues to support the expanded need for trained pharmacists, social workers and clinical pastoral education (hospital chaplain residents). Training Tomorrow's Nurses: At the Yuma regional education center, nursing students from Northern Arizona University - Yuma apply classroom lessons in a setting that mirrors a hospital environment. Students work in a skills lab that has adult, child and infant Vitalsims - these are mannequins pre-programmed with heart rhythms, lung and bowel sounds and even voices. In a workshop outfitted with more advanced mannequins, called Simsman and Simsbaby, an observing instructor controls the physical traits of the simulated patient in response to the nurse's care during full lifelike scenarios. "The goal of our education center is to provide as many resources as possible to help nursing students and employees grow in knowledge and skill," says a clinical lab specialist at Yuma Regional Medical Center. "We feel it's an essential component in providing excellent patient care." Palliative Care: At times when acute medical care is no longer effective in addressing a patient's illness, patients need a team of nurses, social workers, chaplains and physicians to help patients and their families with palliative care services which help people work through the physical, emotional and spiritual concerns of serious, progressive illnesses. The goals are to help people have the best possible quality of life and to be allowed to die with dignity. Treatments and techniques focus on improving the quality of life of patients with illnesses such as cancer, heart failure and chronic obstructive pulmonary disease. Pain management plays a key role in palliative care. Palliative care helps patients understand the nature of their illness and make timely, informed decisions about their lives. Clinical Pastoral Education Program: The Clinical Pastoral Education (CPE) program at Yuma Regional Medical Center trains clergy of all faiths to provide healing, comfort and support to patients and their families during their hospital experience. YRMC offers level 1, level 2 and supervisory CPE. The CPE program is accredited by the Association for Clinical Pastoral Education. Recognized for its exceptionally high standards, the year-long residency program at YRMC offers a stimulating learning environment that encourages both personal and professional growth. Students learn how to provide emotional and spiritual support to individuals of all faiths and beliefs to help empower them in their healthcare experience. Students may experience a wide range of unique opportunities to practice chaplaincy within a clinical team environment, such as working with trauma situations and end-of-life issues and celebrating births. Residents become expert in active-listening skills, organ and tissue donation processes and advance directives. YRMC typically offers five chaplaincy residencies per year. Ensuring the Health Needs of Tomorrow: YRMC leaders and residents providing mentoring and support to high school students through the uniquely designed "Mentor Me MD." Residents and leaders teach and mentor young students who have interest in pursuing medicine. The program offers a variety of hands-on learning, mentoring and support. Form 990, Part VI, Section B, line 11b Prior to filing the Form 990, the return is uploaded to the Board Portal and Board members are encouraged to review it prior to the board meeting. Management also reviews the Form 990 prior to filing. At the board meeting, the Board approves the Form 990 for filing. Form 990, Part VI, Section B, line 12c The Conflict of Interest Policy covers members of the Yuma Regional Medical Center (YRMC) Board, including any ex-officio member, who by virtue of their position, may influence decisions affecting YRMC. YRMC requires the disclosure of potential conflicts of interest so that appropriate action may be taken to ensure that such conflicts will not inappropriately influence important decisions. The disclosures are reviewed by general counsel. In the event of a potential conflict, the board member must disclose to the Board the existence of any such interest and be given the opportunity to disclose all material facts. The Board may request additional information from all reasonable sources and shall involve the general counsel in its deliberations. Once all necessary information has been obtained, the Board shall make a finding as to whether a conflict of interest indeed exists. The Board determines by a majority vote in executive session without the subject member as to whether the disclosed interest may result in a conflict of interest. If the Board determines that subject board member has a conflict of interest, subject board member will be disqualified from voting on the decision under consideration. Form 990, Part VI, Section B, line 15 The Board of Yuma Regional Medical Center (YRMC) has adopted a competitive pay strategy in order to attract and retain qualified executives to lead our organization and to fairly compensate executives for advancing the mission of YRMC. The policy is also intended to establish a formal, consistent process for governing executive compensation decisions. This process is meant to establish a rebuttable presumption of reasonableness under IRC Section 4958. In determining compensation of the President/CEO and other executives considered disqualified individuals, an outside consultant is engaged periodically to provide market comparability data, and contemporaneous substantiation of the deliberation and decision making, for setting up total compensation packages, including an incentive pay program known as "pay-at-risk and executive retirement programs. Our total compensation philosophy is comprised of the following elements: Role of the Compensation Committee: The Board's Compensation Committee, after reviewing the material provided by the consultant, sets the compensation for the President/CEO as well as the compensation policy and strategy for other executives to be implemented by the President/CEO. The Compensation Committee presents its recommendations to the full Board for endorsement. Peer Group: A national peer group of health care organizations comparable to YRMC in revenue, structure, mission, and scope of operations is used in collecting comparability data. Competitive Positioning: -Salary range midpoints are set at the 60th percentile of the peer group and individual salaries are positioned within the salary ranges based on factors such as qualifications, experience, and performance as well as recruitment and retention need. -Annual incentive: the "pay-at-risk" opportunity for the President/CEO, Senior Vice Presidents, Vice Presidents, and Directors is positioned on par with the average levels provided to individuals occupying comparable positions in the peer groups. -Benefit expenditures are positioned above the 75th percentile and designed to encourage retention and stability of the executive team. -Our total compensation, including cash compensation and benefits, will be positioned at approximately the 75th percentile for expected performance. Total compensation above the 75th percentile may be achieved for exceptional or superior performance. Appropriate perquisites will be provided based on position level and a moderate severance policy is also provided based on position level. "Pay-at-Risk" Incentive Program: YRMC's annual incentive plan is based on YRMC's strategy as outlined by the Board of Directors and uses a combination of organizational and individual performance measures contained in the Organizational Balanced Scorecard and Leadership Scorecards flowing from it. Triggers are established to define certain minimum performance levels that must be met before incentive awards may be paid, including a net operating margin threshold of 80% of budget and maintenance of accreditation. Insurance Products: A number of executive insurance products are available at the executive's choice. The currently available programs are: -Long-term care insurance for the executive and spouse -Executive disability coverage (This would supplement the basic hospital plan.) -Survivor life insurance (For executives enrolling in this benefit, the hospital will pay the executive's premium). Under applicable tax rules, the premium payments made by the hospital will be treated as a loan, and the executive must pay interest on hospital-paid premiums. The hospital will be repaid from the cash surrender value of the policy or the face amount of the policy in the event of death. This arrangement is documented by an agreement acceptable to YRMC. Form 990, Part VI, Section C, line 19 YRMC's governing documents, including Bylaws and Articles of Incorporation, and Conflict of Interest Policy are available to the general public upon request. YRMC's financial statements are posted on the EMMA website. Form 990, Part IX, line 11g Physicians fees: Program service expenses 59,081,792. Management and general expenses 0. Fundraising expenses 0. Total expenses 59,081,792. Purchased services: Program service expenses 27,670,202. Management and general expenses 6,984,321. Fundraising expenses 0. Total expenses 34,654,523. Consulting fees: Program service expenses 0. Management and general expenses 5,397,799. Fundraising expenses 0. Total expenses 5,397,799. Medical director fees: Program service expenses 906,725. Management and general expenses 0. Fundraising expenses 0. Total expenses 906,725. Therapist fees: Program service expenses 4,031,973. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,031,973. Medical services: Program service expenses 1,076,037. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,076,037. Form 990, Part XI, line 9: Change in fair value of interest rate swaps 1,105,859. Decrease in pension liability 14,182,885. Other changes in net assets 2,979. Accounting change in pension plan expense - non-service cost -596,769. Change in interest in Foundation 972,536. Southwest Health Collaborative LLC 2400 S Avenue A Yuma AZ 85364 822352860 Healthcare AZ 115824 415119 YUMA REGIONAL MEDICAL CENTER Yuma Regional Health System Insurance LLC 2400 S Avenue A Yuma AZ 85364 823158109 Healthcare AZ 6451009 22388714 YUMA REGIONAL MEDICAL CENTER Foundation of Yuma Regional Medical Center 2400 S Avenue A Yuma AZ 85364 510179146 Supporting AZ 501(c)(3) Line 12a, I Yuma Regional Medical Center 1 Yuma Rehabilitation Hospital LLC 9001 Liberty Parkway Birmingham AL 35242 943427408 Rehabilitation hospital AL N/A Related 2592074 7868606 0 0 0.49000 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 Foundation of Yuma Regional Medical Center B 242927 Cash Transferred Foundation of Yuma Regional Medical Center C 428067 Cash Transferred Yuma Rehabilitation Hospital LLC S 2079184 Cash transferred