TY 2010 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
Staff Care Inc PO Box 281923 Atlanta,GA303841923	Contract Labor	164,546
Concentric Healthcare Solutions 4250 North Drinkwater Blvd 165 Scottsdale,AZ85251	Contract Labor	168,667
Comphealth Inc PO Box 972651 Dallas,TX753972651	Contract Labor	145,808
Cobre Properties LLC co Ensemble Real Est 4722 North 24th St Ste 400 Phoenix,AZ85016	Office Space Rent	177,880
Affilion of Cobre Valley LLC 80 E Rio Salado Pkwy Ste 703 Tempe,AZ85281	ER Physicians	159,650
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 9

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21	0
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	12,987,315	11,039,218	1,948,097
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	0
9	Other employee benefits .......	2,649,505	2,252,079	397,426
10	Payroll taxes ...........	0
11	Fees for services (non-employees):
a	Management ......	440,359	374,305	66,054
b	Legal .........	80,869	68,739	12,130
c	Accounting ...........	29,500	25,075	4,425
d	Lobbying ...........	0
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	0
g	Other ..........	0
12	Advertising and promotion ....	0
13	Office expenses .......	0
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	0
17	Travel ............	146,433	124,468	21,965
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	450,090	382,577	67,513
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	1,731,058	1,471,399	259,659
23	Insurance ..............	769,012	653,660	115,352
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	Supplies	5,641,186	4,795,008	846,178
b	Purchased Services	3,188,498	2,710,223	478,275
c	Physician Fees	595,769	506,404	89,365
d	Bldg/Equip Rent & Maintenance	1,356,323	1,152,875	203,448
e	Bad Debt	2,157,162	1,833,588	323,574
f	All other expenses	1,258,304	1,069,559	188,745
25	Total functional expenses. Add lines 1 through 24f	33,481,383	28,459,177	5,022,206	0
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	306,345	1	358,763
2	Savings and temporary cash investments .......	18,213,143	2	17,580,939
3	Pledges and grants receivable, net .........		3	0
4	Accounts receivable, net .........	3,797,036	4	4,386,200
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5	0
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6	0
7	Notes and loans receivable, net .............		7	0
8	Inventories for sale or use ..............	784,688	8	1,033,776
9	Prepaid expenses and deferred charges ............	287,993	9	224,240
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	34,663,061
b	Less: accumulated depreciation. .....	10b	21,803,670	11,236,306	10c	12,859,391
11	Investments—publicly traded securities ..........		11	0
12	Investments—other securities. See Part IV, line 11 ......		12	0
13	Investments—program-related. See Part IV, line 11 ..		13	0
14	Intangible assets .........		14	0
15	Other assets. See Part IV, line 11 ...........	1,566,532	15	1,715,116
16	Total assets. Add lines 1 through 15 (must equal line 34)...	36,192,043	16	38,158,425
	17	Accounts payable and accrued expenses .	5,222,253	17	5,341,810
18	Grants payable ..........		18
19	Deferred revenue ..........		19
20	Tax-exempt bond liabilities ..........	6,925,000	20	6,655,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	294,882	23	1,126,873
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	1,010,931	25	1,010,930
26	Total liabilities. Add lines 17 through 25.....	13,453,066	26	14,134,613
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	22,420,032	27	23,678,193
28	Temporarily restricted net assets .....	318,945	28	345,619
29	Permanently restricted net assets .....		29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	22,738,977	33	24,023,812
34	Total liabilities and net assets/fund balances .....	36,192,043	34	38,158,425

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

Cobre Valley Regional Medical Center

Employer identification number

86-0732836

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:	10000105
Software Version:	2010v3.2

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Cobre Valley Regional Medical Center

Employer identification number

86-0732836

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back	(d)Three Years Back	(e)Four Years Back
1a	Beginning of year balance ....
b	Contributions ........
c	Investment earnings or losses ...
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

Permanent endowment: SchDMd Bullet

Term endowment: SchDMd Bullet

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	904,177		904,177
b	Buildings ................	15,307,846	9,024,551	6,283,295
c	Leasehold improvements ............	1,570,915	1,234,942	335,973
d	Equipment ................	16,099,291	11,544,177	4,555,114
e	Other .................	780,832		780,832
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........				12,859,391

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes
Accrued Retiree Health		1,010,930








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		1,010,930
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1	35,666,477
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	33,481,383
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	2,185,094
4	Net unrealized gains (losses) on investments ..........................	4	199,968
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7	-1,100,227
8	Other (Describe in Part XIV) .................................	8
9	Total adjustments (net). Add lines 4 - 8 .............................	9	-900,259
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	1,284,835

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	35,669,839
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d	3,362
e	Add lines 2a through 2d .....................			2e	3,362
3	Subtract line 2e from line 1.....................			3	35,666,477
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV): ...........	4b
c	Add lines 4a and 4b.......................			4c
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......			5	35,666,477

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............			1	33,484,745
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d	3,362
e	Add lines 2a through 2d......................			2e	3,362
3	Subtract line 2e from line 1.....................			3	33,481,383
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV): ............	4b
c	Add lines 4a and 4b.......................			4c
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......			5	33,481,383

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
Part XIII, Line 2d	Part XIII, Line 2d: Other expenses and losses per audited F/S	Special Events Reclassifications $3362
Part XII, Line 2d	Part XII, Line 2d: Other revenue amounts included in F/S but not included on form 990	Special Events Reclassifications $3362

Schedule D (Form 990) 2010

Additional Data

Software ID:	10000105
Software Version:	2010v3.2

- TIN:

SCHEDULE G
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization
Cobre Valley Regional Medical Center

Employer identification number

86-0732836

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and e-mail solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.

(i) Name and address of individual or entity (fundraiser)	(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
	(ii) Activity	Yes	No	(iv) Gross receipts from activity		(vi) Amount paid to (or retained by) organization
Total .................

List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2010

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.

		(a) Event #1 Art & Wine Auction (event type)	(d) Total Events (Add col. (a) through col. (c))
1	Gross receipts . . .	23,231	23,231
2	Less: Charitable contributions . . .	19,655	19,655
3	Gross income (line 1 minus line 2) . . .	3,576	3,576
4	Cash prizes . . .
5	Non-cash prizes . .
6	Rent/facility costs . .
7	Food and beverages . .	1,587	1,587
8	Entertainment . . .	25	25
9	Other direct expenses .	1,750	1,750
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........		3,362
11	Net income summary. Combine lines 3 and 10 in column (d)............		214

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (Add col. (a) through col. (c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," Explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," Explain:

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ...........................

YesNo

Schedule G (Form 990 or 990-EZ) 2010

Page 3

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Provide the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)

Identifier	ReturnReference	Explanation

Schedule G (Form 990 or 990-EZ) 2010

Additional Data

Software ID:	10000105
Software Version:	2010v3.2

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Cobre Valley Regional Medical Center

Employer identification number

86-0732836

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 40000.0000000 %

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

Yes

If "Yes," does the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..
b Unreimbursed Medicaid (from Worksheet 3, column a) .
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....
dTotal Charity Care and Means-Tested Government Programs .....
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	16	2,350,995	80,264	80,264	0.240 %
f Health professions education (from Worksheet 5) ..	7	70,226	811,947	811,947	2.430 %
g Subsidized health services (from Worksheet 6) ..
h Research (from Worksheet 7)
i Cash and in-kind contributions to community groups (from Worksheet 8) ..	3	8,020	20,438	20,438	0.060 %
jTotal Other Benefits ...	26	2,429,241	912,649	912,649	2.730 %
kTotal. Add lines 7d and 7j. ..	26	2,429,241	912,649	912,649	2.730 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	5	166,691	8,531	8,531	0.030 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	1	1,000	834	834
8	Workforce development	1	3,750	4,103	4,103	0.010 %
9	Other
10	Total	7	171,441	13,468	13,468	0.040 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense (at cost).....

2,157,162

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

2,157,162

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

Enter Medicare allowable costs of care relating to payments on line 5.....

10,069,966

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-10,069,966

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
0	Cobre Valley Regional Med Ctr 5880 South Hospital Drive Globe,AZ85501	X	X	X	X

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:Cobre Valley Regional Med Ctr

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1	Yes
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20 10
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3	Yes
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4		No
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5	Yes
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7	Yes
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for free care: 400.0000%

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.0000%
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14	Yes
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16	Yes
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?
Name and address		Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
	Part VI - Additional Information	N/A
	Part V - Explanation of Number of Facility Type	Besides the main hospital, the organization operates three rural health clinics. Additional detail is provided in the response to Part VI, Question 6: how the organization has furthered its exempt purpose.
	Part VI - States Where Community Benefit Report Filed	AZ
	Part VI - Affilated Health Care System Roles and Promotion	N/A
	Part VI - Explanation Of How Organization Furthers Its Exempt Purpose	CVRMC History: Cobre Valley Regional Medical Center has been serving patients of the copper belt region of Arizona for nearly 100 years. Originally a miner's hospital, Miami-Inspiration Hospital opened to serve miners and their families in 1913. Eventually the aging, crowded Miami-Inspiration Hospital could no longer accommodate the growing patient load and the demands of a modern hospital practice. A larger, modern hospital was needed, and during the 1960's, plans were formulated for a new hospital at another location. In 1967, the resident patients and the staff were transferred to the newly completed hospital in Miami Gardens. During the next eleven years, an outstanding group of "company" physicians tended the patients at Miami-Inspiration Hospital. In 1978, the Board of Directors contracted with a Health Maintenance Organization from Phoenix to manage the hospital. The year 1980 was a turning point for Miami-Inspiration Hospital. The HMO contract was not renewed, and the Board hired a hospital management firm to carry on the hospital's business. At the same time, local physicians were given contractual agreements to care for the miners and their families. The physicians were also granted privileges to admit and care for "non-company" patients. It was at this point in time the hospital became a "community" hospital. Three years later the administrative positions were taken over by local individuals.With the closure of Gila General Hospital in 1991, Miami-Inspiration Hospital became the sole provider of acute medical care in Globe-Miami and surrounding areas. Additional personnel were hired, the acute care unit was upgraded and new equipment and computers were put into service. Some already cramped departments became even more overworked, and plans for enlargement and improvement of these areas were initiated.In 1992, the administration of the hospital was taken over by Brim Healthcare (now HealthTech), with the mining companies opting to get out of the healthcare business, the name of the hospital was changed to Cobre Valley Community Hospital (CVCH). The plans to enlarge and improve the hospital facilities became a high priority, and the radiology and laboratory departments were enlarged and modernized. Meanwhile, plans for a major expansion of several departments were initiated, and large, new, state-of-the-art emergency, surgery and intensive care departments were completed in early 1997. In 2003 additional renovations were made to address the Laboratory, Radiology, Medical Records, Administration, and most inpatient care areas. This renovation project also included a steel building for housing records and warehousing supplies.Through the next 13 years, under the management of Brim (HealthTech), Cobre Valley Community Hospital continued to provide the best services available, adding new services, technology and state-of-the-art equipment in all departments. Through growth and expansion of the past few years, CVCH opened clinics in Young, Kearny, and Superior. In March of 2010, Cobre Valley Community Hospital became Cobre Valley Regional Medical Center (CVRMC). The new name is a reflection of the customers and patients served by the expanding facility.The word "Cobre" is Spanish for "copper." The communities of the region served by CVRMC exist because of the long history of copper mining. The words, "Cobre Valley," were preserved in honor of all our copper miners- for their commitment and fortitude to supply the world with the natural resource our region is known for,copper. CVRMC Today: Today, Cobre Valley Regional Medical Center is a 25 bed Critical Access Hospital located in Globe-Miami, Arizona. It serves a population of 45,000 in a full service acute care facility with a medical staff of 25 active physicians and numerous visiting specialists. Because of its location, adjacent to the San Carlos Apache Reservation, it serves as an acute medical/surgical and obstetric provider for reservation residents referred by their clinic or hospital. (Continued on Schedule O)
	Part VI - Community Building Activities	Cobre Valley Regional Medical Center (CVRMC) has a commitment to our employees, physicians of our communities, organizations who depend on us to provide direction in health services, our board of directors, people who have made donations, volunteers, and most importantly to our patients and families of the region we serve. CVRMC is striving to be more inclusive, collaborative, and effective regarding community building activities and donations. The mission of CVRMC is: "To develop and maintain a local health care delivery system that serves the region with quality, efficiency, and compassion. Our mission is your health." This is a living statement within each of our employees who works to provide direct or indirect patient care and is the driving force when setting goals, purchasing equipment, hiring employees, and planning activities throughout the region. The CVRMC Standards of Performance are the required code of conduct which will ensure the mission of CVRMC is carried forth. These standards include personal behaviors regarding privacy, attitude, communication, teamwork, courtesy, accountability, appearance, responsiveness, and safety. Through our community benefit and building activities, utilizing the standards of performance as the driving force, CVRMC is demonstrating accountability, gaining community trust, and fulfilling our mission to all our constituents of our region.Highlighting a few of CVRMC's community benefit and building activities will demonstrate the commitment we have to the region:-Health Fair 2010 - Approximately 500 people attended the annual CVRMC Health Fair which promoted health education, safety information, and a variety of health screenings for cholesterol, blood sugar, spirometry, and blood pressure checks free of charge. Fifty-two community organizations participated to help bring health educational materials to the people of the region. (CVRMC doubled the attendence and participating vendors from the 2009 Health Fair, which had 250 attendents and 30 vendors)-Internships - Students in a variety of medical professions completed clinical hours at CVRMC at no charge. It is our belief that in order to resource the future of nurses, radiology techs, phlebotomists, and PA's, we need to provide the facilities and necessary training for these occupations to help secure the future of health care. 2010 also had an intern in the Public Relations area. -Childbirth Classes - These classes are offered to all expecting mothers throughout the region regardless of which hospital the birth of the baby is scheduled to take place. These classes are free of charge and information regarding child care is also provided.-Diabetic Classes - These classes are open to the public who would like to learn more about diabetes and ways to care for themselves or their loved ones. It is a one hour class held monthly designed to give support and advice. -Customer Service Training - Every employee of CVRMC is required to attend customer service training. As part of the "new hire orientation" once a month, this service is also offered to all regional physicians and office staff.-Community Meetings - Many community organizations have taken advantage of the conference rooms CVRMC has to offer free of charge. Meeting places are difficult to find in rural communities and CVRMC is pleased to accommodate our neighboring associations.-CV Foundation - The CV Foundation is an integral part of CVRMC. Through philanthropic income, driven by the CV Foundation, CVRMC is able to purchase the latest technology and equipment which provides the highest level of care to the patients of our region. The foundation is guided by a governing council of community volunteers who serve without pay and are dedicated to providing the finest healthcare and services to our region. Many CVRMC employees are also part of the foundation, donating time on a volunteer basis. CVRMC also supports the foundation through donation of materials and hosts their monthly luncheon meetings.(Continued on Schedule O)
	Part VI - Community Information	Cobre Valley Regional Medical Center (CVRMC) is located in Globe, Arizona and serves a population of 45,000 within a radius of 65 miles in a full service acute care facility. This population includes both the primary and secondary service areas. CVRMC is located in the heart of the copper belt of Arizona and serves many rural copper communities within the region including its neighboring town of Miami, Superior to the west, Kearny, Hayden, and Winkelman to the south. The Apache San Carlos Nation borders Globe to the east and Roosevelt, Pleasant Valley/Young are located to the north. CVRMC serves as an acute medical/surgical and obstetric provider for all the residents of these communities, with the clinic and hospital located on the San Carlos Apache Nation referring many patients to CVRMC. The CVRMC primary and secondary service area communities are located in two counties, Gila and Pinal. Based on the 2000 U. S. Census, approximately 20% of the total population in Gila County was over the age of 65 while in neighboring Pinal County it was 16%, compared to 13% for Arizona and 12.4 % for the United States. The five leading causes of death among adults age 65 and older in Gila and Pinal Counties are heart disease, cancer, chronic lower respiratory diseases, cerebrovascular disease, and diabetes. Total reported number of people with disabilities within Gila County is 21,239 and 62,382 for Pinal County. Globe, Arizona - Primary Service Area (43.2% Inpatient Patient Origin)Globe is located in Gila County with a population of 12,756. According to the 2000 U. S. Census, Globe consists of 2,814 households, and 1,871 families residing in the city. The ethnic percentages was 46% White, 32% Hispanic or Latino, 1.15% Black or African American, 3% Native American, 1.12% Asian, 0.04% Pacific Islander, 15% from other races, and 2% from two or more races. There were 2,814 households out of which 30.8% had children under the age of 18 living with them, 49.3% were married couples living together, 12.7% had a female householder with no husband present, and 33.5% were non-families. Of all households, 30.1% were made up of individuals and 13.1% had someone living alone who was 65 years of age or older. The average household size was 2.49 and the average family size was 3.09. The population spread was 25.8% under the age of 18, 7.6% from 18 to 24, 26.5% from 25 to 44, 24.4% from 45 to 64, and 15.6% who were 65 years of age or older. The median age was 38 years. Globe's economy remains heavily dependent on the mining industry, but as the county seat, county as well as city government employment are the highest numbers of jobs within the city. Tourism and retirees are also among the most important in Globe's economy.The median income for a household in Globe was $33,071, and the median income for a family was $42,280. Males had a median income of $31,404 versus $21,952 for females. The per capita income for the city was $16,128. About 8.8% of families and 11.4% of the population were below the poverty level, including 14.8% of those under the age of 18 and 8.4% of age 65 or over.(Continued on Schedule O)
	Part VI - Patient Education of Eligibility for Assistance	Education of Charity Care Options to Patients at CVRMC: In public waiting areas of Cobre Valley Regional Medical Center, multi-lingual posters explain to patients in vernacular language that CVRMC is a Medicare participating facility. In addition, posters and signs in these areas explain to the patient what financial obligations may occur and if additional billing will be submitted by providers. If, at the time of admission or visit, the patient does not have active insurance, the patient is offered an AHCCCS application so that they may apply for health-care coverage through public programs. In addition, staff members in the ER are trained to run searches to determine if a patient has existing coverage. Following is a description of the Patient Education policy and below that is a copy of the PATIENT FINANCIAL ASSISTANCE AND DISCOUNT PROGRAM.When neither existing insurance coverage nor AHCCCS eligibility is available, the Patient Accounting Department talks to patients about the Cobre Valley Regional Medical Center's Charity Care program. We offer the patient an AHCCCS application, financial assistance, and financial contract. We advise the patient they must completely follow through with AHCCCS application, appointment, etc. If the patient is denied by AHCCCS, they are to present the denial to the Patient Accounting Department for follow through with the Financial Assistance Program.When the patient is offered the financial assistance application we explain what the patient needs to provide to us to process the application. Demonstrable proof of income, living expenses, size of household and proof of AHCCCS denial are required for completion of the financial assistance application. Included in the income computation are earnings from employment and other income such as child support, alimony, social security and income from other sources. When requesting proof of living expenses, patients are asked to provide documentation of expenses associated with: housing, utilities, transportation, insurance, food, other medical bills and all other living expenses. After all information is obtained we review the information and use the CVRMC charity graph to find the total discount that can be offered to the patient's accounts. Once this is all put together, PAS signs off on charity form then forwards it to the Director and CFO for approval.(CVRMC is highly dependent on payment rates set by Medicare and Medicaid, both of which generally don't cover costs. At CVRMC about 2/3 of patient revenue comes from these government payers. In July of 2011, the Arizona Health Care Cost Containment System (AHCCCS) made drastic changes to help reduce the rising deficits which have impacted the state. These changes, along with the changes at the federal level, the Patient Protection and Affordable Care Act, will change how CVRMC informs and educates patients and families regarding their eligibility for assistance.)Policy Overview: Cobre Valley Regional Medical Center (CVRMC) is committed to providing financial assistance to persons who have health care needs and are uninsured, under-insured, ineligible for a government program and are otherwise unable to pay for medically necessary care based on their individual financial situations. Consistent with its mission to deliver quality healthcare in a safe, respectful, and efficient manner, CVRMC strives to ensure that the financial capacity of people who need health care services does not prevent them from seeking or receiving care. Financial assistance is not considered to be a substitute for personal responsibility, and patients are expected to cooperate with CVRMC's procedures for obtaining financial assistance and to contribute to the cost of their care based on individual ability to pay. Individuals with financial capacity to purchase health insurance shall be encouraged to do so as a means of assuring access to health care services.(Continued on Schedule O)
	Part VI - Needs Assessment	Cobre Valley Regional Medical Center (CVRMC) currently utilizes several methods of assessing community health care needs. Evaluating the health needs of the CVRMC service area leads to identifying physicians needed in the area as well as recognizing those illnesses which can be targeted to provide education and intervention.Community FeedbackCVRMC utilizes many methods of community feedback for needs determination. Our patients, their families, and the greater community enlighten our organization through patient surveys and direct comments. CVRMC strives to give the very best care and in order to accomplish that goal, it is vital that patient and community comments and concerns are addressed.- Professional Research Consultants (PRC) conducts outpatient surveys for the Outpatient Surgery, Emergency, Laboratory, and Radiology Departments on patient satisfaction. PRC also conducts the inpatient, Hospital Consumers Assessment of Healthcare Providers and Systems (HCAHPS), survey which measures patient satisfaction in multiple areas including promptness and efficiency of the admission and registration process, length of time waiting, nursing care, physician care, teamwork, discharge instructions, safety, cleanliness of the facility, food service, overall quality of care, and the likelihood of recommending the hospital to relatives and friends. Statistics regarding patient feedback are calculated on a weekly basis and distributed to all department directors with a hard copy, graphs are posted, and e-mails are dispersed to ensure all staff is informed of results. Management is then able to make necessary assessments of weak areas and strategically plan for improvements. Audio of the actual phone surveys are also available to all management and many changes within CVRMC have been made as a direct result of the feedback obtained in these surveys.- Hospital Consumers Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized survey method conducted nationally and is publicly reported regarding the patients' opinions and observations regarding their hospital care. This survey is helpful in determining how CVRMC is measuring to other hospitals across the nation. The public reporting aspect of this survey is a motivation factor for the hospital as a whole to improve quality of care and focusing on the patients' needs allows objective and meaningful comparisons of hospitals on topics that are important to the consumer. The public reporting aspect of HCAHPS also serves as a transparency tool which drives accountability.- Direct feedback from patients and family members is also a tool utilized for needs assessment. One of the many advantages of a rural hospital is the personal relationships the staff and patients are able to build. Direct phone calls, e-mails, or letters received from patients after the care has been provided is a valuable source of information for determining needs. Legislative Actions Legislative decisions will have a dramatic effect on the direction CVRMC will move regarding community benefit as well as how healthcare for the region will be financed and delivered. As healthcare reform moves forth, CVRMC will continue to offer community benefit programs within its budgetary means in response to the needs of the region served. With changes to the Arizona Health Care Cost Containment (AHCCCS), CVRMC will continue to strive for growth, bringing new services to the hospital while focusing on prevention.The Payor MixBy identifying "customers," CVRMC is able to determine to whom services are provided. This information is invaluable for the strategic planning and management of the hospital in regards to new services or the addition of new providers. The payor mix also provides valuable information regarding the mix of services needed, education programs, new outreach programs, and future demands. (Continued on Schedule O)
Number of Hospital Faciltiy - 0	Part V, Line 19d - Other Billing Determination of Individuals Without Insurance	Please refer to narratives in Schedule H, Part VI.
Number of Hospital Faciltiy - 0	Part V, Line 18c - Limited Eligibility for Emergency Medical Conditions Eligibility	Please refer to narratives in Schedule H, Part VI.
Number of Hospital Faciltiy - 0	Part V, Line 3 - Account Input from Person Who Represent the Community	Please refer to Needs assessment narrative under Schedule H, Part VI.
	Part III, Line 9b - Provisions On Collection Practices For Qualified Patients	Please refer to the Patient education and eligibility for assistance narrative provided in Part VI.
	Part III, Line 8 - Explanation Of Shortfall As Community Benefit	Entire shortfall is attributable to community benefit.
	Part III, Line 4 - Bad Debt Expense	Bad Debt Expense is described in the response to Part VI, question 3, PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. Please refer to that response.
	Part I, Line 7, Column F - Explanation of Bad Debt Expense	Bad Debt Expense is described in the response to Part VI, question 3, PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. Please refer to that response.

Schedule H (Form 990) 2010

Additional Data

Software ID:	10000105
Software Version:	2010v3.2

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Cobre Valley Regional Medical Center

Employer identification number

86-0732836

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) Phuong Nguyen	(i) (ii)	253,410				12,540	265,950
(2) Jacob Albin	(i) (ii)	177,076				5,700	182,776
(3) Dana Miller	(i) (ii)	335,875				12,540	348,415
(4) Bruce Bucklew	(i) (ii)	218,741					218,741
(5) Binoy Chandra	(i) (ii)	258,465					258,465

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation

Schedule J (Form 990) 2010

Additional Data

Software ID:	10000105
Software Version:	2010v3.2

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

Cobre Valley Regional Medical Center

Employer identification number

86-0732836

Identifier	Return Reference	Explanation
	Schedule K	Cobre Valley Regional Medical Center is not required to complete the Schedule K. The Hospital's bonds were issued in the year 2000. The Schedule K is required to be completed for bonds issued after 12/31/2002.
	Schedule H, Part VI-Education (cont.)	G. (Continued) In many instances, these patients are homeless and have few resources to cover the cost of their care.H. Other Circumstances: 1. Deceased patients without an estate or third party coverage will be eligible for charity. 2. Patients who are in bankruptcy or recently completed bankruptcy may be eligible for charity. 3. In rare occasions, a patient's individual circumstances may be such that while they do not meet the regular charity care criteria in this policy, they do not have the ability to pay their Hospital bill. In these situations, with the approval of the CVRMC CEO, part or all of their cost of care may be written off as charity care. There must be complete documentation of why the decision was made to do so and why the patient did not meet the regular criteria.I. Governmental Assistance: 1. In determining whether each individual qualifies for charity care, only those patient billings not covered by other county or governmental assistance programs should also be considered. Many applicants are not aware that they may be eligible for assistance such as AHCCCS, the Healthy Families Program. 2. CVRMC will assist the individual in determining if they are eligible for any governmental or other assistance. 3. Persons eligible for programs such as AHCCCS but whose eligibility status is not established for the period during which the medical services were rendered may be granted charity care for those services. CVRMC may make the granting of charity contingent upon applying for governmental program assistance. This may be prudent, especially if the patient requires ongoing services. J. Time Requirements for Determination: 1. While it is desirable to determine the amount of charity care for which a patient is eligible as close to the time of service as possible, there is no rigid limit on the time when the determination is made. In some cases, eligibility is readily apparent and a determination can be made before, on, or soon after the date of service. In other cases, it can take investigation to determine eligibility, particularly when the patient has limited ability or willingness to provide needed information. If a patient is unwilling to apply for governmental assistance as outlined above, CVRMC may determine that this inaction is reason for denial of charity determination. 2. Every effort should be made to determine a patient's eligibility for charity care. In some cases, a patient eligible for charity care may not have been identified prior to initiating external collection action. Accordingly, each entity's collection agency should be made aware of the policy on charity care. This will allow the agency to report amounts that they have determined to be uncollectible due to the inability to pay in accordance with CVRMC's charity care eligibility guidelines.K. Definition of Income: 1. Annual family earnings and cash benefits from all sources before taxes, less payments made for alimony and child support. 2. Proof of earnings may be determined by annualizing year-to-date family income, giving consideration for current earning rates.L. Accounting for Charity Care: To allow the affiliate to track and monitor the amount and type of charity care being granted, CVRMC will account for the charity care write-offs in separate Deduction from Revenue general ledger accounts as follows:M. Recordkeeping: Records relating to potential charity care patients must be readily obtained. CVRMC will maintain a file and spreadsheet of the Statement of Financial Condition, Charity Care Recommendation Summary forms and final disposition. Notes relating to charity application and approval or denial should be entered on the patient's account.N. Application of Policy: This policy does not create an obligation to pay for any charges or services not included in the Hospital bill at the time of service,nor does it apply to services provided within the Hospital by physicians or other medical providers including: Aneshthesiologists; Radiologists; Pathologists, etc.
	Schedule H, Part VI-Education (cont.)	-For patients who qualify for financial assistance and who are cooperating in good faith to resolve their hospital bills, CVRMC may offer interest free extended payment plans for up to 12 months to eligible patients, and will not impose wage garnishments or liens on primary residences nor send unpaid bills to outside collection agencies. After 12 months CVRMC, at its option, may send unpaid accounts to collections.Regulatory Requirements: In implementing this policy, CVRMC management and CVRMC facilities shall comply with all federal, state and local laws, rules and regulations that may apply to activiites conducted pursuant to this policy.PROCEDURES, Eligibility Criteria: A. Charity Care Application: 1. A low income uninsured hospital patient (or patient representative) who indicates the financial inability to pay a bill for a medically necessary service shall be evaluated for charity care assistance. 2. The CVRMC application form will be used to document each patient's overall financial situation. 3. Once a determination has been made, a notification form will be sent to each applicant advising them of the CVRMC's decision. 4. Credit reports may be used when appropriate to verify an individual's financial status. 5. A patient's employment status may be taken into consideration when evaluating charity care status as well as the amount and frequency of hospital bills and potential payments from pending litigation related to the care. The amount and frequency of hospital bills may also be considered. 6. The data used in making a determination concerning eligibility for charity care should be verified to the extent practical in relation to the amount involved.B. Full Charity Care: The income standard for full charity care write-off will be 100% or less of the most recent Federal Poverty Guidelines.C. Partial Charity Care: Partial charity care will be granted to patients earning over 100% and up to 400% of the most recent Federal Poverty Guidelines. A schedule outlining the patient's financial responsibility is attached, and will be updated at least annually.D. Catastrophic Charity Care: In order to qualify for Catastrophic Charity Care Circumstances any hospital patient must meet the expense qualification as described below: Expense Qualification: The patient's Allowable Medical Expenses must exceed 35% of his or her Family Income determined as follows: 1. The Hospital will multiply the Family Income as determined in Section K. by 35%. 2. The Hospital will determine the patient's Allowable Medical Expenses. 3. The Hospital will compare 35% of the Family Income as determined in Section K. to the total amount of the patient's Allowable Medical expenses. If the total of the Allowable Medical Expenses is greater than 35% of the Family Income, then the patient meets the Catastrophic Charity Care Qualification. The Hospital will subtract 35% of the Family Income from the Allowable Medical Expenses to determine the amount by which the Allowable Medical Expenses exceed the available income. This amount is then eligible for a charity care write-off.E. AHCCCS Denied Patient Days and Non-Covered Services: AHCCCS patients are eligible for charity care write-offs related to denied stays, denied days of care, and non-covered services. These Treatment Authorization Request (TAR) denials and any lack of payment for non-covered services provided to AHCCCS patients are to be classified as charity.F. Eligibility Period: The eligibility period is 60 days from the date of the initial eligibility determination, unless the patient's family income or insurance status changes over the course of that year to such an extent that the patient becomes ineligible.G. Homeless and/or Immigrant Patients: Patients without a payment source may be classified as charity if it is determined that they do not have a job, mailing address, residence, or insurance. Consideration must also be given to classifying emergency room patients who do not provide adequate information as to their financial status.
	Schedule H, Part VI-Education	(Continued from Schedule H)Eligibility for Patient Financial Assistance: -Eligibility for financial assistance will be considered for those individuals who are uninsured, ineligible for any government health care benefit program, and unable to pay for their care, based upon a determination of financial need in accordance with the policy. -The granting of financial assistance shall be based on an individualized determination of financial need, and shall not take into account age, gender, race, socio-economic, sexual orientation, or religious affiliation.Individuals shall be U.S. citizens or shall provide appropriate documentation to show legal status to be in U.S.Determination of Financial Need: - Financial need will be determined through an individual assessment of financial need, including an application process in which the patient or the patient's guarantor is required to cooperate and apply all documentation necessary to make the determination of financial need; a reasonable effort by the CVRMC to explore and assist patients in applying for appropriate alternative sources of payment and coverage from public and private payment programs; and will take into account the patient's assets and other financial resources. If the patient fails to apply for AHCCCS as requested by CVRMC the patient shall be determined in-eligible for financial assistance. - It is preferred, but not required, that a request for financial assistance and a determination of financial need occur prior to rendering of services. The need for financial assistance shall be re-evaluated at each subsequent rendering of services, if the last financial evaluation was completed more than sixty days prior, and at any time additional information relevant to the eligibility of the patient for financial assistance becomes known. - Requests for financial assistance shall be processed promptly, and CVRMC shall notify the patient or applicant in writing within 30 days or less of receipt of a completed application. Patient Financial Assistance Guidelines: Services eligible under the policy will be made available to the patient on a sliding fee scale, in accordance with financial need as determined by the Federal Poverty Levels (FPL) in effect at the time of the determination as follows: - Patients will be eligible according to the "Patient Financial and Discount" table. - Any patient may be eligible for catastrophic charity care based on a percentage of their total annual gross income. Communication of the Financial Assistance Program to Patients and the Public: -information about patient financial assistance available from CVRMC shall be disseminated by various means, including the publication of notices in patient bills and by posting notices in the Emergency and Admitting departments, and at other public places as the CVRMC may elect. - Any member of the CVRMC staff or medical staff may make referral of patients for financial assistance. The patient or a family member, a close friend or associate of the patient may also make a request for financial assistance.Budgeting and Reporting: - Specific dollar amounts for patient financial assistance will be included within each year's annual budget, and actual amounts provided will be reported in the monthly financial statements. - Patient financial assistance statistics disclosed in the financial statements shall not include amounts that are properly considered to be bad debt or contractual discounts.Relationship to Collection Policies: - CVRMC management shall develop policies and procedures for internal and external collection practices that take into account the extent to which the patient qualifies for financial assistance, a patient's good faith effort to apply for a governmental program or for financial assistance from CVRMC, and a patient's good faith effort to comply with his or her payment agreements with the CVRMC.
	Schedule H, Part VI-Community Info.	There were 288 households out of which 31.6% had children under the age of 18 living with them, 54.5% were married couples living together, 13.5% had a female householder with no husband present, and 22.9% were non-families. 21.5% of all households were made up of individuals and 9.0% had someone living alone who was 65 years of age or older. The average household size was 3.10 and the average family size was 3.56. In the town of Hayden the population was spread out with 33.2% under the age of 18, 9.0% from 18 to 24, 20.5% from 25 to 44, 23.2% from 45 to 64, and 14.1% who were 65 years of age or older. The median age was 32 years. The median income for a household in the town was $24,293, and the median income for a family was $26,964. Males had a median income of $35,521 versus $22,500 for females. The per capita income for the town was $9,797. About 20.1% of families and 27.3% of the population were below the poverty line, including 35.2% of those under age 18 and 14.9% of those ages 65 or over.Winkelman, Arizona - Secondary Service Area (2.5% Inpatient Patient Origin)Winkelman is located in Gila and Pinal counties with well over 95% of the population living within Gila County. The major employment is the copper industry of the ASARCO Mine.Winkelman and surrounding unincorporated communities have a total population of 3,100. According to the 2000 U.S. Census, Winkelman is made up of 160 households, and 112 families residing in the town. The racial makeup of the town was 23% White, 74% Hispanic or Latino, 0.23% Black or African American, and 1.58% from two or more races.There were 160 households out of which 30.6% had children under the age of 18 living with them, 46.9% were married couples living together, 15.6% had a female householder with no husband present, and 29.4% were non-families. 26.3% of all households were made up of individuals and 11.9% had someone living alone who was 65 years of age or older. The average household size was 2.77 and the average family size was 3.35.In the town the population was spread out with 29.3% under the age of 18, 9.9% from 18 to 24, 21.2% from 25 to 44, 25.1% from 45 to 64, and 14.4% who were 65 years of age or older. The median age was 37 years. For every 100 females there were 95.2 males. For every 100 females age 18 and over, there were 92.0 males.The median income for a household in the town was $25,455, and the median income for a family was $38,250. Males had a median income of $34,583 versus $17,250 for females. The per capita income for the town was $10,506. About 20.0% of families and 27.2% of the population were below the poverty line, including 42.5% of those under age 18 and 16.7% of those ages 65 or over.Superior, Arizona - Secondary Service Area (2.2% Inpatient Patient Origin)Superior is located in Pinal County 25 miles west of Globe. The town has survived many ups and downs of the copper mining industry throughout the years but during the most recent years is capitalizing on its unique and picturesque location. The town is in a rebuilding phase in its economy and is looking to the areas of tourism and the opportunity for a new underground mine, Resolution Copper, to open in the next 5 years. According to the 2000 U. S. Census, there were 3,254 people, 1,237 households, and 847 families residing in the town of Superior. The racial makeup of the town was 27% White, 69% Hispanic or Latino, 0.46% Black or African American, 1.63% Native American, 0.34% Asian, 0.09% Pacific Islander, and 1.75% from two or more races. There were 1,237 households out of which 26.9% had children under the age of 18 living with them, 48.3% were married couples living together, 14.3% had a female householder with no husband present, and 31.5% were non-families. 27.4% of all households were made up of individuals and 15.0% had someone living alone who was 65 years of age or older. The average household size was 2.63 and the average family size was 3.20.
	Schedule H, Part VI-Community Info.	The population of Superior was spread out with 26.9% under the age of 18, 8.0% from 18 to 24, 21.7% from 25 to 44, 23.4% from 45 to 64, and 19.9% who were 65 years of age or older. The median age was 39 years. The median income for a household in the town was $27,069, and the median income for a family was $31,250. Males had a median income of $34,297 versus $21,607 for females. The per capita income for the town was $12,490. About 22.5% of families and 27.8% of the population were below the poverty line, including 39.0% of those under the age of 18 and 16.5% of those ages 65 or over.Source: HealthTech Healthcare, April 2009; Thomson Reuters/Market Expert; 2000 U.S. Census Data
	Schedule H, Part VI-Community Info.	Community Info (continued from Schedule H)Miami, Arizona - Primary Service Area (24.9% Inpatient Patient Origin)Miami is located in Gila County, bordering Globe to the west, with a population of just under 5,330 which includes the unincorporated community of Claypool, Arizona. According to the 2000 U.S. Census, the ethnic percentages within Miami are 54% Hispanic or Latino descent, 43% white, and 3 % Black, Native American, or Asian. Of the 754 households, 32% had children under the age of 18 living with them, 43% were married couples living together, 17% were households with no husband present, and 34% were non-families. Of all households 31% were made up of individuals and 15% had someone living alone who was 65 years of age or older. The average household size was 2.57 and the average family size was 3.21. The age of the population for the town of Miami is 30% under the age of 18, 17% from 18-24, 23% from 25-44, 30% from 45-65, and 17% 65 years of age or older. The median age was 36.Copper mining accounts for the largest number of jobs in Miami according to the 2002 annual report of the Arizona State Mine Inspector. Freeport McMoRan employs nearly 800 at its Miami operations; Quadra Mining employs nearly 200 at its Carlota facility; while BHP Billiton employs nearly 100 employees between its Pinto Valley and Miami operations. As of 2010, Miami was home to one of the last 4 smelters in the United States.The median income for a household in the town was $27,196, and the median income for a family was $30,625. Males had a median income of $28,250 versus $18,026 for females. The per capita income for the town was $13,674. About 20.5% of families and 23.6% of the population were below poverty level including 28.7% of those under age 18 and 19.7% over the age of 65.Roosevelt, Arizona - Primary Service Area (2.0% Inpatient Patient Origin)Roosevelt is located 20 miles north of CVRMC and is a major center for fishing, boating, camping, water skiing, and other recreational water sports. The community of Roosevelt was developed after the construction of a masonry dam on the Salt River in 1911, making it the oldest artificial reservoir in Arizona and the largest within the boundaries of the state. The population of Roosevelt is estimated at 80 with many visitors moving in and out of the area depending on the season. San Carlos Apache Nation - Secondary Service Area (14.4% Inpatient Patient Origin)The San Carlos Apache Indian Reservation is located 4 miles east of Globe and is located in Gila, Graham, and Pinal Counties. The San Carlos Reservation is home to a number of Apache tribes relocated from traditional Apache homelands from Arizona and New Mexico in 1871. The San Carlos Reservation is one of the poorest Native American communities in the United States, with the median annual household income being approximately $14,000. About 60% of the people live under the poverty level, and one-fourth of the active labor force is unemployed. The population of the San Carlos Reservation is an estimated 10,400 residents, with its largest communities being San Carlos and Peridot, Arizona. The Apache Gold Casino employs 300 people while hunting, fishing, boating, camping, and gaming are attractions to tourists visiting the area.Pleasant Valley/Young, Arizona - Secondary Service AreaSurrounded by the Tonto National Forest, Pleasant Valley/Young is a community in Gila County situated in the beautiful pines of the mountains. There are two main dirt roads in and out of Young, one from the north and one from the south, but no fully paved road to a connecting highway. Globe is 65 miles to the south of Young.
	Schedule H, Part VI-Community Info.	According to the 2000 U. S. Census, Pleasant Valley/Young had a population of 561 people, 250 households, and 171 families living in the Pleasant Valley/Young area. The racial makeup was 94% White, 3% Hispanic or Latino, 0.53% Native American, 0.36% Asian, 2% from other races, and 0.89% from two or more races. The 250 households are comprised of 19% that had children under the age of 18 living with them, 60% were married couples living together, 4% had a female householder with no husband present, and 32% were non-families. Individuals made up 29% of all households and 11% had someone living alone who was 65 years of age or older. The average household size was 2.24 and the average family size was 2.71. The age of the population for Pleasant Valley/Young is 21.6% under the age of 18, 3.0% from 18 to 24, 20.7% from 25 to 44, 33.7% from 45 to 64, and 21.0% who were 65 years of age or older. The median age was 48.Several small businesses exist in Pleasant Valley/Young. There was a restaurant, "The Antlers," but it burned to the ground in 2009 and has yet to be rebuilt. There is a gas station, convenience store, auto parts store, motel, thrift shore, library, and refuse service. Cobre Valley Regional Medical Center services the primary medical needs of the area with a medical clinic.The median income for a household in the Pleasant Valley/Young area was $22,578, and the median income for a family was $26,438. Males had a median income of $32,500 versus $25,313 for females. The per capita income for the area was $12,177. About 16.8% of families and 20.5% of the population were below the poverty line, including 32.4% of those under the age of 18 and 7.1% of those 65 years or older.Kearny, Arizona - Secondary Service Area (.5% Inpatient Patient Origin)Kearny is located in Pinal County and was built by the Kennecott Mining Company in 1958 as a planned community to accommodate the populations of nearby Ray, Sonora and Barcelona, which were eventually swallowed by Kennecott's expanding open-pit copper mine. The town sits near the Gila River in the Copper Basin area along with its sister cities of Hayden and Winkelman. Kearny has a population of 4,027, which includes some remote communities just outside the town limits. The racial makeup of the town was 40% White, 38% Hispanic or Latino, 0.27% Black or African American, 0.84% Native American, 0.09% Asian, 18% from other races, and 3.16% from two or more races. There were 791 households out of which 34.8% had children under the age of 18 living with them, 65.0% were married couples living together, 9.2% had a female householder with no husband present, and 22.1% were non-families. 19.1% of all households were made up of individuals and 10.6% had someone living alone who was 65 years of age or older. The average household size was 2.84 and the average family size was 3.25. In the town of Kearny, the population was spread out with 29.9% under the age of 18, 7.6% from 18 to 24, 21.7% from 25 to 44, 26.7% from 45 to 64, and 14.1% who were 65 years of age or older. The median age was 37 years. The economic base of Kearny is the Ray mine and the Hayden Smelter, both owned and operated by ASARCO. The median income for a household in the town was $39,906, and the median income for a family was $42,313. Males had a median income of $40,056 versus $23,684 for females. The per capita income for the town was $16,797. About 12.1% of families and 13.2% of the population were below the poverty level, including 16.0% of those under age 18 and 19.9% of those ages 65 or over.Hayden, Arizona - Secondary Service AreaHayden is located in both Gila and Pinal counties with the economic base being the Hayden Smelter, one of four smelters in the United States.According to the 2000 U. S. Census, Hayden had a population of 892 people. The racial makeup of the town was 20% White, 72% Hispanic or Latino, 0.45% Black or African American, 1.68% Native American, 0.56% Pacific Islander, and 5.27% from two or more races.
	Schedule H, Part VI-Community Bldg Activ	Community Building Activities (continued from Schedule H): - Community Relations - The Gila County Fair, Downtown Trick or Treat, Holiday Light Parade, Gila County Support our Servicemen, Teen Maze, donations of supplies to local fire departments, and the Easter Egg Hunt are among a few of the community activities CVRMC partakes in and contributes to. Many of these events are for the children of the area. Many professionals of CVRMC have participated on two radio programs, twice a month to provide health information to the listening audience. This service is done free of charge and is utilized to promote and encourage healthy living. CVRMC chose to help the Safe Home (displaced mothers and children) and SMI (Severely Mentally Ill) of the area during Christmas of 2010. Employees through their caring contributions were able to provide needed supplies, food, and gifts to these two organizations in an estimated total of $4,000.- Donations to Community Organizations - CVRMC recognizes the need to contribute to local organizations to help support their causes in regards to awareness, fundraising, or finding a cure. The March of Dimes, Relay for Life, and Little League programs are examples. The State of Arizona has made drastic educational funding reductions the past several years and many schools in our service region have cut physical and health education programs in order to provide the basic requirements of English, Math, Science, and Social Studies. Cobre Valley Regional Medical Center chose to sponsor Little League teams for the entire service area to help encourage the youth of our region to be involved in a healthy, team oriented sport. Many of these youth programs are entirely dependent on the contributions of the major organizations of the area - mining organizations, city and county governments, trucking industries, etc., and CVRMC, the regional medical provider. Many CVRMC employees donate time and expertise to speak at career fairs for the regional high schools, provide job shadowing experiences for the 7 regional high schools, and many tours for civic organizations and elementary/junior high students. Physical Education equipment was also donated to a local high school most in need.
	Schedule H, Part VI - Needs Assessment	Service areas are determined by analyzing the ZIP Codes from several perspectives including patient origin, market share, population and geographic location of the ZIP Code. This information along with payor mix information can determine the inpatient market share by service area, discharges, inpatients market share by payor mix in the primary service area, inpatients market share by payor mix in the secondary service area, service line market share of primary service area, service line market share of the secondary service area, market share of emergency visits in the primary service area, market share of emergency visits in the secondary service area, and Medicare outpatient volume and market share by competing hospitals in the metropolitan areas. Population trends are another determination for needs assessment. Population trends by ZIP Code are provided for the primary and secondary service areas of CVRMC as well as population trends by age. As the population trends increase or decrease and healthcare needs change with age, it is definitely something to consider when strategically planning for future needs.Demographic snapshots are also provided by the report for each of the service areas that reflect various characteristics, including the education, household income and ethnicity. These are important factors to consider when establishing marketing and public relations messages. Those in CVRMC's primary and secondary service areas are primarily white (60%) and Hispanic (33.8%), have a lower percentage than the U.S. with a high school degree, and a higher percentage than the U.S. with lower incomes. Diagnosis-Related GroupsPatient classification provides a means of relating the type of patients CVRMC treats to the costs incurred. Groups of patients tend to have common demographic, diagnostic and therapeutic attributes that determine their health care needs. Diagnosis-Related Groups (DRG) form a manageable, clinically coherent set of patient classes relating CVRMC's case mix to the resource demands and the associated costs experienced by the hospital. Database of AdmissionsQueries of the CVRMC Admissions database are a quick analytical source for determining the major health issues of the region. From this information education, prevention, and intervention can be determined and implemented in community benefit programs or released to other regional health organizations for tracking and trending the impact of their programs within the region. Case Management, Discharge Planning, and Social WorkThrough case management, discharge planning, and social work provided by CVRMC, data is generated by specific diagnosis related groups. This diagnosis data by group could be used to identify key risks for change, i.e. tobacco cessation or weight management programs. Many of these groups are moved on to long-term care facilities, hospice services, or home care needs. CVRMC Board of DirectorsThe CVRMC Board of Directors is strategically designed to encompass a variety of professions from the region. Mining, city and county government, ranching, banking, insurance, and medical professionals make up the members of the board which bring a diversity of ideas and information regarding health needs within the service region.Other- Data from the National Health Association and the Arizona Health Association gives CVRMC comparisons to national and state averages for specific health issues.- Connectivity to organizations such as the County Health Department, regional school districts, and other health, safety, and regional associations provides information regarding health issues and needs.- Diagnosis reports- Chronic disease data
	Schedule H, Part VI - Needs Assessment	Needs Assessment (continued from Schedule H)The Payor Mix (continued)The payor mix is also a very good indicator of the social economic structure of the community, allowing CVRMC to tailor programs to better meet the communities' needs.Medical Staff Development PlanThe approach used to project physician need for the Cobre Valley Regional Medical Center's service area included the following:- Defining the CVRMC service area and market share by service area and service line- Projecting the service area's population growth and characteristics for the next five years- Taking into account competition and other local circumstances such as, in-migration, out-migration- Developing a profile of the current medical staff including number, FTE, specialty, age, activity- Identifying an appropriate demand model from among the available physician need estimation tools.Utilizing the above information, estimates are developed projecting the number of physicians by specialty required to serve the CVRMC service region. Methods used to project physician need include:- Demographics-Population - The source for the population is the Claritas Update Demographics (CUD) product. Estimates are data prepared for the current year and projections are prepared for dates five years in the future. The CUD is brought up to date each year for many geographic levels including national, state, county, city/town, census tract and block group. Data is also available for commonly used areas as metropolitan areas, ZIP Codes, and media areas such as MNAs. Because it is produced for small areas, the update can be easily aggregated to custom geographic areas specified by the user. - Provider Supply - Provider supply is provided by CVRMC management. Much of the physician information is obtained by medical staff rosters and the survey responses. The information gathered for the provider supply is the provider name, specialty, town in which they practice, office days and times, birth date, and any information about their practice. The office days and times are used to calculate a provider full-time equivalent (FTE).- Provider Demand - The two models used to determine provider demand and community need are the:1. Population Based Model which is obtained by multiplying Thomson Reuters physician-to population ratios by the population of the service area. 2. Productivity Based Model provides data on current and projected physician resources required within a defined market. - Service Area Definition - A service area definition takes into consideration multiple factors including patient origin, market share, population and geography. The service area is defined as the geographic area from which a health care facility draws at least 75% of its patients and in which it maintains a considerable share of the health care market. The first step in defining CVRMC's service area is identification of the communities from which the hospital draws 75% of patients, and to assess the hospital's market share in each of these communities. The service area is then divided into two service areas: Primary and Secondary. Three ZIP Codes have been identified as CVRMC's primary service area and five Zip Codes comprise the secondary service area.Out-Migration DataCVRMC is located 85 miles southeast of the largest metropolitan area in Arizona. The cities of Phoenix, Mesa, and Tempe are the out migration areas patients of the CVRMC service area sometimes chose for health services. Out-migration data is provided by the HealthTech Strategic Planning department in the Environmental Assessment and Market Share Report. Two data sources are used for the data:- Arizona hospital discharge database from the Arizona Department of Health Services and - Thomson Reuters Market Expert, the source of the Medicare market share, demographics, insurance estimates and market volume projections
	Sch H, Part VI-Further Exempt Purpose	Further Exempt Purpose (continued from Schedule H)The area also has a significant Mexican-American population and several other ethnic minorities.CVRMC is governed by a Board of Directors made up of a cross-section of community members from many different professions - county officials, mining, ranching, insurance, city officials-including a mayor, an attorney, and medical professionals. The CVRMC Board of Directors meet once a month and act as a trustee for the assets and investments of the hospital for the people of the service area. The board also selects, advises, and evaluates the CEO of the hospital; grants physician staff privileges and ensures that quality medical care is maintained. Responsibilities also include providing direction for the affairs of the hospital and to ensure the development and growth of CVRMC is directed toward fulfilling the mission statement - "To develop and maintain a healthcare delivery system that serves the region with quality, efficiency, and compassion." The hospital has always been a leader among small rural facilities in implementing new technologies, both clinically and in the information area. Direct patient care technologies are state of the art. Health Information Systems within the facility have kept pace, with information technology upgrades taking place frequently and well ahead of any deadlines imposed by outside entities or federal mandates.The hospital is completing its second strategic five (5) year Information Technology plan in advance of federal mandates that require an electronic medical record and will meet the federal definition and rules regarding "meaningful use" by July 2011. It comprehensively integrates the entire patient experience with the hospital and includes interfaces with physician offices and a tertiary provider allowing them to view laboratory and radiology reports as soon as they are available.The next five (5) year plan is to enhance the technological innovations already in place by melding all of the active patient records into a database that will provide a comprehensive chart on each patient within the Cobre Valley Regional Medical Center system, accessible to authorized individuals that will give each practitioner the ability to more meaningfully, salient, current information to provide optimal care to each patient.As the role of the facility has solidified within the community, the Board and administrative staff recognized that needs existed in some of the outlying communities. Health care for residents of Superior, Kearny and Pleasant Valley/Young was limited to single facilities in each community staffed sporadically by medical personnel. Their location meant that health care visits to organizations or offices with greater access to general medical services often involved travel of up to 2 hours, usually in one of two directions and, in the case of Pleasant Valley/Young, affected dramatically by weather.Realizing that this lack of services directly affected the health and well-being of residents of these three areas, Cobre Valley Regional Medical Center determined to optimize local health care services. They have established and staffed health clinics in all three areas with professional and ancillary staffing and services which prevents the necessity for clients to travel many miles for such things as laboratory testing and pharmacy services.Community Programs and Improvements to ServicesInformation Systems and the Region - Cobre Valley Regional Medical Center has had a long history of technological innovation within the facility with many departments integrated electronically so that current information is readily available to staff and practitioners within the facility. This has greatly enhanced the optimization of services and interventions to in-patients, emergency department and out-patient surgery areas.
	Sch H, Part VI-Further Exempt Purp(cont)	The obvious extension of this success is to integrate local physician's offices into the system so information may be obtained quickly to the benefit of the patient and the provider. This has been accomplished through the direction of the Board of Directors, Administration, and the cooperation of the hospital's I.T. Department, trainers, physicians and their office staffs. As an additional component, referring and consultant physicians have been added so they have current information available as well. These benchmarks were achieved within the time-frame identified in the five (5) year I.T. Strategic Plan and have proven very beneficial to both patients and practitioners. Having information readily available has reduced visit times in the Emergency Department and optimized care in the physician's offices.Cobre Valley Regional Medical Center is striving to be the leader of health care in the service area, accountable for the health of the population served. Partnerships with the Gila County Health Department, the Tobacco Cessation Program, the Meth Coalition, Copper Mountain Inn, Heritage Health Care Center, Gila County Community College and the local media have been established and can provide a forum for information dissemination and actual intervention services. State of the Art Equipment/160 Slice CT Scanner - The new 160 Slice Premium CT Scanner arrived at Cobre Valley Regional Medical Center on September 20, 2010. The latest technology in Computed Topography scanning, CVRMC is the first hospital in Arizona to purchase this type of technology.The high end, multi detector CT system offers outstanding imaging quality as well as patient friendly features. In addition to having 160 detector rows that covers up to 8cm of anatomy in one rotation, the thinnest detector elements in the industry are at 0.5 mm which provides ultra high 350 micron resolution for greater detail and the best low contrast for consistent imaging of soft tissues at the lowest possible radiation dose. All of these elements will help enable physicians to make faster and more accurate diagnoses.Multi detector CT has dramatically improved clinicians' ability to accurately diagnose disease at an early stage. While most hospitals are using 32 and 64 slice scanners, the 160 Slice CT Scanner will improve throughput and workflow, while further reducing contrast and radiation doses to patients. The new software applications give CVRMC the ability to acquire the best possible images at the lowest possible radiation and contrast doses. The 160 slice CT has enabled the hospital to perform CTAs of the heart moving from the "step and shoot" technique which can produce inconclusive images, particularly for patients with irregular heartbeats, leading to increased exam times and radiation dose for the patient. The software automatically adjusts to patients with irregular heartbeats, providing quicker, more conclusive exam results. The software will also automate scan parameters and reconstruction based on the patient's heart rate. Also, it speeds up the exam time and eliminates the requirement for additional contrast used with the "step and shoot" method. This scanner will increase workflow and efficiency by enabling physicians to complete an exam of more than one anatomical region consecutively. This gives physicians the flexibility needed for cardiovascular imaging.
	Sch H, Part VI-Further Exempt Purp(cont)	Health Fair - CVRMC hosts an annual health fair to promote good health awareness and to encourage participants to assume responsibility for their own health by providing free health screenings. Many community organizations also are encouraged to participate to bring their valuable health and safety information to one location for the convenience of the people we serve. This year the health fair grew from 32 community associations participating to 59 organizations. Community organizations participating include local fire departments, law enforcement agencies, hospice care facilities, medical air ambulances, marrow donor program, donor networks, massage therapy, the American Heart Association, and many other organizations. The number of community members in attendance grew from 250 to nearly 600 this year. CVRCM will continue to host this annual health event for the communities served. The New Superior Clinic - In July of 2010, CVRMC purchased property to build a new clinic to service the people of Superior with a more modern facility which will include primary care, general surgeon consults, lab draws, CLIA waived testing, well-woman exams, sports physicals, X-Ray, pharmacy, and visiting specialists. For many years the town of Superior did without any medical practices forcing residents to travel at least 40 minutes to the nearest clinic. CVRMC established a clinic in the older downtown area of Superior 10 years ago and is ready and committed to the residents of Superior bring a more modern facility. Construction began in May, 2011 and is expected to complete in October, 2011.New X Ray Equipment in Kearny - CVRMC installed new, state-of-the-art X ray equipment in its facility in Kearny. This new equipment will provide patients the convenience of receiving these services at home rather than traveling up to an hour or more to obtain these services.Internships - For countless years CVRMC has provided internships for medical related fields such as RNs, CNAs, Physician Assistants, OR Techs, Radiology Techs, Phlebotomists, Respiratory Therapists, CRNAs, Medical Assistants, and Doctors of Osteopathy. These internships are provided free of charge and facilitate schools across Arizona - A.T. Stills, Midwestern, Bryman, Central Arizona College, Apollo College, and Gila Community College. The advancement of medical professions is the responsibility of all medical facilities. CVRMC understands its role in resourcing the future of health care professionals and is committed to the interns we serve.Other - CVRMC is involved in many other community activities which help promote and support the mission of the hospital. These activities include the Annual Leadership Retreat, CV Auxiliary, Career Day, Certifications and Training, Childbirth Classes, Smoke Free/Tobacco Free Campaign, Easter Egg Hunt, County Fair, Downtown Halloween Trick or Treat, Horseshoe Tournament, Workforce Development and Quality and Informatics.Summary and FutureThe transition our hospital has gone through since 1910 has been astounding: From a "tent clinic" in 1910, a miner's hospital in 1913, a community hospital in 1980, to a regional medical center in 2010. The accomplishments are a result of the dedicated and compassionate workforce the hospital has maintained throughout the years providing healthcare to its diverse population.Cobre Valley Regional Medical Center has kept its finger on the pulse of its service region throughout 2010, reaching out to help the area in many different aspects, contributing close to $926,000 in community benefit. With the challenges health care reform presents at both the national and state levels, the focus in 2011 will be on growth and added services as we continue to respond to the service area needs and fulfill our mission: "To develop and maintain a healthcare delivery system that serves the region with quality, efficiency, and compassion."
	Sch H, Part VI-Further Exempt Purp(cont)	For example, patients with suspected chest pain can now undergo one CT exam that will provide information to assist physicians in detecting both heart disease and an aortic aneurysm.Cobre Valley Regional Medical Center is committed to bringing the best in technology to improve the health and well being of patients in the region with over $1 million dollars spent on this particular piece of equipment to address the health needs of our region.Employee Education - Cobre Valley Regional Medical Center's commitment to higher education for employees is evident in the number of degrees obtained in 2009 and 2010. CVRMC paid nearly $78,000 in tuition assistance in 2010 and another $200,000 in additional training programs. Employees are encouraged to further their education which in turn provides better care for patients. The tuition assistance program is a benefit provided to assist employees in improving their job capabilities within their work environment. The tuition assistance program will continue in the future as community benefit for the patients of our region. Standards of Performance and Customer Service Training - The CVRMC Standards of Performance were designed and created by a team of hospital staff whose goal was to develop a set of performance expectations for every employee to follow at all times. At CVRMC our position descriptions outline the duties and responsibilities every individual is accountable for in the commission of their respective jobs. The CVRMC Standards of Performance offers a definition and framework of behaviors that every employee will exhibit when interacting with patients, customers, and co-workers. These standards also provide the criteria by which an employee of CVRMC is evaluated. In our Standards of Performance we identify patients, customers, and co-workers as our target service populations. At CVRMC we consider "customers" to include Physicians, Families, Vendors, Suppliers, and anyone else that we have contact with and the behavior expectations include privacy, attitude, communication, teamwork, courtesy, accountability, appearance, responsiveness, and safety.Every employee of CVRMC is required to attend customer service training to help drive our mission statement and to guide them in the standards of performance at every level of the organization. This customer training is also offered to every physician and their office staff within the region, free of charge, in order to create a regional culture of compassionate health care.Community Involvement - Employees of CVRMC are encouraged to volunteer and be involved in charitable community organizations. These associations include Rotary, the Community Concert Association, Little League, United Fund, Elks, County Fairs, blood drives, CARE Fair, Relay for Life, Health Fair, Adopt a Highway, school boards, March of Dimes, youth soccer, youth basketball, the library, job shadowing programs, economic development, Meth Coalition, AZ Youth Partnership, and the chambers of commerce, to name a few. Employees who are involved beyond the hospital facility make a connection to the communities served.Wellness Program - CVRMC has created and implemented a comprehensive Wellness Program that ties incentives to the health plan knowing healthier employees give better care. It is CVRMC's policy to engage employees as partners in assuring their best possible health and in reducing preventable healthcare costs for our employees; provide a supportive work environment that promotes the optimal health and wellbeing of our employees. CVRMC supports patients in their recovery to better health and is making this support available to its employee's health as well. CVRMC recognizes that a healthy lifestyle is a personal choice; the Employee Wellness Program is a great resource to assist those who are seeking help to move towards a healthier life. Exercise classes are offered daily as well as educational materials in regards to healthier food choices.
Amended Explanation		Due to a software glitch, a portion of the Schedule H, Part V, Section B (Pgs 4-6) contained some computer-generated automatic responses that could not be removed for e-filing purposes. Even though this section of the return is optional for CVRMC, after consideration of the substance of the automatic responses, it was decided that the responses were misleading. CVRMC is amending the return in order to respond to these questions on Schedule H, and not exercise its option to forego answering them. Amendments to the return affect: Schedule H, Part V, Section B, (pages 4-6); and removal of disclaimer on Schedule O, stating that this portion of the return was optional and the computer generated responses placed here were to be ignored as they were the result of a software glitch. These answers are now intentionally placed, so the disclaier no longer applies.
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	Documents are readily available in the administrative office, upon request.
Form 990, Part VI, Line 15b	Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	Salary surveys of other similarly sized hopitals with equivalent services and scope of operations, are used to set compensation levels.
Form 990, Part VI, Line 12c	Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	Annual review is monitored by the Executive Assistant and CEO.
Form 990, Part VI, Line 11	Form 990, Part VI, Line 11: Form 990 Review Process	Management prepares with third party assistance and distributes and discusses copy with entire Board prior to issuance/submission to IRS.
Form 990, Part VI, Line 3	Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company	The duties of the CEO and CFO are carried out by employees of an outside management company.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:	10000105
Software Version:	2010v3.2

1	Briefly describe the organization’s mission or most significant activities: The organization will provide medical services which will be competitive with those charged for similar services by comparable facilities. The organization will also allow a portion of its services and facilities to be used for charity patients.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	9
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	312
6	Total number of volunteers (estimate if necessary) ....	6	40
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	37,330	115,523
9	Program service revenue (Part VIII, line 2g) .........	35,707,940	35,011,060
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	274,313	321,760
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	248,793	218,134
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	36,268,376	35,666,477
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4) ....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	14,617,031	15,636,820
16a	Professional fundraising fees (Part IX, column (A), line 11e)....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	18,534,470	17,844,563
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	33,151,501	33,481,383
19	Revenue less expenses. Subtract line 18 from line 12......	3,116,875	2,185,094
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	36,192,043	38,158,425
21	Total liabilities (Part X, line 26)............	13,453,066	14,134,613
22	Net assets or fund balances. Subtract line 21 from line 20 .....	22,738,977	24,023,812

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 28,459,177 including grants of $ ) (Revenue $ 35,228,980 )
	The Organization will provide medical services which will be competitive with those charges for similar services by comparable facilities. The organization will also allow a portion of its services and facilities to be used for charity patients. Along with providing acute health care services to the community as not for profit entity, Cobre Valley Regional Medical Center (CVRMC) hosts many educational programs available to the residents in the service area. The hospital and staff host and sponsor an annual health fair working with other area agencies to distribute and disseminate health, wellness, and information. The hospital also sponsors diabetic workshops, birthing and new baby care classes. The Emergency Department (ED) at CVRMC is the base station for the three Fire/EMS Departments in the service area. The hospital sponsors monthly training to firefighters and paramedics as well as medical supervision at no cost to the departments. The ED also is a clinical training site for Paramedics and Physician Assistants to fulfill clinical internship requirements in their curriculum. CVRMC is also the clinical training site for students attending nursing programs at Gila Community College and Eastern Arizona Community College.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 28,459,177

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) Phuong Nguyen Physician	24.00		X	253,410	0	12,540
(2) K Kane Graves Board Member	1.00	X		0	0	0
(3) Jendean Sartain Chairman	1.00	X		0	0	0
(4) Janice Cook Treasurer	1.00	X		0	0	0
(5) James B Rasmussen Secretary	1.00	X		0	0	0
(6) Jacob Albin Pharmacist	0.00		X	177,076	0	5,700
(7) Gary Gustason MD Board Member	0.00			0	0	0
(8) Fernando Shipley Board Member	1.00	X		0	0	0
(9) Ed Carpenter Vice Chairman	1.00	X		0	0	0
(10) Dana Miller Physician	40.00		X	335,875	0	12,540
(11) Byron Belew Board Member	1.00	X		0	0	0
(12) Bruce Bucklew Physician	40.00		X	218,741	0	0
(13) Brad Werrell DO Board Member	1.00	X		0	0	0
(14) Binoy Chandra Physician	40.00		X	258,465	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,243,567	30,780

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c		19,655
d	Related organizations...1d
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		95,868
g	Noncash contributions included in lines 1a-1f:$ 8,245
h	Total. Add lines 1a-1f.......			115,523
			Business Code
2a	Net Patient Service			35,011,060	35,011,060
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			35,011,060
3	Investment income (including dividends, interest
	and other similar amounts).....			321,760			321,760
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross Rents	77,278
b	Less: rental expenses
c	Rental income or (loss)	77,278
d	Net rental income or (loss).......			77,278	77,278
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss)..........			0
8a	Gross income from fundraising events (not including $ 19,655 of contributions reported on line 1c). See Part IV, line 18 ...
	a		3,576
b	Less: direct expenses ...b		3,362
c	Net income or (loss) from fundraising events..			214			214
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	Rebates/Discounts			19,844	19,844
b	Other Revenue			17,364	17,364
c	Cafeteria Revenue			103,434	103,434
d	All other revenue ....
e	Total. Add lines 11a–11d ......			140,642
12	Total revenue. See Instructions....			35,666,477	35,228,980		321,974


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			306,345	1	358,763
2	Savings and temporary cash investments .......			18,213,143	2	17,580,939
3	Pledges and grants receivable, net .........				3	0
4	Accounts receivable, net .........			3,797,036	4	4,386,200
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5	0
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6	0
7	Notes and loans receivable, net .............				7	0
8	Inventories for sale or use ..............			784,688	8	1,033,776
9	Prepaid expenses and deferred charges ............			287,993	9	224,240
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	34,663,061
b	Less: accumulated depreciation. .....	10b	21,803,670	11,236,306	10c	12,859,391
11	Investments—publicly traded securities ..........				11	0
12	Investments—other securities. See Part IV, line 11 ......				12	0
13	Investments—program-related. See Part IV, line 11 ..				13	0
14	Intangible assets .........				14	0
15	Other assets. See Part IV, line 11 ...........			1,566,532	15	1,715,116
16	Total assets. Add lines 1 through 15 (must equal line 34)...			36,192,043	16	38,158,425
17	Accounts payable and accrued expenses .			5,222,253	17	5,341,810
18	Grants payable ..........				18
19	Deferred revenue ..........				19
20	Tax-exempt bond liabilities ..........			6,925,000	20	6,655,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			294,882	23	1,126,873
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities. Complete Part X of Schedule D.....			1,010,931	25	1,010,930
26	Total liabilities. Add lines 17 through 25.....			13,453,066	26	14,134,613
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			22,420,032	27	23,678,193
28	Temporarily restricted net assets .....			318,945	28	345,619
29	Permanently restricted net assets .....				29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			22,738,977	33	24,023,812
34	Total liabilities and net assets/fund balances .....			36,192,043	34	38,158,425