TY 2021 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
Rural Physicians Management Co LLC 5575 DTC Pkwy Ste 225 Ste A-436 Greenwood,CO80111	Hospitalist Services	905,409
RN Network 2000 NW Corporate Blvd Boca Raton,FL33431	Nursing Contract Labor	727,973
Cardiovascular Associates of Arizona 5882 S Hospital Dr Ste 1 Globe,AZ85501	Cardiology Services	653,584
Snehal Thakkar RAM Oncology PLLC 11177 East Ironwood Drive Scottsdale,AZ85259	Oncology Services	468,932
ARUP Laboratories 500 Chipeta Way Salt Lake City,UT841081221	Laboratory Services	458,681
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 15

- TIN:

SCHEDULE A
(Form 990)

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.
right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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 12, check only one box.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% 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 33 1/3% 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. See section 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 on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2021

Page 2

Part II

Support Schedule for Organizations Described in Sections 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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. If the organization did not check a 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—2021. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. 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 VI 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) 2021

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2021

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2021

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.0

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Name of the organization

Cobre Valley Regional Medical Center

Employer identification number

86-0732836

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization Cobre Valley Regional Medical Center

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization Cobre Valley Regional Medical Center		Employer identification number 86-0732836

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization Cobre Valley Regional Medical Center			Employer identification number 86-0732836
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2021)

Additional Data

Software ID:	21013475
Software Version:	2021v4.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of 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 can 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" on 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 education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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 section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, 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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, 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)

Revenue included on 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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

Using the organization’s acquisition, 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 XIII.

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
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, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on 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	Net investment earnings, gains, and 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 current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

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

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	890,027		890,027
b	Buildings ....	52,750,940	27,038,543	25,712,397
c	Leasehold improvements	4,281,929	2,494,539	1,787,390
d	Equipment ....	34,664,635	28,161,763	6,502,872
e	Other .....	2,171,118		2,171,118
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				37,063,804

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. 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........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1	89,226,703
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3	89,226,703
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 XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5	89,226,703

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1	76,284,062
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 XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3	76,284,062
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 XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	76,284,062

Part XIII

Supplemental Information

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Part X : FIN48 Footnote

Schedule D, Part X, Line 2 - The Hospital is a not-for-profit organization formed under the laws of the State of Arizona. The Hospital has been determined to be exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code by the United States of America's Internal Revenue Service (IRS) and under similar codes by the State of Arizona. Accordingly, no provision for income taxes is included in the accompanying financial statements.

Schedule D (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Cobre Valley Regional Medical Center

Employer identification number

86-0732836

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

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

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did 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.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	5,707,493		5,707,493	7.480 %
b	Medicaid (from Worksheet 3, column a) . . . . .	39,973,747	13,865,054	26,108,693	34.230 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	45,681,240	13,865,054	31,816,186	41.710 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .
k	Total. Add lines 7d and 7j .	45,681,240	13,865,054	31,816,186	41.710 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	83,509	83,509	0.110 %
2	Economic development
3	Community support	1,000	1,000
4	Environmental improvements
5	Leadership development and training for community members	52,590	52,590	0.070 %
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	137,099	137,099	0.180 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

5,707,493

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

5,707,493

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

14,120,531

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

14,370,884

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

-250,353

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

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(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) 2021

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Facility reporting group
1	Cobre Valley Regional Medical 5880 S Hospital Dr Globe,AZ85501 www.cvrmc.org RGH0126	X	X	X	X	1

Schedule H (Form 990) 2021

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	Cobre Valley Regional Medical
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): cvrmc.org

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): cvrmc.org

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Yes

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Cobre Valley Regional Medical
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 100.0000%
and FPG family income limit for eligibility for discounted care of 400.0000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

www.cvrmc.org

The FAP application form was widely available on a website (list url):

www.cvrmc.org

A plain language summary of the FAP was widely available on a website (list url):
www.cvrmc.org

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	Cobre Valley Regional Medical
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Cobre Valley Regional Medical
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Facility: Cobre Valley Regional Medical - Part V, Section B, Line 11	Please refer to the CHNA and Community Health Implementation Plan (CHIP), which are available for viewing and download at cvrmc.org. They have also been attached to the Form 990.

Schedule H (Form 990) 2021

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1	Cobre Valley Surgical Svcs 5880 S Hospital Dr Globe,AZ85501	Rural Health Clinic
2	Cobre Valley Family Practice 5994 S Hospital Dr Globe,AZ85501	Rural Health Clinic
3	Kearny Clinic 100 Tilbury Ave Kearny,AZ85237	Rural Health Clinic
4	Cobre Valley Red Rock Clinic 5990 S Hospital Dr Globe,AZ85501	Rural Health Clinic
5	Superior Clinic 1134 West US Hwy 60 Superior,AZ85173	Rural Health Clinic
6	Tonto Basin Clinic 186 East Stephens Way Tonto Basin,AZ85553	Rural Health Clinic
7	Pleasant Valley Community Medical Ctr 124 N Tewksbury Blvd Young,AZ85554	Rural Health Clinic
8
9
10

Schedule H (Form 990) 2021

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense	Amounts expected to be collected, later determined uncollectible, are recognized as bad debt.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit	The Hospital determines the transaction price based on standard charges for goods and services provided, reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients in accordance with the Hospitals discount policy, and implicit price concessions provided to uninsured patients.The Hospital determines its estimates of contractual adjustments and discounts based on contractual agreements, its discount policies, and historical experience. The Hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Effective with the adoption of ASU 2014-09, for changes in credit issues not assessed at the date of service,such as a payor files for bankruptcy or a patient defaults on a payment plan, the Hospital recognizes these writeoffs as bad debt expense, which is presented on the accompanying statements of operations as a component of net patient service revenues.Bad debt represents amounts expected to be collected from a cost for medical services less patient-related revenue generated from Financial Assistance policies, thus it is a component of the overall cost of community benefits provided by the hospital.
Part III, Line 4 - Bad Debt Expense	The financial statement footnote describing bad debt expense is contained in Note B - Net Patient Service Revenues. The revenues are presented net of bad debts and other estimated contractual allowances calculated based on cost reporting and cost-to-charge methodologies.
Part III, Line 9b - Provisions On Collection Practices For Qualified Patients	Actions that may be taken in event of non-payment or insufficient payment- Accounts for hosptial sercives for patients who are able, but unwilling to pay, are considered uncollectible bad debts and will be referred to outside agencies for collections. Please refer to the Patient Education of Eligibility for Assistance narrative for further information on collection practices.
Part VI, Line 2 - Needs Assessment	Currently, CVRMC utilizes several methods of assessing community healthcare needs. Evaluating the health needs of the CVRMC service area leads to identifying physicians needed in the area as well as recognizing those services that are required to address illnesses which can be targeted for community 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, direct comments, patient volumes for specific needs, and the Environmental Assessment tool provided by our management firm, HealthTech. 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, Physical Therapy, Registration, Med/Surg/ICU, Obstetrics, Respiratory Therapy, Emergency, Laboratory, Clinics, 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 and distributed to all department directors, graphs are posted, and other communication channels are used 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. Many changes within CVRMC have been made as a direct result of 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 measures against 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, focusing on the patients needs. These objective and meaningful comparisons of hospitals on topics that are important to the consumer and the public reporting aspect of HCAHPS serves as a transparency tool which drives accountability and improves quality of care.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 their care has been provided is a valuable source of information for determining need. Comment/Compliment cards are also available throughout the hospital for direct responses from patients and their families.Patient Concerns/Complaints Tracking - is a quality improvement initiative which within the CVRMC EHR tracks concerns and complaints of patients by networking and connecting all involved in one platform for resolution. This program builds trust through service recovery. Building trust is a fundamental characteristic necessary in any relationship and as issues are resolved in a constructive, inclusive approach, our customers are more willing to utilize more services and voice opinions about services that should be brought to the service area.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. CVRMC will continue to offer community benefit programs within its budgetary means in response to the needs of the region served. CVRMC will continue to strive for growth, bringing new services and structures to the hospital while focusing on wellness and prevention.CVRMC has kept a close eye on any legislation that would affect the future of rural hospitals and any work that needs to be accomplished regarding legislative change. Some of these influences/legislative changes include the CAH Pool, opioid legislation, health insurance, etc.The Payer 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 and/or the addition of new providers. The payer mix also provides valuable information regarding the mix of services needed, education programs, new outreach programs, and future demands. The payer mix is also a very good indicator of the social economic structure of the community, allowing CVRMC to tailor programs to better meet community needs.Medical Staff Development PlanThe approach used to project physician need for Cobre Valley Regional Medical Centers service area included the following:Defining the CVRMC service area and market share by service area and service lineProjecting the service areas population growth and characteristics for the next five yearsTaking into account competition and other local circumstances such as, in-migration, out-migrationDeveloping a profile of the current medical staff including number, FTE, specialty, age, activityIdentifying an appropriate demand model from among the available physician need estimation toolsUtilizing 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 other media areas. 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 healthcare facility draws at least 75% of its patients and in which it maintains a considerable share of the healthcare market. The first step in defining CVRMCs service area is identification of the communities from which the hospital draws 75% of patients, and to assess the hospitals market share in each of these communities. The service area was then divided into two service areas: Primary and Secondary. Three ZIP Codes have been identified as CVRMCs primary service area and seven 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 choose for healthcare 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:Arizona hospital discharge database from the Arizona Department of Health Services Thomson Reuters Market Expert is the source of the Medicare market share, demographics, insurance estimates and market volume projectionsService 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 payer mix information can determine the inpatient market share by service area, discharges, inpatients market
Part VI, Line 3 - Patient Education of Eligibility for Assistance	EDUCATION OF FINANCIAL ASSISTANCE (FA) TO PATIENTS- COBRE VALLEY REGIONAL MEDICAL CENTER (CVRMC) IS COMMITTED TO PROVIDING FA TO PERSONS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED. 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. CVRMC HAS A COMPREHENSIVE SYSTEM OF PROVIDING CHARITY CARE SERVICE OR DISCOUNTED MEDICAL CARE TO UNINSURED PATIENTS WITHIN THE AVAILABLE RESOURCES OF CVRMC AND/OR RELATED CLINICS. CVRMC ADDRESSES WITH THE PATIENT: ELIGIBILITY CRITERIA FOR FA, THE EXTENT TO WHICH FA INCLUDES CHARITY CARE OR DISCOUNTED CARE, THE BASIS FOR CALCULATING AMOUNTS CHARGED TO INDIVIDUALS WHO ARE ELIGIBLE FOR ASSISTANCE UNDER THIS POLICY, THE METHOD FOR APPLYING FOR ASSISTANCE, ALL EMERGENCY AND MEDICALLY NECESSARY INPATIENT AND OUTPATIENT HOSPITAL SERVICES PROVIDED TO UNINSURED INDIVIDUALS WHO QUALIFY FOR ASSISTANCE ARE INDIVIDUALLY AND PRIVATELY Counseled REGARDING A PAYMENT STRUCTURE. CVRMC ALSO WORKS WITH PATIENTS WITH HIGH DEDUCTIBLES AND/OR OUT-OF-POCKET COSTS. THIS IS ALSO DONE ON AN INDIVIDUAL BASIS THROUGH A PRIVATE CONVERSATION. MEASURES TO WIDELY PUBLICIZE THE POLICY- THE FA POLICY IS MADE AVAILABLE AT DIFFERENT TIMES OF A PATIENT'S CARE: AT REGISTRATION, ADMISSION, AND DISCHARGE. INDIVIDUALS WHO FEEL THAT THEY QUALIFY FOR FA OR HAVE REQUESTED IT, SUBMIT AN APPLICATION. PERSONAL FINANCIAL INFORMATION IS REQUESTED ON THE APPLICATION, THE APPLICATION IS REVIEWED, AND THE APPLICANT IS INFORMED WITHIN 30 DAYS. A DISCOUNT SCHEDULE IS ALSO USED BASED ON THE PATIENT'S INDIVIDUAL CIRCUMSTANCES. FA INFORMATION IS PUBLISHED ON THE HOSPITAL WEBSITE, AVAILABLE UPON REQUEST FOR PICK-UP AT THE HOSPITAL OR CAN BE MAILED TO THE PATIENT. POLICY RESPONSIBILITY- IT IS THE RESPONSIBILITY OF THE HOSPITAL BOARD OF DIRECTORS TO ENSURE THAT THIS POLICY IS BEING ADMINISTERED AND CARRIED OUT IN A CONSISTENT MANNER AND WITHIN THE GUIDELINES SET FORTH IN CONTROLLING LAWS AND REGULATIONS. SCOPE- THIS POLICY APPLIES TO ALL EMERGENCY AND MEDICALLY NECESSARY INPATIENT AND OUTPATIENT HOSPITAL SERVICES PROVIDED TO UNINSURED INDIVIDUALS WHO QUALIFY FOR ASSISTANCE IN ACCORDANCE WITH THE TERMS AND CONDITIONS HEREIN. IT ALSO APPLIES TO CVRMC EMPLOYED PHYSICIAN SERVICES, CLINIC SERVICES, OR OTHER SERVICES THAT MAY BE OFFERED BY THE HOSPITAL. ANY SERVICES DEEMED NON-MEDICALLY NECESSARY OR COSMETIC IN NATURE ARE NOT ELIGIBLE FOR FA. DEFINITIONS- THE FOLLOWING DEFINITIONS SHALL APPLY TO THIS POLICY: "AGB DISCOUNT PERCENTAGE" IS DETERMINED BY THE SUM OF ALL CLAIMS OF MEDICALLY NECESSARY SERVICES PROVIDED AT CVRMC PAID (INCLUDING PAYMENTS BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS IN THE FORM OF CO-PAYS, CO-INSURANCE OR DEDUCTIBLES) DURING THE RELEVANT PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS. "APPLICATION PERIOD:" THE PERIOD DURING WHICH THE HOSPITAL MUST ACCEPT AND PROCESS AN APPLICATION FOR ASSISTANCE UNDER THIS POLICY IN ORDER TO HAVE MADE 'REASONABLE EFFORTS' TO DETERMINE WHETER THE PATIENT IS AN INDIVIDUAL WHO IS ELIGIBLE FOR ASSISTANCE UNDER THIS POLICY. THE APPLICATION PERIOD ENDS ON THE 120TH DAY THE HOSPITAL PROVIDES THE INDIVIDUAL WITH THE FIRST STATEMENT FOR CARE PROVIDED. "EXTRAORDINARY COLLECTION ACTION(ECA)": ACTIONS TAKEN BY THE HOSPITAL AGAINST A PATIENT OR ANY OTHER INDIVIDUAL WHO HAS ACCEPTED OR IS REQUIRED TO ACCEPT RESPONSIBILITY FOR THE PATIENT'S BILLS INVOLVE (I)A LEGAL OR JUDICIAL PROCESS;(II) SELLING AN INDIVIDUAL'S DEBT TO A THIRD PARTY; OR (III)REPORTING ADVERSE INFORMATION ABOUT THE INDIVIDUAL TO A CONSUMER CREDIT AGENCY OR CREDIT BUREAU. "GROSS CHARGES": THE HOSPTIAL'S FULL, ESTABLISHED PRICE FOR MEDICAL CARE THAT IT CONSISTENTLY AND UNIFORMLY CHARGED to ALL PATIENTS BEFORE APPLYING ANY CONTRACTUAL ALLOWANCES, DISCOUNTS, OR DEDUCTIONS. "HOUSEHOLD INCOME": MEANS THE TOTAL INCOME OF ALL MEMBERS LIVING IN THE INDIVIDUAL'S HOUSEHOLD. "INDIVIDUALS WHO ARE ELIGIBLE FOR ASSISTANCE UNDER THIS POLICY": AN INDIVIDUAL WHO IS UNINSURED AND IS ELIGIBLE FOR FA UNDER THIS POLICY. "INDIVIDUALS WHO QUALIFY FOR FINANCIAL ASSISTANCE": ELIGIBLE INDIVIDUALS WHO HAVE SUBMITTED A COMPLETED FA APPLICATION WITHIN REQUIRED TIME PERIODS AS SET FORTH HEREIN AND HAVE BEEN APPROVED FOR THE FA ACCORDING TO THE PROCESSES SET FORTH HEREIN. "MEDICALLY INDIGENT": INDIVIDUALS WHO DO NOT HAVE HEALTH INSURANCE AND WHO ARE NOT ELIGIBLE FOR OTHER HEALTH CARE COVERAGE, SUCH AS MEDICARE, MEDICAID, OR PRIVATE HEALTH INSURANCE. "NOTIFICATION PERIOD": BEGINS ON THE FIRST DATE CARE IS PROVIDED AND ENDS ON THE 240TH DAY AFTER THE HOSPITAL PROVIDES THE INDIVIDUAL WITH THE FIRST BILL FOR CARE. "UNINSURED": A PATIENT (OR HIS FINANCIALLY RESPONSIBLE INDIVIDUAL) WHO HAS NO INSURANCE OR MEDICAL COVERAGE UNDER GOVERNMENTAL PROGRAMS AND IS NOT ELIGIBLE FOR ANY OTHER THIRD-PARTY PAYMENT.DETERMINATION OF FA ELIGIBILITY- FA 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 SUBMIT ALL DOCUMENTATION NECESSARY TO MAKE THE DETERMINATION OF FINANCIAL NEED; A REASONABLE EFFORT BY 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. IT IS PREFERRED BUT NOT REQUIRED THAT A REQUEST FOR FA WILL TAKE INTO ACCOUNT THE PATIENT'S ASSETS AND OTHER FINANCIAL RESOURCES. IT IS PREFERRED BUT NOT REQUIRED THAT A REQUEST FOR FA AND A DETERMINATION OF FINANCIAL NEED OCCUR PRIOR TO RENDERING OF MEDICALLY NECESSARY SERVICES. THE NEED FOR FA SHALL BE RE-EVALUATED AT EACH SUBSEQUENT RENDERING OF MEDICALLY NECESSARY SERVICES, IF THE TEST FINANCIAL EVALUATION WAS COMPLETED MORE THAN 180 DAYS PRIOR, AND AT ANY TIME ADDITIONAL INFORMATION RELEVANT TO THE ELIGIBILITY OF THE PATIENT FOR FA BECOMES KNOWN. THE GRANTING OF FA SHALL BE BASED ON AN INDIVIDUALIZED DETERMINATION OF FINANCIAL NEED, AND SHALL NOT TAKE INTO ACCOUNT AGE, GENDER, RACE, SOCIO-ECONOMIC STATUS, SEXUAL ORIENTATION OR RELIGIOUS AFFILIATION. IN DETERMINING WHETHER EACH INDIVIDUAL QUALIFIES FOR FA, ONLY THOSE PATIENT BILLINGS NOT COVERED BY OTHER COUNTY OR GOVERNMENTAL ASSISTANCE PROGRAMS SHOULD BE CONSIDERED. MANY APPLICANTS ARE NOT AWARE THAT THEY MAY BE ELIGIBLE FOR ASSISTANCE, SUCH AS AHCCCS (MEDICAID) OR OTHER GOVERNMENT OR PRIVATELY FUNDED PROGRAMS. 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 FA FOR THOSE SERVICES. CVRMC MAY MAKE THE GRANTING OF FA CONTINGENT UPON APPLYING FOR GOVERNMENTAL PROGRAM ASSISTANCE. THIS MAY BE PRUDENT, ESPECIALLY IF THE PATIENT REQUIRES ONGOING SERVICES. EXCLUSIONS- THIS POLICY AND THE FA PROGRAM DO NOT APPLY TO THE PORTION OF CHARGES AN INSURED PATIENT IS PERSONALLY RESPONSIBLE FOR, I.E., CO-PAYS, CO-INSURANCE, AND DEDUCTIBLES, AND DOES NOT APPLY TO ELECTIVE PROCEDURES EXCEPT AS MAY BE DETERMINED AT THE SOLE DISCRETION OF CVRMC, ON A CASE-BY-CASE BASIS. METHOD FOR APPLYING FOR FA- A COPY OF THIS POLICY AND FA APPLICATIONS WILL BE MADE AVAILABLE AT THE HOSPITAL OR BY CONTACTING PATIENT ACCOUNTS/BILLING OFFICE AT (928)425-3261. INDIVIDUALS WHO FEEL THAT THEY QUALIFY FOR FA UNDER THIS POLICY, OR HAVE REQUESTED THAT FA BE PROVIDED, ARE REQUIRED TO SUBMIT AN APPLICATION ON THE HOSPITAL FORM PROVIDED DURING THE APPLICATION PERIOD. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE PROOF OF HOUSEHOLD INCOME AND/OR ANY OTHER INFORMATION PROVIDED ON THE APPLICATION, AS REQUESTED BY THE HOSPITAL. THE APPLICANT IS REQUIRED TO SUBMIT ALL INFORMATION REQUIRED ON THE FA APPLICATION FORM INCLUDING, BUT NOT LIMITED TO THE FOLLOWING INFORMATION: COPY OF AHCCCS DENIAL LETTER (MAY BE WAIVED ON A CASE-BY-CASE BASIS), COPIES OF PAY STUBS FOR THE LAST 2 PAY PERIODS, NUMBER OF DEPENDENTS CLAIMED ON TAX RETURN, AND COPIES OF BILLS SHOWING EXPENSES. DISCOUNT- HOUSEHOLD INCOMES THAT EXCEED 400% OF THE FPG, WHERE THE PATIENT IS MEDICALLY INDIGENT, ARE EVALUATED BASED ON THEIR SPECIAL CIRCUMSTANCES: FAMILY SIZE, FEDERAL POVERTY GUIDELINES (FPG) 100%, 150%, 200%, 250%, 300%, OR 400% OF FPG. THIS POLICY, AN APPLICATION, A PLAIN LANGUAGE SUMMARY OF THE POLICY AND ANY NOTICES OR PUBLICATIONS REGARDING THE POLICY WILL BE MADE AVAILABLE ON THE HOSPITAL'S WEBSITE(WWW.CVRMC.ORG)IN PDF FORM. THE POLICY, APPLICATIONS, AND PLAIN LANGUAGE SUMMARIES ARE ALSO AVAILABLE UPON REQUEST AND WITHOUT CHARGE AT THE PATIENT ACCOUNTS AND BILLING DEPARTMENT AND BY MAIL. A PLAIN LANGUAGE SUMMARY SHALL BE CONSPICUOUSLY DISPLAYED IN HOSIPTAL PATIENT WAITING AREAS AND IN THE PATIENT ACCOUNTS/BILLING DEPARTMENT IN A MANNER THAT IS REASONABLY CALCULATED TO ATTRACT VISTITORS' ATTENTION. A PLAIN LANGUAGE SUMMARY OF THIS P
Part VI, Line 4 - Community Information	Cobre Valley Regional Medical Center (CVRMC) is located in Globe, Arizona and serves a population of 40,000 within a 65 mile radius and is a full-service acute care facility. This population includes both the primary, secondary, and partner 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 towns of Miami and Superior to the west, Kearny, Hayden, and Winkelman to the south. The communities of Roosevelt, Tonto Basin, and Pleasant Valley/Young are located to the north. The San Carlos Apache Nation, our service area partner, borders Globe to the east. CVRMC serves as an acute medical/surgical, obstetric, orthopedic, oncology, pediatric, family practice provider, and a multitude of other services for all the residents of these communities. The CVRMC primary and secondary service area communities are located in two counties, Gila and Pinal. Based on the 2020 U. S. Census, approximately 29.4% of the total population in Gila County was over the age of 65, an increase of .4% from the 2010 Census. In neighboring Pinal County it was 20.9%, an increase of 5% compared to the 2010 Census. Arizonas population 65 and older is 18% while the U.S. is at 16.9%. 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. Also, two leading causes of death in Gila County include death by suicide and drug induced death. People with a disability under the age of 65 years is 13% and 10.6% for Pinal County. Globe and Miami, Arizona Primary Service Area (63% Inpatient Patient Origin) Globe, Miami and the unincorporated areas nearby (including Claypool, Central Heights, and Midland City) are commonly called Globe-Miami. The towns are located on the northeastern slope of the Pinal Mountains, and are surrounded (except to the east) by the Tonto National Forest. Globe-Miami is located on U.S. Routes 60 and 70, and is served industrially by the Arizona Eastern Railway. Globe-Miami is located in Gila County with a total county population of 54,018, according to the 2020 census. Globes economy remains 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 important in Globes economy. Globes current population, according to the 2020 Census, is 7,347.(Demographic Information below)Miami borders Globe to the west and the major copper mines are located in, or near Miami. Copper mines account for the largest employment in the Miami area but many of these employees commute to and from larger metropolitan areas to the east, such as Gold Canyon or Mesa. Miamis current population is 1,524.(Census 2020 data not available)Freeport McMoRan currently employs approximately 820 employees at its Miami operations; KGBM employs 63 at its Carlota facility as it anticipates to continue the SX-EW operations. Capstone Pinto Valley Mine employs approximately 592, while BHP Billiton has shut down, but employs several contracted employees to oversee the closed mine sites. Resolution Copper, the deepest underground mine in the world, is continuing to grow its employee base as the mine reaches production stages. Currently Resolution Copper employs 300 including contracted workers. As of 2020, Miami is home to one of the last 3 copper smelters in the United States. The following is from the U.S. Census Bureau: Demographic Information for Globe, AZ, Age and Sex: Persons under 5 years, percent 4.8%; Persons under 18 years, percent 18.8%;Persons 65 years and over, percent 21.3%; Female persons, percent 47.8%; Race and Hispanic Origin: White alone, percent 84.1%; Black or African American alone, percent 1.8%; American Indian and Alaska Native alone, percent 2.6%; Asian alone, percent 1.5%; Native Hawaiian and Other Pacific Islander alone, percent 0.0%; Two or More Races, percent 6.9%; Hispanic or Latino, percent 40.1%; White alone, not Hispanic or Latino, percent 50.4%.Population Characteristics: Veterans, 2015-2019 686;Foreign born persons, percent, 2015-2019 3.3%.Housing:Housing units, July 1, 2019, (V2019); Owner-occupied housing unit rate, 2015-2019 65.8%; Median value of owner-occupied housing units, 2015-2019 $125,800; Median selected monthly owner costs -with a mortgage, 2015-2019 $1,058; Median selected monthly owner costs-without a mortgage,2015-2019 $375; Median gross rent, 2015-2019$866; Building permits 2020. Families & Living Arrangements: Households, 2015-2019 2,962; Persons per household, 2015-2019 2.36; Living in same house 1 year ago, percent of persons age 1 year+, 2015-2019 77.4%; Language other than English spoken at home, percent of persons age 5 years+, 2015-2019 14.6%. Computer and Internet Use:Households with a computer, percent, 2015-2019 84.9%; Households with a broadband Internet subscription, percent, 2015-2019 65.4%. Education: High school graduate or higher, percent of persons age 25 years+, 2015-2019 89.8%. Bachelor's degree or higher, percent of persons age 25 years+, 2015-2019 20.1%. Health: With a disability, under age 65 years, percent, 2015-2019 12.8%; Persons without health insurance, under age 65 years, percent 13.4%. Economy: In civilian labor force, total, percent of population age 16 years+, 2015-2019 58.2%; In civilian labor force, female, percent of population age 16 years+, 2015-2019 52.0%; Total accommodation and food services sales, 2012 ($1,000); Total health care and social assistance receipts/revenue,2012($1,000)(c) 85,850; Total manufacturers shipments, 2012 ($1,000); Total retail sales, 2012($1,000) 130,066; Total retail sales per capita, 2012 $17,442.Transportation: Mean travel time to work (minutes), workers age 16 years+, 2015-2019 15.5. Income & Poverty: Median household income (in 2019 dollars), 2015-2019 $49,954; Per capita income in past 12 months (in 2019 dollars), 2015-2019 $25,321;Persons in Poverty, percent 15.8%. Roosevelt, Arizona Primary Service Area (1.2% 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, Roosevelt Dam, making it the oldest artificial reservoir in Arizona and the largest within the boundaries of the state. The population of Roosevelt is estimated at 250, with many visitors moving in and out of the area depending on the season.(Census 2020 data not available)Tonto Basin, Arizona Secondary Service Area, Tonto Basin is located 55 miles north of CVRMC and the population fluctuates with the seasons. Tonto Basin is situated next to the Tonto Creek, a south flowing tributary of the Salt River. When the creek runs at high capacity, many residents living on the east side of the creek become stranded in their homes, having to wait for the water to recede. As of 2020, 1,685 people live in Tonto Basin, but the community experiences a population surge during the winter months to about 2800 people. People living in Tonto Basin work in office and administrative support, law enforcement and fire fighting, and management occupations. Many of these residents are employed in Payson or Globe, having to travel up to 55 miles one way for work.(Census 2020 data not available) San Carlos Apache Nation San Carlos, Ft. Apache, and Peridot, Arizona Partner Service Area (21.3% 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 U.S., with the median annual household income being approximately $13,000. About 60% of the people live under the poverty level, and 1/4 of the active labor force is unemployed. With many families co-habitating, the poverty level, and other socio-economic factors, the population of the San Carlos Nation was hit severely by COVID-19. The population of the San Carlos Reservation is just under 10,000 residents with its largest communities being San Carlos, Ft. Thomas, and Peridot, Arizona. The Apache Gold Casino employs 300 people while hunting, fishing, boating, camping, and gaming are attractions to tourists visiting the area.The following demographic information is from the Bureau of Womens and Childrens Health, Arizona Department of Health Services:RESOURCES for the SAN CARLOS APACHE TRIBE-FACILITIES: General hospitals Yes; Hospital Beds/ 1000 Residents 0.0; Designated as Sole Community Provider? No; Specialty Beds 0; Skilled Nursing Facilities 0; Nursing Beds 0. SERVICES: Licensed Home Health Agencies0; A
Part VI, Line 4 - Community Building Activities	Cobre Valley Regional Medical Center (CVRMC) has a health commitment to our employees, physicians, health and wellness organizations, our board of directors, benefactors, volunteers, and most importantly, to our patients and families of the region we serve. CVRMC is inclusive, collaborative, and effective regarding community building activities and donations.The mission of CVRMC is:To develop and maintain a local healthcare delivery system that serves the region with high quality, efficient and compassionate care. Our mission is your health. This is a living statement within each of our employees who work 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 within our service region.CVRMC receives expert operational support services through HealthTech Management Services. These areas of expertise include quality patient care, finance, revenue cycle, materials management, and strategic planning. The resources HealthTech Management Services provide are invaluable in assisting the CVRMC Board of Directors, administration, physicians, directors, and clinical and non-clinical staff in fulfilling the hospitals mission of Quality, Efficiency, Compassion, and Health for all our communities.Through our strategic planning process, CVRMC identified The Patient Experience, People, Growth, Financial Stewardship, and Community as our key strategic goals for the next three years. These goals are not independent of each other, but rather interdependent, connected and overlapping, each individual function thriving on the success of the others. The Patient Experience is defined as the combination of customer service and the quality provided to patients and families receiving services at CVRMC and its surrounding clinics. CVRMC will foster an environment where the quality of care and customer service provided to our patients, physicians and employees is relentlessly pursued with a philosophy of continuous improvement in delivery and outcome. Compassion is the key driver and employing people with great character creates a culture where patients and families want to choose CVRMC for their healthcare.People make the difference in the delivery of care and in the lives of our patients, physicians, fellow workers, and associates. CVRMC is committed to cultivate a workforce and medical provider community that are highly engaged, accountable, collaborative and committed to fulfilling the mission of maintaining a local healthcare delivery system that serves the region with quality, efficiency, and compassion.Growth, in both services and facilities, will provide for the needs of all the communities that depend on the healthcare provided by CVRMC. It is a strategy of CVRMC to aggressively pursue an increased share of the market and reduce out-migration by improving, expanding, adding and promoting services and physical structures that meet service area needs and are clinically and financially feasible. Financial Stewardship, by effectively controlling costs, reducing turnover, strategic investments, and employee responsibility for financial management are all expectations to secure financial strength to move CVRMC into the future of service and property expansion.Community is the heart of our healthcare mission. Focused on promoting healthy living and prevention of chronic diseases, CVRMC realizes healthier communities are safer, have a stronger environment, are socially connected, and have people who truly care for one another. CVRMC has a commitment to care for its communities and the overall health of the people who make these communities great. Through strategic planning, relationship building, and collaboration, CVRMC will be able to address community health needs and move our population to a healthier state.Benefit to Community -One Call is a service implemented by CVRMC in late 2015. The phone service is to help reduce the number of calls a customer needs to make in order to obtain information on health needs and/or social service agencies within the service region. One Call is a free service open to the general public and is staffed by a registered nurse who can also act as a liaison between medical staff, medical health facilities, and social services on behalf of the user. -CVRMC's Health Fair(HF), over the past 10 years, has seen a rapid increase in participation of health and wellness organizations as well as public attendance. After interruption in 2020 due to the Pandemic,in 2021, an estimated 500 members of our communities attended the HF, Get Out and Get Fit, with 85 organizations providing health and wellness information. Previous public attendance has reached about 1,000 for the past six years with participation of health and wellness organizations continuing to climb from 42 participants to an average of 90 participants in 2015-2018, and 2021. The decline in 2021's attendance is attributed to the Pandemic. Beginning in 2018, the HF began to rotate yearly with another huge fundraising event the CV Foundation hosts, the Art and Wine Auction.-Our professional staff participates in Community Health Fairs and Education Events throughout our service region. These events include health and wellness checks for mining company employees, school children, and seniors. CVRMC has also been actively involved in the Science/Technology/Engineering/Math (STEM) project through the Gila County Superintendents Office, offering professional health personnel for guest speakers, science fair judging, health career counseling, and much more professional information.-The PACT Committee (Positive Attitudes Creates Teamwork) is comprised of CVRMC staff who dedicates their efforts to make a difference in employee and community relations. The PACT Committee ensures the hospitals presence in community events such as the Globe-Miami Light Parade, Relay for Life, March of Dimes, skilled nursing facility events, and other holiday community celebrations. -The CVRMC Foundation is an integral part of CVRMC. Through philanthropic income, driven by the CVRMC Foundation, CVRMC is supported in purchasing 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.-Grief Support Meetings have brought the pastoral leadership from 2 different hospice groups to provide encouragement and assistance to those who have lost loved ones.-Clinical/Non-Clinical Internships-Teenage Outreach Pregnancy Support-The CVRMC Conference Rooms are used by many community organizations for education, hosts many educational programs available to the residents in the service area. -Community Involvement is an expectation of CVRMC employees. The strength of our communities is dependent on community involvement. Employees are Little League, soccer, football, and youth basketball coaches. Employees serve on the Chamber of Commerce for several communities, Rotary, Southern Gila County Network Team, Copper Basin Coalition, Elderly Quality of Life, Cobre Valley Transit, Labor Force Development, housing, and many other committees across the service region.-Cancer Awareness and Support Group-The CVRMC Angel Tree is supported solely by employees who provide gifts for the families in the local Safe Home and those pre-school children who are in need of gifts at Christmas. -Job Shadowing students from 6 area high schools enjoy a day at CVRMC learning from professionals in their chosen field. CVRMC realizes the importance of resourcing for the future of healthcare professionals.-Facebook and the Website provide valuable health information to all our communities and are platforms to inform our population about health events and community events which would benefit their health.-Donations to Community Organizations CVRMC recognizes the need to contribute to local organizations to help support their causes in regards to awareness, fundraising, promoting health/exercise/wellness, education, or finding a cure for cancer. Relay for Life and Little League programs are examples. The S
Part VI, Line 5 - Promotion of Community Health	Cobre Valley Regional Medical Center has kept its finger on the pulse of its service region throughout the COVID-19 years of 2020 and 2021, reaching out to help the region in many different aspects, contributing considerable resources (Much of the resources are from federal and state pandemic relief grants)to support community Pandemic "Fighting" endeavors and initiatives. The focus in 2021 continued to be the patient experience, people, growth, and community even though COVID-19 took the worlds health care systems to a new level. In 2021 CVRMC continued the Pandemic responses initiated in 2020 by responding to the shortage of PPE, securing respirators, managing patient census, offering tele-health provider visits, set up check stations, reduced patient visitation and more. Throughout 2021 and the onslaught of COVID-19, we continued to respond to the service area needs to fulfill our mission: To develop and maintain a healthcare delivery system that serves the region with quality, efficiency, and compassion. 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, Meals on Wheels, economic development, Meth Coalition, AZ Youth Partnership, church charities, and the Globe-Miami and Superior Chambers of Commerce, to name a few. Employees who are involved beyond the hospital facility make a connection to the communities served.Health Fair (HF) CVRMC hosts a bi-annual HF to promote good health awareness and to encourage participants to assume responsibility for their own health by providing free health screenings. Many community organizations are also encouraged to participate to bring their valuable health and safety information to one location, the CVRMC campus, for the convenience of the people we serve. Immediate Care Services (ICS) - The decision to include ICS as a health priority was based on several findings in the CHNA. Every focus group identified the need for an urgent care facility and extended hours pharmacy services as a priority health need. Participants frequently stated that not having an urgent care was impacting access to care and a financial burden. Participants discussed the time, expense, and stress of having to travel to urgent care facilities that were typically about an hour away in the middle of the night or on weekends to have their urgent healthcare needs met. Participants also discussed avoiding having their urgent health care needs addressed, such as ear infections with young children, for the reason of not having enough money to be able to afford a visit to the hospital Emergency Department and not having enough money to travel out of the community. The mention of pharmacy services often accompanied the discussion on urgent care needs. Participants often mentioned the importance of having medications filled after hours or on weekends and experiencing a lapse in medication management when prescriptions could not be filled right away. Participants that were aware of the CVRMC pharmacy services, including the mailing options, expressed appreciation for the ability to access medications through CVRMC. Some expressed challenges in delays in receiving CVRMC prescription mail orders or needing consistent pharmacy services available in the case of the CVRMC Kearny clinic. It was felt that an urgent care facility with pharmacy services that is available after hours and on weekends would meet these needs. CVRMC is currently moving forward with this health priority. (CHIP 2020-2024)Aquatic Center (ONGOING) With the closure of the Globe Community pool 7 years ago, a team of community members are working on bringing a modern aquatic center with amenities that would provide water recreation for all. CVRMC is committed to see this project come to fruition. This project is in the CVRMC Strategic Plan to improve the health and wellness of our region. In 2021 CVRMC pledged a major grant to the city of Globe for its public pool restoration initiative. Without CVRMC's pledge, the overall viability and success of the initiative was at risk to re-establish a vital summertime healthy activity for children and families of the community and CVRMC service area.Walking Path - A Walking Path as a health priority is supported through the CHNA indicators, the community survey, and key informant interviews. Walkability scores reflect a communitys ability to offer safe places to walk and bike which also encourages frequent connections among community members to promote physical activity, but also reduces isolation. Walkability scores range between 1 and 20; the lower the score, the less walkable the area. The average walkability score for the CVRMC service region is 3. The average walkability score for the State of Arizona: 7.58; Source: US Census 2017. Participants also mentioned the lack of sidewalks and lack of safe places to walk and bike as a barrier to being physically active. When asked about a vision for a healthy community in the next three years, key informants described a healthy region as one that is a walkable and bikeable destination, efficient, and connected. The CHIP Administrative Team discussed where an initial walking path could be created. It was determined that a mile long stretch of path strategically placed along Hospital Drive in cooperation with BHP and possibly Cecil Trucking would be a great place to begin. Through CVRMC's leadership and collaboration with BHP, this project became a health improvement reality for the community in 2021. (CHIP 2020-2024)Increase Access to Aging in Place Services - It was identified that community members age 65+ are some of the most vulnerable in the region. Many of the older adults in the region have a lack of family support as they get older. It was discussed by key informants the resulting increase in demands on the health-care system, requiring additional support for specialty providers, like neurologists, cardiologists and orthopedists. There was also discussion by key informants of having additional options to age in place. These additional options included in-home care, having a wellness center available at a free and reduced rate for seniors, transportation services, and Alzheimers care for both patients and their caregivers. During 2020 and 2021 several of the specialty provider services have been enhanced and strengthened for the community. There is still opportunity to additionally strengthen specialty services. (CHIP 2020-2024)Access to Preventative Services - Increase access to preventative services was identified as a priority through the community feedback in focus groups and key informant interviews. One of the key themes in the focus groups was a need for improved access to specialty health care services. This theme is repeated in the key informant interviews with an additional focus on mental and behavioral health services. During 2021, CVRMC has sponsored the advanced education of a nurse provider to offer behavioral health service in the rural health clinic setting.Community Fund Raisers CVRMC employees continue to help community members in need whether it is a house fire, a child with an illness, or any other circumstance that creates extreme hardship for a family. Wellness Program CVRMC is currently looking into employee wellness - knowing healthier employees give better care. It is CVRMCs 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 well-being of our employees. Toy Box CVRMC is surrounded by mountains and many trails. Roosevelt Lake is 20 minutes away as well as the Salt River. CVRMC has purchased kayaks, paddle boards, mountain bikes, and many other types of outdoor equipment for employees to check-out free of charge. CVRMC encourages employees to explore the wonderful area in which we live and tell more people about it. This is great for our employees health but it also aids in recruitment and the economy. This program initiated in 2020, continued in 2021.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, Pima, 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 hea
Part VI, Line 7 - States Filing of Community Benefit Report	AZ
Part VI - Additional Information	Needs Assessment (continued) 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 CVRMCs primary and secondary service areas are primarily White and Hispanic; 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 GroupsGroups of patients tend to have common demographic, diagnostic, and therapeutic attributes that determine their healthcare needs. Diagnosis-Related Groups (DRG) form a manageable, clinically coherent set of patient classes relating CVRMCs 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 move on to long-term care facilities, hospice services, or home care needs. Community Health Needs Assessment and Implementation Plan 2019The excerpt below is from the 2019 Needs Assessment conducted by Pinnacle Prevention. Research shows that economic conditions have a significant impact on population health. There is strong evidence that poverty in childhood has long-lasting effects and limits life expectancy, even if social conditions subsequently improve. In addition, the percentage of the population below the federal poverty level, the percentage of the population with no high school diploma, and the percentage of the population with no health insurance are key drivers that predict poor health outcomes. Only 19.0% of the individuals aged 25 and older in Gila County have a bachelors degree or higher (10% less than the state average). The median annual household income is $39,900 (lower than the state average by approximately $17,000 per year), and 21.9% of the Gila County population lives below the federal poverty level, 4% higher than the average for the state of Arizona. The major employment sectors in the region include mining, healthcare, government, education, arts, entertainment, services, and retail. There are several small businesses throughout the county, yet as of August 2019, the unemployment rate averaged 6.2%. Residents within the region frequently describe their communities as close-knit and demonstrate a willingness to help neighbors in need.Selected demographic characteristics of Gila County:Total population of Gila County=53,889Total population of Arizona=7,171,646Population in Gila County and in the state of Arizona is comprised of 20.1% below 18 years old, and 28.8% 65 years and older; and 23.3% below age 18, and 17.1% over 65, respectively. The median age in Gila County is 49.3, versus 37.7 in Arizona.Gila County is 50.6% female and 49.4% male, while Arizona is 50.3% female and 49.7% male.The race/ethnicity distribution in Gila County is: American Indian or Native Alaskan, non Hispanic 17.8%; Asian, non-Hispanic 0.9%; Black, non-Hispanic 0.8%; Hispanic 18.7%; Native Hawaiian/Other Pacific Islander 0.2%; White, non-Hispanic 62%; and two or more races, non-Hispanic 1.7%. The race/ethnicity distribution in Arizona a whole is: American Indian or Native Alaskan, non Hispanic 5.3%; Asian, non-Hispanic 3.5%; Black, non-Hispanic 4.3%; Hispanic 31.4%; Native Hawaiian/Other Pacific Islander 0.3%; White, non-Hispanic 54.9%; and two or more races, non-Hispanic 2.19%. The income inequality (Gini index) for Gila County is 0.468, and for Arizona is 0.47.The median household income for Gila County is $41,179, versus $53,510 for Arizona.In Gila County 24.1% live below the poverty level, as opposed to Arizona, which is at 16.95%. Gila Couny's unemployment rate is 6.2%, while in Arizona as a whole, it is 5%.Travel time to work on average in Gila County is 18.7 minutes, while statewide, it is 25.1 minutes.The graduation rate is 75% in Gila County, and 78% statewide.High school degrees or higher are possessed by 85% in Gila County, and 86.51% statewide. Nineteen percent of Gila County residents have Bachelor's degrees or higher, while that rate is 28.45% for the state as a whole.CVRMC Board of DirectorsThe CVRMC Board of Directors is strategically designed to encompass a variety of professions from the region. Mining, county government, ranching, banking, insurance, business, and medical professionals make up the members of the board which bring a diversity of ideas and information regarding healthcare 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.

Schedule H (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.0

- 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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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 on 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 on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of 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
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

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 on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2021

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(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)
1Peter Seipel Physician	(i) (ii)	444,190 -------------	-------------	-------------	18,543 -------------	23,328 -------------	486,061 -------------	1,050 -------------
2Pierre Gilles Physician	(i) (ii)	435,018 -------------	-------------	-------------	9,584 -------------	23,328 -------------	467,930 -------------	942 -------------
3Scott Croft Physician	(i) (ii)	462,849 -------------	-------------	-------------	18,754 -------------	22,643 -------------	504,246 -------------	1,900 -------------
4Steven Sawyer Physician	(i) (ii)	578,569 -------------	-------------	-------------	11,966 -------------	22,643 -------------	613,178 -------------	659 -------------
5Winlove Suasin Physician	(i) (ii)	442,457 -------------	-------------	-------------	2,783 -------------	-------------	445,240 -------------	-------------

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation

Schedule J (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.0

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
Cobre Valley Regional Medical Center

Employer identification number
86-0732836

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Cobre Valley Regional Med	86-0732836		09-12-2014	33,000,000	Refunding & Financing Construc		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	3,953,075
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	33,000,000
4 Gross proceeds in reserve funds .............	1,214,433
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............	4,807,916
7 Issuance costs from proceeds ...............	215,000
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	26,762,651
11 Other spent proceeds .............	5,745,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...	X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X
b Exception to rebate? ........		X
c No rebate due? .........		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........	NA
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?
b Name of provider ..........	NA
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.0

- TIN:

SCHEDULE O
(Form 990)

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

Cobre Valley Regional Medical Center

Employer identification number

86-0732836

Return Reference	Explanation
Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company	The CEO and CFO duties are carried out by employees of HealthTech Management Services, Inc., an unrelated management company. Compensation is included in the management fee paid to HealthTech Management Services. The management fee for 2021 was $1,186,964.
Form 990, Part VI, Line 11b: Form 990 Review Process	A CPA firm prepared and reviews the form 990 from data gathered and provided by the CVRMC. The return is then provided to the CFO for review and approval. Any questions or concerns the CFO has are addressed and any correction or clarifications are made. The final Form 990, with all required schedules, is made available to the full board prior to filing.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	Board members and officers are covered by the organization's conflict of interest policy and are required to annually complete a questionnaire disclosing any and all possible conflicts of interest.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management	The Officers' compensation is determined by a review conducted by HealthTech Management Services, Inc. using data provided by a nationally recognized management consulting firm, along with Form 990 data from comparable organizations and other hospitals managed by HealthTech. Once this information has been compiled and reviewed, a meeting is held with the board and a decision is made on the Officer's compensation.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	The Officers' compensation is determined by a review conducted by HealthTech Management Services, Inc. using data provided by a nationally recognized management consulting firm, along with Form 990 data from comparable organizations and other hospitals managed by HealthTech. Once this information has been compiled and reviewed, a meeting is held with the board and a decision is made on the Officer's compensation.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	Available upon request.
Other Changes In Net Assets Or Fund Balances - Other Increases	Net assets released from restriction = $94591
Continued, Form 990 Part III, Program Service Accomplishments	The PACT (Positive Attitudes Create Teamwork) Committee, comprised of CVRMC staff, dedicates its efforts to making a difference in employee and community relations. The PACT Committee is instrumental in the activities of many hospital activities, promoting employee engagement and satisfaction. The PACT Committee also helps CVRMC employees through the HOPE (Helping Our People in Emergencies) Fund. Donations made to the HOPE fund are used in times of emergency for employees. The Community Fund is used to help people of our communities who have been faced with a tragedy fire, illness, disease. The PACT Committee holds fund raisers to build the Community Fund and the PACT Committee also participates in community events to ensure the hospitals presence and to build public support and trust.A summary of services CVRMC provides to its service area are: Case Management, Social Services, Cath Lab, Chronic Care Management, Emergency Services, Family Practice, Podiatry, General Surgery, Imaging, Infusion, Laboratory, Laser Vein Center, OB/GYN Womens Healthcare, Oncology/Hematology, Orthopedics, Outpatient Surgery, Pediatrics, Pharmacy, Physical Therapy, Primary Care, Skin Clinic, Sleep Center, Wound Center, Cardiology, Dialysis, Oncology, other visiting Specialty Services, and outlying Family Care Clinics in Pleasant Valley, Kearny, Tonto Basin, and Superior.As we celebrate 108 years of service to the Globe-Miami and surrounding communities, CVRMC continues to evolve with the changing needs of our population base. Healthcare is ever moving and advancing and CVRMC is progressing with the demands of our target markets. The continued accomplishments we have made are a direct result of a dedicated and compassionate workforce, a steadfast Board of Directors, and strong supporting management team which is focused on one mission the mission of health with high quality, efficient and compassionate care. With the development of our next 3-year strategic plan, we are focused on these areas:The Patient Experience (Quality and Customer Service)PeopleGrowthCommunityFinancial StewardshipOur communities deserve accountability and compassion. We strive to respect and collaborate with all who surround us. We have an earnest responsibility to recognize the needs of our population and to respond to the health priorities facing our population. CVRMC is committed to our communities with an unwavering dedicated spirit.
Form 990, Part VII, Section A	Please see note on Part VI, Section A, Line 3. Officers of the organization are provided by a management company.
Form 990, Schedule H Part VI, Line 4 - Community Building Activities	continued from Schedule H 2019 Community Health Needs AssessmentCVRMC completed the Community Health Needs Assessment in 2019. Stakeholders across the CVRMC service region engaged in a community-driven process to identify the most pressing health issues facing residents. Facilitated by Pinnacle Prevention and CVRMC, community members and organizations came together to provide valuable insights on experiences of health and sickness, as well as realistic ways to affect change. The CHNA generated the data through community surveys, focus groups, and key informant interviews. The 2019 CHNA provided in-depth data on the following health indicators:Mortality Rate Totals per 100,000 population in 2017, according to ADHS Population Health and Vital Statistics: Total, all causes Gila Co. 831.1, Arizona 679.3; Cardiovascular disease Gila Co. 223.9, Arizona 189.9; Diseases of the heart Gila Co. 181.0, Arizona 141.9; Coronary heart disease Gila Co. 133.0, Arizona 102.8. Malignant neoplasms Gila Co. 112.5, Arizona 136.6; Lung cancer Gila Co. 32.5, Arizona 30.8; Colorectal cancer Gila Co. 12.0, Arizona 13.0; Breast cancer Gila Co. 8.6, Arizona 9.8; Prostate cancer Gila Co. 3.6, Arizona 7.5; Malignant melanoma of skin Gila Co. 2.9, Arizona 2.2; Cervical cancer Gila Co. 0.7, Arizona 1.1. Accident (unintentional injury) Gila Co. 101.4, Arizona 55.3; Accidental poisoning Gila Co. 25.3, Arizona 20.4; Motor vehicle accident Gila Co. 52.9, Arizona 13.8; Accidental falls Gila Co. 14.6, Arizona 12.4; Accidental drowning Gila Co. 0.0, Arizona 1.5. Chronic lower respiratory diseases Gila Co. 62.1, Arizona 43.0. Alzheimer's disease Gila Co. 16.3, Arizona 35.2. Cerebrovascular disease Gila Co. 27.5, Arizona 30.7. Diabetes Gila Co. 31.6, Arizona 23.8. Intentional self-harm (suicide) Gila Co. 37.6, Arizona 18.0. Chronic liver disease and cirrhosis Gila Co. 34.1, Arizona 14.2. Essential (primary) hypertension and hypertensive renal disease Gila Co. 10.3, Arizona 11.8. Influenza and pneumonia Gila Co. 10.3, Arizona 9.9. Parkinson's disease Gila Co. 3.9, Arizona 8.7. Assault (homicide) Gila Co. 11.8, Arizona 6.4. Nephritis Gila Co. 16.6, Arizona 6.2. Septicemia Gila Co. 3.9, Arizona 5.5. HIV disease Gila Co. 0.0, Arizona 1.2. Injury by firearms Gila Co. 30.7, Arizona 15.8. Drug-induced deaths Gila Co. 49.2, Arizona 23.3. Opioid-induced deaths Gila Co. 20.0, Arizona 13.4. Alcohol-induced deaths Gila Co. 35.8, Arizona 16.1. Average age at death Gila Co. 71.8, Arizona 72.6. Median age at death Gila Co. 75.0, Arizona 76.0. The Implementation Plan (CHIP) has been developed and is being executed to respond to key factors that may be limiting our communities ability to lead full, happy and healthy lives.The 2019 Community Health Needs Assessment and Community Health Implementation Plan can be found on the CVRMC website, www.CVRMC.org. Culture-The CVRMC Mission and Vision statements set the stage for the culture of our hospital. The CVRMC Standards of Performance are the framework of behaviors that all employees will exhibit when interacting with patients, customers, and co-workers. The standards reflect our philosophy of service.-Customer service training reinforces the expectations of each employee, moving everyones behaviors, manners, and actions in the same positive direction.-Empathic Communication training for all employees reinforces our commitment to patients first and foremost.-Communication training for all employees develops the ability to resolve conflict and address patient and family concerns.-Recruitment has become one of attitude as well as aptitude. Those potential employees are sought out not only for their ability and skills to perform a work assignment but the strength of their character as it aligns with the mission, vision, and standards expected of a CVRMC employee. Community Partnerships-Collaboration has become a corner stone for CVRMC. We do not function as a separate entity apart from our community but rather as a fundamental link in the chain. CVRMC has created many partnerships throughout its service region and beyond creating interdependence between organizations.As CVRMC moves forward to promote health and wellness within our service communities, our response to the needs of special populations will be essential for the reporting standards for "Community Health Needs. Together, with the assistance of healthcare organizations and professionals of our area, a well-constructed Community Health Needs Assessment and Implementation Plan will be the guiding documents to respond to the identified health needs of our diverse communities, providing charitable care with purpose, and supporting educational services and programs for the good of our public.
Form 990, Schedule H Part VI, Line 4 - Community Information	Continued from Schedule HPleasant Valley-Young, Arizona Secondary Service Area Surrounded by the Tonto National Forest, Pleasant Valley-Young is a community in Gila County situated in the beautiful pines of the Sierra Anches 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. The following demographic information was taken from the 2020 World Population Review: Pleasant Valley-Young has a population of 482. The average household income in Young is $43,299 with a poverty rate of 11.41%. The median rental costs in recent years comes to $499 per month, and the median house value is $190,700. The median age in Young is 56.1 years, 62.7 years for males, and 50 years for females. The female population is 210 or 43.7% and the male population is 272 or 56.43%. The racial makeup is 92.12% White, 6.22% other, and 1.66% Native American. Several small businesses exist in Pleasant Valley-Young. A gas station, convenience store, auto parts store, motel, thrift shore, library, and refuse service are among the businesses. Cobre Valley Regional Medical Center services the primary medical needs of the area with a medical clinic which is open one day per week.The median income for a household in the Pleasant Valley-Young area is $26,250, and the median income for a family was $24,886. Males had a median income of $21,000 versus $26,458 for females. The per capita income for the area was $16,943. (Census 2020 data not available) Kearny, Arizona Secondary Service Area (1.7% 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 Kennecotts 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. The economic base of Kearny is the Ray mine and the Hayden Smelter, both owned and operated by ASARCO. These operations have recently experienced a strike by the unions and have not fully gone back into operation.Hayden, Arizona Secondary Service AreaThe following demographic information was taken from the 2020 World Population Review: Hayden is a city located in Gila County Arizona. With a 2020 population of 629, Hayden is currently declining at a rate of -0.16% annually and its population has decreased by -4.98% since the 2010 census information which recorded a population of 662. Spanning over 1 miles, Hayden has a population density of 497 people per square mile.The average household income in Hayden is $41,408 with a poverty rate of 25.52%. The median rental costs in recent years comes to $632 per month, and the median house value is $34,500. The median age in Hayden is 47.1 years, 42.5 years for males, and 51.9 years for females.The racial population of Hayden:White: 93.52%Other race: 3.05%Two or more races: 2.67%Hayden is located in Gila County with the economic base being the Hayden Smelter, one of three smelters in the United States.(Census 2020 data not available) Winkelman, Arizona Secondary Service Area (1.3% Inpatient Patient Origin)The following demographic information was taken from the 2020 World Population Review: Winkelman is a city located in Gila County Arizona. With a 2020 population of 351, Winkelman is currently been steady in population compared to the recorded population in 2010 of 353. The average household income in Winkelman is $41,507 with a poverty rate of 8.53%. The median rental costs in recent years comes to - per month, and the median house value is $55,300. The median age in Winkelman is 52.9 years, 47.1 years for males, and 55.6 years for females.The racial population of Winkelman:White: 80.55%Two or more races: 12.63%Other race: 5.12%Native American: 1.71%Winkelman is located in Gila County with over 95% of the population living within Gila County. The major employment is the copper industry of the ASARCO Mine.(Census 2020 data not available) Superior, Arizona Secondary Service Area (2.1% 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 few years. The following demographic information was taken from the 2020 World Population Review: With a current population of 3,272, Superior is currently growing at a rate of 1.46% annually and its population has increased by 15.33% since the most recent census, which recorded a population of 2,837 in 2010 and has a population density of 1,668 people per square mile.The average household income in Superior is $46,986 with a poverty rate of 18.92%. The median rental costs in recent years comes to $814 per month, and the median house value is $90,500. The median age in Superior is 54.1 years, 49.6 years for males, and 56.3 years for females.The racial population of Superior:White: 84.34%Other race: 7.13%Asian: 4.46%Two or more races: 2.64%Native American: 1.43%
Form 990, Schedule H Part VI, Line 5-Promotion of Community Health	Continued from Schedule H.Tele-Pharmacy/Curbside service - Through its expanded ambulatory pharmacy services, CVRMC makes curbside prescription delivery available. Community Awareness, Education (Facebook/News Articles/Webpage, etc.)Sponsorships for Education/Athletic/TeamsCommunity Events Downtown Halloween, Homecoming parades, job fairs, etc.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, CV Foundation Career Day, Certifications and Training, Childbirth Classes, Smoke Free/Tobacco Free Campaign, Easter Egg Hunt, County Fair, Grief Support, Downtown Halloween Trick or Treat, Horseshoe Tournament, STEM activities, job shadowing, and workforce development, to name a few.Kearny Clinic - Plans to build a new clinic for the residents of the Town of Kearny continued to take shape in 2020. Architect designs were advanced in late 2021 with plans and contract commitment secured for the demolition of the original Kearny healthcare facility. Anticipation of the new Kearny Clinic's completion was revised to 2023.Community Programs and Improvements to Services Information 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. Meditech "expanse" has put the entire CVRMC healthcare system under one EMR. During 2021 the facility continued to advance patient-provider communication and empowering patients a more active role in their health through the patient portal, which continues to promise improved patient outcomes and satisfaction. Community Health Partnerships - Through 2021, CVRMC along with the Gila County Health Department created a strong alliance through the pandemic. Disseminating knowledge and information throughout the county (especially Southern Gila County for CVRMC) was crucial during this time. Communication was happening on a daily basis and the securing of necessary resources was a top priority for both organizations. Early 2021 the Hospital, with strong support from the county, continued to take the lead role for vaccination clinics in the region, setting early records for the percentage of the population vaccinated. Cobre Valley Regional Medical Center continues to be the leader of healthcare 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, Haven of Globe, Heritage Healthcare Center, Gila County Community College, etc., and the local media have been established and can provide a forum for information dissemination and actual intervention services. Employee Education Cobre Valley Regional Medical Centers commitment to higher education for employees is evident in the continuation of tuition assistance. 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. New Standards of Performance and Customer Service Training The CVRMC Standards of Performance were re-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 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, their office staff, and organizations within the region, free of charge, in order to create a regional culture of courtesy and respect.San Carlos, Partner Service Area (CONTINUED THROUGH 2020) - Adjacent to the San Carlos Apache Reservation, CVRMC serves as a partner in acute obstetric, podiatry, orthopedic, oncology and surgical services for reservation residents referred by their hospital or our visiting physicians.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.0

1	Briefly describe the organization’s mission or most significant activities: The mission of our Hospital is to develop and maintain a local health care delivery system that serves the region with quality, efficiency, and compassion.
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 2021 (Part V, line 2a) ......	5	572
6	Total number of volunteers (estimate if necessary) .............	6	9
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	53,124	1,888,904
9	Program service revenue (Part VIII, line 2g) .........	68,973,737	86,380,775
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	322,250	380,633
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	723,743	576,391
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	70,072,854	89,226,703
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)	31,446,266	34,540,191
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–24e)....	34,266,198	41,743,871
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	65,712,464	76,284,062
19	Revenue less expenses. Subtract line 18 from line 12.......	4,360,390	12,942,641
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	106,774,506	131,779,953
21	Total liabilities (Part X, line 26).............	54,602,576	65,199,305
22	Net assets or fund balances. Subtract line 21 from line 20.....	52,171,930	66,580,648

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 43,028,029 including grants of $ ) (Revenue $ 87,991,426 )
	For the year ended 12/31/2021, Cobre Valley Regional Medical Center (CVRMC) carried out 159,941 patient visits, comprised as: 79,121 Hospital outpatient, 13,731 outpatient emergency visits, 65,219 Clinic outpatient,1743 Hospital inpatient, and 127 Specialty clinic. Along with providing acute healthcare services to the community as a non-profit entity, CVRMC is committed to the many communities we serve. Several members of our administration, directors, managers, and staff serve on various community associations including: Chambers of Commerce, Rotary, Work Force Development, Economic Development, Cancer Awareness Committees, Diabetes Education, Grief Support Teams, Scholarship Committees, Aquatic Center, Housing Committees, Community Development, and Youth Athletic Programs, to name just a few. CVRMC has its finger on the pulse of the community, provides charitable care with purpose, and offers educational services and programs for the good of our public. The Community Health Need Assessment (CHNA) was completed in late 2019. As we evaluate the recently completed CHNA and work our Community Health Implementation Plan (CHIP), CVRMC will continue to actively work with other healthcare organizations, be involved with state and federal legislation initiatives, and continue to connect to the communities we serve to address health priorities. CHNA IMPLEMENTATION PROGRESS THROUGH 2021 INCLUDES:1.PRIORITY 1: IMMEDIATE CARE SERVICES LAND HAS BEEN PURCHASED WITH FRONTAGE ON THE HIGHWAY 60 CORRIDOR AND BUILDING PLANS ARE BEING DEVELOPED WITH EXPECTATION OF A FULLY EXECUTED WALK-IN SERVICE IN PLACE BY THE END OF 20242.PRIORITY 2: BUILD A WALKING PATH IN COLLABORATION WITH BHP, THIS PROJECT WAS COMPLETED WITH A GRAND OPENING CELEBRATION IN 2021.3.PRIORITY 3: INCREASE ACCESS TO PREVENTIVE SERVICES CVRMC CONITNUES THE BUILD OUT OF THE POPULATION HEALTH MODULE OF ITS MEDITECH EHR WHICH WILL BE THE FOUNDATION OF THE TECHNOLOGY NEEDED TO MANAGE AND TRACK THE PREVENTATIVE SERVICES OFFERED TO PATIENTS.4.PRIORITY 4: OMCREASE ACCESS TO AGING IN PLACE SERVICES FOR OUR AGING POPULATION CVRMC COUNTINUES TO DEVELOP ITS COLLABORATION WITH THE VARIOUS PROVIDERS AND AGENCIES FOCUSED ON SERVICES TO THE ELDERLY. ALSO, SPECIALTY SERVICE LINES OF CARDIOLOGY AND ORTHOPEDICS HAVE ENHANCED SERIVCES FOR HEALTH CONDITIONS PROMINENT IN AN AGING POPULATION. CONTINUED AWARENESS TRAINING HAS BEEN PROVIDED TO HOSPITAL LEADERSHIP AND STAFF ON COMMUNICATING AVAILABLE SERVICES TO THE COMMUNITY, PARTICULARLY THE SENIOR POPULATION. AS WE CELEBRATE 109 YEARS OF SERVICE TO THE GLOBE-MIAMI AND SURROUNDING COMMUNITIES, CVRMC CONTINUES TO EVOLVE WITH THE CHANGING NEEDS OF OUR POPULATION BASE.HEALTHCARE IS EVER MOVING AND ADVANCING AND CVRMC IS PROGRESSING WITH THE DEMANDS OF OUR TARGET MARKETS. THROUGH THE DURATION OF THE PANDEMIC WHICH CONTINUED THROUGH 2021, CVRMC PROVIDED A COMMUNITY HEALTH LEADERSHIP ROLE TO SUPPORT THE COMMUNITY EFFORTS AND RESPONSE TO THE PANDEMIC. THE INTENSE FOCUS REQUIRED OF OPERATIONS AND RESOURCES TO PROVIDE AND MAINTAIN THE COMMUNITY HEALTH PANDEMIC RESPONSE LEADERSHIP HAD SEVERE NEGATIVE IMPACT ON CVRMCS ABILITY TO ADVANCE THE PRIORITIES OF THE CHNA IMPLEMENTATION PLAN. HOWEVER, THROUIGH THE CVRMCS PANDEMIC RESPONOSE, OUR ORGANIZATION WAS ONCE AGAIN PROFOUNCLY REMINDED THAT THE CONTINUED ACCOMPLISHMENTS WE HAVE MADE ARE A DIRECT RESULT OF A DEDICATED AND COMPASSIONATE WORKFORCE, A STEADFAST BOARD OF DIRECTORS, AND STRONG SUPPORTING MANAGEMENT TEAM WHICH IS FOCUSED ON ONE MISSION THE MISSION OF HEALTH WITH HIGH QUALITY, EFFICIENT AND COMPASSIONATE CARE.CVRMCS STRATEGIC PLAN FOCUS CONTINUES TO BE THE FOLLOWING AREAS:THE PATIENT EXPERIENCE (QUALITY AND CUSTOMER SERVICE)PEOPLEGROWTHCOMMUNITYFINANCIAL STEWARDSHIPOUR COMMUNITIES DESERVE ACCOUNTABILITY AND COMPASSION. WE STRIVE TO RESPECT AND COLLABORATE WITH ALL WHO SURROUND US. WE HAVE AN EARNEST RESPONSIBILITY TO RECOGNIZE THE NEEDS OF OUR POPULATION AND TO RESPOND TO THE HEALTH PRIORITIES FACING OUR POPULATION. CVRMC IS COMMITTED TO OUR COMMUNITIES WITH AN UNWAVERING DEDICATED SPIRIT.

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 expenses43,028,029

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) Steven Sawyer...................................................................... Physician	40.00 ................. 0.00		578,569	0	34,609
(2) Scott Croft...................................................................... Physician	40.00 ................. 0.00		462,849	0	41,397
(3) Peter Seipel...................................................................... Physician	40.00 ................. 0.00		444,190	0	41,871
(4) Pierre Gilles...................................................................... Physician	40.00 ................. 0.00		435,018	0	32,912
(5) Winlove Suasin...................................................................... Physician	40.00 ................. 0.00		442,457	0	2,783
(6) Robert Hollis...................................................................... Chair	1.00 ................. 0.00	X	0	0	0
(7) Jendean Sartain...................................................................... Vice Chair	1.00 ................. 0.00	X	0	0	0
(8) Ed Carpenter...................................................................... Treasurer	1.00 ................. 0.00	X	0	0	0
(9) Janice Cook...................................................................... Secretary	1.00 ................. 0.00	X	0	0	0
(10) Fernando Shipley...................................................................... Trustee	1.00 ................. 0.00	X	0	0	0
(11) Judy Bessee...................................................................... Trustee	1.00 ................. 0.00	X	0	0	0
(12) James B Rasmussen...................................................................... Trustee	1.00 ................. 0.00	X	0	0	0
(13) Carolyn Mawson Haro...................................................................... Trustee	1.00 ................. 0.00	X	0	0	0
(14) Alan Osumi MD...................................................................... Trustee	1.00 ................. 0.00	X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,363,083	153,572

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	1,796,210

f	All other contributions, gifts, grants, and similar amounts not included above		1f	92,694

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		1,888,904

		Business Code
2a	Net Patient Svc Revenue	621400	86,380,775	86,380,775
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		86,380,775

3 Investment income (including dividends, interest, and othersimilar amounts) ......			380,633			380,633
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		94,197	6a
b	Less: rental expenses			6b
c	Rental income or (loss)		94,197	6c
d	Net rental income or (loss).......			94,197			94,197
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........			0
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	Other Operating Revenue		621400	482,194	482,194
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			482,194
12	Total revenue. See instructions.....			89,226,703	86,862,969		474,830

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. 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........	28,307,968	15,967,111	12,340,857
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	0
9	Other employee benefits .......	4,324,377	2,439,165	1,885,212
10	Payroll taxes ...........	1,907,846	1,076,121	831,725
11	Fees for services (non-employees):
a	Management ......	1,186,964	669,507	517,457
b	Legal .........	74,177	41,840	32,337
c	Accounting ...........	27,350	15,427	11,923
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	6,686,504	3,771,523	2,914,981
12	Advertising and promotion ....	0
13	Office expenses .......	0
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	1,137,606	641,667	495,939
17	Travel ............	189,266	106,755	82,511
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	1,694,126	955,572	738,554
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	5,192,872	2,929,040	2,263,832
23	Insurance ...	899,106	507,141	391,965
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Supplies	12,838,610	7,241,619	5,596,991
b	Purchased services & Other	6,240,003	3,519,672	2,720,331
c	Dues & Subscriptions	4,451,852	2,511,067	1,940,785
d	Repairs & Maintenance	1,125,435	634,802	490,633
e	All other expenses	0
25	Total functional expenses. Add lines 1 through 24e	76,284,062	43,028,029	33,256,033	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			26,151,596	1	50,966,258
2	Savings and temporary cash investments .........			26,704,196	2	28,445,544
3	Pledges and grants receivable, net ......				3	0
4	Accounts receivable, net .............			8,279,675	4	9,011,203
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6	0
7	Notes and loans receivable, net ...........			507,752	7	323,513
8	Inventories for sale or use ............			1,972,964	8	2,379,556
9	Prepaid expenses and deferred charges ......			700,096	9	747,132
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	94,758,649
b	Less: accumulated depreciation	10b	57,694,845	39,842,787	10c	37,063,804
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 ...........			2,615,440	15	2,842,943
16	Total assets. Add lines 1 through 15 (must equal line 33)...			106,774,506	16	131,779,953

17	Accounts payable and accrued expenses .....	21,851,453	17	34,548,902
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	29,861,138	20	29,049,925
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	2,889,985	23	1,600,478
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	54,602,576	26	65,199,305

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	51,314,657	27	65,628,784
28	Net assets with donor restrictions ...........	857,273	28	951,864
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	52,171,930	32	66,580,648
33	Total liabilities and net assets/fund balances ........	106,774,506	33	131,779,953

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)RHS 1 5880 South Hospital Drive Globe,AZ85501 85-3369589	Support Charitable Healthcare	AZ	501c3	3	Cobre Valley Regional Medical Center		No
(2)RHS 5880 South Hospital Drive Globe,AZ85501 85-3388099	Parent of Healthcare Support Orgs	AZ	501c3	3	Cobre Valley Regional Medical Center		No

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Return Reference	Explanation
Explanation of Relationship to Related Orgs	The relationship between Cobre Valley Regional Medical Center (CVRMC) with RHS and RHS 1 exists to enable the entities to continue to further their common charitable purposes. Their common agents/officers, provided by CVRMC, make them related organizations.
Sch R, Part V, Section 2	For all items marked "Yes" in Part V, Section I, the amounts are less than the transaction threshold of $50,000, and thus are not required to be reported.