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← COMMUNITY HOSPITAL ASSOCIATION INC

Form 990 for tax year 2022

Filed by COMMUNITY HOSPITAL ASSOCIATION INC.

Totals

Total revenue
$45,431,559
Total expenses
$48,697,025
Contributions and grants received
$537,651
Grants paid
$0
Program service revenue
$44,678,759
Investment income
$114,031
Other revenue
$101,118
Total assets, end of year
$31,918,445
Total liabilities, end of year
$26,832,530
Net assets or fund balances, end of year
$5,085,915
Program services expenses (Part IX)
$45,158,144
Management and general expenses
$3,380,816
Fundraising expenses
$158,065
Program service expenses (Part III)
$45,158,144

Program services were 92.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1e · Government grants (contributions)

    $534,822

  • 1f · All other contributions, gifts and grants

    $2,829

  • 2a · Program service revenue: Patient Service Revenue

    total $41,672,524 · related or exempt $41,672,524

  • 2b · Program service revenue: Pharmacy Revenue

    total $2,013,118 · related or exempt $2,013,118

  • 2c · Program service revenue: 340B Drug Program

    total $471,327 · related or exempt $471,327

  • 2f · All other program service revenue

    total $521,790 · related or exempt $521,790

  • 3 · Investment income

    total $112,231 · excluded $112,231

  • 6a · Gross rents

    real property $101,118

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $101,118

  • 6d · Net rental income or loss

    total $101,118 · excluded $101,118

  • 7a · Gross sales of assets other than inventory

    securities $1,800

  • 7b · Less cost or other basis and sales expenses

    securities $0

  • 7c · Gain or loss

    securities $1,800

  • 7d · Net gain or loss

    total $1,800 · excluded $1,800

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $1,095,096 · program services $364,967 · management and general $730,129

  • 7 · Other salaries and wages

    total $14,792,785 · program services $14,280,316 · management and general $365,637 · fundraising $146,832

  • 8 · Pension plan contributions

    total $196,594 · program services $196,594

  • 9 · Other employee benefits

    total $1,499,450 · program services $1,389,649 · management and general $109,801

  • 10 · Payroll taxes

    total $1,125,809 · program services $1,029,952 · management and general $84,624 · fundraising $11,233

  • 11a · Fees: management

    total $3,533 · program services $3,308 · management and general $225

  • 11b · Fees: legal

    total $263,251 · program services $250,858 · management and general $12,393

  • 11c · Fees: accounting

    total $81,299 · program services $77,472 · management and general $3,827

  • 11g · Fees: other

    total $14,446,059 · program services $13,587,973 · management and general $858,086

  • 13 · Office expenses

    total $1,343,177 · program services $1,257,504 · management and general $85,673

  • 14 · Information technology

    total $1,023,734 · program services $958,436 · management and general $65,298

  • 16 · Occupancy

    total $748,348 · program services $700,615 · management and general $47,733

  • 17 · Travel

    total $102,568 · program services $96,026 · management and general $6,542

  • 20 · Interest

    total $439,998 · program services $92,043 · management and general $347,955

  • 22 · Depreciation, depletion and amortization

    total $2,086,406 · program services $2,026,203 · management and general $60,203

  • 23 · Insurance

    total $429,492 · program services $402,097 · management and general $27,395

  • 24a · Other expenses: Medical Supplies

    total $6,397,628 · program services $5,989,562 · management and general $408,066

  • 24b · Other expenses: AHCCCS Tax

    total $928,104 · program services $868,906 · management and general $59,198

  • 24c · Other expenses: Repairs & Maintenance

    total $747,491 · program services $699,813 · management and general $47,678

  • 24d · Other expenses: Food

    total $80,655 · program services $75,511 · management and general $5,144

  • 24e · All other expenses

    total $865,548 · program services $810,339 · management and general $55,209

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $4,549,410 · end of year $2,093,254

  • 4 · Accounts receivable

    beginning of year $7,195,603 · end of year $6,238,305

  • 8 · Inventories for sale or use

    beginning of year $1,102,029 · end of year $1,142,732

  • 9 · Prepaid expenses and deferred charges

    beginning of year $477,212 · end of year $427,629

  • 10a · Land, buildings and equipment: cost or other basis

    $36,202,302

  • 10b · Land, buildings and equipment: accumulated depreciation

    $17,730,268

  • 10c · Land, buildings and equipment, net

    beginning of year $19,264,188 · end of year $18,472,034

  • 11 · Investments: publicly traded securities

    beginning of year $4,500,137 · end of year $323,224

  • 14 · Intangible assets

    end of year $2,130,005

  • 15 · Other assets

    beginning of year $873,232 · end of year $1,091,262

  • 17 · Accounts payable and accrued expenses

    beginning of year $6,849,415 · end of year $6,406,972

  • 23 · Secured mortgages and notes payable

    beginning of year $16,792,935 · end of year $16,091,888

  • 24 · Unsecured notes and loans payable

    beginning of year $300,000 · end of year $0

  • 25 · Other liabilities

    beginning of year $4,864,873 · end of year $4,333,670

  • 27 · Net assets without donor restrictions

    beginning of year $8,643,642 · end of year $4,600,211

  • 28 · Net assets with donor restrictions

    beginning of year $510,946 · end of year $485,704

Mission and programs · 2022

Mission

To provide quality health and wellness services where the patient, family and community come first.

Activities or mission (Part I)

Provide quality health and wellness services where patient, family and community come first.

  • Community Hospital Association, Inc. d/b/a Wickenburg Community Hospital is a 25-bed critical access hospital that provides inpatient and outpatient diagnostic and therapeutic health care services to the residents and visitors of greater Wickenburg, Arizona, a rural community of approximately 23,000. The Hospital operates physician clinics and a surgery center in the same geographic area.

    Expenses $45,158,144 · Revenue $44,678,759

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Dee Pollock

    Chair

    Total calculated
    $0
    Hours/week
    1
  • Brian Warnock

    Vice Chair

    Total calculated
    $0
    Hours/week
    1
  • Virginia Collier

    Secretary

    Total calculated
    $0
    Hours/week
    1
  • Dean Sandvik

    Treasurer

    Total calculated
    $0
    Hours/week
    1
  • Dave Bennett

    Director

    Total calculated
    $0
    Hours/week
    1
  • Jenifer Finley

    Director

    Total calculated
    $0
    Hours/week
    1
  • Jan Currier

    Director

    Total calculated
    $0
    Hours/week
    1
  • Betsy Deibel

    Director

    Total calculated
    $0
    Hours/week
    1
  • Jeanie Hankins

    Director

    Total calculated
    $0
    Hours/week
    1
  • John Summers

    Director

    Total calculated
    $0
    Hours/week
    1
  • Cynthia Clark

    Director

    Total calculated
    $0
    Hours/week
    1
  • Ed Kientz

    Director

    Total calculated
    $0
    Hours/week
    1
  • Jay Farquhar

    Director

    Total calculated
    $0
    Hours/week
    1
  • Jackie Lundblad

    CEO

    Total calculated
    $286,562
    From this org
    $262,237
    From related orgs
    $0
    Other
    $24,325
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $261,156
    Bonus
    $300
    Other
    $781
    Deferred
    $10,450
    Nontaxable benefits
    $14,096
    Filer's total
    $286,783
  • Patti Clavette

    CFO

    Total calculated
    $165,268
    From this org
    $149,352
    From related orgs
    $0
    Other
    $15,916
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $147,871
    Bonus
    $300
    Other
    $1,181
    Deferred
    $2,749
    Nontaxable benefits
    $13,333
    Filer's total
    $165,434
  • Todd Kravetz MD - Chief of

    Staff, Clinical Medical Di

    Total calculated
    $363,130
    From this org
    $331,547
    From related orgs
    $0
    Other
    $31,583
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $245,195
    Bonus
    $83,796
    Other
    $2,556
    Deferred
    $15,352
    Nontaxable benefits
    $16,661
    Filer's total
    $363,560
  • Peter Stachowicz

    COO

    Total calculated
    $195,647
    From this org
    $186,650
    From related orgs
    $0
    Other
    $8,997
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $185,742
    Bonus
    $300
    Other
    $608
    Deferred
    $2,714
    Nontaxable benefits
    $6,477
    Filer's total
    $195,841
  • Matthew Jones

    Family Nurse Practitioner

    Total calculated
    $151,849
    From this org
    $151,847
    From related orgs
    $0
    Other
    $2
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $142,266
    Bonus
    $8,960
    Other
    $621
    Deferred
    $0
    Nontaxable benefits
    $148
    Filer's total
    $151,995
  • Juan Vazquez

    Physician

    Total calculated
    $225,624
    From this org
    $202,774
    From related orgs
    $0
    Other
    $22,850
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $192,418
    Bonus
    $9,531
    Other
    $825
    Deferred
    $8,948
    Nontaxable benefits
    $14,332
    Filer's total
    $226,054
  • Diane Bejerano

    Family Physician

    Total calculated
    $327,958
    From this org
    $314,173
    From related orgs
    $0
    Other
    $13,785
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $287,480
    Bonus
    $23,377
    Other
    $3,316
    Deferred
    $13,783
    Nontaxable benefits
    $433
    Filer's total
    $328,389
  • Brian Schuele

    Director of Pharmacy Services

    Total calculated
    $162,929
    From this org
    $146,428
    From related orgs
    $0
    Other
    $16,501
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $143,116
    Bonus
    $300
    Other
    $3,012
    Deferred
    $3,170
    Nontaxable benefits
    $13,478
    Filer's total
    $163,076
  • Jodi Allen

    CNO

    Total calculated
    $149,467
    From this org
    $146,486
    From related orgs
    $0
    Other
    $2,981
    Hours/week
    40

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Part I, Line 1a
Description of health club dues: Wickenburg community hospital reimburses employees for health club dues which are recorded in the individuals' taxable compensation. Golf club dues were paid to the golf club by the organization, but are not paid for a specific employee.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Provenance

Return type
form_990
Tax year
2022
Filed
15 November 2023
IRS schema version
2022v5.0
Source object
202313199349316496

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