Form 990 for tax year 2022
Filed by TRINIDAD AREA HEALTH ASSOCIATION.
Totals
- Total revenue
- $46,034,130
- Total expenses
- $46,065,336
- Contributions and grants received
- $487,750
- Grants paid
- $0
- Program service revenue
- $44,807,160
- Investment income
- $110,886
- Other revenue
- $628,334
- Total assets, end of year
- $63,520,714
- Total liabilities, end of year
- $35,206,173
- Net assets or fund balances, end of year
- $28,314,541
- Program services expenses (Part IX)
- $41,741,110
- Management and general expenses
- $4,324,226
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $41,741,110
Program services were 90.6% 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.
-
1f · All other contributions, gifts and grants
$487,750
-
2a · Program service revenue: PATIENT SERVICES
total $43,085,401 · related or exempt $43,085,401
-
2b · Program service revenue: INCENTIVE PAYMENTS
total $1,721,759 · related or exempt $1,721,759
-
3 · Investment income
total $87,431 · excluded $87,431
-
4 · Income from investment of tax-exempt bond proceeds
total $0
-
5 · Royalties
total $0
-
6a · Gross rents
real property $14,030
-
6c · Rental income or loss
real property $14,030 · personal property $0
-
6d · Net rental income or loss
total $14,030 · excluded $14,030
-
7a · Gross sales of assets other than inventory
other assets $28,855
-
7b · Less cost or other basis and sales expenses
other assets $5,400
-
7c · Gain or loss
other assets $23,455
-
7d · Net gain or loss
total $23,455 · excluded $23,455
-
8a · Fundraising events: gross income
$25,450
-
8b · Fundraising events: direct expenses
$6,394
-
8c · Net income from fundraising events
total $19,056 · excluded $19,056
-
9a · Gaming: gross income
$0
-
9b · Gaming: direct expenses
$0
-
9c · Net income from gaming
total $0
-
10a · Gross sales of inventory
$0
-
10b · Cost of goods sold
$0
-
10c · Net income from sales of inventory
total $0
-
11a · Other revenue: ANCILLARY SERVICES
total $595,248 · related or exempt $595,248
-
11e · Other revenue, total
$595,248
Functional expenses
Part IX, the statement of functional expenses.
-
1 · Grants to domestic organizations and governments
total $0
-
2 · Grants to domestic individuals
total $0
-
3 · Grants to foreign organizations and individuals
total $0
-
4 · Benefits paid to or for members
total $0
-
5 · Compensation of officers, directors and key employees
total $4,691,895 · program services $4,105,015 · management and general $586,880
-
6 · Compensation of disqualified persons
total $0
-
7 · Other salaries and wages
total $16,263,649 · program services $15,558,079 · management and general $705,570
-
8 · Pension plan contributions
total $0
-
9 · Other employee benefits
total $0
-
10 · Payroll taxes
total $1,188,890 · program services $1,115,564 · management and general $73,326
-
11a · Fees: management
total $0
-
11b · Fees: legal
total $229,735 · management and general $229,735
-
11c · Fees: accounting
total $202,223 · management and general $202,223
-
11d · Fees: lobbying
total $0
-
11e · Fees: professional fundraising services
total $0
-
11f · Fees: investment management
total $0
-
11g · Fees: other
total $10,314,223 · program services $8,070,098 · management and general $2,244,125
-
12 · Advertising and promotion
total $0
-
13 · Office expenses
total $747,794 · program services $714,509 · management and general $33,285
-
14 · Information technology
total $0
-
15 · Royalties
total $0
-
16 · Occupancy
total $697,000 · program services $697,000
-
17 · Travel
total $0
-
18 · Travel or entertainment for public officials
total $0
-
19 · Conferences, conventions and meetings
total $0
-
20 · Interest
total $841,492 · program services $841,492
-
21 · Payments to affiliates
total $0
-
22 · Depreciation, depletion and amortization
total $2,253,986 · program services $2,206,775 · management and general $47,211
-
23 · Insurance
total $317,281 · program services $317,281
-
24a · Other expenses: OPERATING EXPENSE
total $369,936 · program services $177,704 · management and general $192,232
-
24b · Other expenses: REPAIRS AND MAINTENANCE
total $574,115 · program services $564,476 · management and general $9,639
-
24c · Other expenses: BAD DEBT EXPENSE
total $3,283,572 · program services $3,283,572
-
24d · Other expenses: MEDICAL SUPPLIES
total $4,089,545 · program services $4,089,545
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $17,910,424 · end of year $16,673,876
-
2 · Savings and temporary cash investments
beginning of year $1,715,984 · end of year $1,734,645
-
3 · Pledges and grants receivable
beginning of year $0 · end of year $0
-
4 · Accounts receivable
beginning of year $3,898,767 · end of year $4,398,613
-
5 · Loans and receivables from officers and key people
beginning of year $0 · end of year $0
-
6 · Loans and receivables from disqualified persons
beginning of year $0 · end of year $0
-
7 · Other notes and loans receivable
beginning of year $0 · end of year $0
-
8 · Inventories for sale or use
beginning of year $700,282 · end of year $636,378
-
9 · Prepaid expenses and deferred charges
beginning of year $327,537 · end of year $135,147
-
10a · Land, buildings and equipment: cost or other basis
$66,885,602
-
10b · Land, buildings and equipment: accumulated depreciation
$26,943,547
-
10c · Land, buildings and equipment, net
beginning of year $42,207,469 · end of year $39,942,055
-
11 · Investments: publicly traded securities
beginning of year $0 · end of year $0
-
12 · Investments: other securities
beginning of year $0 · end of year $0
-
13 · Investments: program-related
beginning of year $0 · end of year $0
-
14 · Intangible assets
beginning of year $0 · end of year $0
-
15 · Other assets
beginning of year $0 · end of year $0
-
17 · Accounts payable and accrued expenses
beginning of year $6,265,405 · end of year $4,014,881
-
18 · Grants payable
beginning of year $0 · end of year $0
-
19 · Deferred revenue
beginning of year $0 · end of year $0
-
20 · Tax-exempt bond liabilities
beginning of year $0 · end of year $0
-
21 · Escrow or custodial account liability
beginning of year $0 · end of year $0
-
22 · Loans and payables to officers and key people
beginning of year $0 · end of year $0
-
23 · Secured mortgages and notes payable
beginning of year $32,111,696 · end of year $31,191,292
-
24 · Unsecured notes and loans payable
beginning of year $0 · end of year $0
-
25 · Other liabilities
beginning of year $37,615 · end of year $0
-
27 · Net assets without donor restrictions
beginning of year $28,345,747 · end of year $28,314,541
-
28 · Net assets with donor restrictions
beginning of year $0 · end of year $0
Mission and programs · 2022
Mission
MT. SAN RAFAEL HOSPITAL IS COMMITTED TO PROVIDE QUALITY HEALTHCARE TO THE COMMUNITIES WE SERVE AND IN A MANNER WHERE PATIENTS RECEIVE COMPASSIONATE AND PERSONALIZED CARE.
Activities or mission (Part I)
PROVIDE QUALITY HEALTHCARE TO THE COMMUNITIES WE SERVE AND IN A MANNER WHERE PATIENTS RECEIVE COMPASSIONATE AND PERSONALIZED CARE.
-
MT SAN RAFAEL HOSPITAL PROVIDES GENERAL MEDICAL AND SURGICAL CARE FOR INPATIENT, OUTPATIENT, AND EMERGENCY ROOM PATIENTS, AND PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS. MT SAN RAFAEL IS A 25 BED CRITICAL ACCESS FACILITY SERVICING THE MEDICAL AND SURGICAL NEEDS OF TRINIDAD RESIDENTS AND THE SURROUNDING AREAS. DURING 2022, PATIENT DAYS TOTALED 1,743, ER VISITS 9,859, SURGERIES 1,281, OP VISITS 41,770.
Expenses $41,741,110 · Revenue $45,402,408
As filed on the 2022 return.
Listed in Part VII
-
Damian Mizera
Member/Ortho Surgeon
- Total calculated
- $643,084
- From this org
- $581,377
- From related orgs
- $0
- Other
- $61,707
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $581,227
- Bonus
- $150
- Other
- not reported
- Deferred
- $24,147
- Nontaxable benefits
- $37,560
- Filer's total
- $643,084
-
James Conrad
Surgeon
- Total calculated
- $563,249
- From this org
- $503,341
- From related orgs
- $0
- Other
- $59,908
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $503,191
- Bonus
- $150
- Other
- not reported
- Deferred
- $22,348
- Nontaxable benefits
- $37,560
- Filer's total
- $563,249
-
Jose M Flores
Member/Physician
- Total calculated
- $512,810
- From this org
- $449,624
- From related orgs
- $0
- Other
- $63,186
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $257,098
- Bonus
- $192,526
- Other
- not reported
- Deferred
- $40,735
- Nontaxable benefits
- $22,451
- Filer's total
- $512,810
-
Heather Cook
Surgeon
- Total calculated
- $455,083
- From this org
- $431,512
- From related orgs
- $0
- Other
- $23,571
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $431,362
- Bonus
- $150
- Other
- not reported
- Deferred
- $10,500
- Nontaxable benefits
- $13,071
- Filer's total
- $455,083
-
Precious Castro-FloresMD
Physician
- Total calculated
- $424,876
- From this org
- $377,570
- From related orgs
- $0
- Other
- $47,306
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $271,990
- Bonus
- $105,580
- Other
- not reported
- Deferred
- $34,235
- Nontaxable benefits
- $13,071
- Filer's total
- $424,876
-
Thomas Goodell MD
Physician
- Total calculated
- $327,628
- From this org
- $278,216
- From related orgs
- $0
- Other
- $49,412
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $278,066
- Bonus
- $150
- Other
- not reported
- Deferred
- $24,146
- Nontaxable benefits
- $25,266
- Filer's total
- $327,628
-
Joseph Jimenez
Physician
- Total calculated
- $316,109
- From this org
- $300,831
- From related orgs
- $0
- Other
- $15,278
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $219,137
- Bonus
- $81,694
- Other
- not reported
- Deferred
- not reported
- Nontaxable benefits
- $15,278
- Filer's total
- $316,109
-
Douglas McFarland
Chief of Staff/Physician
- Total calculated
- $289,318
- From this org
- $248,583
- From related orgs
- $0
- Other
- $40,735
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $241,600
- Bonus
- $6,983
- Other
- not reported
- Deferred
- $40,735
- Nontaxable benefits
- not reported
- Filer's total
- $289,318
-
John Tucker
CEO Through 07/01
- Total calculated
- $254,437
- From this org
- $214,971
- From related orgs
- $0
- Other
- $39,466
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $175,261
- Bonus
- $39,710
- Other
- not reported
- Deferred
- $19,624
- Nontaxable benefits
- $19,842
- Filer's total
- $254,437
-
Kimberly Lucero
CEO Starting 07/02
- Total calculated
- $245,980
- From this org
- $204,714
- From related orgs
- $0
- Other
- $41,266
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $204,564
- Bonus
- $150
- Other
- not reported
- Deferred
- $41,266
- Nontaxable benefits
- not reported
- Filer's total
- $245,980
-
Calvin Carey
CFO
- Total calculated
- $224,610
- From this org
- $224,610
- From related orgs
- $0
- Other
- $0
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $224,610
- Bonus
- $0
- Other
- $0
- Deferred
- not reported
- Nontaxable benefits
- not reported
- Filer's total
- $224,610
-
Shannon Castellano
CNO Starting 07/31
- Total calculated
- $193,031
- From this org
- $159,241
- From related orgs
- $0
- Other
- $33,790
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $159,091
- Bonus
- $150
- Other
- not reported
- Deferred
- $16,895
- Nontaxable benefits
- $16,895
- Filer's total
- $193,031
-
Mandy Shaiffer
CNO Through 07/30
- Total calculated
- $122,722
- From this org
- $109,473
- From related orgs
- $0
- Other
- $13,249
- Hours/week
- 40
-
Kathleen Griego
Current President
- Total calculated
- $0
- Hours/week
- 1
-
Daniel Berry DDS
Vice President
- Total calculated
- $0
- Hours/week
- 1
-
Joe DeGarbo
SEC/TREASURER
- Total calculated
- $0
- Hours/week
- 1
-
Mike Tranter
Member
- Total calculated
- $0
- Hours/week
- 1
-
Rhonda Epper
Member
- Total calculated
- $0
- Hours/week
- 1
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
- 3 · Independent compensation consultant
- 3 · Written employment contract
- 3 · Compensation survey or study
- 3 · Approval by the board or compensation committee
- 7 · Other non-fixed payments
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
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- Sch J Part I line 7
- Physicians receive a quarterly incentive bonus for productivity and all employees receive a one time Christmas bonus.
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
- 202313199349314041
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