FLAGSTAFF MEDICAL CENTER: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- FLAGSTAFF MEDICAL CENTER (EIN 86-0110232)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-12
- IRS object ID
- 201741329349304959
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-12T14:54:42-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2 NORTH CENTRAL AVE STE 2300 | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860110232 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Flagstaff Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JOHN A CORTESE CPA | InCareOfNm |
| Business Name Control | FLAG | BusinessNameControlTxt |
| Phone | 9287793366 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | POST OFFICE BOX 1268 | AddressLine1Txt |
| City | FLAGSTAFF | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 860021268 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFFREY TREASURE | PersonNm |
| Person Title | NAH CFO | PersonTitleTxt |
| Phone | 9282143545 | PhoneNum |
| Signature | 2017-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PAYNE | PreparerPersonNm |
| PTIN | P01442310 | PTIN |
| Phone | 6023223000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT P THAMES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 N BEAVER ST | AddressLine1Txt |
| City | FLAGSTAFF | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $438,519,961 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NAHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1936 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | WILL PROVIDE PATIENTS WITH EXCEPTIONAL CARE WHILE TRANSFORMING THE HEALTH OF THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 656 | TotalVolunteersCnt |
| Total Gross UBI | $1,120,342 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$69,799 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,264,906 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,307,861 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $384,744,452 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $425,924,675 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,939,996 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,121,818 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,614,467 | PYOtherRevenueAmt |
| CY Other Revenue | $3,103,447 | CYOtherRevenueAmt |
| PY Total Revenue | $398,563,821 | PYTotalRevenueAmt |
| CY Total Revenue | $438,457,801 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,224,065 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $899,200 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $165,131,833 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $166,996,998 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $751,272 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $188,888,684 | PYOtherExpensesAmt |
| CY Other Expenses | $202,487,623 | CYOtherExpensesAmt |
| PY Total Expenses | $355,244,582 | PYTotalExpensesAmt |
| CY Total Expenses | $370,383,821 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $43,319,239 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $68,073,980 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $654,539,176 | TotalAssetsBOYAmt |
| Total Assets EOY | $671,843,968 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $175,264,002 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $203,692,160 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $479,275,174 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $468,151,808 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Flagstaff Medical Center will provide patients with exceptional care while transforming the health of the communities we serve. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $247,881,848 | ExpenseAmt |
| Grant | $899,200 | GrantAmt |
| Revenue | $399,462,384 | RevenueAmt |
| Desc | FLAGSTAFF MEDICAL CENTER PROVIDES COMPREHENSIVE HEALTHCARE SERVICES, INCLUDING PRIMARY CARE AND SPECIALTY PHYSICIAN CLINICS, CANCER CENTERS OF NORTHERN ARIZONA HEALTHCARE, ENTIRECARE REHAB & SPORTS MEDICINE, AND FIT KIDS OF ARIZONA. SEE SCHEDULE O FOR FURTHER DETAILS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $21,590,000 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $18,535,000 | RevenueAmt |
| Desc | GUARDIAN AIR PROVIDES AIR TRANSPORTATION SERVICES TO PATIENTS THROUGHOUT THE NORTHERN ARIZONA COMMUNITY, ENABLING FLAGSTAFF MEDICAL CENTER TO EXPAND ITS SCOPE OF SERVICES BY SERVING PATIENTS FROM THE MOMENT TREATMENT BEGINS IN THE AIR TRANSPORT. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,993,000 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $10,064,000 | RevenueAmt |
| Desc | GUARDIAN MEDICAL TRANSPORT PROVIDES AMBULANCE SERVICES TO PATIENTS THROUGHOUT THE NORTHERN ARIZONA COMMUNITY, ENABLING FLAGSTAFF MEDICAL CENTER TO EXPAND ITS SCOPE OF SERVICES BY SERVING PATIENTS FROM THE MOMENT TREATMENT BEGINS IN THE GROUND AMBULANCE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $0 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $276,464,848 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | Yes (true) | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 537 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | AZ | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN A CORTESE CPA | PersonNm |
| Phone | 9282143545 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 914 N SAN FRANCISCO ST SUITE M | AddressLine1Txt |
| City | FLAGSTAFF | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ANDREW ALDRIDGE MD | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| WILLIAM AUSTIN MD | ||||||||||
| DIRECTOR (THRU 9/15) | 1.0 | 1.0 | Yes (X) | $0 | $56,283 | $0 | ||||
| ALICE GAGNAIRE RN | ||||||||||
| DIRECTOR | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| VALERIE CARO | ||||||||||
| DIRECTOR/TREASURER (THRU 9/15) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| RICHARD CRANMER | ||||||||||
| DIRECTOR | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | ||||
| JAMES DORMAN | ||||||||||
| DIRECTOR/PAST CHAIR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| WAYNE FOX CPA | ||||||||||
| DIRECTOR/CHAIR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| WILLIAM JEFFERS | ||||||||||
| DIRECTOR/VICE CHAIR | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| RICHARD KRUSE | ||||||||||
| DIRECTOR (AS OF 10/15) | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | ||||
| THEODORE LEWIS JR MD | ||||||||||
| DIRECTOR (THRU 9/15) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| CHARLES MARR | ||||||||||
| DIRECTOR (AS OF 10/15) | 1.0 | 6.0 | Yes (X) | $0 | $0 | $0 | ||||
| CYNTHIA MARTIN MD | ||||||||||
| DIRECTOR (THRU 9/15) | 1.0 | 0.0 | Yes (X) | $0 | $12,090 | $0 | ||||
| JOHN MARVEL | ||||||||||
| DIRECTOR (THRU 9/15) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| SHAWN ORME | ||||||||||
| DIRECTOR (AS OF 10/15) | 1.0 | 5.0 | Yes (X) | $0 | $0 | $0 | ||||
| KENNETH SALCE MD | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| RAY SELNA | ||||||||||
| DIRECTOR (AS OF 10/15) | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT THAMES | ||||||||||
| NAH PRESIDENT/CEO | 0.0 | 40.0 | Yes (X) | $0 | $444,857 | $29,885 | Yes (X) | |||
| GUADALUPE WOODSON FNP | ||||||||||
| DIRECTOR/SECRETARY | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| RICHARD LANGOSCH | ||||||||||
| INTERIM CEO (THRU 10/15) | 40.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||||
| JEFFREY TREASURE | ||||||||||
| CFO (AS OF 12/15) | 0.0 | 40.0 | $0 | $31,923 | $0 | Yes (X) | ||||
| HOPE WADE | ||||||||||
| CFO (THRU 12/15) | 0.0 | 40.0 | $0 | $180,007 | $6,142 | Yes (X) | ||||
| MARK CARROLL | ||||||||||
| CHIEF MEDICAL OFFICER | 40.0 | 0.0 | $0 | $369,382 | $42,815 | Yes (X) | ||||
| LINDA PARKER | ||||||||||
| INTERIM CNO/VP PATIENT CARE | 40.0 | 0.0 | $0 | $247,686 | $16,285 | Yes (X) | ||||
| RICHARD SMITH | ||||||||||
| VP OF DEVELOPMENT/MARKETING | 40.0 | 0.0 | $0 | $270,744 | $34,048 | Yes (X) | ||||
| RICHARD NEFF | ||||||||||
| DIRECTOR PHYSICIAN RELATIONS | 40.0 | 0.0 | $0 | $365,500 | $44,095 | Yes (X) | ||||
| MARK FOSTER | ||||||||||
| PHYSICIAN | 40.0 | 0.0 | $0 | $219,424 | $30,395 | Yes (X) | ||||
| RICHARD MENDRIBIL | ||||||||||
| HEALTH SYSTEMS DIR OF PHARMACY | 40.0 | 0.0 | $0 | $210,407 | $20,172 | Yes (X) | ||||
| DALE MERRITT | ||||||||||
| REGISTERED NURSE | 40.0 | 0.0 | $0 | $207,819 | $30,156 | Yes (X) | ||||
| BRENDA MUNNS | ||||||||||
| DIRECTOR SURGICAL SERVICES | 40.0 | 0.0 | $0 | $203,808 | $49,522 | Yes (X) | ||||
| JOHN DEMPSEY | ||||||||||
| FORMER VP NAH/PRES LCMC | 40.0 | 0.0 | $0 | $444,110 | $181,355 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,264,040 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $484,870 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Healthcare Select | |||||
| DEPT la 24465 | PASADENA | CA | 91185 | CONTRACT LABOR | $7,862,956 |
| CONIFER HEALTH SOLUTIONS | |||||
| 1500 S DOUGLASS RD | ANAHEIM | CA | 92806 | BILLING SERVICES | $6,672,505 |
| FOREST COUNTRY ANESTHESIA | |||||
| 77 W FOREST AVE | FLAGSTAFF | AZ | 86001 | ANESTHESIA SERVICES | $2,770,892 |
| PHOENIX CARDIAC SURGERY PLLC | |||||
| 3131 E CLARENDON AVE STE 102 | PHOENIX | AZ | 85016 | SURGERY SERVICES | $1,833,326 |
| CRITICAL CARE CONSULTANTS | |||||
| PO BOX 967 | FLAGSTAFF | AZ | 86002 | MEDICAL SERVICES | $1,630,240 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 41 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $311,255 | FundraisingAmt |
| Government Grants | $405,393 | GovernmentGrantsAmt |
| All Other Contributions | $591,213 | AllOtherContributionsAmt |
| Noncash Contributions | $71,337 | NoncashContributionsAmt |
| Total Contributions | $1,307,861 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Patient Services | 621110 | $410,248,929 | $410,248,929 | $0 | $0 |
| Pharmacy | 446110 | $7,256,069 | $6,135,727 | $1,120,342 | $0 |
| PHYSICIAN REVENUE | 900099 | $5,681,292 | $5,681,292 | $0 | $0 |
| CAFETERIA | 900099 | $2,116,957 | $2,116,957 | $0 | $0 |
| INTERCOMPANY RENTAL INCOME | 531120 | $313,487 | $313,487 | $0 | $0 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $307,941 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $307,941 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $425,924,675 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,055,747 | TotalRevenueColumnAmt |
| Exclusion | $8,055,747 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $66,071 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $66,071 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,071 | TotalRevenueColumnAmt |
| Exclusion | $66,071 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $107,465 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $311,255 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $62,160 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,305 | TotalRevenueColumnAmt |
| Exclusion | $45,305 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PROGRAM FEES | 900099 | $541,632 | $541,632 | $0 | $0 |
| NON PATIENT ROOMS | 900099 | $244,730 | $244,730 | $0 | $0 |
| STANDBY FEES | 900099 | $135,071 | $135,071 | $0 | $0 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,136,709 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,136,709 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,058,142 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $438,457,801 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $427,862,475 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,120,342 | UnrelatedBusinessRevenueAmt |
| Exclusion | $8,167,123 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $899,200 | TotalAmt |
| Program Services | $899,200 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,229,665 | TotalAmt |
| Program Services | $1,206,959 | ProgramServicesAmt |
| Management And General | $751,962 | ManagementAndGeneralAmt |
| Fundraising | $270,744 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,490,018 | TotalAmt |
| Program Services | $112,861,316 | ProgramServicesAmt |
| Management And General | $17,362,521 | ManagementAndGeneralAmt |
| Fundraising | $266,181 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,943,753 | TotalAmt |
| Program Services | $7,735,486 | ProgramServicesAmt |
| Management And General | $1,190,023 | ManagementAndGeneralAmt |
| Fundraising | $18,244 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,760,060 | TotalAmt |
| Program Services | $4,981,898 | ProgramServicesAmt |
| Management And General | $766,412 | ManagementAndGeneralAmt |
| Fundraising | $11,750 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,573,502 | TotalAmt |
| Program Services | $16,929,197 | ProgramServicesAmt |
| Management And General | $2,604,378 | ManagementAndGeneralAmt |
| Fundraising | $39,927 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,202,252 | TotalAmt |
| Program Services | $1,202,252 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $421,179 | TotalAmt |
| Program Services | $73,320 | ProgramServicesAmt |
| Management And General | $340,569 | ManagementAndGeneralAmt |
| Fundraising | $7,290 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,862 | TotalAmt |
| Program Services | $4,000 | ProgramServicesAmt |
| Management And General | $95,862 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,845 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $63,845 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,841 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $13,841 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,437,528 | TotalAmt |
| Program Services | $18,373,066 | ProgramServicesAmt |
| Management And General | $2,051,856 | ManagementAndGeneralAmt |
| Fundraising | $12,606 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $377,237 | TotalAmt |
| Program Services | $253,414 | ProgramServicesAmt |
| Management And General | $101,788 | ManagementAndGeneralAmt |
| Fundraising | $22,035 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,152,384 | TotalAmt |
| Program Services | $91,352,739 | ProgramServicesAmt |
| Management And General | $6,748,220 | ManagementAndGeneralAmt |
| Fundraising | $51,425 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,508,939 | TotalAmt |
| Program Services | $683,101 | ProgramServicesAmt |
| Management And General | $795,520 | ManagementAndGeneralAmt |
| Fundraising | $30,318 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,736,300 | TotalAmt |
| Program Services | $5,201,374 | ProgramServicesAmt |
| Management And General | $534,926 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $414,490 | TotalAmt |
| Program Services | $263,426 | ProgramServicesAmt |
| Management And General | $143,307 | ManagementAndGeneralAmt |
| Fundraising | $7,757 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,205 | TotalAmt |
| Program Services | $168,205 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,678,765 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $3,678,765 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,493,840 | TotalAmt |
| Program Services | $10,150,705 | ProgramServicesAmt |
| Management And General | $5,332,082 | ManagementAndGeneralAmt |
| Fundraising | $11,053 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,372,971 | TotalAmt |
| Program Services | $333,758 | ProgramServicesAmt |
| Management And General | $2,039,213 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| EXP REIMBURSEMENT TO NAH | $44,668,276 | -$648,982 | $45,317,258 | $0 |
| CBO SERVICES | $4,229,619 | $2,292,902 | $1,936,717 | $0 |
| RECRUITING | $1,318,405 | $25,043 | $1,293,362 | $0 |
| CONSULTING | $677,451 | $673,701 | $3,750 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,452,234 | TotalAmt |
| Program Services | $1,384,923 | ProgramServicesAmt |
| Management And General | $65,369 | ManagementAndGeneralAmt |
| Fundraising | $1,942 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $370,383,821 | TotalAmt |
| Program Services | $276,464,848 | ProgramServicesAmt |
| Management And General | $93,167,701 | ManagementAndGeneralAmt |
| Fundraising | $751,272 | FundraisingAmt |
Total Joint Costs TotalJointCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,175,828 | BOYAmt |
| EOY | $15,892,166 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,081 | BOYAmt |
| EOY | $17,655,518 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,462,123 | BOYAmt |
| EOY | $77,998,073 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,557,328 | BOYAmt |
| EOY | $5,400,108 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,972,921 | BOYAmt |
| EOY | $7,923,713 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,028,404 | BOYAmt |
| EOY | $3,035,037 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $365,689,413 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $227,403,111 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,613,687 | BOYAmt |
| EOY | $138,286,302 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $350,474,784 | BOYAmt |
| EOY | $386,201,133 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,226,461 | BOYAmt |
| EOY | $2,348,183 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,022,441 | BOYAmt |
| EOY | $17,103,735 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $654,539,176 | BOYAmt |
| EOY | $671,843,968 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,892,422 | BOYAmt |
| EOY | $32,226,790 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,333,026 | BOYAmt |
| EOY | $104,913,910 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $240,805 | BOYAmt |
| EOY | $239,296 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,797,749 | BOYAmt |
| EOY | $66,312,164 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $175,264,002 | BOYAmt |
| EOY | $203,692,160 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $479,275,174 | BOYAmt |
| EOY | $468,090,153 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $61,655 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $479,275,174 | BOYAmt |
| EOY | $468,151,808 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $654,539,176 | BOYAmt |
| EOY | $671,843,968 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $68,073,980 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$12,252,088 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$66,945,258 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Media Advertisements | $0 | MediaAdvertisementsAmt |
| Mailings Members | false | MailingsMembersInd |
| Mailings Members | $0 | MailingsMembersAmt |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Publications Or Broadcast | $0 | PublicationsOrBroadcastAmt |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $0 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Direct Contact Legislators | $0 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Rallies Demonstrations | $0 | RalliesDemonstrationsAmt |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $63,845 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $63,845 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | LOBBYING ELECTION: FLAGSTAFF MEDICAL CENTER PAID DUES TO THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION. A PERCENTAGE OF THIS AMOUNT, $63,845, WAS ESTIMATED TO BE ATTRIBUTABLE TO LOBBYING RELATED TO HEALTH CARE ADVOCACY AT THE FEDERAL, STATE, REGIONAL AND LOCAL LEVELS. FLAGSTAFF MEDICAL CENTER ALSO PARTICIPATES IN HEALTHCARE-RELATED LOBBYING ACTIVITIES THROUGH THE SOLE COMMUNITY HOSPITAL COALITION. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,355,284 | BeginningYearBalanceAmt |
| Contributions | $2,046,265 | ContributionsAmt |
| Investment Earnings Or Losses | $132,851 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $17,407 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,700,082 | OtherExpendituresAmt |
| Administrative Expenses | $74,363 | AdministrativeExpensesAmt |
| End Year Balance | $5,742,548 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,955,576 | BeginningYearBalanceAmt |
| Contributions | $2,231,957 | ContributionsAmt |
| Investment Earnings Or Losses | $78,473 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $26,231 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,811,945 | OtherExpendituresAmt |
| Administrative Expenses | $72,546 | AdministrativeExpensesAmt |
| End Year Balance | $5,355,284 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,818,218 | BeginningYearBalanceAmt |
| Contributions | $2,491,393 | ContributionsAmt |
| Investment Earnings Or Losses | $210,156 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $16,596 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,475,958 | OtherExpendituresAmt |
| Administrative Expenses | $71,637 | AdministrativeExpensesAmt |
| End Year Balance | $4,955,576 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,836,339 | BeginningYearBalanceAmt |
| Contributions | $2,188,719 | ContributionsAmt |
| Investment Earnings Or Losses | $133,179 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $412,045 | GrantsOrScholarshipsAmt |
| Other Expenditures | $862,349 | OtherExpendituresAmt |
| Administrative Expenses | $65,625 | AdministrativeExpensesAmt |
| End Year Balance | $3,818,218 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,426,552 | BeginningYearBalanceAmt |
| Contributions | $1,102,892 | ContributionsAmt |
| Investment Earnings Or Losses | $18,115 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $388,081 | GrantsOrScholarshipsAmt |
| Other Expenditures | $299,259 | OtherExpendituresAmt |
| Administrative Expenses | $23,880 | AdministrativeExpensesAmt |
| End Year Balance | $2,836,339 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,901,300 | OtherCostOrOtherBasisAmt |
| Book Value | $5,901,300 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $191,728,621 | OtherCostOrOtherBasisAmt |
| Depreciation | $112,000,876 | DepreciationAmt |
| Book Value | $79,727,745 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,042,857 | OtherCostOrOtherBasisAmt |
| Depreciation | $945,610 | DepreciationAmt |
| Book Value | $97,247 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $150,857,879 | OtherCostOrOtherBasisAmt |
| Depreciation | $114,456,625 | DepreciationAmt |
| Book Value | $36,401,254 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,158,756 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $16,158,756 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $138,286,302 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| MINIMUM PENSION LIABILITY | $54,095,989 |
| MALPRACTICE INSURANCE RESERVE LT | $6,969,931 |
| PATIENT CREDIT BALANCES | $2,935,990 |
| BCBS IBNR | $1,124,109 |
| MALPRACTICE INSURANCE RESERVE ST | $861,554 |
| BIO-MED RESERVE | $202,120 |
| WORKER'S COMP LIABILITY | $107,226 |
| UNEMPLOYMENT | $15,245 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $66,312,164 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | MOST OF THE CURRENT ENDOWMENTS ARE BOARD DESIGNATED. FMC FOUNDATION'S QUASI ENDOWMENTS ARE SPENT ACCORDING TO THE FOLLOWING CRITERIA: 1) ADDRESS COMMUNITY HEALTH CARE NEEDS; 2) ADHERE TO THE CORE MISSION OF THE HOSPITAL; AND/OR 3) REFLECT PROJECTS THAT ARE DEEMED IN THE BEST INTEREST OF THE HOSPITAL. |
| Schedule D, Part X, Line 2 | The corporation is a not-for-profit corporation and is exempt from income taxes under section 501(c)(3) of the internal revenue code. Accordingly, no provision for income taxes is included in the accompanying consolidated financial statements. The corporation's management is not aware of any events that would cause the corporation to lose its tax-exempt status. Management has reviewed all open tax years and has determined that the corporation has no significant uncertain tax positions. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | turquoise ball | Event1Nm |
| Gross Receipts Event1 | $224,647 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $152,427 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $72,220 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $24,019 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $3,000 | EntertainmentEvent1Amt |
| Event2 | Golf Tournamnt | Event2Nm |
| Gross Receipts Event2 | $44,306 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $29,298 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $15,008 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $4,501 | NonCashPrizesEvent2Amt |
| Food And Beverage Event2 | $5,818 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $7,360 | EntertainmentEvent2Amt |
| Other Events Total | 3 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $141,733 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $129,530 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $12,203 | GrossRevenueOtherEventsAmt |
| Non Cash Prizes Other Events | $6,484 | NonCashPrizesOtherEventsAmt |
| Food And Beverage Other Events | $3,378 | FoodAndBeverageOtherEventsAmt |
| Entertainment Other Events | $7,600 | EntertainmentOtherEventsAmt |
| Gross Receipts Total | $410,686 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $311,255 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $99,431 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $10,985 | NonCashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $33,215 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $17,960 | EntertainmentTotalEventsAmt |
| Direct Expense Summary Events | $62,160 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $37,271 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | false | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $485,117 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $485,117 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $104,882,827 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $50,815,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $54,067,827 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14600 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $105,367,944 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $50,815,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $54,552,944 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14730 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,297,968 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $114,981 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,182,987 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $390,752 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $390,752 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,096,900 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,438,171 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$341,271 | NetCommunityBenefitExpnsAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,010,534 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,010,534 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,796,154 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,553,152 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,243,002 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00880 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $110,164,098 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $52,368,152 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $57,795,946 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15600 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 60 | PersonsServedCnt |
| Total Community Benefit Expns | $1,614 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,614 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 197 | ActivitiesOrProgramsCnt |
| Persons Served | 3981 | PersonsServedCnt |
| Total Community Benefit Expns | $179,536 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $179,536 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 15 | PersonsServedCnt |
| Total Community Benefit Expns | $410 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $410 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 128 | ActivitiesOrProgramsCnt |
| Persons Served | 42845 | PersonsServedCnt |
| Total Community Benefit Expns | $35,367 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $35,367 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 60 | PersonsServedCnt |
| Total Community Benefit Expns | $6,691 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,691 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $55,677 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $55,677 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 332 | ActivitiesOrProgramsCnt |
| Persons Served | 46961 | PersonsServedCnt |
| Total Community Benefit Expns | $279,295 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $279,295 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $36,911,000 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,436,000 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $113,649,115 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $92,551,346 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $21,097,769 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLAGSTAFF MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 N BEAVER STREET | AddressLine1Txt |
| City | FLAGSTAFF | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://NAHEALTH.COM | WebsiteAddressTxt |
| State License | HO169 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLAGSTAFF MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | false | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SCH H, PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SCH H, PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SCH H, PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SCH H, PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, SECTION B, PART V, LINE 5 | AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA"), A FOCUS GROUP WAS HELD IN NOVEMBER 2015 IN COLLABORATION WITH COCONINO AND YAVAPAI COUNTIES AS PART OF THEIR COMMUNITY HEALTH IMPROVEMENT PLANS. KEY INFORMANTS IN THE COMMUNITY INCLUDED: REPRESENTATIVES FROM PUBLIC HEALTH, PHYSICIANS, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY LEADERS. A LIST OF RECOMMENDED PARTICIPANTS FOR THE FOCUS GROUP WAS PROVIDED BY FLAGSTAFF MEDICAL CENTER. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED REPRESENTATIVES OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS. FOCUS GROUP CANDIDATES WERE FIRST CONTACTED BY LETTER TO REQUEST THEIR PARTICIPATION. FOLLOW-UP PHONE CALLS WERE THEN MADE TO ASCERTAIN WHETHER THEY WOULD BE ABLE TO ATTEND. CONFIRMATION CALLS WERE PLACED THE DAY BEFORE THE GROUPS WERE SCHEDULED TO INSURE A REASONABLE TURNOUT. AUDIO FROM THE FOCUS GROUP SESSION WAS RECORDED, FROM WHICH VERBATIM COMMENTS IN THIS REPORT ARE TAKEN. THERE ARE NO NAMES CONNECTED WITH THE COMMENTS, AS PARTICIPANTS WERE ASKED TO SPEAK CANDIDLY AND ASSURED OF CONFIDENTIALITY. THIS BOX IS CHECKED "NO" BECAUSE THE HOSPITAL SOLICITED ONLY ORAL, AND NOT WRITTEN COMMENTS ON THE 2012 CHNA AND IMPLEMENTATION STRATEGY WHEN DEVELOPING THE 2015 CHNA. THIS WAS NOT REQUIRED AT THE TIME THAT CHNA WAS PREPARED, BUT WILL BE IMPLEMENTED IN FUTURE CHNA DEVELOPMENT. SCHEDULE H, PART V, LINE 6A THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN CONJUNCTION WITH ITS RELATED HOSPITAL FACILITY, VERDE VALLEY MEDICAL CENTER. |
| SCHEDULE H, SECTION B, PART V, LINE 7A | THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://NAHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| SCHEDULE H, SECTION B, PART V, LINE 10A | THE 2016 IMPLEMENTATION STRATEGY IS AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://NAHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| SCHEDULE H, SECTION B, PART V, LINE 11 | FMC RANKED HEALTH ISSUES IDENTIFIED BY THE CHNA AGAINST THE FOLLOWING ESTABLISHED, UNIFORM CRITERIA: MAGNITUDE - THE NUMBER OF PERSONS AFFECTED; IMPACT/SERIOUSNESS - THE DEGREE TO WHICH THE ISSUE AFFECTS OR EXACERBATES QUALITY OF LIFE AND HEALTH-RELATED ISSUES; FEASIBILITY - THE ABILITY TO REASONABLY IMPACT THE ISSUES, GIVEN AVAILABLE RESOURCES; AND CONSEQUENCES OF INACTION - THE RISK OF NOT ADDRESSING THE PROBLEM AT THE EARLIEST OPPORTUNITY. AREAS OF OPPORTUNITY WERE PRIORITIZED AS FOLLOWS: ACCESS TO HEALTHCARE SERVICES INJURY & VIOLENCE PREVENTION MENTAL HEALTH & MENTAL DISORDERS MATERNAL, INFANT AND CHILD HEALTH ORAL HEALTH SUBSTANCE ABUSE SEXUALLY TRANSMITTED DISEASES Access to Health Services: The organization began "BeWellNow", its telehealth primary and urgent care program. The organization started a Transitions Clinic for those patients who are not able to see their primary care provider ("PCP") within 72 hours of discharge or who need same day service from a PCP. The organization is working with Transportation group for better ride options for patients. The organization is beginning a Community Health Worker program. The organization is broadening our Community Paramedicine program. Injury and Violence Prevention: The organization consistently screens all emergency department ("ED") patients for domestic violence. The organizations Community Paramedicine program conducts home assessments that include fall prevention. Mental Health and Mental Disorders: The organization is hosting a Mental First Aid program and performs depression screening for all related physician clinic patients. Respiratory Disease: The organization is increasing health insurance premiums for employee and employee dependents who use tobacco products. HEALTH PRIORITIES NOT CHOSEN FOR ACTION AND REASON: SUBSTANCE ABUSE - FMC CURRENTLY PARTICIPATES IN COMMUNITY COLLABORATIONS TO ADDRESS SUBSTANCE ABUSE. THESE COLLABORATIONS ARE LED BY OTHER COMMUNITY ORGANIZATIONS WHO HAVE EXPERTISE AND RESOURCES DIRECTED SPECIFICALLY TOWARD EDUCATION AND PREVENTION EFFORTS. FMC WILL CONTINUE TO BE A COMMUNITY PARTNER WITH THESE COLLABORATIONS RUN THROUGH OTHER ORGANIZATIONS. ORAL HEALTH - ORAL HEALTH PROGRAMS FOR COMMUNITY MEMBERS ARE OFFERED THROUGH THE FEDERALLY QUALIFIED HEALTH CENTER ("FQHC"), INDIAN HEALTH, AND REGIONAL PROVIDERS. FMC SUPPORTS THESE EFFORTS WHEN EMERGENCY OR TRAUMA CARE IS REQUIRED. MATERNAL, INFANT AND CHILD HEALTH - FMC PARTICIPATES IN CHILDREN'S HEALTH AND REHABILITATION, INPATIENT OBSTETRICS, NICU, PEDIATRICS AND PICU SERVICES. PRENATAL PROGRAMS, NUTRITIONAL SUPPORT AND INSURANCE COVERAGE ARE PROVIDED BY THE FQHC, LOCAL PROVIDERS, AND FEDERAL AND STATE PROGRAMS. THESE PROGRAMS LEAD THE MAIN EFFORTS IN PRENATAL CARE, TEEN PREGNANCY PREVENTION, AND HIGH RISK PREGNANCIES. SEXUALLY TRANSMITTED DISEASES - THE NORTHERN ARIZONA COUNTY HEALTH DEPARTMENTS ARE REGIONAL LEADS FOR PREVENTING, MONITORING, AND EDUCATING THE PUBLIC ABOUT SEXUALLY TRANSMITTED DISEASES. SCHEDULE H, PART V, LINE 13(B) Eligibility for charitable assistance is based on the income and family size of the patient/guarantor. Income levels are based on the FEDERAL POVERTY LEVELS ("FPL") published by the Federal Register annually. Household members are defined as all dependents and adults residing with the patient. Applicants with household income of 400% of FPL or lower may receive financial assistance based upon a tiered discount. |
| SCHEDULE H, SECTION B, PART V, LINES 16A AND B | THE FINANCIAL ASSISTANCE POLICY ("FAP") AND APPLICATION ARE AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://NAHEALTH.COM/PATIENT-RIGHTS-POLICIES/FINANCIAL-ASSISTANCE |
| SCHEDULE H, SECTION B, PART V, LINE 22D | AMOUNTS GENERALLY BILLED ("AGB"): HOSPITAL-SPECIFIC AGB PERCENTAGE MEANS, FOR EACH HOSPITAL, A PERCENTAGE IS DERIVED BY DIVIDING (1) THE SUM OF ALL CLAIMS FOR MEDICALLY NECESSARY SERVICES PROVIDED AT SUCH HOSPITAL PAID DURING THE RELEVANT PERIOD BY (2) ALL PRIVATE HEALTH INSURERS AS PRIMARY PAYORS, TOGETHER WITH ANY ASSOCIATED PORTIONS OF THESE CLAIMS PAID BY INSURED INDIVIDUALS IN THE FORM OF CO-PAYS, CO-INSURANCE OR DEDUCTIBES. THE AGB PERCENTAGE IS CALCULATED BY JANUARY 31 AND IS EFFECTIVE UNTIL THE NEXT ANNUAL CALCULATION. THE CALCULATION SHALL COMPLY WITH THE "LOOK-BACK METHOD" DESCRIBED IN TREASURY REGULATION 1-501(R)-5(B)(1)(B). |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 3A AND 3B | EXPLANATION FOR VARIOUS PERCENTAGES USED: 200% OF THE FEDERAL POVERTY LEVEL ("FPL")= 100% CHARITY WRITE OFF. 201-250% OF FPL = 75% CHARITY WRITE-OFF. 251-300% OF FPL = 50% WRITE-OFF. 301-350% OF FPL = 25% WRITE-OFF. 351-400% OF FPL = 15% WRITE-OFF. |
| SCHEDULE H, PART I, LINE 3C | CHARITY CARE INCOME LEVELS ARE BASED ON THE FEDERAL POVERTY GUIDE PUBLISHED IN THE FEBRUARY FEDERAL REGISTER ON AN ANNUAL BASIS. A TIERED METHOD IS UTILIZED FOR DETERMINING WHETHER A PATIENT IS ELIGIBLE FOR 100%, 75%, 50%, 25%, OR 15% WRITE-OFF OF THE SELF PAY BALANCE. |
| SCHEDULE H, PART I, LINE 6A | THE INFORMATION FOR THE COMMUNITY BENEFITS REPORT IS GATHERED BY THE COMMUNICATIONS DEPARTMENT, WHICH IS A DEPARTMENT OF NORTHERN ARIZONA HEALTHCARE. FLAGSTAFF MEDICAL CENTER AND VERDE VALLEY MEDICAL CENTER ARE IDENTIFIED SEPARATELY ON THESE REPORTS. THE COMMUNITY BENEFIT REPORT IS AVAILABLE AT: HTTPS://NAHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| SCHEDULE H, PART I, LINE 7 | FLAGSTAFF MEDICAL CENTER USED A COST-TO-CHARGE RATIO, WHERE APPLICABLE, TO CALCULATE THE MOST ACCURATE COST OF CHARITY CARE AND OTHER COMMUNITY BENEFITS REPORTED IN LINE 7. |
| SCHEDULE H, PART II | COMMUNITY BUILDING IS ADVANCED BY FLAGSTAFF MEDICAL CENTER THROUGH ITS SUPPORT OF PHYSICIAN RECRUITMENT AND WORK WITH VARIOUS COMMUNITY ORGANIZATIONS INCLUDING THE AMERICAN CANCER SOCIETY, BIG BROTHERS AND BIG SISTERS, FLAGSTAFF LEADERSHIP PROGRAM, FLAGSTAFF CHAMBER OF COMMERCE AND THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION. |
| SCHEDULE H, PART III, LINE 2 | THE COSTING METHODOLOGY USED TO DETERMINE THE BAD DEBT COST COMES FROM THE PERCENTAGE CALCULATED IN SCHEDULE H PART I WORKSHEET 2. |
| SCHEDULE H, PART III, LINE 3 | FLAGSTAFF MEDICAL CENTER'S CALCULATION OF FINANCIAL ASSISTANCE COST IS BASED ON ACTUAL FINANCIAL ASSISTANCE WRITE-OFFS BY THE BUSINESS OFFICE MULTIPLIED BY THE COST-TO-CHARGE RATIO. ALL OF THE FINANCIAL ASSISTANCE WRITE-OFFS ARE ATTRIBUTABLE TO PATIENTS WHO QUALIFIED UNDER THE FINANCIAL ASSISTANCE POLICY. AS A NOT-FOR-PROFIT ENTITY, SERVICES ARE PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND MAKING THIS AVAILABLE TO THE COMMUNITY QUALIFIES BAD DEBT AS A COMMUNITY BENEFIT. |
| SCHEDULE H, PART III, LINE 4 | FOOTNOTE 2 TO THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS INDICATES THAT NET PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE HAVE BEEN ADJUSTED TO THE ESTIMATED AMOUNTS EXPECTED TO BE RECEIVED BASED ON CONTRACT RATES FOR THE SERVICES RENDERED. THESE ESTIMATED AMOUNTS ARE SUBJECT TO FURTHER ADJUSTMENTS UPON REVIEW BY THIRD-PARTY PAYORS. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD OR DISCOUNTED RATES. HISTORICALLY, A SIGNIFICANT PORTION OF THE UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. ACCORDINGLY, THE CORPORATION RECORDS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR DOUBTFUL ACCOUNTS, RELATED TO UNINSURED PATIENTS, IN THE PERIOD THE SERVICES WERE PROVIDED USING AN ENTITY WIDE ASSESSMENT BASED ON HISTORICAL COLLECTION EXPERIENCES. MANAGEMENT REGULARLY REVIEWS PAYMENT DATA FOR EACH MAJOR PAYOR IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. DURING 2016, THE CORPORATION EXPERIENCED A SLIGHT DECREASE IN SELF-PAY REVENUE AS A RESULT OF THE ARIZONA MEDICAID RESTORATION PROGRAM AND THE ESTABLISHMENT OF THE STATE INSURANCE EXCHANGE UNDER THE AFFORDABLE CARE ACT. THIS ALSO RESULTED IN A SLIGHT DECREASE IN THE PROVISION FOR DOUBTFUL ACCOUNTS. |
| SCHEDULE H, PART III, LINE 8 | THE SOURCE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS THE FY2016 MEDICARE COST REPORT FOR THE ORGANIZATION. MEDICARE REPRESENTS 37% OF THE ORGANIZATIONS GROSS CHARGES. FOR FY2016 MEDICARE IS A SURPLUS PRIMARILY BECAUSE THE ORGANIZATION RECEIVES HIGHER MEDICARE REIMBURSEMENTS AS A SOLE COMMUNITY HOSPITAL, AS DEFINED AND DESIGNATED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. IN YEARS WHEN THERE IS A SHORTFALL, THE ENTIRE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE ORGANIZATIONS MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, WHETHER OR NOT THIS SERVICE IS PROVIDED AT A LOSS, THEREBY RELIEVING THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST OF THE MEDICARE BENEFICIARIES, MANY OF WHOM WOULD QUALIFY FOR FINANCIAL ASSISTANCE. |
| SCHEDULE H, PART III, LINE 9B | ACCORDING TO OUR FINANCIAL ASSISTANCE POLICY, FINANCIAL COUNSELORS ASSESS THE PATIENT'S ABILITY TO PAY AT TIME OF ADMISSION/REGISTRATION. IF THE PATIENT STATES THAT THEY ARE UNABLE TO PAY OUT-OF-POCKET EXPENSES, A DETERMINATION IS MADE WHETHER COVERAGE IS AVAILABLE THROUGH AHCCCS OR OTHER MEDICAID PROGRAMS. IF NO OUTSIDE ASSISTANCE IS AVAILABLE, AN APPLICATION IS GIVEN TO THE PATIENT TO BE SUBMITTED FOR FINANCIAL ASSISTANCE CONSIDERATION. IF THE PATIENT DOESN'T QUALIFY FOR FINANCIAL ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR A LONG-TERM PAYMENT PROGRAM. IF THE FINANCIAL ASSISTANCE APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT. BEFORE PRE-ADMISSION AND IF A PATIENT IS INELIGIBLE FOR FINANCIAL ASSISTANCE, FLAGSTAFF MEDICAL CENTER CALCULATES AN AMOUNT GENERALLY BILLED (AGB) ON A PERIODIC BASIS PER SECTION 501R OF THE TREASURY REGULATIONS. THE CURRENT RATE IS 68% OF GROSS CHARGES. FLAGSTAFF MEDICAL CENTER CURRENTLY OFFERS A 50% DISCOUNT TO THESE PATIENTS, WHICH IS WELL BELOW THE AGB CALCULATION. |
| SCHEDULE H, PART VI, LINE 2 | FLAGSTAFF MEDICAL CENTER ASSESSES COMMUNITY HEALTHCARE NEEDS THROUGH A SURVEY DESIGNED AND ADMINISTERED INTERNALLY. THIS SURVEY WAS LAST CONDUCTED IN NOVEMBER 2015 AND WAS A FOLLOW-UP TO OTHER SURVEYS THE HOSPITAL HAS CONDUCTED. THE SURVEY INSTRUMENT USED FOR THIS STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. |
| SCHEDULE H, PART VI, LINE 3 | ACCORDING TO OUR FINANCIAL ASSISTANCE POLICY, FINANCIAL COUNSELORS ASSESS THE PATIENT'S ABILITY TO PAY AT TIME OF ADMISSION/REGISTRATION. IF THE PATIENT STATES THAT THEY ARE UNABLE TO PAY OUT-OF-POCKET EXPENSES, A DETERMINATION IS MADE WHETHER COVERAGE IS AVAILABLE THROUGH AHCCCS OR OTHER MEDICAID PROGRAMS. IF NO OUTSIDE ASSISTANCE IS AVAILABLE, AN APPLICATION IS GIVEN TO THE PATIENT TO BE SUBMITTED FOR FINANCIAL ASSISTANCE CONSIDERATION. IF THE PATIENT DOESN'T QUALIFY FOR FINANCIAL ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR A LONG-TERM PAYMENT PROGRAM. IF THE CHARITY APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT. FLAGSTAFF MEDICAL CENTER WEBSITE HAS A BILLING CONTACT NUMBER. BEFORE PRE-ADMISSION, PATIENTS ARE CONTACTED BY FMC'S CASHIER. WHEN PATIENTS ARE CONTACTED, THEY ARE EDUCATED ABOUT THE FINANCIAL ASSISTANCE POLICY. FMC FINANCIAL COUNSELORS ASSIGNED TO EACH NURSING UNIT ARE ABLE TO ANSWER OR ASSIST WITH BILLING QUESTIONS. AT EACH PATIENT REGISTRATION DESK THERE ARE DISPLAYS AND BROCHURES OF THE BILLING INFORMATION, INCLUDING THE FINANCIAL ASSISTANCE POLICY. |
| SCHEDULE H, PART VI, LINE 4 | THE STUDY AREA FOR THE SURVEY EFFORT (REFERRED TO AS THE "NAH SERVICE AREA"FLAGSTAFF OR VERDE VALLEY REGION" IN THIS REPORT) INCLUDES THE FOLLOWING COUNTIES REPRESENTED IN NORTHERN AZ: APACHE, GILA, MOJAVE, NAVAJO, COCONINO AND YAVAPAI. COCONINO COUNTY (CC) - AS OF 2015, THE TOTAL POPULATION IN COCONINO COUNTY WAS 139,097. THE POPULATION IS EVENLY SPLIT BETWEEN MALES AND FEMALES. THE POPULATION WAS FOUND TO BE 54.9% WHITE (NOT HISPANIC OR LATINO), 27.3% AMERICAN INDIAN OR ALASKAN NATIVE, 13.9% HISPANIC OR LATINO, 1.6% BLACK OR AFRICAN AMERICAN, AND 1.8% ASIAN. MOHAVE COUNTY (MC) - THE TOTAL POPULATION IN MOHAVE COUNTY WAS 204,737 IN 2015. THE COUNTY IS 49.7% FEMALE AND 50.3% MALE. THE MAJORITY OF THE COUNTY IS WHITE (NOT HISPANIC OR LATINO) AT 78%, WHILE THE LARGEST MINORITY GROUP IS HISPANIC OR LATINO AT 15.8% OF THE POPULATION. THE POPULATION IS 2.9% AMERICAN INDIAN OR ALASKAN NATIVE, 1.3% BLACK OR AFRICAN AMERICAN, AND 1.2% ASIAN. GILA COUNTY (GC) - GILA COUNTYS POPULATION WAS 53,159 IN 2015. THE POPULATION WAS FOUND TO BE 50.4% FEMALE AND 49.6% MALE. THE MAJORITY OF THE COUNTY IS WHITE (NOT HISPANIC OR LATINO) AT 63.2%. THE COUNTY IS 18.8% HISPANIC OR LATINO, 16.5% AMERICAN INDIAN OR ALASKAN NATIVE, .9% BLACK OR AFRICAN AMERICAN, AND .8% ASIAN. APACHE COUNTY (AC) - AS OF 2015, THE TOTAL POPULATION IN APACHE COUNTY WAS 71,474. APACHE COUNTY HAS SLIGHTLY MORE FEMALES, WITH 50.6% OF THE POPULATION FEMALE AND 49.4% MALE. THE MAJORITY OF THE POPULATION IS AMERICAN INDIAN OR ALASKAN NATIVE AT 73.5%. THE POPULATION IS 19% WHITE (NOT HISPANIC OR LATINO) AND 6.4% HISPANIC OR LATINO. NAVAJO COUNTY (NC) - THE POPULATION OF NAVAJO COUNTY WAS 108,277 IN 2015. THIS COUNTY IS EVENLY SPLIT BETWEEN MALES AND FEMALES. THE COUNTYS POPULATION IS 42.2% WHITE (NOT HISPANIC OR LATINO), 44.9% NATIVE AMERICAN OR ALASKAN NATIVE, 11.1% HISPANIC, 1.3% BLACK AND .7% ASIAN. YAVAPAI COUNTY (YC) - IN 2015 THERE WERE 222,255 INDIVIDUALS LIVING IN YAVAPAI COUNTY. THE MAJORITY OF THE POPULATION IS WHITE (NOT HISPANIC OR LATINO) AT 80.9%. THE POPULATION IS 14.2% HISPANIC OR LATINO, 2.1% AMERICAN INDIAN OR ALASKAN NATIVE, 1% ASIAN, AND .9% BLACK OR AFRICAN AMERICAN. YAVAPAI IS EXPERIENCING AN EXTREMELY HIGH GROWTH IN HISPANICS. IN THE NEXT 5 YEARS, THE HISPANIC POPULATION IS ESTIMATED TO INCREASE BY 6,424 NEW LIVES. AGE DISTRIBUTION CC - IN 2014, PERSONS UNDER THE AGE OF 18 IS 21.8%, NEARING THE STATE AVERAGE OF 24.1%. AN ESTIMATED 12.3% OF THE POPULATION IS 65 YEARS OR OLDER, AND THIS IS EXPECTED TO INCREASE SLIGHTLY OVER THE NEXT FIVE YEARS TO 13.5%. MC - IT WAS FOUND THAT 18.7% OF MOHAVE COUNTYS RESIDENTS WERE UNDER THE AGE OF 18, WHILE 26.9% WERE OVER THE AGE OF 65. GC - THE POPULATION OF GILA COUNTY HAD 20.4% OF ITS RESIDENTS AGED 18 OR UNDER AND 26.6% AGED 65 OR OLDER IN 2014. AC - IN APACHE COUNTY, PERSONS UNDER THE AGE OF 18 IS 29.3% AND PERSONS OLDER THAT 65 WAS AT 13.5% IN 2014. NC - IT WAS FOUND THAT 28% OF NAVAJO COUNTYS POPULATION IS UNDER THE AGE OF 18 AND 15.8% IS OVER THE AGE OF 65. YC - AN ESTIMATED 28.1% OF THE POPULATION IS 65 YEARS OR OLDER, NEARLY DOUBLING THE STATE ESTIMATED AVERAGE PERCENT OF 15.9%, CARE FOR THE AGING WAS IDENTIFIED BY 20% OF THE RESPONDENTS IN A COMMUNITY HEALTH SURVEY AS A CRITICAL ISSUE. THE POPULATION WITHIN THE AGE OF 65 AND 74 WILL EXPERIENCE THE MOST GROWTH AT 21.53%. PEOPLE BETWEEN THE AGES OF 45 AND 54 PRESENT THE SMALLEST GROWTH AT -12.44% IN THE NEXT FIVE YEARS. YAVAPAI, IN TOTAL, HAS A GREATER PERCENT OF GROWTH THAN THE UNITED STATES AVERAGE IN ALL AGE GROUPS EXCEPT BETWEEN THE AGES OF 45 AND 64. |
| SCHEDULE H, PART VI, LINE 5 | COMMUNITY HEALTH AND COMMUNITY BUILDING ARE A FOCUS AT FLAGSTAFF MEDICAL CENTER AS EVIDENCED BY THE NUMEROUS ACTIVITIES SPONSORED EACH YEAR. THE CANCER CENTER AT FMC HOSTS A SERIES OF FREE OR LOW-COST SCREENINGS DESIGNED TO HELP RESIDENTS IN THE COMMUNITY DETECT ISSUES AS SOON AS POSSIBLE. THE SAFE CHILD CENTER IS A CHILD ADVOCACY CENTER THAT SERVES CHILDREN FROM BIRTH THROUGH 18 YEARS OLD AND IS DEDICATED TO REDUCING THE STRESS CHILDREN EXPERIENCE AS VICTIMS OF CRIME. FMC'S PALLIATIVE CARE PROGRAM PROVIDES HIGH QUALITY CARE TO PATIENTS WHO HAVE A CHRONIC DISEASE OR LIFE-THREATENING ILLNESS. FIT KIDS OF ARIZONA, WHICH WORKS TO REDUCE THE HEALTH CONSEQUENCES OF CHILDHOOD OBESITY BY PROMOTING HEALTHY LIFESTYLES, AND THE DIABETES TOGETHER COMMUNITY COLLABORATION ARE FMC'S PREMIER COMMUNITY HEALTH INITIATIVES. THE CARE BEYOND WALLS AND WIRES PROGRAM USES TELEMEDICINE TO MONITOR AND SUPPORT PATIENTS WHO LIVE REMOTELY AND HAVE RECENTLY BEEN DIAGNOSED WITH CONGESTIVE HEART FAILURE. COMMUNITY BUILDING IS ADVANCED BY FMC THROUGH ITS SUPPORT OF PHYSICIAN RECRUITMENT AND WORK WITH VARIOUS COMMUNITY ORGANIZATIONS INCLUDING THE AMERICAN CANCER SOCIETY, BIG BROTHERS AND BIG SISTERS, FLAGSTAFF LEADERSHIP PROGRAM, FLAGSTAFF CHAMBER OF COMMERCE AND THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION. |
| SCHEDULE H, PART VI, LINE 6 | FLAGSTAFF MEDICAL CENTER IS AFFILIATED WITH VERDE VALLEY MEDICAL CENTER. THE BOARD MEMBER MEETINGS ARE COMBINED. THE COMMUNITY BENEFIT REPORT IS SUMMARIZED TOGETHER AND POSTED ON THE HOSPITAL'S WEBSITE. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (21 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Address Line2USAddress/AddressLine2Txt | Purpose Of GrantPurposeOfGrantTxt | Non Cash AssistanceNonCashAssistanceAmt |
|---|---|---|---|---|---|---|---|---|---|
| ARIZONA COMMUNITY FOUNDATION | |||||||||
| 2201 E CAMELBACK RD | PHOENIX | AZ | 85016 | 860348306 | 501(C)(3) | $8,000 | |||
| ARIZONA SNOWBOWL RESORT | |||||||||
| PO BOX 40 | FLAGSTAFF | AZ | 86002 | 860718649 | $15,000 | STE 4058 | NATE AVERY RUN | ||
| BOYS AND GIRLS CLUB OF FLAGSTAFF | |||||||||
| 301 S PASEO DEL FLAG | FLAGSTAFF | AZ | 86001 | 860688398 | 501(C)(3) | $6,000 | STE 1010 | ADAPTIVE SKI PROGRAM | $0 |
| COCONINO COMMUNITY COLLEGE | |||||||||
| 2800 S LONETREE RD | FLAGSTAFF | AZ | 86001 | 860717956 | SCHOOL | $105,000 | FLAGSTAFF COMMUNITY FOUNDATION | $0 | |
| Coconino Econ Sustainable Dev Initiative | |||||||||
| PO BOX 22110 | FLAGSTAFF | AZ | 86002 | 261077054 | 501(C)(3) | $10,000 | MEETINGS, SPONSOR, NURSING | $0 | |
| ECONOMIC COLLABORATIVE OF NORTHERN AZ | |||||||||
| 201 E BIRCH AVE STE 12 | FLAGSTAFF | AZ | 86001 | 860699786 | 501(C)(3) | $10,000 | TEACHER AWARDS | $0 | |
| FLAGSTAFF FAMILY FOOD CENTER | |||||||||
| 1903 N 2ND ST | FLAGSTAFF | AZ | 86004 | 860754044 | 501(C)(3) | $10,000 | FIRST ROBOTICS CONFERENCE | $0 | |
| FLAGSTAFF SYMPHONY ORCHESTRA | |||||||||
| PO BOX 122 | FLAGSTAFF | AZ | 86002 | 860186038 | 501(C)(3) | $6,000 | ATHENA AWARDS ANNUAL MEETING | $0 | |
| FLAGSTAFF UNIFIED SCHOOL DISTRICT | |||||||||
| 3285 E SPARROW | FLAGSTAFF | AZ | 86004 | 860593041 | SCHOOL | $384,821 | FCF | $0 | |
| JLB PROJECT | |||||||||
| PO BOX 537 | FLAGSTAFF | AZ | 86002 | 273224466 | 501(C)(3) | $5,500 | SPONSOR, FSO CONCERT | $0 | |
| MOUNTAIN CHARTER SCHOOLS | |||||||||
| 311 W CATTLE DRIVE | FLAGSTAFF | AZ | 86005 | 953564584 | SCHOOL | $19,840 | SPONSOR | $0 | |
| NORTH COUNTRY HEALTHCARE | |||||||||
| PO BOX 3630 | FLAGSTAFF | AZ | 86003 | 860663432 | 501(C)(3) | $20,900 | STE 506 | TICKETS, CONFERENCES, NURSING | $0 |
| NORTHERN ARIZONA UNIVERSITY | |||||||||
| PO BOX 122 | FLAGSTAFF | AZ | 86002 | 866004791 | SCHOOL | $90,860 | NACASA | $0 | |
| NORTHLAND HOSPICE & PALLIATIVE CARE | |||||||||
| PO BOX 997 | FLAGSTAFF | AZ | 86002 | 742385187 | 501(C)(3) | $10,000 | FCF | $0 | |
| POORE MEDICAL CLINIC | |||||||||
| 120 W FINE AVE | FLAGSTAFF | AZ | 86001 | 800751712 | 501(C)(3) | $8,500 | FCF | $0 | |
| RONALD MCDONALD HOUSE CHARITIES | |||||||||
| 501 E ROANOK AVE | PHOENIX | AZ | 85004 | 860483792 | 501(C)(3) | $6,000 | FCF | $0 | |
| SAN FRANCISCO DE ASIS PARISH | |||||||||
| 320 W HUMPHREYS ST | FLAGSTAFF | AZ | 86001 | 300515246 | SCHOOL | $7,105 | STE D-1 | SPONSOR | $0 |
| SEDONA INTERNATIONAL FILM FESTIVAL | |||||||||
| PO BOX 162 | SEDONA | AZ | 86339 | 200351857 | 501(C)(3) | $7,000 | STE 4 | FCF | $0 |
| ST MARY'S FOOD BANK ALLIANCE | |||||||||
| 1801 W State Route 66 | FLAGSTAFF | AZ | 86001 | 237353532 | 501(C)(3) | $10,000 | DONATION, SPONSOR | $0 | |
| UNITED WAY OF NORTHERN AZ | |||||||||
| 1515 E Cedar Ave | FLAGSTAFF | AZ | 86004 | 860211666 | 501(C)(3) | $35,425 | Fit Kids School Program | $0 | |
| WILLIAMS UNIFIED SCHOOL DISTRICT | |||||||||
| PO BOX 427 | WILLIAMS | AZ | 86046 | 860592836 | SCHOOL | $106,191 | Fit Kids School Program | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 20 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART IV, PROCEDURES TO MONITOR GRANTS | FormAndLineReferenceDesc |
| Explanation | FLAGSTAFF MEDICAL CENTER FOUNDATION - GRANTS 1) INDIVIDUALS ON THE USER LEVEL ARE RESPONSIBLE FOR SCREENING AND IDENTIFYING THE NEEDS FOR DISTRIBUTION OF GRANT FUNDS. 2) DEPARTMENT HEADS AND/OR PROGRAM COORDINATORS MUST VALIDATE AND SIGN ALL REQUESTS FOR PAYMENT OR DISBURSEMENT OF THESE FUNDS. 3) WRITTEN REQUESTS ARE REVIEWED BY THE FOUNDATION SPECIALIST FOR OPERATIONS TO VERIFY AVAILABLE FUND BALANCES AND PROPER ACCOUNT NUMBERS. 4) THE FOUNDATION SPECIALIST FOR GRANTS THEN INITIALS THE DOCUMENTS AFTER VERIFYING THE CRITERIA FOR DISBURSEMENT. 5) THE VICE PRESIDENT OF DEVELOPMENT AUTHORIZES THE DISBURSEMENT OF FUNDS BY SIGNATURE. 6) THE FOUNDATION SCANS ALL DOCUMENTS AND SAVES THEM DIGITALLY ON A SECURE SERVER. 7) ALL ORIGINAL DOCUMENTS ARE SUBMITTED TO ACCOUNTS PAYABLE FOR FINAL RECORDING AND PAYMENT. ORIGINAL DOCUMENTS ARE FILED AND ARCHIVED IN A SECURE LOCATION FOR THE REQUIRED LENGTH OF TIME. FMC RELIES ON THE GOVERNANCE PRACTICES OF THE RECIPIENT ORGANIZATION TO USE THE FUNDS FOR THE INTENDED PURPOSE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT THAMES | ||||||||||||||
| NAH PRESIDENT/CEO | $0 | $302,952 | $0 | $127,500 | $0 | $14,405 | $0 | $9,696 | $0 | $20,189 | $0 | $474,742 | $0 | $0 |
| HOPE WADE | ||||||||||||||
| CFO (THRU 12/15) | $0 | $167,550 | $0 | $12,261 | $0 | $196 | $0 | $5,142 | $0 | $1,000 | $0 | $186,149 | $0 | $0 |
| MARK CARROLL | ||||||||||||||
| CHIEF MEDICAL OFFICER | $0 | $323,105 | $0 | $44,829 | $0 | $1,448 | $0 | $15,900 | $0 | $26,915 | $0 | $412,197 | $0 | $0 |
| LINDA PARKER | ||||||||||||||
| INTERIM CNO/VP PATIENT CARE | $0 | $210,964 | $0 | $35,015 | $0 | $1,707 | $0 | $14,845 | $0 | $1,440 | $0 | $263,971 | $0 | $0 |
| RICHARD SMITH | ||||||||||||||
| VP OF DEVELOPMENT/MARKETING | $0 | $226,783 | $0 | $40,485 | $0 | $3,476 | $0 | $15,900 | $0 | $18,148 | $0 | $304,792 | $0 | $0 |
| RICHARD NEFF | ||||||||||||||
| DIRECTOR PHYSICIAN RELATIONS | $0 | $363,531 | $0 | $0 | $0 | $1,969 | $0 | $15,900 | $0 | $28,195 | $0 | $409,595 | $0 | $0 |
| MARK FOSTER | ||||||||||||||
| PHYSICIAN | $0 | $212,369 | $0 | $0 | $0 | $7,055 | $0 | $12,975 | $0 | $17,420 | $0 | $249,819 | $0 | $0 |
| RICHARD MENDRIBIL | ||||||||||||||
| HEALTH SYSTEMS DIR OF PHARMACY | $0 | $191,010 | $0 | $14,170 | $0 | $5,227 | $0 | $11,536 | $0 | $8,636 | $0 | $230,579 | $0 | $0 |
| DALE MERRITT | ||||||||||||||
| REGISTERED NURSE | $0 | $200,657 | $0 | $4,300 | $0 | $2,862 | $0 | $4,892 | $0 | $25,264 | $0 | $237,975 | $0 | $0 |
| BRENDA MUNNS | ||||||||||||||
| DIRECTOR SURGICAL SERVICES | $0 | $186,388 | $0 | $13,965 | $0 | $3,455 | $0 | $32,686 | $0 | $16,836 | $0 | $253,330 | $0 | $0 |
| JOHN DEMPSEY | ||||||||||||||
| FORMER VP NAH/PRES LCMC | $0 | $331,407 | $0 | $72,204 | $0 | $40,499 | $0 | $155,917 | $0 | $25,438 | $0 | $625,465 | $0 | $32,101 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1A & 1B | SUPPLEMENTAL COMPENSATION INFORMATION ALL COMPENSATION, BENEFITS AND REIMBURSEMENTS ARE PAID BY NORTHERN ARIZONA HEALTHCARE, THE PARENT ORGANIZATION. GROSS-UP OF TAXES IS DONE ON ALL EMPLOYEE GIFT CERTIFICATES of $25 OR MORE. IN PRACTICE, THE BOARD MEMBER AND OFFICER BUSINESS TRAVEL EXPENSES ARE APPROVED BY THE NEXT HIGHEST LEVEL. |
| SCHEDULE J, PART I, LINE 3 | CEO COMPENSATION IS DERIVED BY THE PARENT ORGANIZATION, NORTHERN ARIZONA HEALTHCARE, BY THE FOLLOWING METHODS: COMPENSATION COMMITTEE, WRITTEN CONTRACT, INDEPENDENT CONSULTANT, COMPENSATION SURVEY, AND RECOMMENDATION OF COMPENSATION COMMITTEE TO BOARD FOR APPROVAL. SCHEDULE J, PART I, LINE 4B CERTAIN EMPLOYEES RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN DURING 2015 AS FOLLOWS: JOHN DEMPSEY: $32,101 THIS AMOUNT WAS INCLUDED IN TAXABLE WAGES AND IS REPORTED IN SCHEDULE J, PART II, COLUMN B(III) AND ALSO IN COLUMN F SINCE THIS AMOUNT HAS PREVIOUSLY BEEN REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. |
| SCHEDULE J, PART I, LINE 7 | NORTHERN ARIZONA HEALTHCARE CORPORATION MAKES DISCRETIONARY PAYMENTS AS PART OF A SHORT-TERM INCENTIVE PLAN (STIP). PAYMENTS ARE BASED ON MEETING VARIOUS ORGANIZATION GOALS. |
| Schedule J Part II | THE FOLLOWING INDIVIDUALS PARTICIPATE IN A DEFINED BENEFIT RETIREMENT PLAN. AS SUCH, ACTUARIAL INCREASES IN THEIR ACCOUNTS ARE REPORTED ON PART II, COLUMN (C) AS DEFERRED COMPENSATION. INCREASE DUE TO ACTUARIAL BENEFIT: JOHN DEMPSEY $111,008 THE FOLLOWING INDIVIDUALS RECEIVED ONE-TIME SIGN-ON BONUSES. THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(ii): ROBERT P. THAMES $52,500 JEFFREY TREASURE $25,000 THE FOLLOWING INDIVIDUAL RECEIVED A ONE-TIME PAYMENT FOR RELOCATION. THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(iii): ROBERT P. THAMES $13,074 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| INDUSTRIAL DEVELOPMENT AUTHORITY OF YAVAPAI COUNTY | ||||||||
| A | 860376099 | 985900cx5 | 2011-10-12 | $65,094,379 | See Part VI | false | false | false |
| INDUSTRIAL DEVELOPMENT AUTHORITY OF YAVAPAI COUNTY | ||||||||
| B | 860376099 | 2015-06-30 | $54,783,825 | See Part VI | false | false | false | |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $0 | $0 | $65,094,379 | $0 | $0 | $0 | $629,060 | $0 | $0 | $0 | $64,465,319 | $0 | 2011 | Yes (true) | false | Yes (true) | Yes (true) |
| B | $0 | $0 | $54,783,825 | $0 | $0 | $0 | $1,111,308 | $0 | $0 | $0 | $54,299,049 | $0 | 2015 | Yes (true) | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | false | false | Yes (true) | Yes (true) | false | 0 | false | false | false | Yes (true) |
| B | false | false | Yes (true) | Yes (true) | false | 0 | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1Txt | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 0 | ||||||||||
| A | false | false | Yes (true) | false | false | false | false | 0 | false | Yes (true) |
| 0 | ||||||||||
| B | false | false | Yes (true) | false | false | false | false | 0 | false | Yes (true) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART I, COLUMN (F) | FormAndLineReferenceDesc |
| Explanation | LINE A - THE NAME OF THE ISSUE IS HOSPITAL REVENUE REFUNDING BONDS (NORTHERN ARIZONA HEALTHCARE SYSTEM) SERIES 2011. THIS ISSUE REFUNDS THE 1996A AND 1998 SERIES BOND. TOTAL ISSUANCE PRICE WAS $78,923,520, WHICH WAS ALLOCATED $65,094,379 TO FLAGSTAFF MEDICAL CENTER (FMC) AND $13,829,141 TO VERDE VALLEY MEDICAL CENTER (VVMC). LINE B - THE NAME OF THE ISSUE IS HOSPITAL REVENUE REFUNDING BONDS (NORTHERN ARIZONA HEALTHCARE SYSTEM) SERIES 2015A AND 2015B. THIS ISSUE REFUNDS THE 2008A AND 2008B BONDS. TOTAL ISSUANCE PRICE OF SERIES 2015A WAS $80,395,000, WHICH WAS ALLOCATED $37,213,075 TO FMC, $9,274,438 TO VVMC, AND $33,906,585 TO NORTHERN ARIZONA HEALTHCARE OUTPATIENT SURGERY CENTER. THE 2015A BONDS WERE ALSO USED, IN PART, TO FINANCE "NEW MONEY" PROJECTS. $33,611,679 WAS USED FOR ACQUISITION OF SUMMIT SURGERY CENTER. TOTAL ISSUANCE PRICE OF SERIES 2015B WAS $45,635,975, WHICH WAS ALLOCATED $17,569,850 TO FMC AND $28,066,125 TO VVMC. | ExplanationTxt |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $40 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | REPLACEMENT COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp |
Books And Publications BooksAndPublicationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $1,218 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | REPLACEMENT COST | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $18,657 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | REPLACEMENT COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp |
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 30 | ContributionCnt |
| Noncash Contributions Rpt F990 | $401 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | REPLACEMENT COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Drugs And Medical Supplies | DrugsAndMedicalSuppliesGrp | |
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp |
Other Non Cash Contri Table OtherNonCashContriTableGrp (4 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | TOYS/CERTIFICATES | 905 | $17,066 | REPLACEMENT COST |
| Yes (X) | JEWELRY | 6 | $10,720 | REPLACEMENT COST |
| Yes (X) | ADMISSIONS/MEMBERSHIP | 201 | $23,188 | REPLACEMENT COST |
| Yes (X) | ALCOHOL | 2 | $47 | REPLACEMENT COST |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PART I, COLUMN B | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN COLUMN (B). THE NUMBER OF CONTRIBUTIONS OR ITEMS CONTRIBUTED IS NOT ASCERTAINABLE FOR THE FOLLOWING DUE TO VOLUME: BOOKS AND PUBLICATIONS CLOTHING AND HOUSEHOLD GOODS | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 6 | FMC VOLUNTEERS PROVIDE CLERICAL ASSISTANCE IN MULTIPLE DEPARTMENTS AND SUPPORT SERVICES SUCH AS WHEELCHAIR ASSISTANCE AND ESCORTING PATIENTS AND FAMILIES WHO ENTER AT THE MAIN ENTRY. THEY VOLUNTEER AT THE INFORMATION DESK AND GIFT SHOP AND MAKE DELIVERIES OF GIFTS, READING MATERIALS AND MAIL TO PATIENT ROOMS. THEY PROVIDE LOBBY MUSIC, NAVAJO AND SPANISH INTERPRETATION, SPIRITUAL CARE, AND CARING CANINE AND CARING CLOWN VISITS TO PATIENTS. THEY ROCK BABIES IN THE SPECIAL CARE NURSERY, PROVIDE MENDED HEARTS PATIENT AND FAMILY SUPPORT, AND ASSIST AT THE FOUNDATION AND AT SPECIAL EVENTS. VOLUNTEERS ASSIST IN OTHER DEPARTMENTS SUCH AS THE CANCER CENTER, BIOMEDICAL ENGINEERING, MAIL ROOM, NUTRITION SERVICES, PHARMACY, WOMEN AND INFANTS' CENTER, PHYSICAL THERAPY, FIT KIDS, BARIATRIC CLINIC, EMERGENCY AND SURGICAL SERVICES, AND THE TAYLOR HOUSE. |
| FORM 990 PART III LINE 4A | ONE OF THE NICEST THINGS ABOUT LIVING IN NORTHERN ARIZONA IS YOU DON'T HAVE TO TRAVEL TO GET EXCELLENT HEALTHCARE. SINCE 1936, FLAGSTAFF MEDICAL CENTER (FMC), A MEMBER OF NORTHERN ARIZONA HEALTHCARE, HAS PROVIDED HIGH QUALITY HEALTHCARE SERVICES TO RESIDENTS AND VISITORS OF NORTHERN ARIZONA. WE ARE DEDICATED TO PATIENT-CENTERED CARE WITH A PERSONAL TOUCH. FMC IS LICENSED BY MEDICARE AND THE STATE OF ARIZONA. FOUNDED BY DR. CHARLES SECHRIST AS FLAGSTAFF HOSPITAL, THE 25-BED HOSPITAL WAS DONATED TO THE COMMUNITY OF FLAGSTAFF IN 1955. TODAY, FLAGSTAFF MEDICAL CENTER REMAINS A NOT-FOR-PROFIT HOSPITAL, GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS. WE TREAT EVERY PATIENT, REGARDLESS OF THEIR ABILITY TO PAY. EVERY YEAR, FLAGSTAFF MEDICAL CENTER INVESTS IN YOUR COMMUNITY HOSPITAL TO ENSURE WE ARE PROVIDING THE BEST, SAFEST CARE, CLOSE TO HOME. WE PROVIDE KEY SERVICES TO NORTHERN ARIZONA RESIDENTS AND VISITORS, INCLUDING A REGIONAL TRAUMA CENTER; OPEN-HEART SURGERY; HIGH-TECH IMAGING; A CANCER CENTER; SURGICAL SERVICES; ORTHOPEDIC SERVICES; WOMEN, INFANTSCHILDREN'S SERVICES; AND MORE. FMC CURRENTLY HAS: - 267 INPATIENT BEDS - 223 PHYSICIANS ON OUR ACTIVE MEDICAL STAFF - 14,234 ANNUAL INPATIENT HOSPITAL ADMISSIONS - 63,165 INPATIENT DAYS - 84,007 ANNUAL OUTPATIENT HOSPITAL VISITS - 46,178 ANNUAL EMERGENCY DEPARTMENT VISITS - 1,152 BABIES BORN THIS YEAR AT FMC FLAGSTAFF MEDICAL CENTER'S MISSION, VISION, AND VALUES --------------------------------------------- MISSION - FLAGSTAFF MEDICAL CENTER WILL PROVIDE PATIENTS WITH EXCEPTIONAL CARE WHILE TRANSFORMING THE HEALTH OF THE COMMUNITIES WE SERVE. VISION - FLAGSTAFF MEDICAL CENTER WILL BE A MODEL HEALTHCARE SYSTEM DISTINGUISHED BY OUR PEOPLE, QUALITY, SERVICE AND OUR DEDICATION TO COMMUNITY HEALTH SOLUTIONS. VALUES: -PATIENTS - WE ARE COMMITTED TO MEETING THE NEEDS AND EXCEEDING THE EXPECTATIONS OF OUR PATIENTS. - COLLEAGUES - WE WILL CREATE AN ORGANIZATIONAL CULTURE WHERE COLLEAGUES FEEL VALUED AND TAKE A SENSE OF PRIDE IN THEIR WORK. - QUALITY - WE CONTINUOUSLY STRIVE TO ACHIEVE EXCELLENCE AT ALL LEVELS IN THE ORGANIZATION. - SAFETY - WE ARE COMMITTED TO MAINTAINING A SAFE ENVIRONMENT FOR OUR PATIENTS, VISITORS AND COLLEAGUES. - LEADERSHIP - WE PROMOTE LEADERSHIP AS AN ATTITUDE, NOT A POSITION, PUTTING VALUE ON BOTH PEOPLE AND THE WORK THEY DO. - TEAMWORK - WE ARE COLLEAGUES WORKING TOGETHER, SHARING KNOWLEDGE, TALENTS AND SKILLS TO ACHIEVE COMMON GOALS. - INTEGRITY - WE WILL BE FORTHRIGHT, HONEST AND RESPECTFUL. - DIVERSITY - WE EMBRACE THE DIVERSITY OF OUR PEOPLE, PATIENTS AND THE COMMUNITIES WE SERVE. |
| FORM 990, PART V, LINE 2A; PART VII, SECTION A, AND PART IX | FLAGSTAFF MEDICAL CENTER DOES NOT HAVE EMPLOYEES, BUT SHARES THE COST OF PERSONNEL, SERVICES, AND EXPENSES WITH NORTHERN ARIZONA HEALTHCARE CORPORATION, A RELATED TAX-EXEMPT ORGANIZATION AND FMC'S SOLE MEMBER. |
| FORM 990, PART VI, LINE 1 | THE BOARD OF DIRECTORS DELEGATES AUTHORITY TO AN EXECUTIVE COMMITTEE IN AN EMERGENCY SITUATION ONLY. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE INDIVIDUALS THEN SERVING AS THE EXECUTIVE COMMITTEE OF NAH, AUTOMATICALLY AND WITHOUT SEPARATE ELECTION. THE EXECUTIVE COMMITTEE SHALL ONLY MEET IF A QUORUM OF THE BOARD IS IMPOSSIBLE AND AN URGENT BOARD VOTE IS REQUIRED. IN SUCH CASES IT SHALL EXERCISE THE POWER AND AUTHORITY OF THE BOARD, AND SHALL REPORT ANY ACTIONS TAKEN AT THE FOLLOWING BOARD MEETING. FORM 990, PART VI, LINE 4 THE VERDE VALLEY MEDICAL CENTER BOARD WAS INTEGRATED INTO THE NORTHERN ARIZONA HEALTHCARE BOARD IN OCTOBER 2015. NORTHERN ARIZONA HEALTHCARE MOVED FROM A HOLDING COMPANY TO AN OPERATING COMPANY, SUCCESSFULLY INTEGRATING THREE SEPARATE BOARDS TO ONE SYSTEM BOARD. BOARD BYLAWS AND ARTICLES OF INCORPORATION WERE REWRITTEN TO ACHIEVE "BEST PRACTICE." THE ORGANIZATION MADE THE FOLLOWING SIGNIFICANT CHANGES TO THE BYLAWS, EFFECTIVE ON AUGUST 18, 2016: ARTICLE II: THE CORPORATION SHALL HAVE A SINGLE CLASS OF VOTING MEMBERS, AND THE SOLE MEMBER OF THAT CLASS IS NORTHERN ARIZONA HEALTHCARE CORPORATION. The following actions may be initiated by the Member in its sole and absolute discretion: a) Adoption of the consolidated annual budget for the System and any amendments b) The selection and retention of the President and Chief Executive Officer of this Corporation c) The selection of banking affiliations, accounting firms, legal counsel as well as approval of the engagement of any consultants not specifically provided for in an approved budget d) The selection of the manner and location of investment of any retained earnings e) Authorization of standing or ad hoc committees for controlled subsidiaries within the System ARTICLE III: THE DIRECTORS AT ALL TIMES SHALL BE, AUTOMATICALLY AND WITHOUT THE NEED OF A SEPARATE ELECTION, THE INDIVIDUALS SERVING AS DIRECTORS OF NAH. THE BYLAWS NO LONGER INCLUDE A PROVISION REGARDING THE MINIMUM OR MAXIMUM NUMBER OF BOARD MEMBERS, SINCE THE BOARD OF DIRECTORS FOR VVMC, FMC, AND NAH HAVE MERGED INTO ONE BOARD AS OF OCTOBER 2015. ARTICLE IV: THE OFFICERS OF THE BOARD ARE NOW LISTED AS THE PRESIDENT AND CEO, A CHAIR AND VICE-CHAIR, A SECRETARY, AND A TREASURER. EACH IS A VOTING MEMBER OF THE BOARD. ARTICLE V: DIRECTORS AND OFFICERS OF THE CORPORATION, OTHER THAN THE CEO WHO IS A FULL-TIME EMPLOYEE HIRED TO RUN THE DAY-TO-DAY OPERATIONS, SHALL NOT RECEIVE COMPENSATION FOR SERVING AS DIRECTORS AND/OR OFFICERS, BUT MAY RECEIVE REASONABLE COMPENSATION FOR OTHER PERSONAL SERVICES RENDERED WHICH ARE NECESSARY TO CARRYING OUT THE EXEMPT PURPOSES OF THE CORPORATION TO THE EXTENT PERMISSIBLE UNDER THE CORPORATION'S POLICIES AND PROCEDURES. ARTICLE VI: THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE INDIVIDUALS THEN SERVING AS THE EXECUTIVE COMMITTEE OF NAH, AUTOMATICALLY AND WITHOUT SEPARATE ELECTION. ARTICLE VII: THE BYLAWS NOW CONTAIN PROCEDURES REQUIRING CONDUCT IN ACCORDANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, AND ANNUAL DISCLOSURE OF CONFLICTS. ARTICLE XII: IN ORDER TO BE GRANTED AN AMENDMENT THERE MUST BE A SUPER-MAJORITY (75%) OF DIRECTORS IN OFFICE AND ELIGIBLE TO VOTE. FORM 990, PART VI, LINE 6 NORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE CORPORATE MEMBER OF FLAGSTAFF MEDICAL CENTER. |
| FORM 990, PART VI, LINE 7A | THE BOARD OF DIRECTORS IS DETERMINED BY THE ORGANIZATIONS MEMBER, NORTHERN ARIZONA HEALTHCARE (NAH). THE DIRECTORS AT ALL TIMES SHALL BE, AUTOMATICALLY AND WITHOUT THE NEED OF A SEPARATE ELECTION, THE INDIVIDUALS SERVING AS DIRECTORS OF NAH. |
| FORM 990, PART VI, LINE 7B | NORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE VOTING MEMBER. The following actions may be initiated by the Member in its sole and absolute discretion: a) Adoption of the consolidated annual budget for the System and any amendments b) The selection and retention of the President and Chief Executive Officer of this Corporation c) The selection of banking affiliations, accounting firms, legal counsel as well as approval of the engagement of any consultants not specifically provided for in an approved budget d) The selection of the manner and location of investment of any retained earnings e) Authorization of standing or ad hoc committees for controlled subsidiaries within the System. THE MEMBER MAY NOT TRANSFER ITS MEMBERSHIP OR ANY RIGHTS ARISING THEREFROM. |
| FORM 990, PART VI, LINE 11B | THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM BASED ON DATA GATHERED BY THE CONTROLLER AND THE ORGANIZATION'S FINANCIAL OPERATIONS GROUP. THE CFO REVIEWS THE DRAFT FORM 990 AND PROVIDES ADDITIONAL COMMENTS. THE FINAL DRAFT VERSION OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE MAY 15 DUE DATE. ANY ADDITIONAL COMMENTS SUGGESTED BY THE GOVERNING BODY ARE THEN INCORPORATED INTO THE FINAL VERSION OF THE FORM 990 TO BE FILED WITH THE IRS BY THE FINAL DUE DATE. IF ANY SUGGESTED CHANGES ARE MATERIAL OR SIGNIFICANT, AN ADDITIONAL DRAFT IS DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING. |
| FORM 990, PART VI, LINE 12C | THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY (BOARD POLICY 6.1). THIS IS ACCOMPLISHED BY A NUMBER OF MECHANISMS. FIRST, THE CONFLICT OF INTEREST QUESTIONNAIRE IS REVIEWED BY THE GOVERNANCE COMMITTEE OF THE BOARD. AS PART OF THE QUESTIONNAIRE, SELF-DISCLOSURE IS REQUIRED BY BOARD MEMBERS, OFFICERS, AND VPS. IN ADDITION, INDIVIDUAL DISCLOSURE BY BOARD MEMBERS OCCURS AT BOARD MEETINGS WHEN NECESSARY. A BOARD MEMBER MUST EXCLUDE HIMSELF OR HERSELF FROM VOTING ON AN ISSUE IN WHICH HE OR SHE MAY HAVE A CONFLICT OF INTEREST. THE CONTROLLER REVIEWS POTENTIAL CONFLICTS AND FOLLOWS UP WITH ANY ADDITIONAL QUESTIONS, IF NECESSARY. THEN THE SUMMARY OF RESPONSES AND CONFLICTS ARE BROUGHT BEFORE THE GOVERNANCE COMMITTEE, WHICH MAKES A DETERMINATION AS TO WHETHER A CONFLICT EXISTS. |
| FORM 990, PART VI, LINES 15A & 15B | THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO AND OTHER OFFICERS INCLUDES THE PREPARATION OF COMPARABLE DATA BY WILLIS TOWERS WATSON, AN INDEPENDENT CONSULTING FIRM. IN ADDITION, THIS INFORMATION IS REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD AND IS DOCUMENTED IN THE BOARD MINUTES. THE MOST RECENT REVIEW WAS PERFORMED IN SEPTEMBER 2016. |
| FORM 990, PART VI, LINE 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE ARIZONA DEPARTMENT OF HEALTH SERVICES. IN ADDITION, THEY ARE AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) AS PART OF THE ORGANIZATION'S CONTINUING DISCLOSURE DOCUMENTS THAT ARE REQUIRED BY ITS PUBLIC DEBT REQUIREMENTS. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, AS THIS IS NOT REQUIRED. FORM 990, PART VII NORTHERN ARIZONA HEALTHCARE CORPORATION (NAH) PAID $446,634 TO THE COKER GROUP HOLDINGS, LLC ("COKER") FOR THE SERVICES OF THE INTERIM CFO RICHARD LANGOSCH, WHO IS AN EMPLOYEE OF COKER GROUP. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS Increase in temporarily restricted assets $ 61,650 Additional Pension Liability $ (26,772,326) Transfers to Affiliates $ (40,234,582) -------------- TOTAL $ (66,945,258) |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TASC LLC (THRU 12312015) | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 N BEAVER ST | AddressLine1Txt |
| City | FLAGSTAFF | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860913157 | EIN |
| Primary Activities | AMBULATORY SV | PrimaryActivitiesTxt |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FMC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| NORTHERN ARIZONA HEALTHCARE | ||||||||||
| PO BOX 1268 | FLAGSTAFF | AZ | 86001 | 742410946 | HEALTHCARE | AZ | 501(C)(3) | 9 | NA | false |
| VERDE VALLEY MEDICAL CENTER | ||||||||||
| 269 SOUTH CANDY LANE | COTTONWOOD | AZ | 86326 | 860100882 | HEALTHCARE | AZ | 501(C)(3) | 3 | NAH | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |