VERDE VALLEY MEDICAL CENTER: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- VERDE VALLEY MEDICAL CENTER (EIN 86-0100882)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-13
- IRS object ID
- 201641349349307684
- Schema version
- 2014v6.0
- 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 L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-13T17:53:39-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | 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 | TWO NORTH CENTRAL AVENUE 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 | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860100882 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VERDE VALLEY MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JOHN CORTESE CPA | InCareOfNm |
| Business Name Control | VERD | BusinessNameControlTxt |
| Phone | 9286396442 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 269 SOUTH CANDY LANE | AddressLine1Txt |
| City | COTTONWOOD | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86326 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFFREY TREASURE | PersonNm |
| Person Title | NAH CFO | PersonTitleTxt |
| Phone | 9286396442 | PhoneNum |
| Signature | 2016-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRENDA GRIESEMER | PreparerPersonNm |
| PTIN | P00264669 | PTIN |
| Phone | 6023223000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | 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 | 269 SOUTH CANDY LANE | AddressLine1Txt |
| City | COTTONWOOD | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86326 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $134,503,739 | 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 | 1939 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE PATIENTS WITH EXCEPTIONAL CARE WHILE TRANSFORMING THE HEALTH OF THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 384 | TotalVolunteersCnt |
| Total Gross UBI | $327,008 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $535,050 | PYContributionsGrantsAmt |
| CY Contributions Grants | $889,167 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $125,038,068 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $126,628,973 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,681,913 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,194,364 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,974,150 | PYOtherRevenueAmt |
| CY Other Revenue | $3,596,602 | CYOtherRevenueAmt |
| PY Total Revenue | $134,229,181 | PYTotalRevenueAmt |
| CY Total Revenue | $134,309,106 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $407,141 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $488,186 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $64,727,549 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $62,139,510 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $967,675 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $63,875,714 | PYOtherExpensesAmt |
| CY Other Expenses | $65,025,996 | CYOtherExpensesAmt |
| PY Total Expenses | $129,010,404 | PYTotalExpensesAmt |
| CY Total Expenses | $127,653,692 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,218,777 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,655,414 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $242,857,215 | TotalAssetsBOYAmt |
| Total Assets EOY | $267,939,944 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $92,740,195 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $79,482,941 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $150,117,020 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $188,457,003 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO 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 | $99,246,018 | ExpenseAmt |
| Grant | $488,186 | GrantAmt |
| Revenue | $119,128,194 | RevenueAmt |
| Desc | TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. TO PROVIDE HEALTH CARE SERVICES TO THE COMMUNITY THROUGH INPATIENT, OUTPATIENT AND EMERGENCY HOSPITAL CARE AND RELATED MEDICAL SERVICES, CHARITY CARE AND COMMUNITY SERVICE. TOTAL INPATIENT DISCHARGES WERE 5,022 AND 20,707 PATIENT DAYS. OUTPATIENT VISITS APPROXIMATED 42,609 AND 24,375 EMERGENCY VISITS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,484,323 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $9,256,464 | RevenueAmt |
| Desc | TO PROVIDE EMERGENCY SERVICES, CANCER TREATMENT AND OTHER ANCILLARY SERVICES TO THE COMMUNITY THROUGH THE OPERATION OF THE VERDE VALLEY MEDICAL CENTER SEDONA CAMPUS. EMERGENCY VISITS WERE 7,087. RADIATION ONCOLOGY PROCEDURES WERE 12,666. MEDICAL IMAGING PROCEDURES WERE 9,780. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,559,928 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,435,746 | RevenueAmt |
| Desc | TO PROVIDE GERIATRIC PSYCHIATRIC SERVICES TO THE COMMUNITY THROUGH THE OPERATION OF THE SENIOR BEHAVIORAL HEALTH UNIT. DISCHARGES WERE 146 AND PATIENT DAYS 2,022. | 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 | $106,290,269 | 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 | Yes (true) | 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 | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | 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 | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | Yes (true) | 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 | 224 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | 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 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 (23 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| RON BARBER | ||||||||||
| DIRECTOR (THRU 9/14) | 2.7 | 0.0 | Yes (X) | $0 | $468 | $0 | ||||
| SAMUEL BUTMAN MD | ||||||||||
| DIRECTOR/PAST CHIEF OF STAFF | 40.0 | 0.0 | Yes (X) | $0 | $642,753 | $30,540 | ||||
| RICHARD CRANMER | ||||||||||
| DIRECTOR/PAST CHAIR | 2.7 | 3.3 | Yes (X) | $0 | $749 | $0 | Yes (X) | |||
| Barbara Dember | ||||||||||
| DIRECTOR/VVMC PRESIDENT/CEO | 40.0 | 0.0 | Yes (X) | $0 | $564,873 | $27,788 | Yes (X) | |||
| PAUL HANSON MD | ||||||||||
| DIRECTOR (THRU 9/14) | 4.4 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD KRUSE | ||||||||||
| DIRECTOR/TREASURER | 1.4 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| JAMES LEDBETTER | ||||||||||
| DIRECTOR/TREASURER | 2.4 | 0.8 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| CHARLES MARR | ||||||||||
| DIRECTOR/VICE CHAIR | 6.4 | 1.7 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| ELIZABETH MCFARLAND | ||||||||||
| DIRECTOR | 1.6 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| SHAWN ORME | ||||||||||
| DIRECTOR/CHAIR | 8.7 | 5.1 | Yes (X) | $0 | $336 | $0 | Yes (X) | |||
| JAMES PARKEL | ||||||||||
| DIRECTOR | 2.3 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| MATIAS SANDOVAL | ||||||||||
| DIRECTOR | 2.1 | 0.3 | Yes (X) | $0 | $604 | $0 | ||||
| RAY SELNA | ||||||||||
| DIRECTOR/SECRETARY | 3.2 | 3.5 | Yes (X) | $0 | $1,216 | $0 | Yes (X) | |||
| Harry Alberti | ||||||||||
| VVMC VP/CMO (THRU 12/14) | 40.0 | 0.0 | $0 | $409,842 | $33,395 | Yes (X) | ||||
| JOHN DEMPSEY | ||||||||||
| VP NAH(thru 12/14)/PRES LCMC | 0.0 | 40.0 | $0 | $469,221 | $87,567 | Yes (X) | ||||
| Susanne Maiden | ||||||||||
| CNO/VP/INTERIM CAO | 40.0 | 0.0 | $0 | $228,909 | $25,663 | Yes (X) | ||||
| Rick Peterson | ||||||||||
| VP SUPPORT SERVICES | 40.0 | 0.0 | $0 | $286,215 | $42,345 | Yes (X) | ||||
| SUZANNE BALLARD | ||||||||||
| DIRECTOR/QUALITY SYSTEMS | 40.0 | 0.0 | $0 | $160,412 | $4,234 | Yes (X) | ||||
| DEBORAH ASHBY | ||||||||||
| CLINICAL RESOURCES COORDINATOR | 40.0 | 0.0 | $0 | $159,609 | $10,619 | Yes (X) | ||||
| LORI STEVENS | ||||||||||
| DIRECTOR NURSING | 40.0 | 0.0 | $0 | $158,995 | $23,718 | Yes (X) | ||||
| REBECCA KHIN | ||||||||||
| PHARMACIST | 40.0 | 0.0 | $0 | $153,081 | $20,341 | Yes (X) | ||||
| CHARLES SECHRIST | ||||||||||
| PHARMACIST | 40.0 | 0.0 | $0 | $137,035 | $20,134 | Yes (X) | ||||
| GREGORY KUZMA | ||||||||||
| FORMER VP FINANCE/NAH CFO | 0.0 | 0.0 | $0 | $400,712 | $48,758 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,775,030 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $375,102 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 65 | IndivRcvdGreaterThan100KCnt |
| 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 |
|---|---|---|---|---|---|
| CONIFER HEALTH SOLUTIONS LLC | |||||
| 1500 S DOUGLASS RD | ANAHEIM | CA | 92806 | HEALTHCARE FIN SVCS | $1,985,026 |
| CLIMATE BUILDING TECH GROUP | |||||
| DEPT 730047 | DALLAS | TX | 75266 | HVAC SERVICES | $1,758,918 |
| MAYO COLLABORATIVE SERVICES | |||||
| PO BOX 9146 | MINNEAPOLIS | MN | 55480 | LABRATORY SERVICES | $556,989 |
| HEALTHWORKS FOUNDATION OF AZ | |||||
| PO BOX 3150 | CAMP VERDE | AZ | 86322 | HEALTH SERVICES | $331,000 |
| TRIAGE STAFFING INC | |||||
| 13934 GOLD CIRCLE | OMAHA | NE | 68144 | STAFF SUPPORT | $330,071 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 21 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $83,688 | FundraisingAmt |
| Government Grants | $262,483 | GovernmentGrantsAmt |
| All Other Contributions | $542,996 | AllOtherContributionsAmt |
| Noncash Contributions | $17,811 | NoncashContributionsAmt |
| Total Contributions | $889,167 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICES REVENUE | 621110 | $86,625,268 | $86,625,268 | |
| LABORATORY SERVICES | 621500 | $49,732,527 | $49,406,379 | $326,148 |
| LABRATORY PATHOLOGY FEES | 621500 | $3,534,528 | $3,533,668 | $860 |
| NAHPG LLC K-1 PASS THROUGH INCOME | 621110 | -$13,263,350 | -$13,263,350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $126,628,973 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,595,288 | TotalRevenueColumnAmt |
| Exclusion | $2,595,288 | 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 |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $404,368 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $404,368 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $404,368 | TotalRevenueColumnAmt |
| Exclusion | $404,368 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $758,962 | SecuritiesAmt |
| Other | $5,596 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $165,482 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $758,962 | SecuritiesAmt |
| Other | -$159,886 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $599,076 | TotalRevenueColumnAmt |
| Exclusion | $599,076 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $29,954 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $83,688 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $29,151 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $803 | TotalRevenueColumnAmt |
| Exclusion | $803 | 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 |
|---|---|---|---|
| MEANINGFUL USE INCENTIVE | 900099 | $1,540,276 | $1,540,276 |
| CAFETERIA SALES | 722514 | $590,118 | $590,118 |
| GIFT SHOP | 900099 | $222,399 | $222,399 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $838,638 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $838,638 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,191,431 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $134,309,106 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $129,493,396 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $327,008 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,599,535 | 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 | $473,741 | TotalAmt |
| Program Services | $473,741 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,445 | TotalAmt |
| Program Services | $14,445 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,489,837 | TotalAmt |
| Program Services | $1,204,523 | ProgramServicesAmt |
| Management And General | $285,314 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,475,307 | TotalAmt |
| Program Services | $40,905,806 | ProgramServicesAmt |
| Management And General | $7,360,361 | ManagementAndGeneralAmt |
| Fundraising | $209,140 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,539,522 | TotalAmt |
| Program Services | $3,781,219 | ProgramServicesAmt |
| Management And General | $737,374 | ManagementAndGeneralAmt |
| Fundraising | $20,929 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,321,486 | TotalAmt |
| Program Services | $3,599,605 | ProgramServicesAmt |
| Management And General | $701,958 | ManagementAndGeneralAmt |
| Fundraising | $19,923 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,313,358 | TotalAmt |
| Program Services | $2,759,879 | ProgramServicesAmt |
| Management And General | $538,203 | ManagementAndGeneralAmt |
| Fundraising | $15,276 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240,551 | TotalAmt |
| Program Services | $161,521 | ProgramServicesAmt |
| Management And General | $79,030 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,292 | TotalAmt |
| Management And General | $116,292 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,005 | TotalAmt |
| Management And General | $30,005 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,585,838 | TotalAmt |
| Program Services | $3,135,502 | ProgramServicesAmt |
| Management And General | $2,875,055 | ManagementAndGeneralAmt |
| Fundraising | $575,281 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,594 | TotalAmt |
| Program Services | $23,686 | ProgramServicesAmt |
| Management And General | $150,989 | ManagementAndGeneralAmt |
| Fundraising | $60,919 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,100,285 | TotalAmt |
| Program Services | $4,780,887 | ProgramServicesAmt |
| Management And General | $2,293,676 | ManagementAndGeneralAmt |
| Fundraising | $25,722 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,032,905 | TotalAmt |
| Program Services | $1,909,628 | ProgramServicesAmt |
| Management And General | $110,273 | ManagementAndGeneralAmt |
| Fundraising | $13,004 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $370,818 | TotalAmt |
| Program Services | $145,487 | ProgramServicesAmt |
| Management And General | $218,564 | ManagementAndGeneralAmt |
| Fundraising | $6,767 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $641,060 | TotalAmt |
| Program Services | $516,356 | ProgramServicesAmt |
| Management And General | $124,704 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,224,908 | TotalAmt |
| Program Services | $7,119,793 | ProgramServicesAmt |
| Management And General | $1,098,998 | ManagementAndGeneralAmt |
| Fundraising | $6,117 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,141,356 | TotalAmt |
| Program Services | $974,830 | ProgramServicesAmt |
| Management And General | $166,526 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| EXP REIMBURSEMENT TO NAH | $17,605,176 | $16,497,064 | $1,104,585 | $3,527 |
| MEDICAL SUPPLIES | $15,130,953 | $15,130,953 | ||
| REGISTRATION SERVICES | $2,003,276 | $2,003,276 | ||
| AIR AMBULANCE PURCHASE SVCS | $1,155,441 | $1,155,441 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,411,538 | TotalAmt |
| Program Services | $1,999,903 | ProgramServicesAmt |
| Management And General | $400,565 | ManagementAndGeneralAmt |
| Fundraising | $11,070 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,653,692 | TotalAmt |
| Program Services | $106,290,269 | ProgramServicesAmt |
| Management And General | $20,395,748 | ManagementAndGeneralAmt |
| Fundraising | $967,675 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,425 | BOYAmt |
| EOY | $4,895 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,655,439 | BOYAmt |
| EOY | $22,951,814 | 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 | $24,928,044 | BOYAmt |
| EOY | $19,821,011 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,695,702 | BOYAmt |
| EOY | $2,628,715 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,304,007 | BOYAmt |
| EOY | $1,932,581 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $172,026,185 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $104,283,444 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,145,829 | BOYAmt |
| EOY | $67,742,741 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,234,031 | BOYAmt |
| EOY | $134,004,559 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $1,916,526 | BOYAmt |
| EOY | $1,916,526 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,975,212 | BOYAmt |
| EOY | $16,937,102 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $242,857,215 | BOYAmt |
| EOY | $267,939,944 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,376,836 | BOYAmt |
| EOY | $15,449,630 | 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 | $50,283,164 | BOYAmt |
| EOY | $48,912,721 | 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 | $0 | BOYAmt |
| EOY | $0 | 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 | $22,080,195 | BOYAmt |
| EOY | $15,120,590 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,740,195 | BOYAmt |
| EOY | $79,482,941 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,117,020 | BOYAmt |
| EOY | $188,457,003 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $150,117,020 | BOYAmt |
| EOY | $188,457,003 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $242,857,215 | BOYAmt |
| EOY | $267,939,944 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,655,414 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,142,513 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $32,827,082 | 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 |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $30,005 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $30,005 | 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 1F | FormAndLineReferenceDesc |
| Explanation | VERDE VALLEY MEDICAL CENTER PAID DUES TO THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION. A PERCENTAGE OF THIS AMOUNT, $30,005, WAS ESTIMATED TO BE ATTRIBUTABLE TO LOBBYING RELATED TO HEALTH CARE ADVOCACY AT THE FEDERAL, STATE, REGIONAL, AND LOCAL LEVELS. | 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 | $3,984,487 | BeginningYearBalanceAmt |
| Contributions | $1,113,890 | ContributionsAmt |
| Investment Earnings Or Losses | $64,455 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $9,445 | GrantsOrScholarshipsAmt |
| Other Expenditures | $929,756 | OtherExpendituresAmt |
| Administrative Expenses | $67,283 | AdministrativeExpensesAmt |
| End Year Balance | $4,156,348 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,633,768 | BeginningYearBalanceAmt |
| Contributions | $528,277 | ContributionsAmt |
| Investment Earnings Or Losses | $418,492 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $6,902 | GrantsOrScholarshipsAmt |
| Other Expenditures | $529,321 | OtherExpendituresAmt |
| Administrative Expenses | $59,827 | AdministrativeExpensesAmt |
| End Year Balance | $3,984,487 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Minus2 Yr Endwmt Fund | CYMinus2YrEndwmtFundGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| 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 | $3,746,702 | OtherCostOrOtherBasisAmt |
| Book Value | $3,746,702 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $93,247,223 | OtherCostOrOtherBasisAmt |
| Depreciation | $56,443,081 | DepreciationAmt |
| Book Value | $36,804,142 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $486,836 | OtherCostOrOtherBasisAmt |
| Depreciation | $150,575 | DepreciationAmt |
| Book Value | $336,261 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $54,660,529 | OtherCostOrOtherBasisAmt |
| Depreciation | $43,404,092 | DepreciationAmt |
| Book Value | $11,256,437 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,884,895 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,285,696 | DepreciationAmt |
| Book Value | $15,599,199 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $67,742,741 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (10 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| VVMC INVESTMENT TO NAHPG | $11,173,972 |
| LAND HELD FOR FUTURE USE | $4,957,655 |
| UNAMORTIZED BOND ISSUE COST | $420,002 |
| SPLIT DOLLAR PLAN | $215,232 |
| SMC DONATED ART | $133,530 |
| GAAP PRESENTATION OF INS | $65,778 |
| CANCER CENTER DONATED ART | $10,256 |
| SECURITY DEPOSITS | $9,000 |
| SEVEN CANYONS CLUB MEMBERSHIP | $5,000 |
| APS REFUNDABLE REBATES | -$53,323 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $16,937,102 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| MINIMUM PENSION LIABILITY | $13,547,377 |
| MALPRACTICE RESERVE | $1,573,213 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $15,120,590 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | ENDOWMENT FUNDS ARE INTENDED TO: (1) ADDRESS COMMUNITY HEALTH CARE NEEDS; (2) ADHERE TO THE CORE MISSION OF THE HOSPITAL; 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 | COPPER BALL | Event1Nm |
| Gross Receipts Event1 | $93,371 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $65,993 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $27,378 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $24,785 | FoodAndBeverageEvent1Amt |
| Event2 | LOVEN 5K RUN | Event2Nm |
| Gross Receipts Event2 | $20,271 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $17,695 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $2,576 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $2,126 | NonCashPrizesEvent2Amt |
| Food And Beverage Event2 | $2,240 | FoodAndBeverageEvent2Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $113,642 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $83,688 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $29,954 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $2,126 | NonCashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $27,025 | FoodAndBeverageTotalEventsAmt |
| Direct Expense Summary Events | $29,151 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $803 | 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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 0 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 0 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | false | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| 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 | $227,443 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $227,443 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,853,248 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,664,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,189,248 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05630 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,080,691 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,664,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,416,691 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05820 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $628,713 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $628,713 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00490 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,131,569 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,131,569 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01670 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $108,657 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $108,657 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $405,467 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $405,467 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,274,406 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,274,406 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02570 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,355,097 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,664,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,691,097 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08390 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 12 | PersonsServedCnt |
| Total Community Benefit Expns | $1,131 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,131 | NetCommunityBenefitExpnsAmt |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2332 | ActivitiesOrProgramsCnt |
| Persons Served | 4109 | PersonsServedCnt |
| Total Community Benefit Expns | $215,689 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $215,689 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 12 | PersonsServedCnt |
| Total Community Benefit Expns | $2,192 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,192 | NetCommunityBenefitExpnsAmt |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 315 | PersonsServedCnt |
| Total Community Benefit Expns | $7,047 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,047 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 42735 | PersonsServedCnt |
| Total Community Benefit Expns | $252,879 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $252,879 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $246,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $246,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2358 | ActivitiesOrProgramsCnt |
| Persons Served | 47183 | PersonsServedCnt |
| Total Community Benefit Expns | $724,938 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $724,938 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00570 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,281,949 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $227,423 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $77,282,000 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $86,617,273 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$9,335,273 | 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 | VERDE VALLEY MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 269 S CANDY LANE | AddressLine1Txt |
| City | COTTONWOOD | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86326 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.nahealth.com | WebsiteAddressTxt |
| State License | H0122 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VERDE VALLEY 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 | Yes (true) | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | HTTP://VERDEVALLEY.HEALTHFORECAST.NET/ | OtherWebsiteURLTxt |
| 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 |
| Strategy Attached | false | StrategyAttachedInd |
| 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 | 125. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 175. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 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 |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, A FOCUS GROUP WAS HELD IN NOVEMBER 2015. AMONG 17 KEY INFORMANTS IN THE COMMUNITY, INCLUDING: 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 VERDE VALLEY 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 A REPRESENTATIVE 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. |
| SCHEDULE H, PART V, SECTION B, LINE 6a | THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED IN CONJUNCTION WITH ITS RELATED HOSPITAL FACILITY, FLAGSTAFF MEDICAL CENTER. SCHEDULE H, PART V, SECTION B, 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, PART V, SECTION B, LINE 10A | THE 2016 IMPLEMENTATION STRATEGY IS AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://NAHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| SCHEDULE H, PART V, SECTION B, LINE 11 | VERDE VALLEY MEDICAL CENTER FOCUSES ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INTIATIVES TO IMPROVE ACCESS TO HEALTH SERVICES, HEART DISEASE, RESPIRATORY DISEASE, AND IMMUNIZATIONS. HEALTH PRIORITIES NOT CHOSEN AND REASON: SUBSTANCE ABUSE - VVMC HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS ALCOHOL, TOBACCO AND OTHER DRUG ISSUES. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. FAMILY PLANNING - VVMC BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. ARTHRITIS, OSTEOPOROSIS & CHRONIC BACK CONDITIONS - VVMC OFFERS PHYSICAL THERAPY AND JOINT REPLACEMENT CLASSES. HOWEVER THE PREVENTION OF THESE CONDITIONS IS ADDRESSED BY THE STATE AND COUNTY HEALTH DEPARTMENTS, SO WE HAVE EXCLUDED THIS AREA AS CHOSEN FOR ACTION. ORAL HEALTH - VVMC BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. INJURY & VIOLENCE PREVENTION - VVMC BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 8 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| VVMC SEDONA CAMPUS | ||||
| 3700 WEST HIGHWAY 89A | SEDONA | AZ | 86366 | PHYSICIAN OFFICES, LAB, X-RAY, AND EMERGENCY SERVICES |
| VVMC AMBULATORY CENTER | ||||
| 300 WEST HIGHWAY 89A | COTTONWOOD | AZ | 86336 | SURGERY ENDOSCOPY |
| VV MEDICAL IMAGING CENTER | ||||
| 450 S WILLARD ST SUITE 109 111 1 | COTTONWOOD | AZ | 86336 | X-RAY LAB |
| VVMC MOB | ||||
| 294 WEST HIGHWAY 89A | COTTONWOOD | AZ | 86336 | PHYSICIAN OFFICES SLEEP LAB |
| CAMP VERDE HEALTH CENTER | ||||
| 460 FINNEY FLATS ROAD | CAMP VERDE | AZ | 86322 | OFFICE X-RAY LAB PHYSICAL THERAPY |
| VOC MOB | ||||
| 61 BELL ROCK PLAZA | SEDONA | AZ | 86351 | PHYSICIAN OFFICES |
| NAHPG - EMPLOYED PHYSICIAN OFFICE | ||||
| 450 WILLARD ST STE 101 107 | COTTONWOOD | AZ | 86336 | PHYSICIAN OFFICE |
| NAHPG - FAMILY PRACTICE PHYSICIAN OFFICE | ||||
| 199 S CANDY LANE STE 1A | COTTONWOOD | AZ | 86326 | PHYSICIAN OFFICE |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 3A | EXPLANATION FOR VARIOUS PERCENTAGES USED: 100% OF THE FEDERAL POVERTY LEVEL = 100% CHARITY WRITE OFF. SCHEDULE H, PART I, LINE 3B EXPLANATION FOR VARIOUS PERCENTAGES USED: 125% OF THE FEDERAL POVERTY LEVEL = 100% CHARITY WRITE-OFF. 150% OF FPL = 75% WRITE-OFF. 175% OF FPG = 50% WRITE-OFF. 200% OF FPG = 25% WRITE-OFF. 300% OF FPG = 15% WRITE-OFF. SCHEDULE H, PART I, LINE 3C FINANCIAL ASSISTANCE 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. OTHER CONSIDERATIONS SUCH AS DISPOSABLE ASSETS ARE CONSIDERED IN THE EVALUATION OF ELIGIBILITY. A DISPOSABLE ASSET MAY BE EXPENSIVE JEWELRY, PLEASURE HORSES, RECREATIONAL VEHICLES, ETC. |
| SCHEDULE H, PART I, LINE 6A | THE INFORMATION FOR THE COMMUNITY BENEFITS REPORT IS GATHERED BY THE COMMUNITY RELATIONS 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 HTTP:VERDEVALLEY.HEALTHFORECAST.NET. |
| SCHEDULE H, PART I, LINE 7 | VERDE VALLEY 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 A FOCUS AT VERDE VALLEY MEDICAL CENTER. COMMUNITY BUILDING IS ADVANCED BY VERDE VALLEY MEDICAL CENTER THROUGH ITS SUPPORT OF PHYSICIAN RECRUITMENT AND WORK WITH VARIOUS COMMUNITY ORGANIZATIONS INCLUDING LOCAL SCHOOLS, THE COTTONWOOD AND SEDONA CHAMBER OF COMMERCE, AND THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION. SCHEDULE H, PART III, LINE 2 BAD DEBT AMOUNTS ARE FROM THE BILLING SOFTWARE AND A MONTHLY CALCULATED AMOUNT BASED ON THE ACCOUNTS RECEIVABLE BALANCES BY FINANCIAL CLASS - PRIMARILY SELF-PAY. ACCOUNTS REFERRED TO BAD DEBT AS DEFINED IN NORTHERN ARIZONA HEALTHCARE POLICY ARE AUTOMATICALLY ADJUSTED BY A FILE UPLOAD PROCESS USING A DEDICATED TRANSACTION CODE. |
| SCHEDULE H, PART III, LINE 3 | THE ACTUAL CHARITY CARE AMOUNTS ARE FROM THE BILLING SOFTWARE WHICH IDENTIFIES THE AMOUNTS THAT ARE DIRECTLY RELATED TO PATIENTS WHO QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY (FAP). THE FINANCIAL ASSISTANCE ADJUSTMENT PERCENTAGE IS DETERMINED BASED UPON THE FEDERAL POVERTY LINE GRID AS DEFINED IN NORTHERN ARIZONA HEALTHCARE'S FAP. THE ADJUSTMENT IS MANUALLY ENTERED INTO THE BILLING SOFTWARE WITH A DEDICATED TRANSACTION CODE. REMAINING BALANCES ARE THE RESPONSIBILITY OF THE PATIENT. SCHEDULE H, PART III, LINE 4 FOOTNOTE 2 TO THE FINANCIAL STATEMENTS INDICATES NET PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE HAVE BEEN ADJUSTED TO THE ESTIMATED AMOUNTS EXPECTED TO BE RECEIVED. THESE ESTIMATED AMOUNTS ARE SUBJECT TO FURTHER ADJUSTMENTS UPON REVIEW BY THIRD-PARTY PAYORS. MANAGEMENT ESTIMATES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON THE HISTORICAL COLLECTION EXPERIENCE SUBJECT TO FURTHER ADJUSTMENTS UPON REVIEW BY THIRD-PARTY PAYORS. MANAGEMENT ESTIMATES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON THE HISTORICAL COLLECTION EXPERIENCE. |
| SCHEDULE H, PART III, LINE 8 | THE ENTIRE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE OUR MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, WHETHER OR NOT THIS SERVICE IS PROVIDED AT A LOSS TO THE HOSPITAL. MEDICARE IS A LARGE PORTION OF THE HOSPITAL'S GROSS PAYOR MIX (62%) AND IS A SIGNIFICANT LOSS FOR A 99-BED SOLE COMMUNITY HOSPITAL. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SIGNIFICANT LOSS AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST OF THE MEDICARE BENEFICIARIES. MANY OF THESE PATIENTS WOULD QUALIFY FOR CHARITY CARE IF THEY WERE NOT IN THE MEDICARE PROGRAM. THE MEDICARE AMOUNTS WERE OBTAINED FROM THE PD&R AND COST REPORT. |
| SCHEDULE H, PART III, LINE 9B | ACCORDING TO OUR CHARITY CARE POLICY, THE 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 CHARITY CARE CONSIDERATION. THE PATIENT DOESN'T QUALIFY FOR CHARITY CARE ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR 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. |
| SCHEDULE H, PART VI, LINE 2 | VERDE VALLEY MEDICAL CENTER ASSESSES COMMUNITY HEALTHCARE NEEDS THROUGH A SURVEY DESIGNED AND ADMINISTERED BY PROFESSIONAL RESEARCH CONSULTANTS, INC. THIS SURVEY WAS LAST CONDUCTED IN 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 | THE VERDE VALLEY MEDICAL CENTER (VVMC) WEBSITE HAS A BILLING CONTACT NUMBER. BEFORE PRE-ADMISSION, PATIENTS ARE CONTACTED BY VVMC'S CASHIER. WHEN PATIENTS ARE CONTACTED, THEY ARE EDUCATED OF THE FINANCIAL ASSISTANCE POLICY. VVMC FINANCIAL COUNSELORS ASSIGNED TO EACH NURSING UNIT ARE ABLE TO ANSWER OR ASSIST WITH BILLING QUESTIONS. AT EACH PATIENT REGISTRATION DESK ARE DISPLAYS AND BROCHURES OF THE BILLING INFORMATION, INCLUDING THE FINANCIAL ASSISTANCE POLICY. ACCORDING TO THE POLICY, THE FINANCIAL COUNSELORS ASSESS THE PATIENTS' 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 CHARITY CARE CONSIDERATION. IF THE PATIENT DOESN'T QUALIFY FOR CHARITY CARE ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR 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. |
| SCHEDULE H, PART VI, LINE 4 | VERDE VALLEY MEDICAL CENTER IS A 99-BED ADULT AND PEDIATRIC SOLE COMMUNITY HOSPITAL AND 11-BED GERIATRIC PSYCHIATRY. THE HOSPITAL IS LOCATED IN COTTONWOOD, ARIZONA BUT THE PRIMARY SERVICE AREA INCLUDES COTTONWOOD, CLARKDALE, JEROME, SEDONA, VILLAGE OF OAK CREEK, RIMROCK, CAMP VERDE, LAKE MONTEZUMA, AND CORNVILLE WHICH COVERS APPROXIMATELY A 50-SQUARE MILE SPAN. THE CLOSEST HOSPITAL TO THE NORTH IS FLAGSTAFF MEDICAL CENTER (VVMC AFFILIATE) WHICH IS 70 MILES. THE CLOSEST HOSPITAL TO THE SOUTH IS 40 MILES. THE POPULATION IN THE PRIMARY SERVICE AREA IS APPROXIMATELY 73,000. THE HOSPITAL GROSS PAYOR MIX IS AS FOLLOWS: MEDICARE 62%, AHCCCS/MEDICAID 18%, COMMERCIAL/OTHER 16%, AND SELF PAY 4%. VERDE VALLEY MEDICAL CENTER IS THE LARGEST EMPLOYER IN THE COMMUNITY. THE PRIMARY SERVICE AREA DOES NOT HAVE MUCH INDUSTRY AND THE COMMUNITY HAS MANY SMALL BUSINESS ORGANIZATIONS. |
| SCHEDULE H, PART VI, LINE 5 | COMMUNITY HEALTH AND COMMUNITY BUILDING ARE A FOCUS AT VERDE VALLEY MEDICAL CENTER AS EVIDENCED BY THE NUMEROUS ACTIVITIES SPONSORED EACH YEAR. THE CANCER CENTER AT SEDONA CAMPUS HOSTS A SERIES OF FREE OR LOW-COST SCREENINGS DESIGNED TO HELP RESIDENTS IN THE COMMUNITY DETECT ISSUES AS SOON AS POSSIBLE. 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 VERDE VALLEY MEDICAL CENTERS'S PREMIER COMMUNITY HEALTH INITIATIVES. COMMUNITY BUILDING IS ADVANCED BY VERDE VALLEY MEDICAL CENTER THROUGH ITS SUPPORT OF PHYSICIAN RECRUITMENT AND WORK WITH VARIOUS COMMUNITY ORGANIZATIONS INCLUDING THE COTTONWOOD AND SEDONA CHAMBER OF COMMERCE AND THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION. |
| SCHEDULE H, PART VI, LINE 6 | VERDE VALLEY MEDICAL CENTER IS AFFILIATED WITH FLAGSTAFF 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 (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|---|---|---|---|---|
| Camp Verde School District | ||||||||||
| 410 Camp Lincoln Rd | Camp Verde | AZ | 86322 | 866003046 | school | $28,969 | FIT KIDS AT SCHOOL | |||
| City of Cottonwood | ||||||||||
| 827 N Main St | Cottonwood | AZ | 86326 | 866007877 | government | $13,500 | LOOKIN' GOOD COTTONWOOD & MEMORIAL RUN | |||
| Connections Equine Therapy | ||||||||||
| 11585 E Purple Sage Rd | Cornville | AZ | 86325 | 860987445 | 501(C)(3) | $9,500 | SERVICE & PROGRAM EXPANSION | |||
| Cottonwood-Oak Creek School District | ||||||||||
| 1 N Willard St | Cottonwood | AZ | 86326 | 866000563 | school | $66,742 | HEALTH AIDS, SCREENING, DISTRICT NURSE, COHORT CLASS, FIT KIDS AT SCHOOL PROGRAM | |||
| Mingus Union High School | ||||||||||
| 1801 E Fir St | Cottonwood | AZ | 86326 | 866006215 | school | $48,545 | Verde Valley School Nurse Program | |||
| Sedona Chamber of Commerce | ||||||||||
| PO BOX 72 | SEDONA | AZ | 86339 | 860134659 | 501(C)(6) | $20,000 | SCF - Title sponsor for Sedona Marathon | |||
| Sedona Community Center | ||||||||||
| 2615 MELODY LN | Sedona | AZ | 86336 | 860491174 | 501(C)(3) | $7,253 | SCF - The Breakfast Club | |||
| Sedona Community Food Bank | ||||||||||
| PO BOX 3962 | Sedona | AZ | 86340 | 860922917 | 501(C)(3) | $9,500 | SCF - sponsorship | |||
| Sedona International Film Festival | ||||||||||
| 2030 ARIZONA 89A | Sedona | AZ | 86336 | 200351857 | 501(C)(3) | $7,000 | Sponsor | |||
| Verde Valley Little League | ||||||||||
| 457 MINERDS GULCH DR | CLARKDALE | AZ | 86324 | 860508848 | 501(c)(3) | $10,000 | Safety fence | |||
| Verde Valley Senior Center | ||||||||||
| PO BOX 681 | COTTONWOOD | AZ | 86326 | 860328194 | 501(C)(3) | $12,000 | "LUCKY 7" GOLF TOURNAMENT; CHRISTMAS LUNCHEON; MARCH-A-MILE FOR MEALS SPONSOR; A "MAGICAL JUBILEE" | |||
| Verde Valley Caregivers | ||||||||||
| 299 VAN DEREN RD SUITE 2 | SEDONA | AZ | 86336 | 860725787 | 501(C)(3) | $140,000 | SUPPORT IN-HOME ASSISTANCE PROGRAM (135,000), SPONSORSHIP (5,000) | |||
| Yavapai County Wellness Clinic | ||||||||||
| 1090 COMMERCE DR | PRESCOTT | AZ | 86305 | 866000561 | GOVERNMENT | $0 | PROVIDE LAB & MEDICAL IMAGING SERVICES TO LOW INCOME PATIENTS | $70,731 | FMV | LAB SERVICES |
| Yavapai College | ||||||||||
| 1100 E SHELDON | PRESCOTT | AZ | 86301 | 237232985 | SCHOOL | $27,500 | Faculty support & scholarship funding | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 13 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Nursing Scholarships | GrantTypeTxt |
| Recipient | 6 | RecipientCnt |
| Cash Grant | $9,445 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | -YAVAPAI COLLEGE: MONITOR SCHOOL PROGRAM AND MAKE SURE THEY HAVE THE APPROPRIATE INSTRUCTORS AND OTHER EMPLOYEES PER THE AGREEMENT. -YAVAPAI COMMUNITY WELLNESS CENTER: PATIENTS' INCOMES ARE SCREENED BY THE COUNTY FOR THOSE QUALIFIED TO RECEIVE FREE SERVICES, PATIENTS ARE IDENTIFIED ON PRESCRIPTIONS FOR LAB AND RADIOLOGY SERVICES, THEY ARE REGISTERED UNDER THE COUNTY AND TOTAL DOLLARS USED IS ACCUMULATED IN THE SYSTEM. DONATIONS TO OTHER TAX-EXEMPT ENTITIES ARE MADE IN SUPPORT OF THEIR MISSIONS AND VVMC RELIES UPON THE GOVERNANCE PRACTICES OF RECIPIENT ORGANIZATIONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | 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 (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Harry Alberti | ||||||||||||||
| VVMC VP/CMO (THRU 12/14) | $0 | $308,072 | $0 | $99,726 | $0 | $2,044 | $0 | $5,200 | $0 | $28,195 | $0 | $443,237 | $0 | $0 |
| SAMUEL BUTMAN MD | ||||||||||||||
| DIRECTOR/PAST CHIEF OF STAFF | $0 | $638,910 | $0 | $0 | $0 | $3,843 | $0 | $10,400 | $0 | $20,140 | $0 | $673,293 | $0 | $0 |
| Barbara Dember | ||||||||||||||
| DIRECTOR/VVMC PRESIDENT/CEO | $0 | $369,029 | $0 | $123,679 | $0 | $72,165 | $0 | $10,400 | $0 | $17,388 | $0 | $592,661 | $0 | $37,209 |
| JOHN DEMPSEY | ||||||||||||||
| VP NAH(thru 12/14)/PRES LCMC | $0 | $368,579 | $0 | $53,608 | $0 | $47,034 | $0 | $59,970 | $0 | $27,597 | $0 | $556,788 | $0 | $0 |
| GREGORY KUZMA | ||||||||||||||
| FORMER VP FINANCE/NAH CFO | $0 | $127,368 | $0 | $0 | $0 | $273,344 | $0 | $46,414 | $0 | $2,344 | $0 | $449,470 | $0 | $0 |
| Susanne Maiden | ||||||||||||||
| CNO/VP/INTERIM CAO | $0 | $187,469 | $0 | $30,283 | $0 | $11,157 | $0 | $9,035 | $0 | $16,628 | $0 | $254,572 | $0 | $0 |
| Rick Peterson | ||||||||||||||
| VP SUPPORT SERVICES | $0 | $195,880 | $0 | $77,739 | $0 | $12,596 | $0 | $10,400 | $0 | $31,945 | $0 | $328,560 | $0 | $0 |
| SUZANNE BALLARD | ||||||||||||||
| DIRECTOR/QUALITY SYSTEMS | $0 | $147,124 | $0 | $12,490 | $0 | $798 | $0 | $3,213 | $0 | $1,021 | $0 | $164,646 | $0 | $0 |
| DEBORAH ASHBY | ||||||||||||||
| CLINICAL RESOURCES COORDINATOR | $0 | $127,339 | $0 | $9,865 | $0 | $22,405 | $0 | $0 | $0 | $10,619 | $0 | $170,228 | $0 | $0 |
| LORI STEVENS | ||||||||||||||
| DIRECTOR NURSING | $0 | $129,566 | $0 | $12,673 | $0 | $16,756 | $0 | $6,506 | $0 | $17,212 | $0 | $182,713 | $0 | $0 |
| REBECCA KHIN | ||||||||||||||
| PHARMACIST | $0 | $138,787 | $0 | $3,501 | $0 | $10,793 | $0 | $0 | $0 | $20,341 | $0 | $173,422 | $0 | $0 |
| CHARLES SECHRIST | ||||||||||||||
| PHARMACIST | $0 | $114,701 | $0 | $4,824 | $0 | $17,510 | $0 | $0 | $0 | $20,134 | $0 | $157,169 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1 A/B | ALL COMPENSATION, BENEFITS AND REIMBURSEMENTS ARE PAID BY NORTHERN ARIZONA HEALTHCARE CORPORATION, THE PARENT ORGANIZATION. BOARD MEMBER AND OFFICER BUSINESS TRAVEL EXPENSES, SUCH AS AIRLINE AND MEALS, FOR SPOUSES WERE PAID AND INFORMATION GATHERED FOR W-2 AND 1099 REPORTING. GROSS UP OF TAXES IS DONE ON ALL EMPLOYEE GIFT CERTIFICATES. THE BOARD MEMBER AND OFFICER BUSINESS TRAVEL EXPENSES ARE APPROVED BY NEXT HIGHEST LEVEL. AMOUNTS PAID BY THE PARENT (NAH) FOR "COMPANION TRAVEL" FOR SPOUSES OF THE DIRECTORS WERE AS FOLLOWS: RAY SELNA $1,216 RICHARD CRANMER $ 749 MATIAS SANDOVAL $ 604 RON BARBER $ 468 SHAWN ORME $ 336 SAMUEL BUTMAN, md $ 286 |
| 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, recommendation of compensation committee to Board for approval. SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS WERE MADE AS FOLLOWS: GREGORY KUZMA $273,115 |
| 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 ORGANIZATIONAL GOALS. |
| SCHEDULE J, PART II | THE FOLLOWING INDIVIDUALS PARTICIPATED 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: GREGORY KUZMA $ 46,242 |
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 YAVAPAI COUNTY | ||||||||
| A | 860376099 | 985900CX5 | 2011-10-12 | $13,829,141 | SEE PART VI | false | false | false |
| INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY | ||||||||
| B | 860376099 | 2015-06-30 | $37,340,563 | 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 | $13,829,141 | $0 | $0 | $0 | $133,606 | $0 | $0 | $0 | $13,695,535 | $0 | 2011 | Yes (true) | false | Yes (true) | Yes (true) |
| B | $0 | $0 | $37,340,563 | $0 | $0 | $37,002,552 | $338,010 | $0 | $0 | $0 | $0 | $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 BONDS. 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. 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 FLAGSTAFF MEDICAL CENTER (FMC), $9,274,438 TO VERDE VALLEY MEDICAL CENTER, 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 ACQUISTION OF SUMMIT SURGERY CENTER. TOTAL ISSUANCE PRICE OF SERIES 2015B WAS $45,615,000 WHICH WAS ALLOCATED $17,569,850 TO FLAGSTAFF MEDICAL CENTER (FMC) AND $28,066,125 TO VERDE VALLEY MEDICAL CENTER. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| LEDBETTER LAW FIRM | |||
| JAMES LEDBETTER/DIRECTOR | $154,451 | LEGAL SERVICES | false |
| CELESTE CORREA | |||
| HARRY ALBERTI/SPOUSE | $139,839 | EMPLOYEE COMPENSATION | false |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 9 | ContributionCnt |
| Noncash Contributions Rpt F990 | $4,640 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | 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 | $2,736 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $1,671 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | 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 | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $45 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | 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 (3 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | FLOWER DISPLAY CASE | 1 | $4,350 | FMV |
| Yes (X) | Gift Certificates | 44 | $3,668 | FMV |
| Yes (X) | MISCELLANEOUS ITEMS | 24 | $701 | FMV |
| 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). | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 6 | VOLUNTEERS WORK IN ALMOST EVERY DEPARTMENT IN THE HOSPITAL AND AT OUR OFFSITE LOCATIONS, SUCH AS VERDE VALLEY MEDICAL CENTER (VVMC) SEDONA CAMPUS, CAMP VERDE, AND VILLAGE OF OAK CREEK. THEY PERFORM CLERICAL AND RECEPTION DUTIES IN MANY DEPARTMENTS, SERVE AS PATIENT AND VISITOR GREETERS, SUPPLY DISTRIBUTION, LANDSCAPING, NUTRITIONAL SERVICES - PASS TRAYS, PARTICIPATE IN VARIOUS ACTIVITIES WITH THE SENIOR BEHAVIORAL HEALTH PATIENTS, LIBRARY, TRANSPORT, AND MAKE PILLOWS AND TEDDY BEARS (CRAFTS). FORM 990, PART V, LINE 2A; PART VII, SECTION A, AND PART IX VERDE VALLEY 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. |
| FORM 990, PART VI, LINE 1 | THE BOARD OF DIRECTORS DELEGATES AUTHORITY TO AN EXECUTIVE COMMITTEE. THE MEMBERS OF THE EXECUTIVE COMMITTEE INCLUDE THE BOARD OFFICERS, THE PRESIDENT, THE IMMEDIATE PAST CHIEF OF STAFF OF THE MEDICAL STAFF AND ANY OTHER PARTY THE BOARD OF DIRECTOR APPOINTS. THE EXECUTIVE COMMITTEE POSSESSES AND MAY EXERCISE THE POWERS OF THE BOARD OF DIRECTORS IN BETWEEN MEETINGS. THE EXECUTIVE COMMITTEE DOES NOT POSSESS THE AUTHORITY TO REMOVE ANY DIRECTOR, FIX DIRECTOR COMPENSATION, EXERCISE ANY RESERVED POWER WHICH REQUIRES SUBSIDIARY BAORD APPROVAL, OR ANY EXERCISE ANY AUTHORITY PROHIBITED BY LAW. FORM 990, PART VI, LINE 6 NORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE CORPORATE MEMBER OF VERDE VALLEY MEDICAL CENTER. |
| FORM 990, PART VI, LINE 7A | THE VERDE VALLEY MEDICAL CENTER (VVMC) GOVERNANCE COMMITTEE NOMINATES FOR POSITIONS ON THE VVMC BOARD OF DIRECTORS. DIRECTORS ARE ELECTED BY THE BOARD OF DIRECTORS OF THE SOLE CORPORATE MEMBER, NORTHERN ARIZONA HEALTHCARE CORPORATION (NAHC) FROM THE NOMINATIONS THAT HAVE BEEN PROVIDED. NAHC ELECTS THOSE PERSONS NOMINATED UNLESS THE BOARD OF DIRECTORS OF THE NAHC BY A SUPER MAJORITY VOTE DETERMINES THAT A NOMINEE'S ELECTION WOULD BE DETRIMENTAL TO THE BEST INTERESTS OF VVMC OR NAHC. |
| FORM 990, PART VI, LINE 7B | AS SOLE CORPORATE MEMBER, NORTHERN ARIZONA HEALTHCARE CORPORATION (NAHC) APPROVES THE BOARD OF DIRECTORS THAT ARE ELECTED BY THIS ENTITY. ALSO AS SOLE CORPORATE MEMBER, NAHC HAS RESERVED THE RIGHT AND AUTHORITY TO APPROVE OR DISAPPROVE THOSE ACTS OR POWERS AS SET FORTH IN THE "RESERVED POWERS CHART" THAT IS PART OF THE BYLAWS. |
| FORM 990, PART VI, LINE 11 | 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 AND KEY OFFICERS AT A BOARD MEETING HELD PRIOR TO THE MAY 15 DUE DATE FOR THE FORM 990. A REPRESENTATIVE FROM THE ACCOUNTING FIRM ATTENDS THE MEETING AND EXPLAINS SOME OF THE SIGNIFICANT DISCLOSURES IN THE FORM 990. 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 CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AND REQUIRES DISCLOSURE OF CHANGES IN CIRCUMSTANCES - NEW JOB/POSITION OR BUSINESS, SIGNIFICANT PURCHASE/SALE OF PROPERTY, SIGNIFICANT INVESTMENT CHANGE. THE BOARD OF DIRECTORS AND CEO FILL OUT THE BOARD CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS REVIEWED BY THE LEGAL DEPARTMENT. THE RESTRICTIONS IMPOSED WOULD DEPEND WHAT THE CONFLICT IS; HOWEVER, IF A DISCUSSION PURSUES AND A BOARD MEMBER HAS A CONFLICT IDENTIFIED BY HIM AND OTHERS, THE DIRECTOR WILL LEAVE THE ROOM. THE DIRECTORS AND VPS ALSO HAVE A POLICY AND QUESTIONNAIRE THAT IS FILLED OUT ANNUALLY. ANY YES RESPONSE IS SIGNALED BY SYSTEM TO SEND TO LEGAL FOR REVIEW. |
| FORM 990, PART VI, LINES 15A & 15B | DETERMINATION OF CEO SALARY IS GUIDED BY INDEPENDENT PERSONS, INVOLVING A BOARD-DESIGNATED COMPENSATION COMMITTEE THAT MAKES A RECOMMENDATION TO THE BOARD; BASED UPON BOARD DEVELOPED AND APPROVED COMPENSATION PHILOSOPHY; DERIVED FROM NATIONWIDE COMPARABLE DATA THAT IS COLLECTED BY THE INDEPENDENT PERSONS; APPROVED BY ENTIRE BOARD OF DIRECTORS AFTER DELIBERATION. VICE PRESIDENT COMPENSATION IS GUIDED BY INDEPENDENT PERSONS; BASED UPON BOARD DEVELOPED AND APPROVED COMPENSATION PHILOSOPHY; DERIVED FROM NATIONWIDE COMPARABLE DATA THAT IS COLLECTED BY THE INDEPENDENT PERSONS; DETERMINED BY THE VP'S SUPERVISOR. THE LAST TIME THE BOARD REVIEWED AND DOCUMENTED THE COMPENSATION WAS IN AUGUST 2014. |
| 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. |
| FORM 990, PART XI, LINE 9 | Transfer from Affiliates 31,587,000 Decrease Pension Plan Valuation 5,541,756 Other Changes in Net Assets (109,059) Partnership Book to Tax Difference (4,196,869) Rounding 4,264 ------------ Total $32,827,082 |
Schedule R IRS990ScheduleR
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| FLAGSTAFF MEDICAL CENTER | ||||||||||
| PO BOX 1268 | FLAGSTAFF | AZ | 86002 | 860110232 | HEALTHCARE | AZ | 501(C)(3) | 3 | NAH | Yes (true) |
| NORTHERN ARIZONA HEALTHCARE CORPORATION | ||||||||||
| PO BOX 1268 | FLAGSTAFF | AZ | 86002 | 742410946 | HEALTHCARE | AZ | 501(C)(3) | 9 | NA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NAHPG LLC | 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 | 86002 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454464070 | EIN |
| Primary Activities | ADMIN AND BILLING | PrimaryActivitiesTxt |
| Legal Domicile State | AZ | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VVMC AND FMC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$13,263,350 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $15,467,547 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| UBI Code V | $0 | UBICodeVAmt |
| General Or Managing Partner | Yes (true) | GeneralOrManagingPartnerInd |
| Ownership | 0.50000 | OwnershipPct |
| 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 | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| FLAGSTAFF MEDICAL CENTER | ||
| P | $63,149,049 | COST |
| NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP | ||
| R | $36,973,816 | COST |