STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

FLAGSTAFF MEDICAL CENTER: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
FLAGSTAFF MEDICAL CENTER (EIN 86-0110232)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-15
IRS object ID
201441359349306539
Schema version
2012v2.3
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-15T14:18:43-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1TWO NORTH CENTRAL AVENUE STE 2300AddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN860110232EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FLAGSTAFF MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JOHN CORTESEInCareOfName
Name ControlFLAGNameControl
Phone9287793366Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1POST OFFICE BOX 1268AddressLine1
Address Line2SuiteAddressLine2
CityFLAGSTAFFCity
StateAZState
ZIP Code860021268ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameIRWIN BLOOMName
TitlePRESIDENT/CEOTitle
Date Signed2014-05-15DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameBRENDA D GRIESEMERName
Phone6023223000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonWILLIAM T BRADELNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11200 N BEAVER STAddressLine1
CityFLAGSTAFFCity
StateAZState
ZIP Code86001ZIPCode
FieldValueIRS element (for citing)
Gross Receipts355870458GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.FLAGSTAFFMEDICALCENTER.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1936YearFormation
State Legal DomicileAZStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE PATIENTS WITH EXCEPTIONAL CARE WHILE TRANSFORMING THE HEALTH OF THE COMMUNITIES WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers400TotalNbrVolunteers
Total Gross UBI1148877TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year824192ContributionsGrantsPriorYear
Contributions Grants Current Year999633ContributionsGrantsCurrentYear
Program Service Revenue Prior Year359213831ProgramServiceRevenuePriorYear
Program Service Revenue CY354262286ProgramServiceRevenueCY
Investment Income Prior Year2735190InvestmentIncomePriorYear
Investment Income Current Year-3842480InvestmentIncomeCurrentYear
Other Revenue Prior Year1382485OtherRevenuePriorYear
Other Revenue Current Year4101140OtherRevenueCurrentYear
Total Revenue Prior Year364155698TotalRevenuePriorYear
Total Revenue Current Year355520579TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year431558GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY490220GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year154615373SalariesEtcPriorYear
Salaries Etc Current Year150908869SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1008118TotalFundrsngExpCurrentYear
Other Expense Prior Year160428013OtherExpensePriorYear
Other Expenses Current Year167103387OtherExpensesCurrentYear
Total Expenses Prior Year315474944TotalExpensesPriorYear
Total Expenses Current Year318502476TotalExpensesCurrentYear
Revenues Less Expenses Prior Year48680754RevenuesLessExpensesPriorYear
Revenues Less Expenses CY37018103RevenuesLessExpensesCY
Total Assets BOY549242471TotalAssetsBOY
Total Assets EOY576871043TotalAssetsEOY
Total Liabilities BOY217039517TotalLiabilitiesBOY
Total Liabilities EOY199217656TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY332202954NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY377653387NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE PATIENTS WITH EXCEPTIONAL CARE WHILE TRANSFORMING THE HEALTH OF THE COMMUNITIES WE SERVE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense254133741Expense
Grants490220Grants
Revenue346419258Revenue
DescriptionSEE SCHEDULE ODescription
Total Program Service Expense254133741TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondstrueInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With1096556NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TranstrueProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJOHN CORTESENamePerson
Telephone Number9282143545TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1914 N SAN FRANCISCO SUITE MAddressLine1
CityFLAGSTAFFCity
StateAZState
ZIP Code86001ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (32 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
ANDREW ALDRIDGE MD
DIRECTOR/MEDICAL STAFF PRES0.10.0X0400000
WILLIAM AUSTIN MD
DIRECTOR1.70.5X0614000
CHRIS BAVASI
DIRECTOR/PAST CHAIR0.31.0X000
VALERIE CARO
DIRECTOR/TREASURER0.00.0X000
GARY CHRISTENSEN MD
DIRECTOR0.80.7X000
JAMES DORMAN
DIRECTOR/CHAIRMAN2.03.7X000X
WAYNE FOX
DIRECTOR/VICE CHAIRMAN0.90.9X000X
RICHARD HAYS
DIRECTOR (THRU 12/12)0.40.0X000
ALICE GAGNAIRE RN
DIRECTOR2.00.0X000
L GEORGE HERSHEY DO
DIRECTOR(NONVOTING AS OF 9/12)0.60.0X000
WILLIAM JEFFERS
DIRECTOR/TREASURER1.10.5X000X
THEODORE H LEWIS MD
DIRECTOR0.90.0X033330
BERT MCKINNON MD
DIRECTOR0.40.7X000
ROBERT M MONTOYA
DIRECTOR (THRU 3/13)0.51.6X000
MOLLY MUNGER
DIRECTOR(NONVOTING AS OF 9/12)0.21.2X000
RICHARD NEFF
DIRECTOR/MEDICAL STAFF PRES2.00.0X026285230789
STEVE PERU
DIRECTOR (THRU 9/12)0.40.0X000
KENNETH SALCE
DIRECTOR0.10.0X000
GUADALUPE WOODSON FNP
DIRECTOR/SECRETARY0.40.0X000X
WILLIAM T BRADEL
DIRECTOR/PRESIDENT/CEO40.010.0X062347035673X
JOHN J DEMPSEY
EXECUTIVE VP LAW & ETHICS40.00.0042081258635X
GREGORY KUZMA
VP FINANCE/CFO14.026.0038576511333X
STEVEN W LEWIS MD
CHIEF MEDICAL OFFICER40.00.0042682312559X
MARILYNN P BELCHER
CNO/VP PATIENT CARE SERVICES40.00.0023484421961X
KAI R MCSWAIN
VP PROFESSIONAL SERVICES40.00.0021975928955X
RICHARD A SMITH
VP DEVELOPMENT40.00.0021899723841X
IRWIN P BLOOM
VP ANCILLARY SERVICES40.00.002126274119X
STEVEN M PETERSON MD
PHYSICIAN40.00.0076217225636X
MARK E DONNELLY MD
PHYSICIAN40.00.0064906635635X
OMAR R WANI MD
PHYSICIAN40.00.0064291727400X
JAMES G DWYER MD
PHYSICIAN40.00.0063303032835X
ERIC D COHEN MD
PHYSICIAN40.00.0059195325974X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs6389820TotalReportableCompFrmRltdOrgs
Total Other Compensation375345TotalOtherCompensation
Number Individuals GT100 K179NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CAREFUSION SOLUTIONSPYXIS
25082 NETWORK PLACECHICAGOIL606731250MEDICAL SERVICES2894300
FOREST COUNTRY ANESTHESIA
PO BOX 53301PHOENIXAZ850723301MEDICAL SERVICES2460000
CRITICAL CARE CONSULTANTS PLLC
PO BOX 967FLAGSTAFFAZ86002MEDICAL SERVICES1625000
NORTHERN ARIZONA ORTHOPAEDICS
1485 N TURQUOISE DR STE 200FLAGSTAFFAZ86001MEDICAL SERVICES1419908
AUREUS RADIOLOGY LLC
PO BOX 3037OMAHANE681030037MEDICAL SERVICES867651
FieldValueIRS element (for citing)
Number Of Contractors GT100 K50NumberOfContractorsGT100K
Info In Schedule O Part VIIIXInfoInScheduleOPartVIII
Fundraising Events206799FundraisingEvents
Government Grants202332GovernmentGrants
All Other Contributions590502AllOtherContributions
Noncash Contributions24677NoncashContributions
Total Contributions999633TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICES622111342114602342114602
PHYSICIAN REVENUE90009955619555561955
PHARMACY44611031714432532213639230
CAFETERIA90009917903201790320
ALL OTHER PROGRAM SERVICE REVENUE90009916239661114319509647
FieldValueIRS element (for citing)
Total Program Service Revenue354262286TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column-7270630TotalRevenueColumn
Related Or Exempt Function Income-11885783RelatedOrExemptFunctionIncome
Exclusion$4,615,153ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real73958Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real73958Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column73958TotalRevenueColumn
Exclusion$73,958ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3362667Securities
Other287986Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other222503Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3362667Securities
Other65483Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3428150TotalRevenueColumn
Exclusion$3,428,150ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events111803GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events206799CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses127376FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-15573TotalRevenueColumn
Exclusion-$15,573ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE/MEDICADE EHR INCENTIVE90009929406932940693
PROGRAM FEES900099480394480394
NON PATIENT ROOMS900099185045185045

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column436623TotalRevenueColumn
Related Or Exempt Function Income436623RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue4042755TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column355520579TotalRevenueColumn
Related Or Exempt Function Income345270381RelatedOrExemptFunctionIncome
Unrelated Business Revenue1148877UnrelatedBusinessRevenue
Exclusion$8,101,688ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total490220Total
Program Services490220ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total4240813Total
Program Services3017864ProgramServices
Management And General1113450ManagementAndGeneral
Fundraising109499Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total239762Total
Program Services239762ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total113278738Total
Program Services96749658ProgramServices
Management And General16065298ManagementAndGeneral
Fundraising463782Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total11917514Total
Program Services10181945ProgramServices
Management And General1686583ManagementAndGeneral
Fundraising48986Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4204267Total
Program Services3592096ProgramServices
Management And General594994ManagementAndGeneral
Fundraising17177Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total17027775Total
Program Services14548413ProgramServices
Management And General2409795ManagementAndGeneral
Fundraising69567Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total825412Total
Program Services825412ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total751619Total
Program Services114883ProgramServices
Management And General524304ManagementAndGeneral
Fundraising112432Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total178434Total
Program Services43355ProgramServices
Management And General115748ManagementAndGeneral
Fundraising19331Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total33525Total
Management And General33525ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total28174Total
Management And General28174ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total30190270Total
Program Services29556066ProgramServices
Management And General634204ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total653721Total
Program Services242197ProgramServices
Management And General386426ManagementAndGeneral
Fundraising25098Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total14610882Total
Program Services7396461ProgramServices
Management And General7146847ManagementAndGeneral
Fundraising67574Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1894421Total
Program Services748344ProgramServices
Management And General1141079ManagementAndGeneral
Fundraising4998Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5645070Total
Program Services4816895ProgramServices
Management And General808863ManagementAndGeneral
Fundraising19312Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total470473Total
Program Services133073ProgramServices
Management And General319485ManagementAndGeneral
Fundraising17915Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total265180Total
Program Services265180ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total2618185Total
Management And General2618185ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total17793Total
Program Services17793ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total15566005Total
Program Services9493189ProgramServices
Management And General6061524ManagementAndGeneral
Fundraising11292Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total265252Total
Program Services375059ProgramServices
Management And General-109807ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES4998629049986290
REIMBURSEMENT TO NAH391771821958859119588591
CONSULTING148845660822686525514975
RECRUITING116093115801159351

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1276112Total
Program Services1101189ProgramServices
Management And General168743ManagementAndGeneral
Fundraising6180Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total318502476Total
Program Services254133741ProgramServices
Management And General63360617ManagementAndGeneral
Fundraising1008118Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY27168803BOY
EOY-6052515EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY40497362BOY
EOY40945086EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY49902024BOY
EOY58449651EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY3791007BOY
EOY25341887EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY6301499BOY
EOY6966525EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1906927BOY
EOY1913631EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis328495339LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec193708015LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY134335057BOY
EOY134787324EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY275794364BOY
EOY310857386EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2204901BOY
EOY2393071EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY7340527BOY
EOY1268997EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY549242471BOY
EOY576871043EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY26288159BOY
EOY26949826EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY124710703BOY
EOY118743509EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY249710BOY
EOY249064EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY65790945BOY
EOY53275257EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY217039517BOY
EOY199217656EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY332202954BOY
EOY377653387EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY332202954BOY
EOY377653387EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY549242471BOY
EOY576871043EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses37018103ReconcilationRevenueExpenses
Reconciliation Unrealized Invest11452452ReconciliationUnrealizedInvest
Reconcilation Other Changes-3020122ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$23,637OtherActivitiesAmount
Total Lobbying Expenditures IIB23637TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE C, PART II-B, LINE 1IIdentifier
Return ReferenceLOBBYING ACTIVITY EXPLANATIONReturnReference
ExplanationLOBBYING ELECTION: AZHHA MEMBERSHIP, AHA MEMBERSHIP. IT IS ESTIMATED THAT 17.71 PERCENT OF DUES ARE NOT DEDUCTIBLE FOR INCOME TAX PURPOSES. THIS PERCENTAGE REPRESENTS THE AMOUNT OF DUES EXPENDED BY THE ASSOCIATION FOR LOBBYING. FLAGSTAFF MEDICAL CENTER ALSO PARTICIPATES IN HEALTHCARE-RELATED LOBBYING ACTIVITIES THROUGH THE SOLE COMMUNITY HOSPITAL COALITION.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2836339BeginningOfYearBalance
Contributions2188719Contributions
Investment Earnings Or Losses133179InvestmentEarningsOrLosses
Grants Or Scholarships412045GrantsOrScholarships
Other Expenditures862349OtherExpenditures
Administrative Expenses65625AdministrativeExpenses
End Of Year Balance3818218EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2426552BeginningOfYearBalance
Contributions1102892Contributions
Investment Earnings Or Losses18115InvestmentEarningsOrLosses
Grants Or Scholarships388081GrantsOrScholarships
Other Expenditures299259OtherExpenditures
Administrative Expenses23880AdministrativeExpenses
End Of Year Balance2836339EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1950655BeginningOfYearBalance
Contributions1285728Contributions
Investment Earnings Or Losses130323InvestmentEarningsOrLosses
Grants Or Scholarships319442GrantsOrScholarships
Other Expenditures537702OtherExpenditures
Administrative Expenses83010AdministrativeExpenses
End Of Year Balance2426552EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1706509BeginningOfYearBalance
Contributions521365Contributions
Investment Earnings Or Losses77663InvestmentEarningsOrLosses
Grants Or Scholarships242115GrantsOrScholarships
Other Expenditures67946OtherExpenditures
Administrative Expenses44821AdministrativeExpenses
End Of Year Balance1950655EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1227217BeginningOfYearBalance
Contributions734776Contributions
Investment Earnings Or Losses17197InvestmentEarningsOrLosses
Grants Or Scholarships52946GrantsOrScholarships
Other Expenditures173685OtherExpenditures
Administrative Expenses46050AdministrativeExpenses
End Of Year Balance1706509EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.70000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.24000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.06000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5283742OtherCostOrOtherBasis
Book Value5284742BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis176629756OtherCostOrOtherBasis
Depreciation94253167Depreciation
Book Value82376589BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1065373OtherCostOrOtherBasis
Depreciation813485Depreciation
Book Value251888BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis132616500OtherCostOrOtherBasis
Depreciation96550548Depreciation
Book Value36065952BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12899968OtherCostOrOtherBasis
Depreciation2090815Depreciation
Book Value10809153BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings134788324TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (9 entries)

DescriptionDescriptionAmountAmount
ADDITIONAL MIN PENSION LIABILITY$43,553,116
PATIENT CREDIT BALANCES$3,790,092
MALPRACTICE INSURANCE RESERVE LT$2,668,882
BCBS IBNR$2,073,028
CBO PEROT RESERVE$232,901
BIOMED RESERVE$202,120
WORKMAN'S COMP LIABILITY$165,390
UNEMPLOYMENT$144,764
OTHER CURRENT LIABILITIES$444,964
FieldValueIRS element (for citing)
Total Of Amounts53275257TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE D, PART V, LINE 4INTENDED USES OF ENDOWED FUNDSMOST OF THE CURRENT ENDOWMENTS ARE BOARD DESIGNATED. CURRENTLY 5% OF THESE FUNDS ARE DESIGNATED FOR DISTRIBUTION BY THE FLAGSTAFF MEDICAL CENTER FOUNDATION COMMITTEE. SUCH DISTRIBUTIONS SHOULD: 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 2UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740)IN ACCORDANCE WITH ACCOUNTING GUIDANCE, MANAGEMENT HAS REVIEWED ALL OPEN TAX YEARS AND HAS DETERMINED THAT THE CORPORATION HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1TURQUOISE BALLNameOfEvent1
Gross Receipts Event1156515GrossReceiptsEvent1
Charitable Contributions Event1100511CharitableContributionsEvent1
Gross Revenue Event156004GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Non Cash Prizes Event10NonCashPrizesEvent1
Rent Facility Costs Event124779RentFacilityCostsEvent1
Food And Beverage Event188FoodAndBeverageEvent1
Entertainment Event14143EntertainmentEvent1
Other Direct Expenses Event145677OtherDirectExpensesEvent1
Name Of Event2GOLF TOURNAMNTNameOfEvent2
Gross Receipts Event245177GrossReceiptsEvent2
Charitable Contributions Event236142CharitableContributionsEvent2
Gross Revenue Event29035GrossRevenueEvent2
Cash Prizes Event20CashPrizesEvent2
Non Cash Prizes Event20NonCashPrizesEvent2
Rent Facility Costs Event26606RentFacilityCostsEvent2
Food And Beverage Event22689FoodAndBeverageEvent2
Entertainment Event20EntertainmentEvent2
Other Direct Expenses Event22773OtherDirectExpensesEvent2
Total Number Of Other Events3TotalNumberOfOtherEvents
Gross Receipts Other Events116910GrossReceiptsOtherEvents
Charitable Contrib Other Events70146CharitableContribOtherEvents
Gross Revenue Other Events46764GrossRevenueOtherEvents
Cash Prizes Other Events0CashPrizesOtherEvents
Non Cash Prizes Other Events998NonCashPrizesOtherEvents
Rent Facility Costs Other Events16134RentFacilityCostsOtherEvents
Food And Beverage Other Events9201FoodAndBeverageOtherEvents
Entertainment Other Events0EntertainmentOtherEvents
Other Direct Expenses Other Events14288OtherDirectExpensesOtherEvents
Gross Receipts Total318602GrossReceiptsTotal
Charitable Contributions Total206799CharitableContributionsTotal
Gross Revenue Total Events111803GrossRevenueTotalEvents
Cash Prizes Total Events0CashPrizesTotalEvents
Non Cash Prizes Total Events998NonCashPrizesTotalEvents
Rent Facility Costs Total Events47519RentFacilityCostsTotalEvents
Food And Beverage Total Events11978FoodAndBeverageTotalEvents
Entertainment Total Events4143EntertainmentTotalEvents
Other Direct Expenses Total Events62738OtherDirectExpensesTotalEvents
Direct Expense Summary Events127376DirectExpenseSummaryEvents
Net Income Summary-15573NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage125.FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage0DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigentfalseFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2249459TotalCommunityBenefitExpense
Net Community Benefit Expense2249459NetCommunityBenefitExpense
Percent Of Total Expense0.00710PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense76604063TotalCommunityBenefitExpense
Direct Offsetting Revenue35882000DirectOffsettingRevenue
Net Community Benefit Expense40722063NetCommunityBenefitExpense
Percent Of Total Expense0.12810PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense78853522TotalCommunityBenefitExpense
Direct Offsetting Revenue35882000DirectOffsettingRevenue
Net Community Benefit Expense42971522NetCommunityBenefitExpense
Percent Of Total Expense0.13520PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1871242TotalCommunityBenefitExpense
Direct Offsetting Revenue412994DirectOffsettingRevenue
Net Community Benefit Expense1458248NetCommunityBenefitExpense
Percent Of Total Expense0.00460PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense942300TotalCommunityBenefitExpense
Direct Offsetting Revenue1800DirectOffsettingRevenue
Net Community Benefit Expense940500NetCommunityBenefitExpense
Percent Of Total Expense0.00300PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1616065TotalCommunityBenefitExpense
Net Community Benefit Expense1616065NetCommunityBenefitExpense
Percent Of Total Expense0.00510PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense1253138TotalCommunityBenefitExpense
Net Community Benefit Expense1253138NetCommunityBenefitExpense
Percent Of Total Expense0.00390PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5682745TotalCommunityBenefitExpense
Direct Offsetting Revenue414794DirectOffsettingRevenue
Net Community Benefit Expense5267951NetCommunityBenefitExpense
Percent Of Total Expense0.01660PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense84536267TotalCommunityBenefitExpense
Direct Offsetting Revenue36296794DirectOffsettingRevenue
Net Community Benefit Expense48239473NetCommunityBenefitExpense
Percent Of Total Expense0.15180PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense501814TotalCommunityBuildingExpense
Net Community Building Expense501814NetCommunityBuildingExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense8099TotalCommunityBuildingExpense
Net Community Building Expense8099NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense119725TotalCommunityBuildingExpense
Net Community Building Expense119725NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense4486TotalCommunityBuildingExpense
Net Community Building Expense4486NetCommunityBuildingExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense250885TotalCommunityBuildingExpense
Net Community Building Expense250885NetCommunityBuildingExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense885009TotalCommunityBuildingExpense
Net Community Building Expense885009NetCommunityBuildingExpense
Percent Of Total Expense0.00280PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$24,982,033BadDebtExpenseAmount
Amount Attributable To2249532AmountAttributableTo
Amount Reimbursed By Medicare111281000AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare128255240CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-16974240MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1SURGI-CENTER AT FMCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityOUTPATIENT SURGERY SERVICESDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.70002OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0.00000OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.29998PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1FLAGSTAFF MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11200 N BEAVER STAddressLine1
CityFLAGSTAFFCity
StateAZState
ZIP Code86001ZIPCode
FieldValueIRS element (for citing)
Website AddressWWW.FLAGSTAFFMEDICALCENTER.COMWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1FLAGSTAFF MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent125.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Lowest Negotiated RatesXLowestNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE H, PART I, LINE 3BEXPLANATION FOR VARIOUS PERCENTAGES USED:125% OF THE FEDERAL POVERTY GUIDE = 100% CHARITY WRITE-OFF. 150% OF FPG = 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 CHARITY CARE INCOME LEVELS ARE BASED ON THE FEDERAL POVERTY GUIDE PUBLISHED IN THE FEBRUARY FEDERAL REGISTER ON AN ANNUAL BASIS. A TIERED METHOD IS UTILIZED FOR DETERMINING WHETHER A PATIENT IS ELIGIBLE FOR 100%, 75%, 50%, 25%, OR 15% WRITE-OFF OF THE SELF PAY BALANCE. 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 6ATHE 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.
SCHEDULE H, PART I, LINE 7PART I, LINE 7 FLAGSTAFF MEDICAL CENTER USED A COST-TO-CHARGE RATIO, WHERE APPLICABLE, TO CALCULATE THE MOST ACCURATE COST OF CHARITY CARE AND OTHER COMMUNITY BENEFITS REPORTED IN LINE 7.
SCHEDULE H, PART III, LINE 2THE COSTING METHODOLOGY USED TO DETERMINE THE BAD DEBT COST COMES FROM THE PERCENTAGE CALCULATED IN SCHEDULE H PART I WORKSHEET 2. SCHEDULE H, PART III, LINE 3 FLAGSTAFF MEDICAL CENTER'S CALCULATION OF FINANCIAL ASSISTANCE COST IS BASED ON ACTUAL FINANCIAL ASSISTANCE WRITE-OFFS BY THE BUSINESS OFFICE MULTIPLIED BY THE COST-TO-CHARGE RATIO. ALL OF THE FINANCIAL ASSISTANCE WRITE-OFFS ARE ATTRIBUTABLE TO PATIENTS WHO QUALIFIED UNDER THE FINANCIAL ASSISTANCE POLICY. AS A NOT-FOR-PROFIT ENTITY, SERVICES ARE PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND MAKING THIS AVAILABLE TO THE COMMUNITY QUALIFIES BAD DEBT AS A COMMUNITY BENEFIT.
SCHEDULE H, PART III, LINE 4THE FOOTNOTE 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.
SCHEDULE H, PART III, LINE 8IN YEARS WHEN THERE IS A SHORTFALL, 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 REPRESENTS 46% OF THE HOSPITAL'S GROSS CHARGES AND IS A LOSS FOR THE 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 FINANCIAL ASSISTANCE IF THEY WERE NOT IN THE MEDICARE PROGRAM.
SCHEDULE H, PART III, LINE 9BACCORDING TO OUR FINANCIAL ASSISTANCE 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 FINANCIAL ASSISTANCE CONSIDERATION. IF THE PATIENT DOESN'T QUALIFY FOR FINANCIAL ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR LONG-TERM PAYMENT PROGRAM. IF THE FINANCIAL ASSISTANCE APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT. BEFORE PRE-ADMISSION AND IF A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, FLAGSTAFF MEDICAL CENTER'S CASHIER COLLECTS 50% OF THE ESTIMATED LIABILITY. THE REST OF THE 50% IS SET UP ON A SIX-MONTH PAYMENT PLAN WITH A SELF-PAY REPRESENTATIVE OF THE CENTRAL BUSINESS OFFICE.
SCHEDULE H, SECTION B, PART V, LINE 3AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, A FOCUS GROUP WAS HELD ON MAY 22, 2012, 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 FLAGSTAFF MEDICAL CENTER. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED 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, SECTION B, PART V, LINE 4THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN CONJUNCTION WITH ITS RELATED HOSPITAL FACILITY, VERDE VALLEY MEDICAL CENTER.
SCHEDULE H, SECTION B, PART V, LINE 5CTHIS COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL: http://flagstaff.healthforecast.net/ HEALTHFORECAST IS AN INTERACTIVE, DYNAMIC TOOL DESIGNED TO SHARE CHNA DATA WITH COMMUNITY PARTNERS AND THE PUBLIC AT LARGE.
SCHEDULE H, SECTION B, PART V, LINE 7HEALTH PRIORITIES NOT CHOSEN AND REASON.SUBSTANCE ABUSE - FMC 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 - FMC 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 - FMC 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 - FMC 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 CHOSE FOR ACTION. INJURY & VIOLENCE PREVENTION - FMC 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. SCHEDULE H, SECTION B, PART V, LINE 11 SEE PART VI EXPLANATION FOR SCHEDULE H, PART 1, LINE 3B.
SCHEDULE H, PART VI, LINE 2NEEDS ASSESSMENTFLAGSTAFF MEDICAL CENTER ASSESSES COMMUNITY HEALTHCARE NEEDS THROUGH A SURVEY DESIGNED AND ADMINISTERED BY PROFESSIONAL RESEARCH CONSULTANTS, INC. THIS SURVEY WAS LAST CONDUCTED IN 2012 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 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEACCORDING TO OUR FINANCIAL ASSISTANCE 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 FINANCIAL ASSISTANCE CONSIDERATION. IF PATIENT DOESN'T QUALIFY FOR FINANCIAL 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. FLAGSTAFF MEDICAL CENTER WEBSITE HAS A BILLING CONTACT NUMBER. BEFORE PRE-ADMISSION, PATIENTS ARE CONTACTED BY FMC'S CASHIER. WHEN PATIENTS ARE CONTACTED, THEY ARE EDUCATED ABOUT THE FINANCIAL ASSISTANCE POLICY. FMC FINANCIAL COUNSELORS ASSIGNED TO EACH NURSING UNIT ARE ABLE TO ANSWER OR ASSIST WITH BILLING QUESTIONS. AT EACH PATIENT REGISTRATION DESK ARE DISPLAYS AND BROCHURES OF THE BILLING INFORMATION, INCLUDING THE FINANCIAL ASSISTANCE POLICY.
SCHEDULE H, PART VI, LINE 4COMMUNITY INFORMATIONFLAGSTAFF MEDICAL CENTER IS A 267-BED ACUTE CARE HOSPITAL LOCATED IN FLAGSTAFF, AZ. THE PRIMARY SERVICE AREA COVERS APPROXIMATELY 9,600 SQUARE MILES WITH THE CLOSEST HOSPITAL TO EH SOUTH IS VERDE VALLEY MEDICAL CENTER (FMC AFFILIATE). THE POPULATION IN THE PRIMARY SERVICE AREA IS APPROXIMATELY 100.000. FMC OPERATES AS A NOT-FOR-PROFIT TAX-EXEMPT CORPORATION. FMC PROVIDES GENERAL MEDICAL AND SURGICAL ACUTE CARE, BEHAVIORAL HEALTH SERVICES, AND A FULL RANGE OF OUTPATIENT SERVICES TO NORTHERN ARIZONA RESIDENTS AND VISITORS. KEY SERVICES PROVIDED TO THE COMMUNITY INCLUDE A REGIONAL TRAUMA CENTER, OPEN-HEART SURGERY, HIGH-TECH IMAGING, RADIATION/ONCOLOGY, SURGICAL SERVICES, ORTHOPEDIC SERVICES, AND WOMEN, INFANTS AND CHILDREN'S SERVICES. THE HOSPITAL GROSS PAYOR MIX IS AS FOLLOWS: MEDICARE 46%, AHCCCS/MEDICAID 18%, COMMERCIAL AND OTHER 30%, AND SELF PAY 6%. FLAGSTAFF MEDICAL CENTER IS ONE OF THE THREE LARGEST EMPLOYERS IN NORTHERN ARIZONA.
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTHCOMMUNITY HEALTH AND COMMUNITY BUILDING ARE A FOCUS AT FLAGSTAFF MEDICAL CENTER AS EVIDENCED BY THE NUMEROUS ACTIVITIES SPONSORED EACH YEAR. THE CANCER CENTER AT FMC HOSTS A SERIES OF FREE OR LOW-COST SCREENINGS DESIGNED TO HELP RESIDENTS IN THE COMMUNITY DETECT ISSUES AS SOON AS POSSIBLE. FIT KIDS OF ARIZONA, WHICH WORKS TO REDUCE THE HEALTH CONSEQUENCES OF CHILDHOOD OBESITY BY PROMOTING HEALTHY LIFESTYLES, AND THE DIABETES TOGETHER COMMUNITY COLLABORATION ARE FMC'S PREMIER COMMUNITY HEALTH INITIATIVES. THE CARE BEYOND WALLS AND WIRES PROGRAM USES TELEMEDICINE TO MONITOR AND SUPPORT PATIENTS WHO LIVE REMOTELY AND HAVE RECENTLY BEEN DIAGNOSED WITH CONGESTIVE HEART FAILURE. COMMUNITY BUILDING IS ADVANCED BY FMC THROUGH ITS SUPPORT OF PHYSICIAN RECRUITMENT AND WORK WITH VARIOUS COMMUNITY ORGANIZATIONS INCLUDING THE AMERICAN CANCER SOCIETY, BIG BROTHERS AND BIG SISTERS, FLAGSTAFF LEADERSHIP PROGRAM, FLAGSTAFF CHAMBER OF COMMERCE AND THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION.
SCHEDULE H, PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEMFLAGSTAFF MEDICAL CENTER IS AFFILIATED WITH VERDE VALLEY MEDICAL CENTER. THE BOARD MEMBER MEETINGS ARE COMBINED. THE COMMUNITY BENEFIT REPORT IS SUMMARIZED TOGETHER AND POSTED ON THE HOSPITAL'S WEBSITE.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
BIG BROTHERS BIG SISTERS OF FLAGSTAFF
PO BOX 1701FLAGSTAFFAZ86002237170086501(C)(3)14311SPONSORSHIP
CITY OF FLAGSTAFF
211 W ASPENFLAGSTAFFAZ86001866000244GOVT7560SPONSORSHIP
COCONINO COMMUNITY COLLEGE
3000 N 4TH ST SUITE 17FLAGSTAFFAZ86004860717956SCHOOL105000FUNDING FOR THE NURSING PROGRAM (100K) OTHER SPONSPONSOR (5K)
GUIDANCE CENTER INC
2187 N VICKEY STFLAGSTAFFAZ86004860223720501(C)(3)25000CONTRIBUTION
HOZHONI FOUNDATION
2133 N WALGREEN STFLAGSTAFFAZ86004860255127501(C)(3)9000GENERAL OPERATIONS SUPPORT
JLB PROJECT INC
PO BOX 537FLAGSTAFFAZ86002273224466501(C)(3)7609BEREAVEMENT SUPPORT
NAU ATHLETICS
PO BOX 15400FLAGSTAFFAZ86001742576628SCHOOL11200SPONSORSHIP
NORTH COUNTRY COMMUNITY HEALTHCARE
2920 N 4TH STFLAGSTAFFAZ86004860663432501(C)(3)19528NACASA & OTHER SPONSORSHIP
NORTHERN ARIZONA UNIVERSITY FOUNDATION
PO BOX 4094FLAGSTAFFAZ86011860193726SCHOOL87300SUPPORT OF THE SCHOOL OF NURSING
NORTHLAND FAMILY HELP
2532 N 4TH ST 506FLAGSTAFFAZ86004860351566501(C)(3)6500SUPPORT OF THE HALO HOUSE
POORE MEDICAL CLINIC
120 W FINE AVEFLAGSTAFFAZ86001800751712501(C)(3)15000GENERAL OPERATIONS SUPPORT
RONALD MCDONALD HOUSE
501 E ROANOAKE AVEPHOENIXAZ85004860483792501(C)(3)7500SUPPORT PATIENT FAMILY LODGING
UNITED WAY
1515 E CEDAR AVE D-1FLAGSTAFFAZ86004860211666501(C)(3)25225ORGANIZATION CONTRIBUTION MATCH
VICTIM WITNESS SERVICE
201 E BIRCH AVEFLAGSTAFFAZ86001860481748501(C)(3)17091CRISIS RESPONSE
YMCA
1001 N TURQUOISE DRFLAGSTAFFAZ86001860096799501(C)(3)14500CAPITAL CAMPAIGN PROJECT
FLAGSTAFF DOWNTOWN BUSINESS ALLIANCE
PO BOX 1546FLAGSTAFFAZ86002861033923501(C)(3)19000SPONSORSHIP
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants16TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE I, PART I, LINE 2Identifier
Return ReferenceDESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTSReturnReference
ExplanationFLAGSTAFF MEDICAL CENTER FOUNDATION - GRANTS 1) INDIVIDUALS ON THE USER LEVEL ARE RESPONSIBLE FOR SCREENING AND IDENTIFYING THE NEEDS FOR DISTRIBUTION OF GRANT FUNDS. 2) DEPARTMENT HEADS AND/OR PROGRAM COORDINATORS MUST VALIDATE AND SIGN ALL REQUESTS FOR PAYMENT OR DISBURSEMENT OF THESE FUNDS. 3) WRITTEN REQUESTS ARE REVIEWED BY THE FOUNDATION SPECIALIST FOR OPERATIONS TO VERIFY AVAILABLE FUND BALANCES AND PROPER ACCOUNT NUMBERS. 4) THE FOUNDATION SPECIALIST FOR GRANTS THEN INITIALS THE DOCUMENTS AFTER VERIFYING THE CRITERIA FOR DISBURSEMENT. 5) THE VICE PRESIDENT OF DEVELOPMENT AUTHORIZES THE DISBURSEMENT OF FUNDS BY SIGNATURE. 6) THE FOUNDATION SCANS ALL DOCUMENTS AND SAVES THEM DIGITALLY ON A SECURE SERVER. 7) ALL ORIGINAL DOCUMENTS ARE SUBMITTED TO ACCOUNTS PAYABLE FOR FINAL RECORDING AND PAYMENT. 8) ORIGINAL DOCUMENTS ARE FILED AND ARCHIVED IN A SECURE LOCATION FOR THE REQUIRED LENGTH OF TIME. FMC RELIES ON THE GOVERNANCE PRACTICES OF THE RECIPIENT ORGANIZATION TO USE THE FUNDS FOR THE INTENDED PURPOSE.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RICHARD NEFF
DIRECTOR/MEDICAL STAFF PRES02276270341690105604900025889029364100
WILLIAM T BRADEL
DIRECTOR/PRESIDENT/CEO047658008874805814209800025873065914300
JOHN J DEMPSEY
EXECUTIVE VP LAW & ETHICS030951406522004607803133527300047944700
STEVEN W LEWIS MD
CHIEF MEDICAL OFFICER03686360470120111750980002759043938200
MARILYNN P BELCHER
CNO/VP PATIENT CARE SERVICES02074280262870112908837013124025680500
KAI R MCSWAIN
VP PROFESSIONAL SERVICES01958810221570172107549021406024871400
RICHARD A SMITH
VP DEVELOPMENT01808090316410654708069015772024283800
IRWIN P BLOOM
VP ANCILLARY SERVICES0195654010006069670207702042021674600
STEVEN M PETERSON MD
PHYSICIAN055239902082570151609800015836078780800
MARK E DONNELLY MD
PHYSICIAN037901802682940175409800025835068470100
OMAR R WANI MD
PHYSICIAN05829630583340162009800017600067031700
JAMES G DWYER MD
PHYSICIAN0499613012294101047609800023035066586500
ERIC D COHEN MD
PHYSICIAN0583161000879209800016174061792700
GREGORY KUZMA
VP FINANCE/CFO031892106604907950-5445016778039709800

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE J, PART ISUPPLEMENTAL COMPENSATION INFORMATIONLINE 1A/B: ALL COMPENSATION, BENEFITS AND REIMBURSEMENTS ARE PAID BY NORTHERN ARIZONA HEALTHCARE, THE PARENT ORGANIZATION. BOARD MEMBER AND OFFICER TAXABLE EXPENSES ARE PAID AND REPORTED ON A W-2 OR 1099. GROSS-UP OF TAXES IS DONE ON ALL EMPLOYEE GIFT CERTIFICATES. CURRENTLY, THERE IS NO WRITTEN POLICY FOR THESE ITEMS. IN PRACTICE, THE BOARD MEMBER AND OFFICER BUSINESS TRAVEL EXPENSES ARE APPROVED BY THE NEXT HIGHEST LEVEL. LINE 3: CEO COMPENSATION IS DETERMINED BY THE RELATED PARENT ENTITY - NORTHERN ARIZONA HEALTHCARE.
SCHEDULE J, PART IILINE 4BTHE FOLLOWING INDIVIDUALS PARTICIPATE IN A DEFINED BENEFIT RETIREMENT PLAN. AS SUCH, ACTUARIAL INCREASES OR DECREASES IN THEIR ACCOUNTS ARE REPORTED ON PART II, COLUMN (C) AS DEFERRED COMPENSATION. FOR THE CURRENT YEAR, THE CHANGES WERE SUBSTANTIALLY LESS THAN NORMAL DUE TO AN INCREASE IN THE DISCOUNT RATE USED IN THE ACTUARIAL ANALYSIS AS FOLLOWS: CHANGE DUE CHANGE DUE TO BENEFIT TO INCREASE IN ACCRUAL DISCOUNT RATE TOTAL JOHN J. DEMPSEY 71,257 (39,922) 31,335 GREGORY KUZMA 59,590 (65,035) (5,445)

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancingCUSIP NumberCUSIPNumber
INDUSTRIAL DEVELOPMENT AUTHORITY OF YAVAPAI COUNTY
A8603760992008-07-2545703133SEE PART VIfalsefalsefalse
INDUSTRIAL DEVELOPMENT AUTHORITY OF YAVAPAI COUNTY
B8603760992009-01-0820326075SEE PART VIfalsefalsefalse985900BTS
INDUSTRIAL DEVELOPMENT AUTHORITY OF YAVAPAI COUNTY
C8603760992011-10-1265094379SEE PART VIfalsefalsefalse985900CXS

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindYear Of Subst CompletionYearOfSubstCompletion
A00457031330045697693544000000truefalsetruetrue
B002032607500100126162272460127801007343300truefalsetruetrue
C0065094379006446531962906000000truefalsetruetrue2011

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropPrcntge Bond Financed PropPrcntgeBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
Afalsefalsetruetruefalse0.000000.000000.00000truefalse0.00000falsefalse
Bfalsefalsetruetruefalse0.000000.000000.00000truefalse0.00000falsefalse
Cfalsefalsetruetruefalse0.000000.000000.00000truefalse0.00000falsefalse

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
0
Afalsefalsetruefalsetruefalsefalse0truetrue
0
Bfalsefalsetruefalsetruefalsefalse0truetrue
0
Cfalsefalsetruefalsetruefalsefalse0truetrue

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
Atrue
Btrue
Ctrue

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return Reference0ReturnReference
ExplanationLINE A - THE NAME OF THE ISSUE IS HOSPITAL REVENUE REFUNDING BONDS (NORTHERN ARIZONA HEALTHCARE SYSTEM) SERIES 2008A. THIS ISSUE REFUNDS BONDS FROM 12/12/96 AND 10/31/02. TOTAL ISSUANCE PRICE WAS $57,096,705 WHICH WAS ALLOCATED $45,703,133 TO FLAGSTAFF MEDICAL CENTER AND $11,393,572 TO VERDE VALLEY MEDICAL CENTER. LINE B - THE NAME OF THE ISSUE IS $52,795,000 HOSPITAL REVENUE BONDS (NORTHERN ARIZONA HEALTHCARE SYSTEM) SERIES 2008B. THIS ISSUE REFUNDS BONDS FROM 1/27/05. TOTAL ISSUANCE PRICE WAS $52,795,000 WHICH WAS ALLOCATED $20,326,075 TO FLAGSTAFF MEDICAL CENTER AND $32,468,925 TO VERDE VALLEY MEDICAL CENTER. THE 2008B BONDS WERE ALSO USED, IN PART, TO FINANCE "NEW MONEY" PROJECTS. $10,073,432 WAS USED FOR BUILDINGS AND LONG-LIVED EQUIPMENT. LINE C - 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 AND $13,829,141 TO VERDE VALLEY MEDICAL CENTER.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
FOREST COUNTRY ANESTHESIA
CHRISTENSEN / PARTNER2460000MEDICAL SERVICES FOR FMCfalse
NORTHERN AZ SURGICAL ASSOCIATES
ANDREW ALRIDGE / PARTNER205920MEDICAL SERVICES FOR FMCfalse
VICKIE LEWIS
STEVE LEWIS SPOUSE171204COMPENSATIONfalse
KATHY KUZMA
GREGORY KUZMA SPOUSE68558COMPENSATIONfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FORM 990, PART I, LINE 6VOLUNTEER RESPONSIBILITIESFMC VOLUNTEERS PROVIDE CLERICAL ASSISTANCE IN MULTIPLE DEPARTMENTS AND SUPPORT SERVICES SUCH AS WHEELCHAIR ASSISTANCE AND ESCORTING PATIENTS AND FAMILIES WHO ENTER AT THE MAIN ENTRY. THEY VOLUNTEER AT THE INFORMATION DESK AND GIFT SHOP AND MAKE DELIVERIES OF GIFTS, READING MATERIALS AND MAIL TO PATIENT ROOMS. THEY PROVIDE LOBBY MUSIC, NAVAJO AND SPANISH INTERPRETATION, SPIRITUAL CARE, AND CARING CANINE AND CARING CLOWN VISITS TO PATIENTS. THEY ROCK BABIES IN THE SPECIAL CARE NURSERY, PROVIDE MENDED HEARTS PATIENT AND FAMILY SUPPORT, AND ASSIST IN THE FOUNDATION AND AT SPECIAL EVENTS. VOLUNTEERS ASSIST IN OTHER DEPARTMENTS SUCH AS THE CANCER CENTER, BIOMEDICAL ENGINEERING, MAIL ROOM, NUTRITION SERVICES, PHARMACY, WOMEN AND INFANTS' CENTER, PHYSICAL THERAPY, FIT KIDS, BARIATRIC CLINIC, EMERGENCY AND SURGICAL SERVICES AND THE TAYLOR HOUSE.
FORM 990 PART III LINE 4ADESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTSONE OF THE NICEST THINGS ABOUT LIVING IN NORTHERN ARIZONA IS YOU DON'T HAVE TO TRAVEL TO GET EXCELLENT HEALTHCARE. SINCE 1936, FLAGSTAFF MEDICAL CENTER (FMC), A MEMBER OF NORTHERN ARIZONA HEALTHCARE, HAS PROVIDED HIGH QUALITY HEALTHCARE SERVICES TO RESIDENTS AND VISITORS TO NORTHERN ARIZONA. WE ARE DEDICATED TO PATIENT-CENTERED CARE WITH A PERSONAL TOUCH. FMC IS LICENSED BY MEDICARE AND THE STATE OF ARIZONA. FOUNDED BY DR. CHARLES SECHRIST AS FLAGSTAFF HOSPITAL, THE 25-BED HOSPITAL WAS DONATED TO THE COMMUNITY OF FLAGSTAFF IN 1955. TODAY, FLAGSTAFF MEDICAL CENTER REMAINS A NOT-FOR-PROFIT HOSPITAL, GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS. WE TREAT EVERY PATIENT, REGARDLESS OF THEIR ABILITY TO PAY. EVERY YEAR, FLAGSTAFF MEDICAL CENTER INVESTS IN YOUR COMMUNITY HOSPITAL TO ENSURE WE ARE PROVIDING THE BEST, SAFEST CARE, CLOSE TO HOME. WE PROVIDE KEY SERVICES TO NORTHERN ARIZONA RESIDENTS AND VISITORS, INCLUDING A REGIONAL TRAUMA CENTER; OPEN-HEART SURGERY; HIGH-TECH IMAGING; A CANCER CENTER; SURGICAL SERVICES; ORTHOPEDIC SERVICES; WOMEN, INFANTS' AND CHILDREN'S SERVICES; AND MORE. FMC CURRENTLY HAS: - 267 INPATIENT BEDS - 229 PHYSICIANS ON OUR ACTIVE MEDICAL STAFF - 14,677 ANNUAL INPATIENT HOSPITAL ADMISSIONS - 63,992 INPATIENT DAYS - 104,975 ANNUAL OUTPATIENT HOSPITAL VISITS - 38,289 ANNUAL EMERGENCY DEPARTMENT VISITS - 1,287 BABIES BORN THIS YEAR AT FMC FLAGSTAFF MEDICAL CENTER'S MISSION AND VISION --------------------------------------------- VISION - NORTHERN ARIZONA HEALTHCARE, IN PARTNERSHIP WITH OUR COLLEAGUES AND PHYSICIANS, WILL BE THE HIGHEST QUALITY, COST-EFFECTIVE, PREFERRED HEALTHCARE DELIVERY SYSTEM IN NORTHERN AND CENTRAL ARIZONA. WE WILL EXCEED THE EXPECTATIONS OF THOSE WE SERVE BY: - DEVELOPING QUALITY HEALTHCARE SERVICES USING ADVANCED TECHNOLOGY TO IMPROVE THE HEALTH STATUS AND TO MEET THE GROWING NEEDS OF THE COMMUNITIES WE SERVE. - FOSTERING AN ORGANIZATIONAL CULTURE THAT ACTS AS A MAGNET FOR RECRUITING AND RETAINING HIGHLY QUALIFIED COLLEAGUES AND PHYSICIANS. - ENSURING EXCEPTIONAL VALUE FOR OUR PATIENTS AND FINANCIAL STRENGTH FOR OUR INSTITUTIONS. - DEVELOPING STRATEGIC ALLIANCES AND PARTNERSHIPS WITH PROVIDERS AND ORGANIZATIONS TO ENSURE COMPREHENSIVE SERVICES FOR OUR PATIENTS. VALUES - WE ARE COMMITTED TO MEETING THE NEEDS AND EXCEEDING THE EXPECTATIONS OF OUR PATIENTS. - COLLEAGUES - WE WILL CREATE AN ORGANIZATIONAL CULTURE WHERE COLLEAGUES FEEL VALUED AND TAKE A SENSE OF PRIDE IN THEIR WORK. - QUALITY - WE CONTINUOUSLY STRIVE TO ACHIEVE EXCELLENCE AT ALL LEVELS IN THE ORGANIZATION. - SAFETY - WE ARE COMMITTED TO MAINTAINING A SAFE ENVIRONMENT FOR OUR PATIENTS, VISITORS AND COLLEAGUES. - LEADERSHIP - WE PROMOTE LEADERSHIP AS AN ATTITUDE, NOT A POSITION, PUTTING VALUE ON BOTH PEOPLE AND THE WORK THEY DO. - TEAMWORK - WE ARE COLLEAGUES WORKING TOGETHER, SHARING KNOWLEDGE, TALENTS, AND SKILLS TO ACHIEVE COMMON GOALS. - INTEGRITY - WE WILL BE FORTHRIGHT, HONEST AND RESPECTFUL. - DIVERSITY - WE EMBRACE THE DIVERSITY OF OUR PEOPLE, PATIENTS AND THE COMMUNITIES WE SERVE.
FORM 990, PART VI, QUESTION 6DESCRIPTION OF THE MEMBERS OF THE ORGANIZATION AND THEIR RIGHTSNORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE CORPORATE MEMBER OF FLAGSTAFF MEDICAL CENTER.
FORM 990, PART VI, QUESTION 7ADESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTSTHE FLAGSTAFF MEDICAL CENTER (FMC) GOVERNANCE COMMITTEE NOMINATES FOR POSITIONS ON THE FMC BOARD OF DIRECTORS. DIRECTORS ARE ELECTED BY THE BOARD OF DIRECTORS OF THE SOLE CORPORATE MEMBER FROM THE NOMINATIONS THAT HAVE BEEN PROVIDED. THE SOLE CORPORATE MEMBER ELECTS THOSE PERSONS NOMINATED UNLESS THE BOARD OF DIRECTORS OF THE SOLE CORPORATE MEMBER BY A SUPER MAJORITY VOTE DETERMINES THAT A NOMINEE'S ELECTION WOULD BE DETRIMENTAL TO THE BEST INTERESTS OF FMC OR THE SOLE CORPORATE MEMBER. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS AS SOLE CORPORATE MEMBER, NORTHERN ARIZONA HEALTHCARE CORPORATION APPROVES THE BOARD OF DIRECTORS THAT ARE ELECTED BY THIS ENTITY. ALSO AS SOLE CORPORATE MEMBER, NORTHERN ARIZONA HEALTHCARE CORPORATION 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, QUESTION 11BREVIEW OF THE FORM 990 BY THE ORGANIZATION'S GOVERNING BODYTHE 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 PRIOR TO THE MAY 15 DUE DATE FOR 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, QUESTION 12CDESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICT OF INTERESTTHE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY (BOARD POLICY 6.1). THIS IS ACCOMPLISHED BY A NUMBER OF MECHANISMS. FIRST, THE CONFLICT OF INTEREST QUESTIONNAIRE IS REVIEWED BY THE GOVERNANCE COMMITTEE OF THE BOARD. AS PART OF THE QUESTIONNAIRE, SELF-DISCLOSURE IS REQUIRED BY BOARD MEMBERS. IN ADDITION, INDIVIDUAL DISCLOSURE BY BOARD MEMBERS OCCURS AT BOARD MEETINGS WHEN NECESSARY (I.E. A BOARD MEMBER WILL EXCLUDE HIMSELF FROM VOTING ON AN ISSUE IN WHICH HE MAY HAVE A CONFLICT OF INTEREST).
FORM 990, PART VI, QUESTIONS 15A & 15BCOMPENSATION PROCESSTHE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO AND OTHER OFFICERS INCLUDES THE PREPARATION OF COMPARABLE DATA BY TOWERS WATSON, AN INDEPENDENT CONSULTING FIRM. IN ADDITION, THIS INFORMATION IS REVIEWED BY THE GOVERNANCE COMMITTEE OF THE BOARD AND IS DOCUMENTED IN BOARD MINUTES. THE MOST RECENT REVIEW WAS PERFORMED IN AUGUST 2013.
FORM 990, PART VI, QUESTION 19AVAILABILITY OF CERTAIN DOCUMENTS TO THE GENERAL PUBLICTHE 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 9EXPLANATION OF OTHER CHANGES IN NET ASSETSDECREASE IN UNFUNDED PENSION LIABILITY $ 13,766,772 TRANSFERS TO AFFILIATES ( 16,610,206) ELIMINATIONS ( 176,688) -------------- TOTAL $( 3,020,122) ==============
FORM 990, PART V, QUESTION 5APARTY TO PROHIBITED TAX SHELTER TRANSACTIONFLAGSTAFF MEDICAL CENTER IS FILING TWO FORMS 8886, REPORTABLE TRANSACTION DISCLOSURE STATEMENT, ON A PROTECTIVE BASIS TO REPORT ITS INTERESTS IN THE FOLLOWING LIMITED PARTNERSHIPS: JORDAN FAMILY INVESTMENTS LP, AND NAAM ENTERPRISES LP. FLAGSTAFF MEDICAL CENTER IS FILING ONE FORM 8886 TO REPORT ITS INTEREST IN DUDDIE FAMILY LIMITED PARTNERSHIP. FLAGSTAFF MEDICAL CENTER IS NOT REQUIRED TO DISCLOSE THE DUDDIE FAMILY LP ON FORM 8886-T, DISCLOSURE BY TAX-EXEMPT ENTITY REGARDING PROHIBITED TAX SHELTER TRANSACTION, BECAUSE IT RECEIVED THE DONATED LIMITED PARTNERSHIP INTEREST PRIOR TO MAY 17, 2006. TREAS. REG. 1.6033-5(D)(4) ("[D]ISCLOSURE IS NOT REQUIRED WITH RESPECT TO ANY PROHIBITED TAX SHELTER TRANSACTION ENTERED INTO BY A TAX-EXEMPT ENTITY ON OR BEFORE MAY 17, 2006.")
FORM 8886, 1 OF 3THE DUDDIE FAMILY LIMITED PARTNERSHIPNOTE: THE TAX ADVICE PROVIDED BY ERNST & YOUNG LLP, FENNEMORE CRAIG, P.C., AND POLSINELLI PC (FKA POLSINELLI SHUGHART PC) WAS LIMITED TO ADVICE PERTAINING TO THE DISCLOSURE OF THE TRANSACTION DESCRIBED IN THIS FORM 8886. THE SERVICES PROVIDED BY ERNST & YOUNG LLP, FENNEMORE CRAIG, P.C., AND POLSINELLI PC DID NOT INVOLVE ANY TAX ADVICE PERTAINING TO THE STRUCTURING OF THE TRANSACTION DISCLOSED IN THIS FORM 8886 OR ADVISING THE TAXPAYER BEYOND ITS REPORTABLE TRANSACTION DISCLOSURE AND RELATED OBLIGATIONS. THE FEES PAID BY THE TAXPAYER TO ERNST & YOUNG LLP, FENNEMORE CRAIG, P.C., AND POLSINELLI PC RELATE ONLY TO POST-TRANSACTIONAL TAX ADVICE CONCERNING ITS DISCLOSURE OBLIGATIONS AND ITS WITHDRAWAL FROM THE DUDDIE FAMILY LIMITED PARTNERSHIP. LINE 7B - CONTINUATION FROM FORM 8886 (5) THE PETERSON GRANDCHILDREN'S TRUST (TRUST #2"). DONORS AND FOUNDATION ENTERED INTO THE TRANSACTION, THE PARTNERSHIP, ON OR ABOUT DECEMBER 31, 1990. ON OR ABOUT JANUARY 30, 1997, FOUNDATION, EIN 94-2540279, ADOPTED ARTICLES OF DISSOLUTION, AND ON OR ABOUT NOVEMBER 1, 2000, FOUNDATION, EIN 94-2540279, WAS ADMINISTRATIVELY DISSOLVED AND FLAGSTAFF MEDICAL CENTER INC. ("FLAGSTAFF"), EIN 86-0100232, THE THEN SOLE MEMBER OF THE FOUNDATION, SUCCEEDED TO THE INTERESTS OF THE FOUNDATION IN THE REMAINING ASSETS OF THE FOUNDATION AFTER PROVISION FOR ALL LIABILITIES OF THE FOUNDATION UPON ITS DISSOLUTION. FLAGSTAFF IS THE SUCESSOR ENTITY TO FOUNDATION FOR FEDERAL INCOME TAX PURPOSES. CONSEQUENTLY, FLAGSTAFF MEDICAL CENTER, INC. IS THE ENTITY RESPONSIBLE FOR DISCLOSING THIS TRANSACTION UNDER TREAS. REG. SECTION 1.6011-4, ET SEQ. THE DUDDIE FAMILY LIMITED PARTNERSHIP AGREEMENT (THE "AGREEMENT") DESCRIBES DONORS HAVING CONTRIBUTED $800,000 TO THE PARTNERSHIP AS AN INITIAL CAPITAL CONTRIBUTION. THE AGREEMENT FURTHER DESCRIBES TIMOTHY G. DUDDIE AND SHERYL P. DUDDIE CONTRIBUTING AN ADDITIONAL $200,000 TO THE PARTNERSHIP "ON BEHALF OF" FOUNDATION, RESULTING IN FOUNDATION OWNING APPROXIMATELY 20% OF THE LIMITED PARTNERSHIP INTERESTS. PER FOUNDATION'S 2009 SCHEDULE K-1 PROVIDED TO FLAGSTAFF BY PARTNERSHIP, FOUNDATION IS ALLOCATED 19.4% OF THE PROFIT, LOSS AND CAPITAL OF PARTNERSHIP FOR FEDERAL INCOME TAX PURPOSES. PURSUANT TO THE TERMS OF THE AGREEMENT, THE GENERAL PARTNERS HAVE FULL CONTROL OVER THE TIMING AND AMOUNT OF DISTRIBUTIONS FROM THE PARTNERSHIP. LIMITED PARTNERS IN THE PARTNERSHIP HAVE NO RIGHTS TO DEMAND DISTRIBUTIONS OR PARTAKE IN THE MANAGEMENT OF THE PARTNERSHIP. FLAGSTAFF, IN ITS CAPACITY AS AN ASSIGNEE OF FOUNDATION'S INTEREST IN THE PARTNERSHIP, DOES NOT HAVE ANY RIGHTS TO REVIEW THE BOOKS AND RECORDS OF THE PARTNERSHIP AND ITS RIGHTS ARE LIMITED TO RECEIVING ANY DISTRIBUTIONS ON ACCOUNT OF THE INTEREST. FOR FLAGSTAFF TO OBTAIN THE RIGHTS OF A LIMITED PARTNER, INCLUDING THE RIGHTS TO REVIEW THE BOOKS AND RECORDS OF THE PARTNERSHIP, FLAGSTAFF WOULD HAVE TO SATISFY CERTAIN CONDITIONS, INCLUDING THE PAYMENT OF A $20,000 FEE AND RIGHTS OF FIRST REFUSAL HELD BY THE GENERAL PARTNER AND THE LIMITED PARTNERS UNDER THE TERMS OF THE AGREEMENT. THE OPTION AGREEMENT (THE "OPTION"), EFFECTIVE DECEMBER 31, 1990, WAS ENTERED INTO BY TRUST #1 AND FOUNDATION. THE OPTION PROVIDES FOUNDATION THE RIGHT TO REQUIRE TRUST #1 TO PURCHASE ITS INTEREST IN PARTNERSHIP, AT THE GREATER OF FAIR MARKET VALUE OR THE ORIGINAL GIFT VALUE OF FOUNDATION'S LIMITED PARTNERSHIP INTEREST, WHICH WAS ESTABLISHED WHEN FOUNDATION RECEIVED ITS INTEREST IN THE PARTNERSHIP. THE RIGHT TO EXERCISE THE OPTION RUNS FOR 60 DAYS AFTER THE DATE OF DEATH OF THE LAST TO DIE OF "THE INSURED GENERAL PARTNERS OR GRANTORS, IF THE GENERAL PARTNERS ARE REVOCABLE FAMILY TRUSTS." THE OPTION ALSO PROVIDES THAT TRUST #1 "HAS OR WILL PROCURE LIFE INSURANCE ON THE LIVES OF THE GENERAL PARTNERS." FLAGSTAFF DOES NOT POSESS ENOUGH INFORMATION TO DETERMINE TO WHAT EXTENT, IF ANY, TRUST #2 HAS PARTICIPATED IN THE PARTNERSHIP WITHIN THE MEANING OF TREAS. REG. SECTION 1.6011-4, ET SEQ. PARTNERSHIP PROVIDED A 2009 SCHEDULE K-1 TO FLAGSTAFF INDICATING THAT TRUST #2 OWNS A 1.54% OF THE PROFIT, LOSS AND CAPITAL OF PARTNERSHIP FOR FEDERAL INCOME TAX PURPOSES. ON OR ABOUT OCTOBER 25, 2010 FLAGSTAFF FIRST BECAME AWARE THAT PARTNERSHIP MIGHT BE VIEWED AS SUBSTANTIALLY SIMILAR TO THE NOTICE 2004-30 TRANSACTION, AND THEREFORE MAY HAVE PARTICIPATED IN A LISTED TRANSACTION WITHIN THE MEANING OF TREAS. REG. SECTION 1.6011-4, ET SEQ. CONSEQUENTLY, FLAGSTAFF'S INITIAL DISCLOSURE OF PARTNERSHIP WAS FILED WITH THE 2009 FORM 990 WITH RESPECT TO FLAGSTAFF'S TAXABLE YEAR ENDED JUNE 30, 2010. FLAGSTAFF HAS RETAINED LEGAL COUNSEL AND, AFTER REPEATED ATTEMPTS TO NEGOTIATE WITHDRAWAL FROM THE PARTNERSHIP WERE UNSUCCESSFUL, FILED A LAWSUIT IN THE CALIFORNIA STATE COURTS SEEKING DISSOLUTION OF THE PARTNERSHIP AND OTHER RELIEF. FOUNDATION SOUGHT TO JOIN FLAGSTAFF AS A PLAINTIFF IN THE LAWSUIT AS DEEMED NECESSARY TO WIND UP AND LIQUIDATE FOUNDATION'S AFFAIRS IN FURTHERANCE OF FOUNDATION'S PRIOR DISSOLUTION. THE TRIAL COURT FOUND THAT FLAGSTAFF, AS A MERE ASSIGNEE OF FOUNDATION'S INTEREST IN THE PARTNERSHIP, LACKED STANDING TO ASSERT ITS CLAIMS, AND GRANTED DEFENDANTS' MOTION FOR JUDGMENT ON THE PLEADINGS. THE TRIAL COURT FURTHER DENIED FLAGSTAFF'S MOTION TO AMEND THE PLEADINGS TO JOIN THE FOUNDATION AS A PLAINTIFF IN THE LAWSUIT. THE TRIAL COURT ENTERED JUDGMENT IN FAVOR OF THE DEFENDANTS. AS A RESULT OF THE TRIAL COURT'S RULING, FLAGSTAFF IS PRECLUDED FROM DISSOLVING THE PARTNERSHIP AND HAS NO RIGHTS TO REVIEW THE BOOKS AND RECORDS OF THE PARTNERSHIP. FLAGSTAFF PROVIDED TO DUDDIE FAMILY LIMITED PARTNERSHIP FORMAL NOTICE OF ITS INTENT TO ABANDON ITS PARTNERSHIP INTEREST BY LETTER DATED JULY 18, 2013, AND BY CONFIRMING CORRESPONDENCE DATED SEPTEMBER 13, 2013. FLAGSTAFF HAS NOT, NOR DOES IT, EXPECT ANY TAX BENEFITS FROM THE TRANSACTION, INCLUDING DEDUCTIONS, EXCLUSIONS FROM GROSS INCOME, NONRECOGNITION OF GAIN, TAX CREDITS, ADJUSTMENTS (OR THE ABSENCE OF ADJUSTMENTS) TO THE BASIS OF PROPERTY, LOSS, OR TAX CREDITS. FLAGSTAFF IS EXEMPT FROM FEDERAL INCOME TAXATION UNDER I.R.C. SECTION 501(C)(3). FLAGSTAFF ONLY EXPECTS DISTRIBUTIONS FROM THE PARTNERSHIP IN ITS CAPACITY AS AN ASSIGNEE OF FOUNDATION'S LIMITED PARTNER INTEREST IN THE PARTNERSHIP. THEREFORE, FLAGSTAFF IS UNABLE TO PROVIDE AN ESTIMATE OF ANY SUCH EXPECTED TAX BENEFITS. ADDITIONALLY, THERE SHOULD BE NO DISCLOSURE TO THE EXTENT THAT FLAGSTAFF IS VIEWED AS ENTERING INTO THE PARTNERSHIP SOLELY PRIOR TO FEBRUARY 28, 2000. THE ORIGINAL TEMP. TREAS. REGS. ISSUED FEBRUARY 28, 2000 UNDER TREAS. REG. SECTION 1.6011-4T MAY GOVERN FLAGSTAFF'S PARTICIPATION IN THE PARTNERSHIP. THESE TREAS. REGS. REQUIRE DISCLOSURE ONLY FOR LARGE TRANSACTIONS THAT PROVIDE TAX SAVINGS IN EXCESS OF CERTAIN DOLLAR THRESHOLDS (THE "PROJECTED TAX EFFECT TEST"). THE PROJECTED TAX EFFECT TEST, AS DESCRIBED IN THESE REGULATIONS, REQUIRE A TRANSACTION TO BE REPORTED WHERE IT IS EXPECTED TO REDUCE THE TAXPAYER'S FEDERAL INCOME TAX LIABILITY BY MORE THAN $1 MILLION IN ANY SINGLE TAXABLE YEAR OR BY A TOTAL OF $2 MILLION FOR ANY COMBINATION OF TAXABLE YEARS. HOWEVER, A LISTED TRANSACTION IS NOT TREATED AS A REPORTABLE TRANSACTION IF IT HAS AFFECTED THE TAXPAYER'S FEDERAL INCOME TAX LIABILITY AS REPORTED ON ANY TAX RETURN FILED ON OR BEFORE FEBRUARY 28, 2000. BECAUSE FLAGSTAFF IS A TAX-EXEMPT I.R.C. SECTION 501(C)(3) ENTITY, FLAGSTAFF'S PARTICIPATION IN THE PARTNERSHIP WAS NOT EXPECTED TO REDUCE ITS TAX LIABILITY AT ALL . THEREFORE, UNDER TEMP. TREAS. REG. SECTION 1.6011-4T, FLAGSTAFF MAY NOT HAVE A DISCLOSURE REQUIREMENT WITH RESPECT TO ITS INVESTMENT IN THE PARTNERSHIP PRIOR TO FEBRUARY 28, 2000.* * SINCE 2001, TEMP. TREAS. REG. SECTION 1.6011-4T HAS BEEN MODIFIED A NUMBER OF TIMES BEFORE BEING FINALIZED IN 2003. BASED ON THE VARIOUS EFFECTIVE DATES FOR THE DIFFERENT SECTIONS THAT HAVE CHANGED, IT APPEARS THAT THE FEBRUARY 28, 2000 INITIAL TEMP. TREAS. REG. SECTION 1.6011-4T IN T.D. 8877 MAY GOVERN THE DISCLOSURE OBLIGATIONS OF FLAGSTAFF WITH RESPECT TO ITS PARTICIPATION IN THE PARTNERSHIP THROUGH ITS LIMITED PARTNERSHIP INTEREST THAT WAS OBTAINED PRIOR TO FEBRUARY 28, 2000, ON OCTOBER 5, 1995.
FORM 8886, 2 OF 3JORDAN FAMILY INVESTMENTS LIMITED PARTNERSHIPNOTE: THE TAX ADVICE PROVIDED BY ERNST & YOUNG LLP, FENNEMORE CRAIG, P.C., AND POLSINELLI PC (FKA POLSINELLI SHUGHART PC) WAS LIMITED TO RECENT ADVICE PERTAINING TO THE DISCLOSURE OF THE TRANSACTION DESCRIBED IN THIS FORM 8886. THE SERVICES PROVIDED BY ERNST & YOUNG LLP, FENNEMORE CRAIG, P.C., AND POLSINELLI PC DID NOT INVOLVE ANY TAX ADVICE PERTAINING TO THE STRUCTURING OF THE TRANSACTION DISCLOSED IN THIS FORM 8886 OR ADVISING THE TAXPAYER BEYOND ITS REPORTABLE TRANSACTION DISCLOSURE AND RELATED OBLIGATIONS. THE FEES PAID BY THE TAXPAYER TO ERNST & YOUNG LLP, POLSINELLI PC, AND FENNEMORE CRAIG, P.C. RELATE ONLY TO POST-TRANSACTIONAL TAX ADVICE CONCERNING ITS DISCLOSURE OBLIGATIONS AND ITS WITHDRAWAL FROM THE JORDAN FAMILY INVESTMENTS LIMITED PARTNERSHIP. LINE 7B - CONTINUATION FROM FORM 8886 AT AN UNKNOWN DATE, MICHAEL E. JORDAN, AS A LIMITED PARTNER, TRANSFERRED A PERCENTAGE OF HIS OWNERSHIP INTEREST TO THE FOUNDATION. DONORS ENTERED INTO THE TRANSACTION, THE PARTNERSHIP, ON OR ABOUT DECEMBER 1, 1990. SOME TIME AFTER THE TRANSACTION WAS ENTERED INTO THE BOY SCOUTS OF AMERICA, MONTANA COUNCIL, WERE ADMITTED TO THE PARTNERSHIP AS A LIMITED PARTNER. ON OR ABOUT JANUARY 30, 1997, FOUNDATION, EIN 94-2540279, ADOPTED ARTICLES OF DISSOLUTION, AND ON OR ABOUT NOVEMBER 1, 2000 FOUNDATION, EIN 94-2540279, WAS ADMINISTRATIVELY DISSOLVED AND FLAGSTAFF MEDICAL CENTER, INC. ("FLAGSTAFF"), EIN 86-0110232, THE THEN SOLE MEMBER OF THE FOUNDATION, SUCCEEDED TO THE INTERESTS OF THE FOUNDATION IN THE REMAINING ASSETS OF THE FOUNDATION AFTER PROVISION FOR ALL LIABILITIES OF THE FOUNDATION UPON ITS DISSOLUTION. FLAGSTAFF IS THE SUCCESSOR ENTITY TO FOUNDATION FOR FEDERAL INCOME TAX PURPOSES. CONSEQUENTLY, FLAGSTAFF MEDICAL CENTER, INC. IS THE ENTITY RESPONSIBLE FOR DISCLOSING THIS TRANSACTION UNDER TREAS. REG. SECTION 1.6011-4, ET SEQ. THE JORDAN FAMILY INVESTMENTS LIMITED PARTNERSHIP AGREEMENT, DATED DECEMBER 1, 1990, (THE "AGREEMENT") DESCRIBES DONORS AS HAVING CONTRIBUTED $100 TO THE PARTNERSHIP AS AN INITIAL CAPITAL CONTRIBUTION. THE INITIAL PARTNERSHIP AGREEMENT LISTS MICHAEL E. JORDAN AS THE GENERAL PARTNER. ACCORDING TO THE PARTNERSHIP'S 2009 K-1, THE GENERAL PARTNER IS NOW WILLIAM J. JORDAN. CLIFFORD JORDAN AND THERESA JORDAN BECAME LIMITED PARTNERS PRIOR TO 2008. PER FOUNDATION'S 2010 SCHEDULE K-1 PROVIDED TO FLAGSTAFF BY PARTNERSHIP, FOUNDATION IS ALLOCATED 42.1% OF THE PROFIT, LOSS AND CAPITAL OF PARTNERSHIP FOR FEDERAL INCOME TAX PURPOSES. PURSUANT TO THE TERMS OF THE AGREEMENT, THE GENERAL PARTNERS HAVE FULL CONTROL OVER THE TIMING AND AMOUNT OF DISTRIBUTIONS FROM THE PARTNERSHIP. FLAGSTAFF, IN ITS CAPACITY AS LIMITED PARTNER IN THE PARTNERSHIP, GENERALLY MAY NOT DEMAND DISTRIBUTIONS OR PARTAKE IN THE MANAGEMENT OF THE PARTNERSHIP. FLAGSTAFF MAY NOT TRANSFER ITS LIMITED PARTNERSHIP INTEREST WITHOUT SATISFYING CERTAIN CONDITIONS, INCLUDING RIGHTS OF FIRST REFUSAL HELD BY THE GENERAL PARTNERS AND THE LIMITED PARTNERS UNDER THE TERMS OF THE AGREEMENT. IT IS UNKNOWN IF AN OPTION AGREEMENT EXISTS, WHICH ALLOWS A THIRD PARTY TO PURCHASE FOUNDATION'S INTEREST IN PARTNERSHIP UPON THE DEATH OF THE GENERAL PARTNER. ON OR ABOUT AUGUST 10, 2010 FLAGSTAFF FIRST BECAME AWARE THAT PARTNERSHIP MIGHT BE VIEWED AS SUBSTANTIALLY SIMILAR TO THE NOTICE 2004-30 TRANSACTION, AND THEREFORE MAY HAVE PARTICIPATED IN A LISTED TRANSACTION WITHIN THE MEANING OF TREAS. REG. SECTION 1.6011-4, ET SEQ. CONSEQUENTLY, FLAGSTAFF'S INITIAL DISCLOSURE OF PARTNERSHIP WAS FILED WITH THE 2009 FORM 990 WITH RESPECT TO FLAGSTAFF'S TAXABLE YEAR ENDED JUNE 30, 2010. FLAGSTAFF RETAINED LEGAL COUNSEL AND NEGOTIATED WITHDRAWAL FROM THE PARTNERSHIP. FLAGSTAFF REDEEMED ITS PARTNERSHIP INTEREST BACK TO THE PARTNERSHIP AS OF OCTOBER 1, 2013 FOR GOOD AND VALUABLE CONSIDERATION. FLAGSTAFF HAS NOT, NOR DOES IT, EXPECT ANY TAX BENEFITS FROM THE TRANSACTION, INCLUDING DEDUCTIONS, EXCLUSIONS FROM GROSS INCOME, NONRECOGNITION OF GAIN, TAX CREDITS, ADJUSTMENTS (OR THE ABSENCE OF ADJUSTMENTS) TO THE BASIS OF PROPERTY, LOSS, OR TAX CREDITS. FLAGSTAFF IS EXEMPT FROM FEDERAL INCOME TAXATION UNDER I.R.C. SECTION 501(C)(3). FLAGSTAFF ONLY EXPECTS DISTRIBUTIONS FROM THE PARTNERSHIP IN ITS CAPACITY AS A LIMITED PARTNER. THEREFORE, FLAGSTAFF IS UNABLE TO PROVIDE AN ESTIMATE OF ANY SUCH EXPECTED TAX BENEFITS. ADDITIONALLY, THERE SHOULD BE NO DISCLOSURE TO THE EXTENT THAT FLAGSTAFF IS VIEWED AS ENTERING INTO THE PARTNERSHIP SOLELY PRIOR TO FEBRUARY 28, 2000. THE ORIGINAL TEMP. TREAS. REGS. ISSUED FEBRUARY 28, 2000 UNDER TREAS. REG. SECTION 1.6011-4T MAY GOVERN FLAGSTAFF'S PARTICIPATION IN THE PARTNERSHIP. THESE TREAS. REGS. REQUIRE DISCLOSURE ONLY FOR LARGE TRANSACTIONS THAT PROVIDE TAX SAVINGS IN EXCESS OF CERTAIN DOLLAR THRESHOLDS (THE "PROJECTED TAX EFFECT TEST"). THE PROJECTED TAX EFFECT TEST, AS DESCRIBED IN THESE REGULATIONS, REQUIRE A TRANSACTION TO BE REPORTED WHERE IT IS EXPECTED TO REDUCE THE TAXPAYER'S FEDERAL INCOME TAX LIABILITY BY MORE THAN $1 MILLION IN ANY SINGLE TAXABLE YEAR OR BY A TOTAL OF $2 MILLION FOR ANY COMBINATION OF TAXABLE YEARS. HOWEVER, A LISTED TRANSACTION IS NOT TREATED AS A REPORTABLE TRANSACTION IF IT HAS AFFECTED THE TAXPAYER'S FEDERAL INCOME TAX LIABILITY AS REPORTED ON ANY TAX RETURN FILED ON OR BEFORE FEBRUARY 28, 2000. BECAUSE FLAGSTAFF IS A TAX-EXEMPT I.R.C. SECTION 501(C)(3) ENTITY, FLAGSTAFF'S PARTICIPATION IN THE PARTNERSHIP WAS NOT EXPECTED TO REDUCE ITS TAX LIABILITY AT ALL . THEREFORE, UNDER TEMP. TREAS. REG. SECTION 1.6011-4T, FLAGSTAFF MAY NOT HAVE A DISCLOSURE REQUIREMENT WITH RESPECT TO ITS INVESTMENT IN THE PARTNERSHIP PRIOR TO FEBRUARY 28, 2000.* * SINCE 2001, TEMP. TREAS. REG. SECTION 1.6011-4T HAS BEEN MODIFIED A NUMBER OF TIMES BEFORE BEING FINALIZED IN 2003. BASED ON THE VARIOUS EFFECTIVE DATES FOR THE DIFFERENT SECTIONS THAT HAVE CHANGED, IT APPEARS THAT THE FEBRUARY 28, 2000 INITIAL TEMP. TREAS. REG. SECTION 1.6011-4T IN T.D. 8877 MAY GOVERN THE DISCLOSURE OBLIGATIONS OF FLAGSTAFF WITH RESPECT TO ITS PARTICIPATION IN THE PARTNERSHIP THROUGH ITS LIMITED PARTNERSHIP INTEREST THAT WAS OBTAINED PRIOR TO FEBRUARY 28, 2000, ON OR ABOUT DECEMBER 31, 1990. FLAGSTAFF HAS NOT, NOR DOES IT, EXPECT ANY TAX BENEFIT FROM THE TRANSACTION, INCLUDING DEDUCTIONS, EXCLUSIONS FROM GROSS INCOME, NONRECOGNITION OF GAIN, TAX CREDITS, ADJUSTMENTS (OR THE ABSENCE OF ADJUSTMENTS) TO THE BASIS OF PROPERTY, LOSS, OR TAX CREDITS. FLAGSTAFF IS EXEMPT FROM FEDERAL INCOME TAXATION UNDER I.R.C. SECTION 501(C)(3). FLAGSTAFF ONLY EXPECTS DISTRIBUTIONS FROM THE PARTNERSHIP IN ITS CAPACITY AS LIMITED PARTNER.
FORM 8886, 3 OF 3NAAM ENTERPRISES LIMITED PARTNERSHIPNOTE: THE TAX ADVICE PROVIDED BY ERNST & YOUNG LLP, FENNEMORE CRAIG, P.C., AND POLSINELLI PC (FKA POLSINELLI SHUGHART PC) WAS LIMITED TO RECENT ADVICE PERTAINING TO THE DISCLOSURE OF THE TRANSACTION DESCRIBED IN THIS FORM 8886. THE SERVICES PROVIDED BY ERNST & YOUNG LLP, FENNEMORE CRAIG, P.C., AND POLSINELLI PC DID NOT INVOLVE ANY TAX ADVICE PERTAINING TO THE STRUCTURING OF THE TRANSACTION DISCLOSED IN THIS FORM 8886 OR ADVISING THE TAXPAYER BEYOND ITS REPORTABLE TRANSACTION DISCLOSURE AND RELATED OBLIGATIONS. THE FEES PAID BY THE TAXPAYER TO ERNST & YOUNG LLP, POLSINELLI PC, AND FENNEMORE CRAIG, P.C. RELATE ONLY TO POST-TRANSACTIONAL TAX ADVICE CONCERNING ITS DISCLOSURE OBLIGATIONS AND ITS WITHDRAWAL FROM NAAM ENTERPRISES LIMITED PARTNERSHIP. LINE 7B - CONTINUATION FROM FORM 8886 AT AN UNKNOWN DATE, HARI BHAJAN SINGH KHALSA AND HARI BHAJAN KAUR KHALSA, IN THEIR CAPACITY AS LIMITED PARTNERS, TRANSFERRED A PERCENTAGE OF THEIR OWNERSHIP INTEREST TO THE FOUNDATION. DONORS ENTERED INTO THE TRANSACTION, THE PARTNERSHIP, ON OR ABOUT DECEMBER 1, 1990. ON OR ABOUT NOVEMBER 1, 2000, FOUNDATION, EIN 94-2540279, WAS ADMINISTRATIVELY DISSOLVED AND FLAGSTAFF MEDICAL CENTER, INC. ("FLAGSTAFF"), EIN 86-0110232, THE THEN SOLE MEMBER OF THE FOUNDATION, SUCCEEDED TO THE INTERESTS OF THE FOUNDATION IN THE REMAINING ASSETS OF THE FOUNDATION AFTER PROVISION FOR ALL LIABILITIES OF THE FOUNDATION UPON ITS DISSOLUTION. FLAGSTAFF IS THE SUCCESSOR ENTITY TO FOUNDATION FOR FEDERAL INCOME TAX PURPOSES. CONSEQUENTLY, FLAGSTAFF MEDICAL CENTER, INC. IS THE ENTITY RESPONSIBLE FOR DISCLOSING THIS TRANSACTION UNDER TREAS. REG. SECTION 1.6011-4, ET SEQ. NAAM ENTERPRISES LIMITED PARTNERSHIP AGREEMENT (THE "AGREEMENT") DESCRIBES DONORS AS HAVING CONTRIBUTED $100 TO THE PARTNERSHIP AS AN INITIAL CAPITAL CONTRIBUTION. PER FOUNDATION'S 2012 SCHEDULE K-1 PROVIDED TO FLAGSTAFF BY PARTNERSHIP, FOUNDATION IS ALLOCATED 22% OF THE PROFIT, LOSS AND CAPITAL OF PARTNERSHIP FOR FEDERAL INCOME TAX PURPOSES. PURSUANT TO THE TERMS OF THE AGREEMENT, THE GENERAL PARTNERS HAVE FULL CONTROL OVER THE TIMING AND AMOUNT OF DISTRIBUTIONS FROM THE PARTNERSHIP. FLAGSTAFF, IN ITS CAPACITY AS LIMITED PARTNER IN THE PARTNERSHIP, GENERALLY MAY NOT DEMAND DISTRIBUTIONS OR PARTAKE IN THE MANAGEMENT OF THE PARTNERSHIP. FLAGSTAFF MAY NOT TRANSFER ITS LIMITED PARTNERSHIP INTEREST WITHOUT SATISFYING CERTAIN CONDITIONS, INCLUDING RIGHTS OF FIRST REFUSAL HELD BY THE GENERAL PARTNERS AND THE LIMITED PARTNERS UNDER THE TERMS OF THE AGREEMENT. IT IS UNKNOWN IF AN OPTION AGREEMENT EXISTS, WHICH ALLOWS A THIRD PARTY TO PURCHASE FOUNDATION'S INTEREST IN PARTNERSHIP UPON THE DEATH OF THE GENERAL PARTNER. ON OR ABOUT AUGUST 10, 2010 FLAGSTAFF FIRST BECAME AWARE THAT PARTNERSHIP MIGHT BE VIEWED AS SUBSTANTIALLY SIMILAR TO THE NOTICE 2004-30 TRANSACTION, AND THEREFORE MAY HAVE PARTICIPATED IN A LISTED TRANSACTION WITHIN THE MEANING OF TREAS. REG. SECTION 1.6011-4, ET SEQ. CONSEQUENTLY, FLAGSTAFF'S INITIAL DISCLOSURE OF PARTNERSHIP WAS FILED WITH THE 2009 FORM 990 WITH RESPECT TO FLAGSTAFF'S TAXABLE YEAR ENDED JUNE 30, 2010. FLAGSTAFF RETAINED LEGAL COUNSEL AND NEGOTIATED WITHDRAWAL FROM THE PARTNERSHIP. FLAGSTAFF REDEEMED ITS PARTNERSHIP INTEREST BACK TO THE PARTNERSHIP AS OF NOVEMBER 1, 2013 FOR GOOD AND VALUABLE CONSIDERATION. FLAGSTAFF HAS NOT, NOR DOES IT, EXPECT ANY TAX BENEFITS FROM THE TRANSACTION, INCLUDING DEDUCTIONS, EXCLUSIONS FROM GROSS INCOME, NONRECOGNITION OF GAIN, TAX CREDITS, ADJUSTMENTS (OR THE ABSENCE OF ADJUSTMENTS) TO THE BASIS OF PROPERTY, LOSS, OR TAX CREDITS. FLAGSTAFF IS EXEMPT FROM FEDERAL INCOME TAXATION UNDER I.R.C. SECTION 501(C)(3). FLAGSTAFF ONLY EXPECTS DISTRIBUTIONS FROM THE PARTNERSHIP IN ITS CAPACITY AS A LIMITED PARTNER. THEREFORE, FLAGSTAFF IS UNABLE TO PROVIDE AN ESTIMATE OF ANY SUCH EXPECTED TAX BENEFITS. ADDITIONALLY, THERE SHOULD BE NO DISCLOSURE TO THE EXTENT THAT FLAGSTAFF IS VIEWED AS ENTERING INTO THE PARTNERSHIP SOLELY PRIOR TO FEBRUARY 28, 2000. THE ORIGINAL TEMP. TREAS. REGS. ISSUED FEBRUARY 28, 2000 UNDER TREAS. REG. SECTION 1.6011-4T MAY GOVERN FLAGSTAFF'S PARTICIPATION IN THE PARTNERSHIP. THESE TREAS. REGS. REQUIRE DISCLOSURE ONLY FOR LARGE TRANSACTIONS THAT PROVIDE TAX SAVINGS IN EXCESS OF CERTAIN DOLLAR THRESHOLDS (THE "PROJECTED TAX EFFECT TEST"). THE PROJECTED TAX EFFECT TEST, AS DESCRIBED IN THESE REGULATIONS, REQUIRE A TRANSACTION TO BE REPORTED WHERE IT IS EXPECTED TO REDUCE THE TAXPAYER'S FEDERAL INCOME TAX LIABILITY BY MORE THAN $1 MILLION IN ANY SINGLE TAXABLE YEAR OR BY A TOTAL OF $2 MILLION FOR ANY COMBINATION OF TAXABLE YEARS. HOWEVER, A LISTED TRANSACTION IS NOT TREATED AS A REPORTABLE TRANSACTION IF IT HAS AFFECTED THE TAXPAYER'S FEDERAL INCOME TAX LIABILITY AS REPORTED ON ANY TAX RETURN FILED ON OR BEFORE FEBRUARY 28, 2000. BECAUSE FLAGSTAFF IS A TAX-EXEMPT I.R.C. SECTION 501(C)(3) ENTITY, FLAGSTAFF'S PARTICIPATION IN THE PARTNERSHIP WAS NOT EXPECTED TO REDUCE ITS TAX LIABILITY AT ALL . THEREFORE, UNDER TEMP. TREAS. REG. SECTION 1.6011-4T, FLAGSTAFF MAY NOT HAVE A DISCLOSURE REQUIREMENT WITH RESPECT TO ITS INVESTMENT IN THE PARTNERSHIP PRIOR TO FEBRUARY 28, 2000.* * SINCE 2001, TEMP. TREAS. REG. SECTION 1.6011-4T HAS BEEN MODIFIED A NUMBER OF TIMES BEFORE BEING FINALIZED IN 2003. BASED ON THE VARIOUS EFFECTIVE DATES FOR THE DIFFERENT SECTIONS THAT HAVE CHANGED, IT APPEARS THAT THE FEBRUARY 28, 2000 INITIAL TEMP. TREAS. REG. SECTION 1.6011-4T IN T.D. 8877 MAY GOVERN THE DISCLOSURE OBLIGATIONS OF FLAGSTAFF WITH RESPECT TO ITS PARTICIPATION IN THE PARTNERSHIP THROUGH ITS LIMITED PARTNERSHIP INTEREST THAT WAS OBTAINED PRIOR TO FEBRUARY 28, 2000, ON OR ABOUT DECEMBER 31, 1990. FLAGSTAFF HAS NOT, NOR DOES IT, EXPECT ANY TAX BENEFIT FROM THE TRANSACTION, INCLUDING DEDUCTIONS, EXCLUSIONS FROM GROSS INCOME, NONRECOGNITION OF GAIN, TAX CREDITS, ADJUSTMENTS (OR THE ABSENCE OF ADJUSTMENTS) TO THE BASIS OF PROPERTY, LOSS, OR TAX CREDITS. FLAGSTAFF IS EXEMPT FROM FEDERAL INCOME TAXATION UNDER I.R.C. SECTION 501(C)(3). FLAGSTAFF ONLY EXPECTS DISTRIBUTIONS FROM THE PARTNERSHIP IN ITS CAPACITY AS LIMITED PARTNER.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
NORTHERN ARIZONA HEALTHCARE
PO BOX 1268FLAGSTAFFAZ86001742410946HEALTHCAREAZ501(C)(3)9NAfalse
VERDE VALLEY MEDICAL CENTER
269 SOUTH CANDY LANECOTTONWOODAZ86326860100882HEALTHCAREAZ501(C)(3)3NAHtrue

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

EINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnershipAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCode
TASC LLC
860913157AMBULATORY SVAZNARELATED246994895129false$0true0.58520
NAHPG LLC
454464070ADMIN AND BILLINGAZFMC AND VVMCRELATED-11043223610007falsetrue0.50000PO BOX 1268FLAGSTAFFAZ86002
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
VERDE VALLEY MEDICAL CENTER
Q67682244FINANCIAL STMT
NAHPG LLC
B5096331FINANCIAL STMT
TASC LLC
A370543FINANCIAL STMT