2021-05-15T16:50:05-05:00 2020-06-30 450250958 EIDE BAILLY LLP 2355 E CAMELBACK RD STE 900 PHOENIX AZ 850169065 990 2019-07-01 813137336 NORTHERN ARIZONA HEALTHCARE FOUNDATION NORT 9282239250 1030 N SAN FRANCISCO ST STE 103 FLAGSTAFF AZ 86001 RICHARD SMITH PRESIDENT AND CEO 9282239250 2021-05-15 1 BRENDA BLUNT CPA P00075126 4803151040 2021-05-15 2019 2022-09-23 18:48:47Z RICHARD A SMITH 1030 N SAN FRANCISCO ST STE 103 FLAGSTAFF AZ 86001 4900880 0 X WWW.NAHEALTHFOUNDATION.ORG X 2016 AZ THE MISSION OF NORTHERN ARIZONA HEALTHCARE FOUNDATION ("NAHF") IS TO SUPPORT (CONT'D ON SCH O) NORTHERN ARIZONA HEALTHCARE CORPORATION ("NAHC"), WHILE ADVANCING COMMUNITY HEALTHCARE PRIORITIES. THE VISION IS A FUTURE WHERE EVERY PERSON IN OUR REGION HAS EQUAL ACCESS TO QUALITY HEALTHCARE AND OPPORTUNITY TO ACHIEVE THEIR HIGHEST LEVEL OF HEALTH. 10 9 0 117 0 0 3143076 3573426 16657 7493 1282949 1211974 -46785 -96316 4395897 4696577 4540342 6094979 0 0 1901601 2015862 0 0 1306681 594163 664167 7036106 8775008 -2640209 -4078431 46889379 42473817 1736321 1044016 45153058 41429801 X THE MISSION OF NORTHERN ARIZONA HEALTHCARE FOUNDATION ("NAHF") IS TO SUPPORT NORTHERN ARIZONA HEALTHCARE CORPORATION ("NAHC"), WHILE ADVANCING COMMUNITY HEALTHCARE PRIORITIES. THE VISION IS A FUTURE WHERE EVERY PERSON IN OUR REGION HAS EQUAL (CONT'D ON SCHEDULE O) ACCESS TO QUALITY HEALTHCARE AND OPPORTUNITY TO ACHIEVE THEIR HIGHEST LEVEL OF HEALTH. 0 1 3443666 3230653 DURING THE 2019 TAX YEAR, THE FOUNDATION COMPLETED FUNDING THE CONSTRUCTION OF A NEW HEALTHCARE CENTER FOR THE WILLIAMS HOSPITAL DISTRICT OF COCONINO COUNTY THAT, WHEN COMPLETED, WILL PROVIDE ACCESS TO HEALTHCARE SERVICES TO RESIDENTS OF THE CITY OF WILLIAMS, ARIZONA AND OUTLYING AREAS, SUCH AS TUSAYAN, RED LAKE, ASH FORK, AND PARKS, ARIZONA. IN TOTAL, THE FOUNDATION FUNDED $6 MILLION FOR THE CONSTRUCTION OF THIS FACILITY. 2015243 1890921 THE FOUNDATION GENERATES FUNDS TO SUPPORT THREE HEALTH PRIORITIES IN NORTHERN ARIZONA: INCREASED ACCESS TO HEALTHCARE, IMPROVED BEHAVIORAL HEALTH OUTCOMES, AND DECREASED INCIDENCE OF CHRONIC MEDICAL CONDITIONS. THE FOUNDATION CREATED THE LEADERSHIP FUND FOR NAH HEALTHCARE HEROES IN MARCH 2020 SPECIFICALLY TO GENERATE AND DISBURSE FUNDS TO EMPLOYEES OF NORTHERN ARIZONA HEALTHCARE CORPORATION WORKING FEWER OR NO HOURS DUE TO THE HEALTH SYSTEM'S CESSATION OF ELECTIVE SURGICAL AND OTHER MEDICAL PROCEDURES AND PATIENT SERVICES DUE TO THE COVID-19 PANDEMIC. THE FUNDS WERE DIRECTED FOR THE PAYMENT OF MORTGAGES, RENTS, UTILITIES, FOOD, ETC. IN ADDITION, THE FOUNDATION CREATED A PANDEMIC MITIGATION GRANT PROGRAM IN APRIL 2020 TO BENEFIT NATIVE TRIBES BY ADDRESSING RELATED TRIBAL HEALTH CHALLENGES. DURING THE 2019 (CONT'D ON SCH. O) TAX YEAR, THE FOUNDATION MADE GRANTS TO NORTHERN ARIZONA HEALTHCARE, FLAGSTAFF MEDICAL CENTER, VERDE VALLEY MEDICAL CENTER, AND 24 OTHER NONPROFIT AND GOVERNMENTAL ORGANIZATIONS THAT ADVANCE THE COMMUNITY HEALTH PRIORITIES OF NORTHERN ARIZONA HEALTHCARE AND SUPPORT THE HEALTH AND WELL-BEING OF PEOPLE THROUGHOUT THE NORTHERN ARIZONA COMMUNITY. IN ADDITION, THE FOUNDATION AWARDED GRANTS TO MORE THAN 200 EMPLOYEES OF NORTHERN ARIZONA HEALTHCARE TO ASSIST WITH FINANCIAL HARDSHIPS DIRECTLY CAUSED BY THE COVID-19 PANDEMIC. MORE THAN 158,000 LIVES WERE IMPACTED BY THE FOUNDATION'S EFFORTS. 608216 570592 7493 DURING THE 2019 TAX YEAR, THE FOUNDATION CONDUCTED A NUMBER OF SPECIAL EVENTS THAT RAISED MONIES FOR DEPARTMENTS OF NORTHERN ARIZONA HEALTHCARE, FLAGSTAFF MEDICAL CENTER, AND VERDE VALLEY MEDICAL CENTER, AND FOR THE FOUNDATION'S MENTAL HEALTH FIRST AID PROGRAM. IN ADDITION, THE FOUNDATION SOLICITED GRANTS FROM EXTERNAL GRANTORS, SOME OF WHICH WERE AWARDED DIRECTLY TO NORTHERN ARIZONA HEALTHCARE AND OTHERS OF WHICH WERE AWARDED TO THE FOUNDATION, AND WERE SUBSEQUENTLY SUB-AWARDED TO NORTHERN ARIZONA HEALTHCARE AND ITS RELATED NONPROFIT HOSPITALS. THE FOUNDATION PROVIDED SPONSORSHIP SUPPORT TO 42 NONPROFIT ORGANIZATIONS, GOVERNMENTS, AND INSTITUTIONS OF HIGHER LEARNING THROUGHOUT NORTHERN ARIZONA. 15,107 LIVES WERE IMPACTED BY THESE SPONSORSHIPS. THE FOUNDATION SUSPENDED ITS (CONT'D ON SCH. O) SPONSORSHIP PROGRAM IN MARCH 2020, DUE TO THE COVID-19 PANDEMIC. THE FOUNDATION AWARDED SCHOLARSHIPS TO 28 INDIVIDUALS PURSUING HEALTHCARE EDUCATION, AND RECEIVED GIFTS IN KIND THAT WERE SUBSEQUENTLY CONTRIBUTED DIRECTLY AND INDIRECTLY TO VARIOUS DEPARTMENTS OF NORTHERN ARIZONA HEALTHCARE AND ITS RELATED NONPROFIT HOSPITALS. 429373 402813 DURING THE 2019 TAX YEAR, THE FOUNDATION PROVIDED FUNDING TO OR ON BEHALF OF NORTHERN ARIZONA HEALTHCARE, FLAGSTAFF MEDICAL CENTER, AND VERDE VALLEY MEDICAL CENTER FOR VARIOUS DEPARTMENT INITIATIVES INCLUDING BEHAVIORAL HEALTH, CHILDREN'S HEALTH, CARDIOVASCULAR SERVICES, CANCER CARE, PALLIATIVE AND HOSPICE CARE, EMERGENCY CARE, RESEARCH AND DEVELOPMENT, AND PATIENT, FAMILY, AND COLLEAGUE ASSISTANCE. 429373 402813 6496498 1 1 0 0 0 1 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X KARLA AMBLER JACOBSEN 9282239250 1030 N SAN FRANCISCO ST STE 103 FLAGSTAFF AZ 86001 RICHARD A SMITH EDD PRESIDENT/CEO/DIRECTOR 40.00 X X 587859 0 6281 MATTHEW BRASMER VICE PRESIDENT OF DEVELOPMENT 40.00 X 205492 0 1066 KARLA JACOBSEN CPA SENIOR ACCOUNTANT 40.00 X 105458 0 2079 WAYNE FOX CPA TREASURER/DIRECTOR 1.00 X X 1964 0 0 WILLIAM HICKS III ESQ DIRECTOR 1.00 X 1642 0 0 ALICE GAGNAIRE DIRECTOR 1.00 X X 1518 0 0 DEIRDRE MELDRUM PHD VICE CHAIR/DIRECTOR 1.00 X X 1213 0 0 CHRIS BAVASI CHAIR/DIRECTOR 1.00 X X 1213 0 0 RICHARD KRUSE CPA DIRECTOR 1.00 X 739 0 0 OLIVER HARPER MD DIRECTOR 1.00 X 415 0 0 WILLIAM RILEY PHD DIRECTOR 1.00 X 415 0 0 CHUCK MARR DIRECTOR (THRU 09/19) 1.00 X 0 0 0 JAMES OUSLEY SECRETARY/DIRECTOR 1.00 X X 0 0 0 907928 0 9426 3 0 1 1 0 310686 3262740 219392 3573426 GRANT ADMINISTRATION FEES 561000 7493 7493 7493 1211974 1211974 107987 310686 204303 -96316 -96316 4696577 7493 0 1115658 5777195 5777195 317784 317784 941132 205283 343449 392400 597047 104351 113552 379144 375634 49868 75377 250389 102049 18902 27857 55290 146807 146807 96197 96197 14826 14826 95936 13572 28994 53370 18594 18594 22372 1183 2989 18200 93578 183 93395 55379 8360 18081 28938 8006 8006 BOARD EXPENSE 68114 68114 DONOR CULTIVATION 27549 27549 OTHER 16809 16809 8775008 6496498 971829 1306681 82906 60168 6148400 4580576 3731907 1187699 103183 84551 31133 31133 0 0 36807983 36545823 15000 15000 46889379 42473817 756475 657527 54822 147970 64273 860751 238519 1736321 1044016 X 10981446 6722093 34171612 34707708 45153058 41429801 46889379 42473817 -4078431 355174 0 X 0 1 X 1 0 X 38031508 10600391 3143076 3573426 55348401 38031508 10600391 3143076 3573426 55348401 46609002 8739399 484941 731174 1282949 1211974 3711038 9195 9195 4136 4136 59072770 24150 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2017 AMOUNT: $ 4,136. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 212792 1281961 26640220 1 1 0 27201322 212792 1047402 1281961 539335 26640220 25708936 1384435 1668446 936144 624351 27201322 23136444 1159950 2134416 1136971 415097 25708936 21700507 2211007 775070 23136444 0.00000 0.90350 0.09650 0 0 31133 31133 0 0 457 EMPLOYER LIABILITY 191711 REFUNDABLE ADVANCES 46808 238519 X 5194690 355174 23985 133780 512939 4681751 14826 14826 4696577 8917947 23985 133780 157765 8760182 14826 14826 8775008 PART X, LINE 2: MANAGEMENT BELIEVES THAT THE FOUNDATION HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EVENT EXPENSES 133,780. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EVENT EXPENSES 133,780. SCHEDULE D, PART V, LINE 4 THE NORTHERN ARIZON HEALTHCARE ENDOWMENT FUND WAS ESTABLISHED TO SUPPORT NORTHERN ARIZONA HEALTHCARE CORPORATION AND TO SUPPORT BOTH THE DELIVERY OF QUALITY HEALTH CARE AND TO INCREASE THE IMPACT ON HEALTH IN POSITIVE, COLLABORATIVE WAYS. TURQUOISE BALL 219185 156659 62526 44552 32658 5340 34975 COPPER BALL 54612 32355 22257 19505 4602 5 144876 121672 23204 6626 21246 11790 23009 418673 310686 107987 70683 21246 44448 5340 62586 204303 -96316 1 BOYS & GIRLS CLUB OF FLAGSTAFF 301 S PASEO DEL FLAG FLAGSTAFF AZ 86001 860688398 501(C)(3) 10000 GRANT TO SUPPORT HEALTHY LIFESTYLES PROGRAM FOR CHILDREN AND YOUTH, AGES 6-17, IN THE BELOW POVERTY LEVEL/HOMELESS/UNEMPLOYED/WORKING POOR SOCIO-ECONOMIC GROUP AND LIVING IN COCONINO AND NAVAJO COUNTIES CANCER SUPPORT COMMUNITY ARIZONA 360 E PALM LANE PHOENIX AZ 85004 860897810 501(C)(3) 35000 GRANT TO SUPPORT ADVANCING CANCER SUPPORT SERVICES IN NORTHERN ARIZONA COCONINO COMMUNITY COLLEGE 2800 S LONE TREE ROAD FLAGSTAFF AZ 86005 860717956 501(C)(3) 175000 GRANT TO SUPPORT COCONINO COMMUNITY COLLEGE NURSING, EMERGENCY MEDICAL SERVICES, AND FIRE/RESCUE PROGRAMS. FLAGSTAFF MEDICAL CENTER 1200 N BEAVER STREET FLAGSTAFF AZ 86001 860110232 501(C)(3) 447393 96505 DONOR REPORTED AND FMV CLOTHING & HOUSEHOLD GOODS; BOOKS & PUBLICATIONS; GIFT CERTIFICATES, ETC. GRANTS TO SUPPORT HOSPITAL DEPARTMENT INITIATIVES INCLUDING PALLIATIVE CARE, PEDIATRIC TRAUMA, CHILDREN'S HEALTH, RESEARCH & EDUCATION AND OTHER COMMUNITY SUPPORT HOZHONI FOUNDATION 2133 N WALGREEN STREET FLAGSTAFF AZ 86004 860255127 501(C)(3) 22000 GRANT TO SUPPORT HOZONI HEALTH & HAPPINESS (H3) PROJECT NORTH COUNTRY COMMUNITY HEALTH CENTER INC PO BOX 3630 FLAGSTAFF AZ 860033630 860663432 501(C)(3) 84522 GRANTS TO SUPPORT GIRLS ON THE RUN PROGRAM EXPANSION, WELL WOMAN HEALTHCHECK TREATMENT LINK PROGRAM, AND NORTHERN ARIZONA CARE AFTER SEXUAL ASSAULT (NACASA) PROGRAM NORTHERN ARIZONA ADAPTIVE SPORTS ASSOCIATION PO BOX 1903 FLAGSTAFF AZ 86002 813359695 501(C)(3) 30000 GRANT TO SUPPORT SNOWBOWL ADAPTIVE SPORTS PROGRAM TO TRAIN INSTRUCTORS AND PROVIDE SNOW EXPERIENCES TO INDIVIDUALS WITH DISABILITIES NORTHERN ARIZONA HEALTHCARE 1200 N BEAVER STREET FLAGSTAFF AZ 86001 742410946 501(C)(3) 280537 10608 DONOR REPORTED AND FMV CLOTHING & HOUSEHOLD GOODS FOR SPECIAL CARE NURSERY GRANTS TO SUPPORT SPECIAL CARE NURSERY DEPARTMENT FAMILY INTEGRATED CARE PROGRAM AND ONE NAH SPIRITUAL CARE PROGRAM AND GRANTS TO SUPPORT HOSPITAL DEPARTMENT INITIATIVES INCLUDING PATIENT EDUCATION & NAH COLLEAGUE SUPPORT NORTHERN ARIZONA UNIVERSITY PO BOX 122 FLAGSTAFF AZ 86002 866004791 501(C)(3) 45000 SUPPORT NAU PROGRAMS THAT PROVIDE HEALTHCARE, INCLUDING BEHAVIORAL HEALTH, TO NAU ATHLETES NORTHERN ARIZONA UNIVERSITY FOUNDATION PO BOX 4094 FLAGSTAFF AZ 86011 860193726 501(C)(3) 111000 CONTRIBUTION TO SUPPORT A NURSING SCHOLARSHIP PROGRAM AND GRANT TO SUPPORT NAU SCHOOL OF NURSING IMPROVING CONFIDENCE OF HEALTHCARE PROVIDERS PROGRAM NORTHLAND HOSPICE & PALLIATIVE CARE INC PO BOX 997 FLAGSTAFF AZ 86002 742385187 501(C)(3) 37700 GRANT TO SUPPORT HOSPICE ASSISTED LIVING CARE POORE MEDICAL CLINIC 120 W FINE FLAGSTAFF AZ 86001 800751712 501(C)(3) 10000 GRANT TO ASSIST WITH PATIENT CARE TO UNINSURED AND UNDERINSURED PATIENTS RONALD MCDONALD HOUSE CHARITIES OF CENTRAL AND NORTHERN ARIZONA 501 E ROANOKE AVENUE PHOENIX AZ 85004 953526934 501(C)(3) 25000 GRANT TO SUPPORT HELP A FAMILY PROGRAM SEDONA INTERNATIONAL FILM FESTIVAL PO BOX 162 SEDONA AZ 86339 200351857 501(C)(3) 25000 EVENT SPONSORSHIP STEPS TO RECOVERY 516 E STATE ROUTE 89A SUITE 113 COTTONWOOD AZ 86326 463225513 501(C)(3) 52000 GRANT TO SUPPORT PROJECT EMPOWER 2.0 PROGRAM-HELPING PERSONS RECOVERING FROM SUBSTANCE ABUSE & EVENT SPONSORSHIP TUBA CITY REGIONAL HEALTHCARE CORPORATION PO BOX 600 TUBA CITY AZ 860450600 043651340 501(C)(3) 25533 GRANT TO SUPPORT IMPROVING THE COMFORT AND QUALITY OF LIFE OF TCRHCC CANCER PATIENTS PROGRAM VERDE VALLEY CAREGIVERS COALITION 299 VAN DEREN ROAD SUITE 2 SEDONA AZ 86336 860725787 501(C)(3) 50000 GRANT TO SUPPORT COMMUNITY-BASED CARE COORDINATION WITH ACCESSIBLE MOBILITY FOR HIGH-NEEDS ELDERLY VERDE VALLEY MEDICAL CENTER 1200 N BEAVER STREET FLAGSTAFF AZ 86001 860100882 501(C)(3) 565622 15907 DONOR REPORTED AND FMV COVID-RELATED MASKS, GOWNS, GLOVES, RESPIRATORS, ETC. GRANT TO SUPPORT MOVING UPSTREAM PROGRAM AND GRANTS TO SUPPORT HOSPITAL DEPARTMENT INITIATIVES INCLUDING PALLIATIVE AND COMPLEMENTARY PATIENT CARE WILLIAMS HOSPITAL DISTRICT OF COCONINO COUNTY 301 S 7TH STREET WILLIAMS AZ 86046 866000441 GOVERNMENT 3230653 FUND CONSTRUCTION OF A NEW HEALTHCARE CENTER TO PROVIDE ACCESS TO HEALTHCARE SERVICES TO RESIDENTS OF THE CITY OF WILLIAMS AND OUTLYING AREAS SUCH AS TUSAYAN, RED LAKE, ASH FORK AND PARKS. CATHOLIC CHARITIES COMMUNITY SERVICES INC 4747 N 7TH AVENUE PHOENIX AZ 85013 860223999 501(C)(3) 65958 GRANT TO SUPPORT THE CLOSING THE GAP PROGRAM WEST YAVAPAI GUIDANCE CLINIC 3343 WINDSONG DR PRESCOTT VALLEY AZ 86314 860206928 501(C)(3) 50000 GRANT TO SUPPORT CRISIS STABILIZATION UNIT NAVAJO-HOPI HEALTH FOUNDATION 167 N MAIN ST TUBA CITY AZ 860450600 453548948 501(C)(3) 43864 GRANT TO SUPPORT PANDEMIC MITIGATION EFFORTS ON NAVAJO AND HOPI RESERVATIONS THE HOPI FOUNDATION PO BOX 301 KYKOTSMOVI AZ 86039 742488628 501(C)(3) 40000 GRANT TO SUPPORT PANDEMIC MITIGATION EFFORTS ON THE HOPI RESERVATION FLAGSTAFF UNIFIED SCHOOL DISTRICT NO 1 3285 E SPARROW AVENUE FLAGSTAFF AZ 86004 860593041 GOVERNMENT 33000 W.F. KILLIP ELEMENTARY SCHOOL AND COMMUNITY LEARNING CENTER - COORDINATED SCHOOL HEALTH PLAN LEG UP THERAPY INC 2200 N MONDALE LANE CAMP VERDE AZ 86322 461370983 501(C)(3) 25000 GRANT TO PROVIDE THE DISABLED A LEG UP TO SUCCESS IN THE COMMUNITY NAVAJO COUNTY COMMUNITY COLLEGE DBA NORTHLAND PIONEER COLLEGE PO BOX 610 HOLBROOK AZ 86025 860277526 GOVERNMENT 25000 GRANT TO FUND PROGRAM TO TRAIN QUALIFYING EXCEPTIONAL SURGICAL TECHHNOLOGISTS THROUGH SIMULATION - QESTS RED EARTH THEATRE COMPANY 205 SUNSET DRIVE 135 SEDONA AZ 86336 463424602 501(C)(3) 20000 GRANT TO SUPPORT VETERANS SPEAK - PERFORMING WELLNESS PROGRAM ADULT COMMUNITY CENTER OF ARIZONA 2615 MELODY LANE SEDONA AZ 86336 860491174 501(C)(3) 17000 GRANT TO SUPPORT VITAL FOOD SERVICES PROGRAM CIVITAN FOUNDATION INC 12635 N 42ND STREET PHOENIX AZ 85032 237036797 501(C)(3) 6500 GRANT TO SUPPORT CAMP CIVITAN MEDICAL UPGRADE PROJECT FLAGSTAFF CHAMBER OF COMMERCE 101 W ROUTE 66 FLAGSTAFF AZ 86001 860020635 501(C)(3) 5500 EVENT SPONSORSHIP - 2020 ATHENA AWARDS AMERICAN RED CROSS OF GREATER PHOENIX 4747 N 22ND STREET SUITE 100 PHOENIX AZ 85016 530196605 501(C)(3) 5000 EVENT SPONSORSHIP - NORTHERN ARIZONA FLAGSTAFF COMMUNITY LEADERS BREAKFAST HIGHLANDS FIRE DISTRICT 3350 OLD MUNDS HIGHWAY FLAGSTAFF AZ 86005 860949933 GOVERNMENT 5000 GRANT TO SUPPORT COMMUNITY INTEGRATED PARAMEDIC PROGRAM 32 0 SCHOLARSHIPS 28 28000 ASSISTANCE FOR COVID-19 RELATED FINANCIAL HARDSHIPS 205 282784 FINANCIAL ASSISTANCE TO INJURED EMERGENCY MEDICAL TECHNICIANS AND/OR THEIR SURVIVORS 3 7000 PART I, LINE 2: THE FOUNDATION HAS A ROBUST OVERSIGHT PROGRAM TO MONITOR THE USE OF GRANT FUNDS THAT INCLUDES REQUIRING MID-TERM AND ANNUAL REPORTING BY THE GRANTEE AND ON-SIGHT INSPECTIONS BY FOUNDATION PERSONNEL. X X 0 1 X X X X 0 1 0 0 0 0 0 1 0 RICHARD A SMITH EDD PRESIDENT/CEO/DIRECTOR 262803 0 291544 0 33512 0 0 0 6281 0 594140 0 0 0 MATTHEW BRASMER VICE PRESIDENT OF DEVELOPMENT 176740 0 27223 0 1529 0 0 0 1066 0 206558 0 0 0 PART I, LINE 1A BOARD MEMBERS ARE ENCOURAGED TO BRING COMPANIONS TO OUT-OF-TOWN BOARD MEETINGS AND IT IS CORPORATE PRACTICE TO REIMBURSE THOSE BOARD MEMBERS WHO REQUEST REIMBURSEMENT, MOST OF WHOM DO NOT. THE ORGANIZATION PAYS ANNUAL DUES FOR MEMBERSHIPS IN TWO LOCAL AREA PRIVATE GOLF CLUBS. BY VIRTUE OF THESE MEMBERSHIPS, ONE OF WHICH IS OWNED BY ITS CEO, THE ORGANIZATION IS ALLOWED TO HOST THREE OF ITS ANNUAL FUNDRAISING EVENTS AND TO ENTERTAIN CURRENT AND PROSPECTIVE DONORS FOR CULTIVATION AND ACQUISITION PURPOSES AT THESE SOCIAL CLUBS. ALL COMPANION TRAVEL IS REPORTED AS COMPENSATION AND ESTIMATED PERSONAL USE OF SOCIAL MEMBERSHIPS ARE REPORTED AS COMPENSATION. PART I, LINE 1B BOARD MEMBERS' COMPANION TRAVEL EXPENSES ARE PAID AT BOARD DIRECTION. SOCIAL CLUB DUES ARE PAID BY THE ORGANIZATION IN ACCORDANCE WITH CEO'S EMPLOYMENT AGREEMENT, WHICH WAS APPROVED BY THE FOUNDATION BOARD OF DIRECTORS. ALL COMPANION TRAVEL IS REPORTED AS COMPENSATION AND ESTIMATED PERSONAL USE OF SOCIAL MEMBERSHIPS ARE REPORTED AS COMPENSATION. PART I, LINE 3 CEO COMPENSATION IS DETERMINED BY NORTHERN ARIZONA HEALTHCARE CORPORATION BASED ON A MARKET COMPENSATION STUDY PERFORMED BY A THIRD PARTY CONSULTANT. A COMPENSATION AND INCENTIVE PACKAGE IS STRUCTURED BY A COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF THE ORGANIZATION USING THE MARKET STUDY AND THE FOLLOWING METHODS: WRITTEN CONTRACT, ORGANIZATION MISSION, OPINION OF INDEPENDENT CONSULTANT, AND ORGANIZATION MISSION. PART I, LINE 4B (1) THE ORGANIZATION'S CEO PARTICIPATED IN A 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN ESTABLISHED BY THE ORGANIZATION EFFECTIVE AS OF JULY 1, 2016. THE CEO IS THE ONLY PARTICIPANT IN THIS PLAN. PER THE PLAN DOCUMENT, A DISTRIBUTION OF $206,087 (INCLUDING IMPUTED EARNINGS) WAS MADE TO THE CEO ON AUGUST 30, 2019, AS REQUIRED BY THE PLAN DOCUMENT. ESTIMATED ADDITIONAL DISTRIBUTIONS OF $135,502 WERE ACCRUED AS OF JUNE 30, 2020. (2) THE ORGANIZATION'S VP OF DEVELOPMENT PARTICIPATED IN A 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN ESTABLISHED BY THE ORGANIZATION EFFECTIVE AUGUST 27, 2018. THE VP OF DEVELOPMENT IS THE ONLY PARTICIPANT IN THIS PLAN. ESTIMATED DISTRIBUTIONS FROM THE PLAN OF $76,412 WERE ACCRUED AS OF JUNE 30, 2020. PART I, LINE 7 NORTHERN ARIZONA HEALTHCARE FOUNDATION MAKES ANNUAL, DISCRETIONARY BONUS PAYMENTS, WHICH ARE BASED ON MEETING VARIOUS FINANCIAL AND OTHER ORGANIZATIONAL GOALS. X 40 25925 DONOR ESTIMATE X 599 RETAIL VALUE/DONOR EST X 40077 RETAIL VALUE/DONOR EST X COVID19 MASKS, GLOVES, GOWNS ETC 109030 81458 RETAIL VALUE/DONOR E X GIFT CERTIFICATES 957 52674 RETAIL VALUE X TICKETS/ADMISSION 64 6021 RETAIL VALUE X EVENT FOOD 4545 4972 RETAIL VALUE/DONOR E X JEWELRY 7 4311 RETAIL VALUE/DONOR E X TOYS 301 1870 RETAIL VALUE/DONOR E X ALCOHOL 55 1241 RETAIL VALUE/DONOR E X MEMBERSHIPS 2 245 RETAIL VALUE/DONOR E 0 0 0 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS RECEIVED IN COLUMN (B). FORM 990, PART III, LINE 3 THE FOUNDATION TERMINATED ITS GRANT SOLICITATION PROGRAM TO BENEFIT NORTHERN ARIZONA HEALTHCARE CORPORATION IN MARCH 2020. FORM 990, PART VI, SECTION A, LINE 7A NORTHERN ARIZONA HEALTHCARE CORPORATION HAS THE RIGHT TO APPOINT 20% OF THE TOTAL NUMBER OF VOTING DIRECTORS, ROUNDED UP TO THE NEAREST WHOLE NUMBER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM BASED ON DATA GATHERED BY THE FOUNDATION'S ACCOUNTING DEPARTMENT. THE BOARD OF DIRECTORS IS PROVIDED A COPY OF THE FORM 990 BEFORE IT IS FILED. THE FINANCE COMMITTEE, ACTING ON BEHALF OF THE FOUNDATION'S BOARD OF DIRECTORS, CONVEYS COMMENTS AND APPROVES THE FINAL DRAFT OF THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. BOARD MEMBERS AND OFFICERS ARE COVERED BY THE POLICY. COVERED INDIVIDUALS HAVE A DUTY TO DISCLOSE ALL MATERIAL FACTS IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS. THE DETERMINATION OF HOW TO PROCEED WITH A CONFLICT IS MADE BY THE MEMBERS OF THE GOVERNING BODY WHO ARE NOT AN INTERESTED PERSON WITH RESPECT TO THE PROPOSED TRANSACTION. AFTER DISCLOSURE OF ALL MATERIAL FACTS, THE INTERESTED PERSON LEAVES AND THE REMAINING MEMBERS OF THE GOVERNING BODY DELIBERATE AND VOTE ON THE EXISTENCE OF CONFLICT. WHEN A CONFLICT OF INTEREST IS IDENTIFIED THE GOVERNING BODY, EXCLUDING THE INTERESTED PERSON, SHALL EXERCISE DUE DILIGENCE TO DETERMINE IF A MORE ADVANTAGEOUS TRANSACTION IS REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES. THE GOVERNING BODY, EXCLUDING THE INTERESTED PERSON, VOTES WHETHER THE TRANSACTION IS IN THE FOUNDATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND FAIR AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15A THE PRESIDENT AND CEO OF THE FOUNDATION IS EMPLOYED BY NORTHERN ARIZONA HEALTHCARE CORP (NAHC), AN UNRELATED TAX-EXEMPT ORGANIZATION, AND IS SECUNDED TO THE FOUNDATION. THE FOUNDATION REIMBURSES NAHC FOR ALL PAYROLL COSTS ASSOCIATED WITH ITS EMPLOYMENT OF THE PRESIDENT AND CEO. NAHC HIRED WILLIS TOWERS WATSON TO PERFORM A MARKET COMPENSATION STUDY RELATED TO THIS EXECUTIVE POSITION. RELYING ON THE CONCLUSIONS OF THIS STUDY, THE FOUNDATION'S COMPENSATION COMMITTEE STRUCTURED A COMPENSATION PACKAGE UNDER A PERFORMANCE CONTRACT TIED TO NAHF'S MISSION. FURTHER, THE COMPENSATION COMMITTEE HIRED EIDE BAILLY, LLP, AN INDEPENDENT CONSULTING FIRM, TO PROVIDE AN OPINION AS TO THE REASONABLENESS OF THE COMPENSATION PACKAGE FOR THIS EXECUTIVE POSITION. EIDE BAILLY'S OPINION, WAS THAT THE COMPENSATION PACKAGE WAS REASONABLE. THIS INFORMATION WAS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE MOST RECENT REVIEW WAS PERFORMED IN FISCAL YEAR 2019. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST.