2019-05-15T17:47:06-05:00 2018-06-30 450250958 EIDE BAILLY LLP 1850 N CENTRAL AVE STE 400 PHOENIX AZ 850044624 990 2017-07-01 813137336 NORTHERN ARIZONA HEALTHCARE FOUNDATION NORT 9287732093 1030 N SAN FRANCISCO ST STE 103 FLAGSTAFF AZ 86001 KARLA JACOBSEN FINANCIAL OFFICER 9287732093 2019-05-15 1 BRENDA BLUNT P00075126 6022645844 2019-05-15 8.39.233.205 2019-05-15 15:14:46 US P 0F92C7FECF68049E352FD4A666506CAC7CBA4EE2 D4504F3418A69B1F64DD2B85EBC785D26ACEAFAF 2017 2019-02-21 02:37:17Z KARLA JACOBSEN 1030 N SAN FRANCISCO ST STE 103 FLAGSTAFF AZ 86001 11440099 0 X WWW.NAHEALTHFOUNDATION.ORG X 2016 AZ THE MISSION OF NORTHERN ARIZONA HEALTHCARE FOUNDATION ("NAHF") IS TO SUPPORT NORTHER ARIZONA HEALTHCARE CORPORATION ("NAHC"), WHILE ADVANCING COMMUNITY HEALTHCARE PRIORITIES. THE VISION IS A FUTURE WHERE EVERY PERION IN OUR REGION HAS EQUAL ACCESS TO QUALITY HEALTHCARE AND OPPORTUNITY TO ACHIEVE THEIR HIGHEST LEVEL OF HEALTH. 8 7 0 135 0 0 39253973 10600391 0 0 484940 731174 19800 -47701 39758713 11283864 1877693 2262920 0 0 1427178 1523605 0 0 1127025 415076 654644 3719947 4441169 36038766 6842695 38337762 49210411 521173 2614938 37816589 46595473 X THE MISSION OF NORTHERN ARIZONA HEALTHCARE FOUNDATION ("NAHF") IS TOSUPPORT 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 AN OPPORTUNITY TO ACHIEVE THEIR HIGHEST LEVEL OF HEALTH. 0 0 1316840 1237893 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. DURING THE 2017 TAX YEAR, THE FOUNDATION MADE CONTRIBUTIONS, AWARDS, AND GRANTS TO NORTHERN ARIZONA HEALTHCARE, FLAGSTAFF MEDICAL CENTER, VERDE VALLEY MEDICAL CENTER, AND OTHER NONPROFIT 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. MORE THAN 80,000 LIVES WERE IMPACTED THROUGH FOUNDATION EFFORTS. 882955 830020 DURING THE 2017 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. 207445 195007 DURING THE 2017 TAX YEAR, THE FOUNDATION BEGAN FUNDING THE CONSTRUCTION OF A NEW HEALTHCARE CENTER FOR THE WILLIAMS HOSPITAL DISTRICT OF COCONINO COUNTY THAT, WHEN COMPLETED, WILL PROVIDE HEALTHCARE SERVICES TO RESIDENTS OF THE CITY OF WILLIAMS, ARIZONA, AND OUTLYING AREAS SUCH AS TUSAYAN, RED LAKE, ASH FORK, AND PARKS, ARIZONA. THE FOUNDATION HAS COMMITTED TO FUND UP TO $6 MILLION FOR THE CONSTRUCTION OF THIS FACILITY 2407240 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 X 8 7 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 AZ X KARLA AMBLER JACOBSEN 9287732093 1030 N SAN FRANCISCO ST STE 103 FLAGSTAFF AZ 86001 RICHARD SMITH PRESIDENT/CEO/DIRECTOR 40.00 X X 339898 0 68737 CHRIS BAVASI CHAIR/DIRECTOR 1.00 X X 0 0 0 DEIRDE MELDRUM VICE CHAIR/DIRECTOR 1.00 X X 0 0 0 RICHARD CRANMER CPA ATA ATP TREASURER/DIRECTOR 1.00 X X 0 0 0 JAMES OUSLEY SECRETARY/DIRECTOR 1.00 X X 0 0 0 OLIVER HARPER MD DIRECTOR 1.00 X X 0 0 0 WILLIAM HICKS III ESQ DIRECTOR 1.00 X X 0 0 0 RICHARD KRUSE DIRECTOR 1.00 X X 0 0 0 KARLA JACOBSON FINANCIAL OFFICER 40.00 X 79726 0 1671 JOE WAGNER FINANCIAL OFFICER(THRU 4/18) 40.00 X 59589 0 780 479213 0 71188 1 0 1 1 0 418261 10182130 79014 10600391 731174 731174 104398 418261 156235 -51837 -51837 MISCELLANEOUS INCOME 900099 4136 4136 4136 11283864 0 0 683473 2236220 2236220 26700 26700 1228084 112493 382425 733166 218635 20027 68083 130525 76886 7043 23942 45901 129965 129965 11877 11877 111309 79800 31509 32538 1000 15942 15596 27381 25977 1404 63751 63751 41558 3757 17374 20427 5757 5757 11178 11178 14391 14391 8541 8541 EVENT EXPENSES 103323 103323 BOARD EXPENSE 53179 53179 DONOR CULTIVATION 20825 20825 PURCHASED SERVICES 11294 4633 6661 7777 7024 753 4441169 2407240 906904 1127025 5076342 892497 3001141 10706698 3041799 1290640 4659 31133 24472 21052 6661 28928928 34547756 15000 15000 38337762 49210411 477298 414774 206621 43875 51285 0 1942258 521173 2614938 X 9593867 13601492 6628115 10239424 21594607 22754557 37816589 46595473 38337762 49210411 6842695 1936189 0 X 0 1 X 0 0 X 39264578 10600391 49864969 39264578 10600391 49864969 4706171 45158798 484940 731174 1216114 19800 19800 4136 4136 51105019 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2017 AMOUNT: $ 4,136. 5 1221000 640666 26229421 1 1 0 23136444 1159950 2134416 1136971 415097 25708936 21700507 2211007 775070 23136444 0 0 31133 24472 6661 6661 DUE TO NORTHERN ARIZONA HEALTHCARE CORPORATION 1813391 457 EMPLOYER LIABILITY 128867 1942258 X 13366549 1936189 2138 156235 2094562 11271987 11877 11877 11283864 4587665 2138 156235 158373 4429292 11877 11877 4441169 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 EXPENSES PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES 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 219355 170333 49022 0 1558 5259 29155 4333 23727 COPPER BALL 120565 97197 23368 0 139 3007 0 750 6539 6 182739 150731 32008 5080 6283 38296 2078 0 30031 522659 418261 104398 5080 7980 46562 31233 5083 60297 156235 -51837 1 AMERICAN RED CROSS OF NORTHERN ARIZONA 1750 RAILROAD SPRINGS BLVD FLAGSTAFF AZ 86001 530196605 501(C)(3) 5000 COMMUNITY LEARDER BREAKFAST TO RAISE AWARENESS OF AMERICAN RED CROSS NORTHERN ARIZONA CHAPTER ARIZONA COMMUNITY FOUNDATION OF SEDONA 2201 E CAMELBACK RD STE 405B PHOENIX AZ 85016 860348306 501(C)(3) 20000 VERDE VALLEY IMAGINATION LIBRARY ARIZONA'S CHILDREN ASSOCIATION 3716 E COLUMBIA STREET TUCSON AZ 85714 860096772 501(C)(3) 7933 COMMUNITY DEVELOPMENTAL SCREENING BIG BROTHERS BIG SISTERS 102 W HUNT AVENUE FLAGSTAFF AZ 86001 237170086 501(C)(3) 8000 SPONSOR FUNDRAISING EVENT BOYS & GIRLS CLUB OF NORTHERN ARIZONA 301 S PASEO DEL FLAG FLAGSTAFF AZ 86001 860688398 501(C)(3) 12545 COMMUNITY HEALTHY LIFESTYLES PROGRAM COCONINO COMMUNITY COLLEGE 3000 N 4TH STREET 17 FLAGSTAFF AZ 86004 860686666 COCONINO COMMUNITY C 100000 NURSING & ALLIED HEALTH PROGRAMS CAMP VERDE UNIFIED SCHOOL DISTRICT 510 CAMP LINCOLN RD CAMP VERDE AZ 86322 866003046 CAMP VERDE UNIFIED S 24322 FIT KIDS AT SCHOOL CATHOLIC CARITIES COMMUNITY SERVICES INC 2101 N 4TH STREET FLAGSTAFF AZ 86004 860223999 501(C)(3) 40000 CLOSING THE GAP HOUSE COLLABORATION TO PROVIDE HOUSING TO PEOPLE SUFFERING FROM SUBSTANCE ABUSE AND HOMELESSNESS CITY OF COTTONWOOD 816 N MAIN STREET COTTONWOOD AZ 86326 866007877 CITY OF COTTONWOOD 10000 LOOKING GOOD COTTONWOOD PROGRAM FLAGSTAFF CHAMBER OF COMMERCE FOUNDATION 101 W ROUTE 66 FLAGSTAFF AZ 86001 860020635 501(C)(3) 5000 ANNUAL MEETING SPONSOR SEDONA CHAMBER OF COMMERCE PO BOX 478 SEDONA AZ 86339 860134659 501(C)(6) 15000 SUPPORT FUNDRAISING MARATHON SEDONA INTERNATIONAL FILMFEST PO BOX 478 SEDONA AZ 86339 860134659 501(C)(6) 20000 SUPPORT HEALTHCARE MARATHON NORTH COUNTRY HEALTHCARE INC 2920 N 4TH STEET FLAGSTAFF AZ 86004 860663432 501(C)(3) 27000 SUPPORT DOMESTIC VIOLENCE PROGRAMS WILIAMS HOSPITAL DISTRICT OF COCONINO COUNTY 3000 N 4TH STREET 5 FLAGSTAFF AZ 86004 866000441 WILIAMS HOSPITAL DIS 195007 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. FLAGSTAFF MEDICAL CENTER 1200 BEAVER STREET FLAGSTAFF AZ 86001 860110232 501(C)(3) 413415 SUPPORT HOSPITAL DEPARTMENT INITIATIVES INCLUDING CHILDREN'S HEALTH, EMERGENCY SERVICES, PALLIATIVE/HOSPICE CARE, RESEARCH & EDUCATION AND OTHER COMMUNITY SUPPORT FLAGSTAFF SYMPHONY ASSOCIATION PO BOX 122 FLAGSTAFF AZ 86002 860186038 501(C)(3) 20000 SPONSORSHIP NORTHERN ARIZONA UNIVERSITY PO BOX 122 FLAGSTAFF AZ 86002 900776492 501(C)(3) 135000 SUPPORT PROGRAMS PROVIDING HEALTHCARE AND BEHAVIORAL HEALTH TO NAU ATHLETES AND FUNDING NAU NURSING PROGRAM NORTHERN ARIZONA ADAPTIVE SPORTS ASSOCIATION PO BOX 1903 FLAGSTAFF AZ 86002 866004791 501(C)(3) 15000 SUPPORT SNOWBOWL ADAPTIVE SPORTS PROGRAM TO TRAIN INSTRUCTORS AND PROVIDE SNOW EXPERIENCES TO INDIVIDUALS WITH DISABILITIES NORTHERN ARIZONA HEALTHCARE 1200 BEAVER STREET FLAGSTAFF AZ 86001 742385187 501(C)(3) 251359 SUPPORT HOSPITAL SYSTEM DEPARTMENT INITIATIVES INCLUDING CANCER CARE, CARDIOVASCULAR SERVICES, RESEARCH & EDUCATION, IT, SUICIDE PREVENTION, AND OTHER COMMUNITY SUPPORT VERDE VALLEY MEDICAL CENTER 1200 BEAVER STREET FLAGSTAFF AZ 86001 860100882 501(C)(3) 558154 SUPPORT HOSPITAL DEPARTMENT INITIATIVES INCLUDING CHILDREN'S HEALTH, EMERGENCY SERVICES, PALLIATIVE/HOSPICE CARE, RESEARCH & EDUCATION AND OTHER COMMUNITY SUPPORT NORTHLAND HOSPICE & PALLIATIVE CARE INC 452 N SWITZER CANYON FLAGSTAFF AZ 86001 742385187 501(C)(3) 13000 SUPPORT NORTHLAND HOSPICE ASSISTED LIVING FACILITY POORE MEDICAL CLINIC 120 W FINE STREET FLAGSTAFF AZ 86001 800751712 501(C)(3) 12135 SUPPORT COMMUNITY HEALTH SUNNYSIDE NEIGHBORHOOD ASSOCIATION 2304 THIRD STREET FLAGSTAFF AZ 86004 861012315 501(C)(3) 30000 SUPPORT SUNNYSIDE NEIGHBORHOOD LONGEVITY PROJECT, A STRATEGIC PLAN TO ADDRESS HEALTHCARE DISPARITIES AND INEQUITIES IN THE SUNNYSIDE NEIGHBORHOODSUPPORT SUNNYSIDE NEIGHBORHOOD LONGEVITY PROJECT, A STRATEGIC PLAN TO ADDRESS HEALTHCARE DISPARITIES AND INEQUITIES IN THE SUNNYSIDE NEIGHBORHOOD. SUPPORT SUNNYSIDE NEIGHBORHOOD LONGEVITY PROJECT, A STRATEGIC PLAN TO ADDRESS HEALTHCARE DISPARITIES AND INEQUITIES IN THE SUNNYSIDE NEIGHBORHOOD. THE NARBHA INSTITUTE 616 N BEAVER STREET FLAGSTAFF AZ 86001 866037149 501(C)(3) 12334 COMMUNITY HEALTH NEEDS ASSESSMENT UNITED WAY OF NORTHERN ARIZONA 1515 E CEDAR AVENUE SUITE D-1 FLAGSTAFF AZ 86004 860211666 501(C)(3) 25000 SUPPORT COMMUNITY HEALTH EDUCATION 23 2 SCHOLARSHIPS 30 26700 X X X X 0 1 0 0 0 0 0 1 0 RICHARD SMITH PRESIDENT/CEO/DIRECTOR 255697 0 57200 0 27001 0 64434 0 4303 0 408635 0 0 0 KARLA JACOBSON FINANCIAL OFFICER 79384 0 0 0 342 0 0 0 1671 0 81397 0 0 0 JOE WAGNER FINANCIAL OFFICER(THRU 4/18) 57016 0 2566 0 7 0 0 0 780 0 60369 0 0 0 PART I, LINE 3 CEO COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS OF NORTHERN ARIZONA HEALTHCARE FOUNDATION USING THE FOLLOWING METHODS: WRITTEN CONTRACT, INDEPENDENT CONSULTANT, COMPENSATION SURVEY. PART I, LINE 4B THE ORGANIZATION CONTRIBUTED $64,434 TO A 457B PLAN FOR RICHARD SMITH, PRESIDENT AND CEO OF THE FOUNDATION. 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 2 1500 APPRAISAL X 295 RETAIL VALUE/DONOR EST X 30252 RETAIL VALUE/DONOR EST X EVENT FOOD 1461 39734 RETAIL VALUE/DONOR E X ALCOHOL 22 2920 RETAIL VALUE/DONOR E X TOYS 200 2600 RETAIL VALUE/DONOR E X GIFT CERTIFICATES 12 1195 RETAIL VALUE/DONOR E X OTHER 122 519 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 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 CFO REVIEWS THE DRAFT FORM 990 AND PROVIDES ADDITIONAL COMMENTS FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTERST POLICY. BOARD MEMEBERS AND OFFICERS ARE COVERD BY THE POLICY. COVERED INDIVIDUALS HAVE A DUTY TO DISCLOSE ALL MATERIALS FACT IN CONNETION 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 A 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 IN DETERMINE IF A MORE ADVANTAGEOUS TRANSACTION IS REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES, THE GOVERNING BODY, EXCLUDING THE INTERESTED PERSON, VOTES WHETEHR THE TRANSACTION 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 NAHF IS EMPLOYED BY NORTHERN ARIZONA HEALTHCARE CORP, AN UNRELATED TAX-EXEMPT ORGANIZATION, AND IS SECUNDED TO NAHF. NAHF REIMBURSES NORTHERN ARIZONA HEALTHCARE FOR ALL PAYROLL COSTS ASSOCIATED WITH ITS EMPLOYMENT OF THE PRESIDENT AND CEO. NAHF HIRED EIDE BAILLY, LLP, AN INDEPENDENT CONSULTING FIRM, TO PREPARE COMPARABLE COMPENSATION DATA FOR THIS EXECUTIVE POSITION. THIS INFORMATION WAS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE MOST RECENT REVIEW WAS PERFORMED IN SEPTEMBER 2016. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST.