2019-05-15T11:34:24-05:00 2018-06-30 ERNST & YOUNG US LLP TWO NORTH CENTRAL AVENUE STE 2300 PHOENIX AZ 85004 990 2017-07-01 860110232 FLAGSTAFF MEDICAL CENTER % JOHN A CORTESE CPA FLAG 9287793366 POST OFFICE BOX 1268 FLAGSTAFF AZ 860021268 JOHN CORTESE NAH TREASURER 9282143545 2019-05-13 true BRENDA D GRIESEMER P00264669 6023223000 2019-05-14 164.57.159.253 86597020191355000005 2019-05-15 P AF004A83757AE4CCCA4D7F5FBE81B297DEDD339B 537EC6986AB1F8F0FDE33F35764D968E98BC4D64 2017 2019-02-21 02:37:17Z FLORENCE L SPYROW 1200 N Beaver St FLAGSTAFF AZ 86001 465954141 false X WWW.NAHEALTH.COM X 1936 AZ IMPROVING HEALTH, HEALING PEOPLE. 13 12 0 518 1036438 0 652508 325729 427942687 450072401 12586281 11687189 3310383 3868822 444491859 465954141 33514501 8577385 0 0 167844459 169976104 0 0 0 211141662 224745786 412500622 403299275 31991237 62654866 737576927 765560326 228622927 215369933 508954000 550190393 X IMPROVING HEALTH, HEALING PEOPLE. false false 325139736 8577385 410789223 FLAGSTAFF MEDICAL CENTER PROVIDES COMPREHENSIVE HEALTHCARE SERVICES, INCLUDING PRIMARY CARE AND SPECIALTY PHYSICIAN CLINICS, CANCER CENTERS OF NORTHERN ARIZONA HEALTHCARE, ENTIRECARE REHAB & SPORTS MEDICINE, AND FIT KIDS OF ARIZONA. SEE SCHEDULE O FOR FURTHER DETAILS. 23139000 0 31522000 GUARDIAN AIR PROVIDES AIR TRANSPORTATION SERVICES TO PATIENTS THROUGHOUT THE NORTHERN ARIZONA COMMUNITY, ENABLING FLAGSTAFF MEDICAL CENTER TO EXPAND ITS SCOPE OF SERVICES BY SERVING PATIENTS FROM THE MOMENT TREATMENT BEGINS IN THE AIR TRANSPORT. 8260000 0 11630000 GUARDIAN MEDICAL PROVIDES AMBULANCE SERVICES TO PATIENTS THROUGHOUT THE NORTHERN ARIZONA COMMUNITY, ENABLING FLAGSTAFF MEDICAL CENTER TO EXPAND ITS SCOPE OF SERVICES BY SERVING PATIENTS FROM THE MOMENT TREATMENT BEGINS IN THE GROUND AMBULANCE. 0 0 0 356538736 true false false true false false false false false false true false false false true true false true false false false false false false false false true true true false true true true false false false false false false false false false false false false false false true true true false false true X 568 0 true 0 true true false false false false false false false false false X 13 12 false false false false true true true true true false false true true true true true true true true false AZ X JOHN A CORTESE CPA 9282143545 914 N SAN FRANCISCO ST SUITE M FLAGSTAFF AZ 86001 X FLORENCE SPYROW NAH PRESIDENT/CEO (AS OF 3/18) 24.0 16.0 X X 0 430515 16100 ALICE GAGNAIRE RN DIRECTOR/CHAIR 1.0 2.0 X X 0 0 0 SHAWN ORME DIRECTOR/VICE CHAIR 1.0 6.0 X X 0 0 0 CHARLES MARR DIRECTOR/TREASURER 1.0 7.0 X X 0 0 0 ELIZABETH MCFARLAND DIRECTOR/SECRETARY 1.0 2.0 X X 0 0 0 ANDREW ALDRIDGE MD DIRECTOR 1.0 2.0 X 0 0 0 JANET CORRIGAN DIRECTOR 1.0 2.0 X 0 0 0 WILLIAM JEFFERS DIRECTOR 1.0 2.0 X 0 0 0 RICHARD KRUSE DIRECTOR 1.0 2.0 X 0 0 0 WILLIAM RILEY DIRECTOR (AS OF 10/17) 1.0 2.0 X 0 0 0 KENNETH SALCE MD DIRECTOR 1.0 2.0 X 0 0 0 RAY SELNA DIRECTOR 1.0 3.0 X 0 0 0 GUADALUPE WOODSON FNP DIRECTOR 1.0 2.0 X 0 0 0 ROBERT THAMES NAH PRESIDENT/CEO (THRU 3/18) 1.0 39.0 X X 0 571379 30711 JOHN HARRINGTON INTERIM CAO (AS OF 05/18) 40.0 0.0 X 0 22500 0 JEFFREY TREASURE NAH CHIEF FIN OFFICER 1.0 39.0 X 0 366723 33531 RICHARD NEFF CHIEF MEDICAL OFFICER 40.0 0.0 X 0 364143 40583 DON STOOKEY CHIEF SUPPORT SERVICES 40.0 0.0 X 0 184500 0 KATY WILKENS CHIEF NURSING OFFICER 40.0 0.0 X 0 225279 10135 RENZO CATALDO PHYSICIAN 40.0 0.0 X 0 569311 23285 FRANK RAFIE CHIEF RADIATION PHYSICIAN 40.0 0.0 X 0 270991 35337 RICHARD MENDRIBIL DIR PHARMACY SVCS (THRU 02/18) 40.0 0.0 X 0 212427 1195 DALE MERRIT REGISTERED NURSE 40.0 0.0 X 0 197909 32718 BRENDA MUNNS DIR OF NURSING (THRU 05/18) 40.0 0.0 X 0 196459 47865 JOHN DEMPSEY VP NAH/PRES LCMC 0.0 40.0 X 0 322795 65655 RICHARD SMITH VP OF DEVELOP/MKTG (THRU 7/16) 0.0 0.0 X 0 339898 29148 0 4274829 366263 0 true true false FOREST COUNTRY ANESTHESIA 77 WEST FOREST AVENUE FLAGSTAFF AZ 86001 ANESTHESIA SERVICES 4068598 HEALTHCARE SELECT DEPT LA 24465 PASADENA CA 911854465 CONTRACT LABOR 3366965 MOUNTAIN HEART PLLC 2000 S THOMPSON ROAD FLAGSTAFF AZ 86001 MEDICAL SERVICES 2854845 PHOENIX CARDIAC SURGERY PC 3131 E CLARENDON AVE STE 102 PHOENIX AZ 85016 SURGERY SERVICES 2601837 FLAGSTAFF EMERGENCY PHYSICIANS 2620 DOVES NEST LANE FLAGSTAFF AZ 86001 ER MEDICAL STAFFING 2269110 60 0 177793 147936 0 325729 NET PATIENT SERVICES REVENUE 621110 442150937 442150937 0 0 PHARMACY 446110 5182192 4145754 1036438 0 CAFETERIA 900099 2171315 2171315 0 0 INTERCOMPANY RENT INCOME 531120 316630 316630 0 0 AUXILIARY GIFT SHOP SALES 900099 250683 250683 0 0 644 644 0 450072401 8304813 8304813 0 0 0 0 0 3371814 10562 3371814 10562 3382376 3382376 0 0 0 0 0 0 0 0 0 NON-PATIENT ROOMS 900099 267870 267870 0 0 PROGRAM FEES 900099 198939 198939 0 0 STANDBY FEES 900099 166788 166788 0 0 3235225 3235225 0 0 3868822 465954141 452904785 1036438 11687189 X 8577385 8577385 0 0 0 0 0 0 1750177 518510 1231667 0 0 0 0 0 137233602 120486315 16747287 0 6616172 5858485 757687 0 4053639 3589414 464225 0 20322514 17995171 2327343 0 223728 223728 0 0 396401 -133081 529482 0 198996 169859 29137 0 10608 0 10608 0 0 0 18763 0 18763 37437083 33078779 4358304 0 488042 429809 58233 0 93077906 88484378 4593528 0 1649815 923388 726427 0 0 0 0 0 4755915 4418018 337897 0 543233 453547 89686 0 0 0 0 0 199118 199118 0 0 4023542 0 4023542 0 0 0 16810680 12427152 4383528 0 4047529 373296 3674233 0 EXP REIMBURSEMENTS TO NAH 52900973 53062445 -161472 0 CONTRACT MAINTENANCE 3823839 3823839 0 0 CONSULTING 1723711 507020 1216691 0 COLLECTION EXPENSE 1610618 27044 1583574 0 805286 1045117 -239831 403299275 356538736 46760539 0 0 10286641 9468897 14575072 17709859 0 0 69072616 68955574 0 0 0 0 6260778 5911744 7256909 7976919 2971956 3902422 402473640 256094046 146243172 146379594 424556633 451370247 40000000 36617310 0 0 0 0 16353150 17267760 737576927 765560326 29319493 34781612 0 0 0 0 140154380 135211031 0 0 0 0 210464 185021 0 0 58938590 45192269 228622927 215369933 X 508954000 550190393 0 0 0 0 508954000 550190393 737576927 765560326 X 62654866 16699586 0 0 0 -38118059 X false true X true false X false false false 0 false 0 false 0 false 0 false 0 false 0 true 10608 10608 false SCHEDULE C, PART II-B, LINE 1I LOBBYING ELECTION: FLAGSTAFF MEDICAL CENTER PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION, THE AMERICA'S ESSENTIAL HOSPITALS AND THE ARIZONA HEALTH COLLABORATIVE. A PERCENTAGE OF THIS AMOUNT, $10,608, WAS ESTIMATED TO BE ATTRIBUTABLE TO LOBBYING RELATED TO HEALTH CARE ADVOCACY AT THE FEDERAL, STATE, REGIONAL AND LOCAL LEVELS. FLAGSTAFF MEDICAL CENTER ALSO PARTICIPATES IN HEALTHCARE-RELATED LOBBYING ACTIVITIES THROUGH THE SOLE COMMUNITY HOSPITAL COALITION. 5901300 5901300 205005599 126614623 78390976 1429003 1180515 248488 167782606 128298908 39483698 22355132 22355132 146379594 0 MINIMUM PENSION LIABILITY 32021350 UNEMPLOYMENT PAYABLE 4388351 MALPRACTICE INSURANCE RESERVE LT 4206957 THIRD-PARTY PAYOR SETTLEMENTS 1729919 OTHER-GAAP PRESENTATION 1268425 MALPRACTICE INSURANCE RESERVE ST 914388 OTHER 623938 PROFESSIONAL AND AUDIT FEES 38941 45192269 X SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATIONS MANAGEMENT IS NOT AWARE OF ANY EVENTS THAT WOULD CAUSE THE CORPORATION TO LOSE ITS TAX-EXEMPT STATUS. MANAGEMENT HAS REVIEWED ALL OPEN TAX YEARS AND HAS DETERMINED THAT THE CORPORATION HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS. true true X true X true X false true false true true 8830135 0 8830135 0.02190 129423792 63721000 65702792 0.16290 0 0 0 0.00000 138253927 63721000 74532927 0.18480 138253927 63721000 74532927 0.18480 true 31624000 7768000 117475445 97646397 19829048 X true true 1 1 FLAGSTAFF MEDICAL CENTER 1200 N BEAVER STREET FLAGSTAFF AZ 86001 HTTPS://NAHEALTH.COM HO169 X X X FLAGSTAFF MEDICAL CENTER 1 false false true X X X X X X X X X 15 false true false true X SEE SCH H, PART V, SECTION C X true 16 true SEE SCH H, PART V, SECTION C false true X 200. 400. X X X X X true true X X X true X SEE SCH H, PART V, SECTION C X SEE SCH H, PART V, SECTION C X SEE SCH H, PART V, SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA"), A FOCUS GROUP WAS HELD IN NOVEMBER 2015 IN COLLABORATION WITH COCONINO AND YAVAPAI COUNTIES AS PART OF THEIR COMMUNITY HEALTH IMPROVEMENT PLANS. KEY INFORMANTS IN THE COMMUNITY INCLUDED: REPRESENTATIVES FROM PUBLIC HEALTH, PHYSICIANS, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY LEADERS. A LIST OF RECOMMENDED PARTICIPANTS FOR THE FOCUS GROUP WAS PROVIDED BY FLAGSTAFF MEDICAL CENTER. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED REPRESENTATIVES OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS. FOCUS GROUP CANDIDATES WERE FIRST CONTACTED BY LETTER TO REQUEST THEIR PARTICIPATION. FOLLOW-UP PHONE CALLS WERE THEN MADE TO ASCERTAIN WHETHER THEY WOULD BE ABLE TO ATTEND. CONFIRMATION CALLS WERE PLACED THE DAY BEFORE THE GROUPS WERE SCHEDULED TO INSURE A REASONABLE TURNOUT. AUDIO FROM THE FOCUS GROUP SESSION WAS RECORDED, FROM WHICH VERBATIM COMMENTS IN THIS REPORT ARE TAKEN. THERE ARE NO NAMES CONNECTED WITH THE COMMENTS, AS PARTICIPANTS WERE ASKED TO SPEAK CANDIDLY AND ASSURED OF CONFIDENTIALITY. THIS BOX IS CHECKED "NO" BECAUSE THE HOSPITAL SOLICITED ONLY ORAL, AND NOT WRITTEN COMMENTS ON THE 2012 CHNA AND IMPLEMENTATION STRATEGY WHEN DEVELOPING THE 2015 CHNA. THIS WAS NOT REQUIRED AT THE TIME THAT CHNA WAS PREPARED, BUT WILL BE IMPLEMENTED IN FUTURE CHNA DEVELOPMENT. SCHEDULE H, PART V, SECTION B, LINE 6A THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN CONJUNCTION WITH ITS RELATED HOSPITAL FACILITY, VERDE VALLEY MEDICAL CENTER. SCHEDULE H, PART V, SECTION B, LINES 7A AND 10 THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT AND 2016 IMPLEMENTATION STRATEGY ARE AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://NAHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 11 FMC RANKED HEALTH ISSUES IDENTIFIED BY THE CHNA AGAINST THE FOLLOWING ESTABLISHED, UNIFORM CRITERIA: MAGNITUDE - THE NUMBER OF PERSONS AFFECTED; IMPACT/SERIOUSNESS - THE DEGREE TO WHICH THE ISSUE AFFECTS OR EXACERBATES QUALITY OF LIFE AND HEALTH-RELATED ISSUES; FEASIBILITY - THE ABILITY TO REASONABLY IMPACT THE ISSUES, GIVEN AVAILABLE RESOURCES; AND CONSEQUENCES OF INACTION - THE RISK OF NOT ADDRESSING THE PROBLEM AT THE EARLIEST OPPORTUNITY. AREAS OF OPPORTUNITY WERE PRIORITIZED AS FOLLOWS: ACCESS TO HEALTHCARE SERVICES INJURY & VIOLENCE PREVENTION MENTAL HEALTH & MENTAL DISORDERS MATERNAL, INFANT AND CHILD HEALTH ORAL HEALTH SUBSTANCE ABUSE SEXUALLY TRANSMITTED DISEASES Access to Health Services: The organization began "BeWellNow", its telehealth primary and urgent care program. The organization started a Transitions Clinic for those patients who are not able to see their primary care provider ("PCP") within 72 hours of discharge or who need same day service from a PCP. The organization is working with Transportation group for better ride options for patients. The organization is beginning a Community Health Worker program. The organization is broadening our Community Paramedicine program. Injury and Violence Prevention: The organization consistently screens all emergency department ("ED") patients for domestic violence. The organizations Community Paramedicine program conducts home assessments that include fall prevention. Mental Health and Mental Disorders: The organization is hosting a Mental First Aid program and performs depression screening for all related physician clinic patients. Respiratory Disease: The organization is increasing health insurance premiums for employee and employee dependents who use tobacco products. HEALTH PRIORITIES NOT CHOSEN FOR ACTION AND REASON: SUBSTANCE ABUSE - FMC CURRENTLY PARTICIPATES IN COMMUNITY COLLABORATIONS TO ADDRESS SUBSTANCE ABUSE. THESE COLLABORATIONS ARE LED BY OTHER COMMUNITY ORGANIZATIONS WHO HAVE EXPERTISE AND RESOURCES DIRECTED SPECIFICALLY TOWARD EDUCATION AND PREVENTION EFFORTS. FMC WILL CONTINUE TO BE A COMMUNITY PARTNER WITH THESE COLLABORATIONS RUN THROUGH OTHER ORGANIZATIONS. ORAL HEALTH - ORAL HEALTH PROGRAMS FOR COMMUNITY MEMBERS ARE OFFERED THROUGH THE FEDERALLY QUALIFIED HEALTH CENTER ("FQHC"), INDIAN HEALTH, AND REGIONAL PROVIDERS. FMC SUPPORTS THESE EFFORTS WHEN EMERGENCY OR TRAUMA CARE IS REQUIRED. MATERNAL, INFANT AND CHILD HEALTH - FMC PARTICIPATES IN CHILDREN'S HEALTH AND REHABILITATION, INPATIENT OBSTETRICS, NICU, PEDIATRICS AND PICU SERVICES. PRENATAL PROGRAMS, NUTRITIONAL SUPPORT AND INSURANCE COVERAGE ARE PROVIDED BY THE FQHC, LOCAL PROVIDERS, AND FEDERAL AND STATE PROGRAMS. THESE PROGRAMS LEAD THE MAIN EFFORTS IN PRENATAL CARE, TEEN PREGNANCY PREVENTION, AND HIGH RISK PREGNANCIES. SEXUALLY TRANSMITTED DISEASES - THE NORTHERN ARIZONA COUNTY HEALTH DEPARTMENTS ARE REGIONAL LEADS FOR PREVENTING, MONITORING, AND EDUCATING THE PUBLIC ABOUT SEXUALLY TRANSMITTED DISEASES. SCHEDULE H, PART V, SECTION B, LINE 13B Eligibility for charitable assistance is based on the income and family size of the patient/guarantor. Income levels are based on the FEDERAL POVERTY LEVELS ("FPL") published by the Federal Register annually. Household members are defined as all dependents and adults residing with the patient. Applicants with household income of 400% of FPL or lower may receive financial assistance based upon a tiered discount. SCHEDULE H, PART V, SECTION B, LINES 16A-C THE FINANCIAL ASSISTANCE POLICY ("FAP"), PLAIN LANGUAGE SUMMARY AND APPLICATION ARE AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://NAHEALTH.COM/PATIENT-RIGHTS-POLICIES/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16I DISCLOSURES IN ACCORDANCE WITH REVENUE PROCEDURE 2015-21 FLAGSTAFF MEDICAL CENTER (HOSPITAL) IS COMPLIANT WITH THE SECTION 501(R) STATUTE AND HAS MADE A GOOD-FAITH EFFORT TO BE FULLY COMPLIANT WITH THE REQUIREMENTS OF THE SECTION 501(R) REGULATIONS. THE HOSPITAL HAS IDENTIFIED SOME TEMPORARY GAPS IN COMPLIANCE WITH THE REGULATIONS. THE HOSPITAL HAS NOT IDENTIFIED ANY PERSONS DIRECTLY AFFECTED BY THE TEMPORARY GAPS IN COMPLIANCE. THE HOSPITAL WAS PROVIDING FINANCIAL ASSISTANCE AS PART OF A FORMAL PROGRAM THAT WAS CLEARLY COMMUNICATED TO PATIENTS AND THE GENERAL PUBLIC. THE HOSPITAL HAD ENGLISH VERSIONS OF FAP, FAP APPLICATION, ETC. POSTED ON ITS WEBSITE, OUTREACH WAS DONE FOR MINORITY COMMUNITIES, AND TRANSLATION SERVICES WERE AVAILABLE IN THE FACILITY. THE TEMPORARY GAPS RELATED TO HAVING ITS FAP, FAP APPLICATION AND PLAIN LANGUAGE SUMMARY TRANSLATED INTO THE PRIMARY LANGUAGE(S) SPOKEN BY LEP POPULATIONS AND POSTING THOSE TRANSLATED DOCUMENTS ON ITS WEBSITE. THE HOSPITAL HAS CORRECTED THESE GAPS BY TRANSLATING THE FAP, FAP APPLICATION AND PLAIN LANGUAGE SUMMARY INTO THE PRIMARY LANGUAGE(S) SPOKEN BY LEP POPULATIONS AND WILL POST THOSE TRANSLATED DOCUMENTS ON ITS WEBSITE AROUND THE TIME OF FILING THIS RETURN. THE HOSPITAL WILL CONTINUE TO MONITOR ITS COMPLIANCE WITH THE SECTION 501(R) REGULATIONS AND PROCEDURES WILL BE PUT IN PLACE TO MAINTAIN COMPLIANCE THROUGH QUARTERLY REVIEWS OF ITS WEBSITE AND REASSESSMENTS OF THE LEP POPULATIONS EVERY THREE YEARS. SCHEDULE H, PART I, LINES 3A AND 3B EXPLANATION FOR VARIOUS PERCENTAGES USED: 200% OF THE FEDERAL POVERTY LEVEL ("FPL")= 100% CHARITY WRITE OFF. 201-250% OF FPL = 75% CHARITY WRITE-OFF. 251-300% OF FPL = 50% WRITE-OFF. 301-350% OF FPL = 25% WRITE-OFF. 351-400% OF FPL = 15% WRITE-OFF. SCHEDULE H, PART I, LINE 3C CHARITY CARE INCOME LEVELS ARE BASED ON THE FEDERAL POVERTY GUIDE PUBLISHED IN THE FEBRUARY FEDERAL REGISTER ON AN ANNUAL BASIS. A TIERED METHOD IS UTILIZED FOR DETERMINING WHETHER A PATIENT IS ELIGIBLE FOR 100%, 75%, 50%, 25%, OR 15% WRITE-OFF OF THE SELF PAY BALANCE. SCHEDULE H, PART I, LINE 6A THE INFORMATION FOR THE COMMUNITY BENEFITS REPORT IS GATHERED BY THE COMMUNICATIONS DEPARTMENT, WHICH IS A DEPARTMENT OF NORTHERN ARIZONA HEALTHCARE. FLAGSTAFF MEDICAL CENTER AND VERDE VALLEY MEDICAL CENTER ARE IDENTIFIED SEPARATELY ON THESE REPORTS. THE COMMUNITY BENEFIT REPORT IS AVAILABLE AT: HTTPS://NAHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART I, LINE 7 FLAGSTAFF MEDICAL CENTER USED A COST-TO-CHARGE RATIO, WHERE APPLICABLE, TO CALCULATE THE MOST ACCURATE COST OF CHARITY CARE AND OTHER COMMUNITY BENEFITS REPORTED IN LINE 7. SCHEDULE H, PART II COMMUNITY BUILDING IS ADVANCED BY FLAGSTAFF MEDICAL CENTER THROUGH ITS SUPPORT OF PHYSICIAN RECRUITMENT AND WORK WITH VARIOUS COMMUNITY ORGANIZATIONS INCLUDING THE AMERICAN CANCER SOCIETY, BIG BROTHERS AND BIG SISTERS, FLAGSTAFF LEADERSHIP PROGRAM, FLAGSTAFF CHAMBER OF COMMERCE AND THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION. SCHEDULE H, PART III, LINE 2 THE COSTING METHODOLOGY USED TO DETERMINE THE BAD DEBT COST COMES FROM THE PERCENTAGE CALCULATED IN SCHEDULE H PART I WORKSHEET 2. SCHEDULE H, PART III, LINE 3 FLAGSTAFF MEDICAL CENTER'S CALCULATION OF FINANCIAL ASSISTANCE COST IS BASED ON ACTUAL FINANCIAL ASSISTANCE WRITE-OFFS BY THE BUSINESS OFFICE MULTIPLIED BY THE COST-TO-CHARGE RATIO. ALL OF THE FINANCIAL ASSISTANCE WRITE-OFFS ARE ATTRIBUTABLE TO PATIENTS WHO QUALIFIED UNDER THE FINANCIAL ASSISTANCE POLICY. AS A NOT-FOR-PROFIT ENTITY, SERVICES ARE PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND MAKING THIS AVAILABLE TO THE COMMUNITY QUALIFIES BAD DEBT AS A COMMUNITY BENEFIT. SCHEDULE H, PART III, LINE 4 FOOTNOTE 2 TO THE FINANCIAL STATEMENTS INDICATES NET PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE HAVE BEEN ADJUSTED TO THE ESTIMATED AMOUNTS EXPECTED TO BE RECEIVED. THESE ESTIMATED AMOUNTS ARE SUBJECT TO FURTHER ADJUSTMENTS UPON REVIEW BY THIRD-PARTY PAYORS. MANAGEMENT ESTIMATES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON THE HISTORICAL COLLECTION EXPERIENCE SUBJECT TO FURTHER ADJUSTMENTS UPON REVIEW BY THIRD-PARTY PAYORS. MANAGEMENT ESTIMATES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON THE HISTORICAL COLLECTION EXPERIENCE. SCHEDULE H, PART III, LINE 8 THE SOURCE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS THE FY2018 MEDICARE COST REPORT FOR THE ORGANIZATION. A CONTRACTED COST REPORT PROFESSIONAL PREPARED AN ANALYSIS OF THE AMOUNT BASED ON THE SUBMITTED COST REPORT FOR FLAGSTAFF MEDICAL CENTER. PROFESSIONAL PREPARED AN ANALYSIS OF THE AMOUNT BASED ON THE SUBMITTED COST REPORT FOR FLAGSTAFF MEDICAL CENTER. SCHEDULE H, PART III, LINE 9B ACCORDING TO OUR CHARITY CARE POLICY, THE FINANCIAL COUNSELORS ASSESS THE PATIENT'S ABILITY TO PAY AT TIME OF ADMISSION/REGISTRATION. IF THE PATIENT STATES THAT THEY ARE UNABLE TO PAY OUT-OF-POCKET EXPENSES, A DETERMINATION IS MADE WHETHER COVERAGE IS AVAILABLE THROUGH AHCCCS OR OTHER MEDICAID PROGRAMS. IF NO OUTSIDE ASSISTANCE IS AVAILABLE, AN APPLICATION IS GIVEN TO THE PATIENT TO BE SUBMITTED FOR CHARITY CARE CONSIDERATION. IF THE PATIENT DOESN'T QUALIFY FOR CHARITY CARE ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR A LONG-TERM PAYMENT PROGRAM. IF THE CHARITY APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW-UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT. SCHEDULE H, PART VI, LINE 2 FLAGSTAFF MEDICAL CENTER ASSESSES COMMUNITY HEALTHCARE NEEDS THROUGH A SURVEY DESIGNED AND ADMINISTERED INTERNALLY. THIS SURVEY WAS LAST CONDUCTED IN NOVEMBER 2015 AND WAS A FOLLOW-UP TO OTHER SURVEYS THE HOSPITAL HAS CONDUCTED. THE SURVEY INSTRUMENT USED FOR THIS STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. SCHEDULE H, PART VI, LINE 3 ACCORDING TO OUR FINANCIAL ASSISTANCE POLICY, FINANCIAL COUNSELORS ASSESS THE PATIENT'S ABILITY TO PAY AT TIME OF ADMISSION/REGISTRATION. IF THE PATIENT STATES THAT THEY ARE UNABLE TO PAY OUT-OF-POCKET EXPENSES, A DETERMINATION IS MADE WHETHER COVERAGE IS AVAILABLE THROUGH AHCCCS OR OTHER MEDICAID PROGRAMS. IF NO OUTSIDE ASSISTANCE IS AVAILABLE, AN APPLICATION IS GIVEN TO THE PATIENT TO BE SUBMITTED FOR FINANCIAL ASSISTANCE CONSIDERATION. IF THE PATIENT DOESN'T QUALIFY FOR FINANCIAL ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR A LONG-TERM PAYMENT PROGRAM. IF THE CHARITY APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT. FLAGSTAFF MEDICAL CENTER WEBSITE HAS A BILLING CONTACT NUMBER. BEFORE PRE-ADMISSION, PATIENTS ARE CONTACTED BY FMC'S CASHIER. WHEN PATIENTS ARE CONTACTED, THEY ARE EDUCATED ABOUT THE FINANCIAL ASSISTANCE POLICY. FMC FINANCIAL COUNSELORS ASSIGNED TO EACH NURSING UNIT ARE ABLE TO ANSWER OR ASSIST WITH BILLING QUESTIONS. AT EACH PATIENT REGISTRATION DESK THERE ARE DISPLAYS AND BROCHURES OF THE BILLING INFORMATION, INCLUDING THE FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART VI, LINE 4 THE STUDY AREA FOR THE SURVEY EFFORT (REFERRED TO AS THE "NAH SERVICE AREA"FLAGSTAFF OR VERDE VALLEY REGION" IN THIS REPORT) INCLUDES THE FOLLOWING COUNTIES REPRESENTED IN NORTHERN AZ: APACHE, GILA, MOJAVE, NAVAJO, COCONINO AND YAVAPAI. COCONINO COUNTY (CC) - AS OF 2015, THE TOTAL POPULATION IN COCONINO COUNTY WAS 139,097. THE POPULATION IS EVENLY SPLIT BETWEEN MALES AND FEMALES. THE POPULATION WAS FOUND TO BE 54.9% WHITE (NOT HISPANIC OR LATINO), 27.3% AMERICAN INDIAN OR ALASKAN NATIVE, 13.9% HISPANIC OR LATINO, 1.6% BLACK OR AFRICAN AMERICAN, AND 1.8% ASIAN. MOHAVE COUNTY (MC) - THE TOTAL POPULATION IN MOHAVE COUNTY WAS 204,737 IN 2015. THE COUNTY IS 49.7% FEMALE AND 50.3% MALE. THE MAJORITY OF THE COUNTY IS WHITE (NOT HISPANIC OR LATINO) AT 78%, WHILE THE LARGEST MINORITY GROUP IS HISPANIC OR LATINO AT 15.8% OF THE POPULATION. THE POPULATION IS 2.9% AMERICAN INDIAN OR ALASKAN NATIVE, 1.3% BLACK OR AFRICAN AMERICAN, AND 1.2% ASIAN. GILA COUNTY (GC) - GILA COUNTY'S POPULATION WAS 53,159 IN 2015. THE POPULATION WAS FOUND TO BE 50.4% FEMALE AND 49.6% MALE. THE MAJORITY OF THE COUNTY IS WHITE (NOT HISPANIC OR LATINO) AT 63.2%. THE COUNTY IS 18.8% HISPANIC OR LATINO, 16.5% AMERICAN INDIAN OR ALASKAN NATIVE, .9% BLACK OR AFRICAN AMERICAN, AND .8% ASIAN. APACHE COUNTY (AC) - AS OF 2015, THE TOTAL POPULATION IN APACHE COUNTY WAS 71,474. APACHE COUNTY HAS SLIGHTLY MORE FEMALES, WITH 50.6% OF THE POPULATION FEMALE AND 49.4% MALE. THE MAJORITY OF THE POPULATION IS AMERICAN INDIAN OR ALASKAN NATIVE AT 73.5%. THE POPULATION IS 19% WHITE (NOT HISPANIC OR LATINO) AND 6.4% HISPANIC OR LATINO. NAVAJO COUNTY (NC) - THE POPULATION OF NAVAJO COUNTY WAS 108,277 IN 2015. THIS COUNTY IS EVENLY SPLIT BETWEEN MALES AND FEMALES. THE COUNTY'S POPULATION IS 42.2% WHITE (NOT HISPANIC OR LATINO), 44.9% NATIVE AMERICAN OR ALASKAN NATIVE, 11.1% HISPANIC, 1.3% BLACK AND .7% ASIAN. YAVAPAI COUNTY (YC) - IN 2015 THERE WERE 222,255 INDIVIDUALS LIVING IN YAVAPAI COUNTY. THE MAJORITY OF THE POPULATION IS WHITE (NOT HISPANIC OR LATINO) AT 80.9%. THE POPULATION IS 14.2% HISPANIC OR LATINO, 2.1% AMERICAN INDIAN OR ALASKAN NATIVE, 1% ASIAN, AND .9% BLACK OR AFRICAN AMERICAN. YAVAPAI IS EXPERIENCING AN EXTREMELY HIGH GROWTH IN HISPANICS. IN THE NEXT 5 YEARS, THE HISPANIC POPULATION IS ESTIMATED TO INCREASE BY 6,424 NEW LIVES. AGE DISTRIBUTION CC - IN 2014, PERSONS UNDER THE AGE OF 18 IS 21.8%, NEARING THE STATE AVERAGE OF 24.1%. AN ESTIMATED 12.3% OF THE POPULATION IS 65 YEARS OR OLDER, AND THIS IS EXPECTED TO INCREASE SLIGHTLY OVER THE NEXT FIVE YEARS TO 13.5%. MC - IT WAS FOUND THAT 18.7% OF MOHAVE COUNTY'S RESIDENTS WERE UNDER THE AGE OF 18, WHILE 26.9% WERE OVER THE AGE OF 65. GC - THE POPULATION OF GILA COUNTY HAD 20.4% OF ITS RESIDENTS AGED 18 OR UNDER AND 26.6% AGED 65 OR OLDER IN 2014. AC - IN APACHE COUNTY, PERSONS UNDER THE AGE OF 18 IS 29.3% AND PERSONS OLDER THAT 65 WAS AT 13.5% IN 2014. NC - IT WAS FOUND THAT 28% OF NAVAJO COUNTY'S POPULATION IS UNDER THE AGE OF 18 AND 15.8% IS OVER THE AGE OF 65. YC - AN ESTIMATED 28.1% OF THE POPULATION IS 65 YEARS OR OLDER, NEARLY DOUBLING THE STATE ESTIMATED AVERAGE PERCENT OF 15.9%, CARE FOR THE AGING WAS IDENTIFIED BY 20% OF THE RESPONDENTS IN A COMMUNITY HEALTH SURVEY AS A CRITICAL ISSUE. THE POPULATION WITHIN THE AGE OF 65 AND 74 WILL EXPERIENCE THE MOST GROWTH AT 21.53%. PEOPLE BETWEEN THE AGES OF 45 AND 54 PRESENT THE SMALLEST GROWTH AT -12.44% IN THE NEXT FIVE YEARS. YAVAPAI, IN TOTAL, HAS A GREATER PERCENT OF GROWTH THAN THE UNITED STATES AVERAGE IN ALL AGE GROUPS EXCEPT BETWEEN THE AGES OF 45 AND 64. SCHEDULE H, PART VI, LINE 5 COMMUNITY HEALTH AND COMMUNITY BUILDING ARE A FOCUS AT FLAGSTAFF MEDICAL CENTER AS EVIDENCED BY THE NUMEROUS ACTIVITIES SPONSORED EACH YEAR. THE CANCER CENTER AT FMC HOSTS A SERIES OF FREE OR LOW-COST SCREENINGS DESIGNED TO HELP RESIDENTS IN THE COMMUNITY DETECT ISSUES AS SOON AS POSSIBLE. THE SAFE CHILD CENTER IS A CHILD ADVOCACY CENTER THAT SERVES CHILDREN FROM BIRTH THROUGH 18 YEARS OLD AND IS DEDICATED TO REDUCING THE STRESS CHILDREN EXPERIENCE AS VICTIMS OF CRIME. FMC'S PALLIATIVE CARE PROGRAM PROVIDES HIGH QUALITY CARE TO PATIENTS WHO HAVE A CHRONIC DISEASE OR LIFE-THREATENING ILLNESS. FIT KIDS OF ARIZONA, WHICH WORKS TO REDUCE THE HEALTH CONSEQUENCES OF CHILDHOOD OBESITY BY PROMOTING HEALTHY LIFESTYLES, AND THE DIABETES TOGETHER COMMUNITY COLLABORATION ARE FMC'S PREMIER COMMUNITY HEALTH INITIATIVES. THE CARE BEYOND WALLS AND WIRES PROGRAM USES TELEMEDICINE TO MONITOR AND SUPPORT PATIENTS WHO LIVE REMOTELY AND HAVE RECENTLY BEEN DIAGNOSED WITH CONGESTIVE HEART FAILURE. COMMUNITY BUILDING IS ADVANCED BY FMC THROUGH ITS SUPPORT OF PHYSICIAN RECRUITMENT AND WORK WITH VARIOUS COMMUNITY ORGANIZATIONS INCLUDING THE AMERICAN CANCER SOCIETY, BIG BROTHERS AND BIG SISTERS, FLAGSTAFF LEADERSHIP PROGRAM, FLAGSTAFF CHAMBER OF COMMERCE AND THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION. SCHEDULE H, PART VI, LINE 6 FLAGSTAFF MEDICAL CENTER IS AFFILIATED WITH VERDE VALLEY MEDICAL CENTER. THE BOARD MEMBER MEETINGS ARE COMBINED. THE COMMUNITY BENEFIT REPORT IS SUMMARIZED TOGETHER AND POSTED ON THE HOSPITAL'S WEBSITE. true Northern Arizona Healthcare Foundation 1200 N Beaver Street Flagstaff AZ 86001 813137336 501(c)(3) 8577385 Endowment and Comm Benefit 1 0 SCHEDULE I, PART IV, PROCEDURES TO MONITOR GRANTS FLAGSTAFF MEDICAL CENTER FOUNDATION - GRANTS 1) INDIVIDUALS ON THE USER LEVEL ARE RESPONSIBLE FOR SCREENING AND IDENTIFYING THE NEEDS FOR DISTRIBUTION OF GRANT FUNDS. 2) DEPARTMENT HEADS AND/OR PROGRAM COORDINATORS MUST VALIDATE AND SIGN ALL REQUESTS FOR PAYMENT OR DISBURSEMENT OF THESE FUNDS. 3) WRITTEN REQUESTS ARE REVIEWED BY THE FOUNDATION SPECIALIST FOR OPERATIONS TO VERIFY AVAILABLE FUND BALANCES AND PROPER ACCOUNT NUMBERS. 4) THE FOUNDATION SPECIALIST FOR GRANTS THEN INITIALS THE DOCUMENTS AFTER VERIFYING THE CRITERIA FOR DISBURSEMENT. 5) THE VICE PRESIDENT OF DEVELOPMENT AUTHORIZES THE DISBURSEMENT OF FUNDS BY SIGNATURE. 6) THE FOUNDATION SCANS ALL DOCUMENTS AND SAVES THEM DIGITALLY ON A SECURE SERVER. 7) ALL ORIGINAL DOCUMENTS ARE SUBMITTED TO ACCOUNTS PAYABLE FOR FINAL RECORDING AND PAYMENT. ORIGINAL DOCUMENTS ARE FILED AND ARCHIVED IN A SECURE LOCATION FOR THE REQUIRED LENGTH OF TIME. FMC RELIES ON THE GOVERNANCE PRACTICES OF THE RECIPIENT ORGANIZATION TO USE THE FUNDS FOR THE INTENDED PURPOSE. false true false false false false false true false FLORENCE SPYROW NAH PRESIDENT/CEO (AS OF 3/18) 0 397762 0 30000 0 2753 0 16100 0 0 0 446615 0 0 RICHARD NEFF CHIEF MEDICAL OFFICER 0 343947 0 0 0 20196 0 16100 0 24483 0 404726 0 0 DON STOOKEY CHIEF SUPPORT SERVICES 0 184500 0 0 0 0 0 0 0 0 0 184500 0 0 KATY WILKENS CHIEF NURSING OFFICER 0 224779 0 0 0 500 0 10135 0 0 0 235414 0 0 ROBERT THAMES NAH PRESIDENT/CEO (THRU 3/18) 0 561977 0 0 0 9402 0 10800 0 19911 0 602090 0 0 JEFFREY TREASURE NAH CHIEF FIN OFFICER 0 364172 0 0 0 2551 0 16100 0 17431 0 400254 0 0 RENZO CATALDO PHYSICIAN 0 566925 0 0 0 2386 0 16100 0 7185 0 592596 0 0 FRANK RAFIE CHIEF RADIATION PHYSICIAN 0 217968 0 0 0 53023 0 13808 0 21529 0 306328 0 0 RICHARD MENDRIBIL DIR PHARMACY SVCS (THRU 02/18) 0 202170 0 0 0 10257 0 0 0 1195 0 213622 0 0 DALE MERRIT REGISTERED NURSE 0 195321 0 0 0 2588 0 12385 0 20333 0 230627 0 0 JOHN DEMPSEY VP NAH/PRES LCMC 0 275187 0 18121 0 29487 0 39922 0 25733 0 388450 0 0 BRENDA MUNNS DIR OF NURSING (THRU 05/18) 0 195342 0 0 0 1117 0 31727 0 16138 0 244324 0 0 RICHARD SMITH VP OF DEVELOP/MKTG (THRU 7/16) 0 255697 0 57200 0 27001 0 10800 0 18348 0 369046 0 0 SCHEDULE J, PART I, LINES 1A & 1B ALL COMPENSATION, BENEFITS AND REIMBURSEMENTS ARE PAID BY NORTHERN ARIZONA HEALTHCARE, THE PARENT ORGANIZATION. GROSS-UP OF TAXES IS DONE ON ALL EMPLOYEE GIFT CERTIFICATES OF $25 OR MORE. IN PRACTICE, THE BOARD MEMBER AND OFFICER BUSINESS TRAVEL EXPENSES ARE APPROVED BY THE NEXT HIGHEST LEVEL. SCHEDULE J, PART I, LINE 3 CEO COMPENSATION IS DERIVED BY THE PARENT ORGANIZATION, NORTHERN ARIZONA HEALTHCARE, BY THE FOLLOWING METHODS: COMPENSATION COMMITTEE, WRITTEN CONTRACT, INDEPENDENT CONSULTANT, COMPENSATION SURVEY, AND RECOMMENDATION OF COMPENSATION COMMITTEE TO BOARD FOR APPROVAL. SCHEDULE J, PART I, LINE 7 THE FOLLOWING INDIVIDUALS RECEIVED DISCRETIONARY ONE-TIME BONUSES DURING THE YEAR. THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(II): FLORENCE SPYROW: $30,000 JOHN DEMPSEY: $18,121 RICHARD SMITH: $57,200 SCHEDULE J, PART II THE FOLLOWING INDIVIDUALS PARTICIPATE IN A DEFINED BENEFIT RETIREMENT PLAN. AS SUCH, ACTUARIAL INCREASES IN THEIR ACCOUNTS ARE REPORTED ON PART II, COLUMN (C) AS DEFERRED COMPENSATION. INCREASE DUE TO ACTUARIAL BENEFIT: JOHN DEMPSEY: $3,178 THE FOLLOWING INDIVIDUALS CASHED OUT ACCUMULATED PTO DURING THE YEAR. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(III): JOHN DEMPSEY: $27,506 RICHARD NEFF: $19,262 RICHARD MENDRIBIL: $ 7,875 FRANK RAFIE: $52,724 RICHARD SMITH: $15,000 SCHEDULE J, PART II ADDITIONAL INFORMATION RICHARD SMITH WAS THE DEVELOPMENT DIRECTOR AT NAH THROUGH 7/2016. AT THAT TIME, HE BECAME THE PRESIDENT/CEO OF THE NEWLY-FORMED NAH FOUNDATION, AN UNRELATED TAX EXEMPT ENTITY. NAH HAS AN ARRANGEMENT WITH THE FOUNDATION WHEREBY NAH CONTINUES TO PAY HIS SALARY. FMC paid KESTCO $184,500 during 2017 for Chief Support Services services rendered by Don Stookey. FMC paid B.E. Smith, Inc. $22,500 during 2017 for Interim CAO services rendered by John Harrington. A INDUSTRIAL DEVELOPMENT AUTHORITY OF YAVAPAI COUNTY 860276099 985900CX5 2011-10-12 65094379 SEE PART IV false false false B INDUSTRIAL DEVELOPMENT AUTHORITY OF YAVAPAI COUNTY 860376099 2015-06-30 54783825 SEE PART IV false false false C INDUSTRIAL DEVELOPMENT AUTHORITY OF YAVAPAI COUNTY 860376099 2017-05-29 40000000 SEE PART IV false false false A 0 0 65094379 0 0 0 629060 0 0 0 64465319 0 2011 true false true true B 0 0 54783825 0 0 0 1111308 0 0 0 53672517 0 2015 true false true true C 0 0 40430487 0 0 0 0 0 0 3813177 0 36617310 false false false true A false false true true false 0 false false false true B false false true true false 0 false false false true C false false true true false 0 false false false true A false false true false false false 0 false 0 false true B false false true false false 0 false 0 false true C false true false false true false 0 false 0 false true A true B true C true SCHEDULE K, PART I, COLUMN (F) BOND A - THE NAME OF THE ISSUE IS HOSPITAL REVENUE REFUNDING BONDS (NORTHERN ARIZONA HEALTHCARE SYSTEM) SERIES 2011. THIS ISSUE REFUNDS THE 1996A AND 1998 SERIES BONDS. TOTAL ISSUANCE PRICE WAS $78,923,520 WHICH WAS ALLOCATED $65,094,379 TO FLAGSTAFF MEDICAL CENTER (FMC) AND $13,829,141 TO VERDE VALLEY MEDICAL CENTER. BOND B - THE NAME OF THE ISSUE IS HOSPITAL REVENUE REFUNDING BONDS (NORTHERN ARIZONA HEALTHCARE SYSTEM) SERIES 2015A AND 2015B. THIS ISSUE REFUNDS THE 2008A AND 2008B BONDS. THE TOTAL ISSUANCE PRICE OF SERIES 2015A WAS $80,395,000 WHICH WAS ALLOCATED $37,213,977 TO FLAGSTAFF MEDICAL CENTER (FMC), $9,274,438 TO VERDE VALLEY MEDICAL CENTER, AND $33,906,585 TO NORTHERN ARIZONA HEALTHCARE OUTPATIENT SURGERY CENTER. THE 2015A BONDS WERE ALSO USED, IN PART, TO FINANCE "NEW MONEY" PROJECTS. $33,611,679 WAS USED FOR ACQUISITION OF SUMMIT SURGERY CENTER. TOTAL ISSUANCE PRICE OF SERIES 2015B WAS $45,635,975 WHICH WAS ALLOCATED $17,569,850 TO FLAGSTAFF MEDICAL CENTER (FMC) AND $28,066,125 TO VERDE VALLEY MEDICAL CENTER. BOND C - THE NAME OF THE ISSUE IS HOSPITAL REVENUE BOND (NORTHERN ARIZONA HEALTHCARE SYSTEM) SERIES 2017A. TOTAL ISSUANCE PRICE WAS $40,000,000 WHICH WAS ALLOCATED TO FLAGSTAFF MEDICAL CENTER (FMC). THE ISSUANCE PRICE DIFFERS FROM TOTAL PROCEEDS DUE TO INVESTMENT EARNINGS. FORM 990, PART I, LINE 6 FMC VOLUNTEERS PROVIDE CLERICAL ASSISTANCE IN MULTIPLE DEPARTMENTS AND SUPPORT SERVICES SUCH AS WHEELCHAIR ASSISTANCE AND ESCORTING PATIENTS AND FAMILIES WHO ENTER AT THE MAIN ENTRY. THEY VOLUNTEER AT THE INFORMATION DESK AND GIFT SHOP AND MAKE DELIVERIES OF GIFTS, READING MATERIALS AND MAIL TO PATIENT ROOMS. THEY PROVIDE LOBBY MUSIC, NAVAJO AND SPANISH INTERPRETATION, SPIRITUAL CARE, AND CARING CANINE AND CARING CLOWN VISITS TO PATIENTS. THEY ROCK BABIES IN THE SPECIAL CARE NURSERY, PROVIDE MENDED HEARTS PATIENT AND FAMILY SUPPORT, AND ASSIST AT THE FOUNDATION AND AT SPECIAL EVENTS. VOLUNTEERS ASSIST IN OTHER DEPARTMENTS SUCH AS THE CANCER CENTER, BIOMEDICAL ENGINEERING, MAIL ROOM, NUTRITION SERVICES, PHARMACY, WOMEN AND INFANTS' CENTER, PHYSICAL THERAPY, FIT KIDS, BARIATRIC CLINIC, EMERGENCY AND SURGICAL SERVICES, AND THE TAYLOR HOUSE. FORM 990, PART III, LINE 4A ONE OF THE NICEST THINGS ABOUT LIVING IN NORTHERN ARIZONA IS YOU DON'T HAVE TO TRAVEL TO GET EXCELLENT HEALTHCARE. SINCE 1936, FLAGSTAFF MEDICAL CENTER (FMC), A MEMBER OF NORTHERN ARIZONA HEALTHCARE, HAS PROVIDED HIGH QUALITY HEALTHCARE SERVICES TO RESIDENTS AND VISITORS OF NORTHERN ARIZONA. WE ARE DEDICATED TO PATIENT-CENTERED CARE WITH A PERSONAL TOUCH. FMC IS LICENSED BY MEDICARE AND THE STATE OF ARIZONA. FOUNDED BY DR. CHARLES SECHRIST AS FLAGSTAFF HOSPITAL, THE 25-BED HOSPITAL WAS DONATED TO THE COMMUNITY OF FLAGSTAFF IN 1955. TODAY, FLAGSTAFF MEDICAL CENTER REMAINS A NOT-FOR-PROFIT HOSPITAL, GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS. WE TREAT EVERY PATIENT, REGARDLESS OF THEIR ABILITY TO PAY. EVERY YEAR, FLAGSTAFF MEDICAL CENTER INVESTS IN ITS COMMUNITY HOSPITAL TO ENSURE WE ARE PROVIDING THE BEST, SAFEST CARE, CLOSE TO HOME. WE PROVIDE KEY SERVICES TO NORTHERN ARIZONA RESIDENTS AND VISITORS, INCLUDING A REGIONAL TRAUMA CENTER; OPEN-HEART SURGERY; HIGH-TECH IMAGING; A CANCER CENTER; SURGICAL SERVICES; ORTHOPEDIC SERVICES; WOMEN, INFANTSCHILDREN'S SERVICES; AND MORE. FMC CURRENTLY HAS: - 264 INPATIENT BEDS - 238 PHYSICIANS ON OUR ACTIVE MEDICAL STAFF - 14,220 ANNUAL INPATIENT HOSPITAL ADMISSIONS - 61,249 INPATIENT DAYS - 94,256 ANNUAL OUTPATIENT HOSPITAL VISITS - 47,830 ANNUAL EMERGENCY DEPARTMENT VISITS - 1,077 BABIES BORN THIS YEAR AT FMC FLAGSTAFF MEDICAL CENTER'S MISSION AND VISION ----------------------------------------------------------- MISSION - IMPROVING HEALTH, HEALING PEOPLE. VISION - ALWAYS BETTER CARE. EVERY PERSON, EVERY TIME...TOGETHER. FORM 990, PART V, LINE 2A; PART VII, SECTION A, AND PART IX FLAGSTAFF MEDICAL CENTER DOES NOT HAVE EMPLOYEES, BUT SHARES THE COST OF PERSONNEL, SERVICES, AND EXPENSES WITH NORTHERN ARIZONA HEALTHCARE CORPORATION, A RELATED TAX-EXEMPT ORGANIZATION AND FMC'S SOLE MEMBER. FORM 990, PART VI, LINE 1 THE BOARD OF DIRECTORS DELEGATES AUTHORITY TO AN EXECUTIVE COMMITTEE IN AN EMERGENCY SITUATION ONLY. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE INDIVIDUALS THEN SERVING AS THE EXECUTIVE COMMITTEE OF NAH, AUTOMATICALLY AND WITHOUT SEPARATE ELECTION. THE EXECUTIVE COMMITTEE SHALL ONLY MEET IF A QUORUM OF THE BOARD IS IMPOSSIBLE AND AN URGENT BOARD VOTE IS REQUIRED. IN SUCH CASES IT SHALL EXERCISE THE POWER AND AUTHORITY OF THE BOARD, AND SHALL REPORT ANY ACTIONS TAKEN AT THE FOLLOWING BOARD MEETING. FORM 990, PART VI, LINE 6 NORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE CORPORATE MEMBER OF FLAGSTAFF MEDICAL CENTER. FORM 990, PART VI, LINE 7A THE BOARD OF DIRECTORS IS DETERMINED BY THE ORGANIZATIONS MEMBER, NORTHERN ARIZONA HEALTHCARE (NAH). THE DIRECTORS AT ALL TIMES SHALL BE, AUTOMATICALLY AND WITHOUT THE NEED OF A SEPARATE ELECTION, THE INDIVIDUALS SERVING AS DIRECTORS OF NAH. FORM 990, PART VI, LINE 7B NORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE VOTING MEMBER. The following actions may be initiated by the Member in its sole and absolute discretion: a) Adoption of the consolidated annual budget for the System and any amendments b) The selection and retention of the President and Chief Administrative Officer of this Corporation c) The selection of banking affiliations, accounting firms, legal counsel as well as approval of the engagement of any consultants not specifically provided for in an approved budget d) The selection of the manner and location of investment of any retained earnings e) Authorization of standing or ad hoc committees for controlled subsidiaries within the System. THE MEMBER MAY NOT TRANSFER ITS MEMBERSHIP OR ANY RIGHTS ARISING THEREFROM. FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM BASED ON DATA GATHERED BY THE CONTROLLER AND THE ORGANIZATION'S FINANCIAL OPERATIONS GROUP. THE CEO AND/OR CFO REVIEWS THE DRAFT FORM 990 AND PROVIDES ADDITIONAL COMMENTS. THE FINAL DRAFT VERSION OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE MAY 15 DUE DATE. ANY ADDITIONAL COMMENTS SUGGESTED BY THE GOVERNING BODY ARE THEN INCORPORATED INTO THE FINAL VERSION OF THE FORM 990 TO BE FILED WITH THE IRS BY THE FINAL DUE DATE. IF ANY SUGGESTED CHANGES ARE MATERIAL OR SIGNIFICANT, AN ADDITIONAL DRAFT IS DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, LINE 12C THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY (BOARD POLICY 6.1). THIS IS ACCOMPLISHED BY A NUMBER OF MECHANISMS. FIRST, THE CONFLICT OF INTEREST QUESTIONNAIRE IS REVIEWED BY THE BOARD DEVELOPMENT COMMITTEE. AS PART OF THE QUESTIONNAIRE, SELF-DISCLOSURE IS REQUIRED BY BOARD MEMBERS, OFFICERS, AND VPS. IN ADDITION, INDIVIDUAL DISCLOSURE BY BOARD MEMBERS OCCURS AT BOARD MEETINGS WHEN NECESSARY. A BOARD MEMBER MUST EXCLUDE HIMSELF OR HERSELF FROM VOTING ON AN ISSUE IN WHICH HE OR SHE MAY HAVE A CONFLICT OF INTEREST. THE CONTROLLER REVIEWS POTENTIAL CONFLICTS AND FOLLOWS UP WITH ANY ADDITIONAL QUESTIONS, IF NECESSARY. THEN THE SUMMARY OF RESPONSES AND CONFLICTS ARE BROUGHT BEFORE THE BOARD DEVELOPMENT COMMITTEE, WHICH MAKES A DETERMINATION AS TO WHETHER A CONFLICT EXISTS. FORM 990, PART VI, LINES 15A & 15B THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO AND OTHER OFFICERS INCLUDES THE PREPARATION OF COMPARABLE DATA BY WILLIS TOWERS WATSON, AN INDEPENDENT CONSULTING FIRM. IN ADDITION, THIS INFORMATION IS REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD AND IS DOCUMENTED IN THE BOARD MINUTES. THE MOST RECENT REVIEW WAS PERFORMED IN FEBRUARY 2018. FORM 990, PART VI, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE ARIZONA DEPARTMENT OF HEALTH SERVICES. IN ADDITION, THEY ARE AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) AS PART OF THE ORGANIZATION'S CONTINUING DISCLOSURE DOCUMENTS THAT ARE REQUIRED BY ITS PUBLIC DEBT REQUIREMENTS. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, AS THIS IS NOT REQUIRED. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS $ 8,522,123 - CHANGE IN PENSION LIABILITY ($ 2,147) - OTHER CHANGES ($46,638,035) - TRANSFER TO AFFILIATES ______________ ($38,118,059) - TOTAL NORTHERN ARIZONA HEALTHCARE PO BOX 1268 FLAGSTAFF AZ 86001 742410946 HEALTHCARE AZ 501(c)(3) 10 NA false VERDE VALLEY MEDICAL CENTER 269 SOUTH CANDY LANE COTTONWOOD AZ 86326 860100882 HEALTHCARE AZ 501(c)(3) 3 NAH true false false false false false false false false false true true false false false true false true true true VERDE VALLEY MEDICAL CENTER q 68657998 COST