VERDE VALLEY MEDICAL CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
VERDE VALLEY MEDICAL CENTER (EIN 86-0100882)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-13
IRS object ID
201311339349305236
Schema version
2011v1.5
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)
Timestamp2013-05-13T20:21:46-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

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 Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN860100882EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1VERDE VALLEY MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JOHN CORTESE CPAInCareOfName
Name ControlVERDNameControl
Phone9286396442Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1269 SOUTH CANDY LANEAddressLine1
CityCOTTONWOODCity
StateAZState
ZIP Code86326ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGREG KUZMAName
TitleVICE PRESIDENT/CFOTitle
Date Signed2013-05-13DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone6023223000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJAMES BLEICHERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1269 SOUTH CANDY LANEAddressLine1
CityCOTTONWOODCity
StateAZState
ZIP Code86326ZIPCode
FieldValueIRS element (for citing)
Gross Receipts150474378GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.VERDEVALLEYMEDICALCENTER.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1939YearFormation
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 Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers387TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year578407ContributionsGrantsPriorYear
Contributions Grants Current Year679720ContributionsGrantsCurrentYear
Program Service Revenue Prior Year146151007ProgramServiceRevenuePriorYear
Program Service Revenue CY144815588ProgramServiceRevenueCY
Investment Income Prior Year-196191InvestmentIncomePriorYear
Investment Income Current Year2113499InvestmentIncomeCurrentYear
Other Revenue Prior Year1914509OtherRevenuePriorYear
Other Revenue Current Year2247674OtherRevenueCurrentYear
Total Revenue Prior Year148447732TotalRevenuePriorYear
Total Revenue Current Year149856481TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year567899GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY249706GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year76129119SalariesEtcPriorYear
Salaries Etc Current Year76973597SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year594575TotalFundrsngExpCurrentYear
Other Expense Prior Year62456669OtherExpensePriorYear
Other Expenses Current Year65156709OtherExpensesCurrentYear
Total Expenses Prior Year139153687TotalExpensesPriorYear
Total Expenses Current Year142380012TotalExpensesCurrentYear
Revenues Less Expenses Prior Year9294045RevenuesLessExpensesPriorYear
Revenues Less Expenses CY7476469RevenuesLessExpensesCY
Total Assets BOY230023777TotalAssetsBOY
Total Assets EOY230505315TotalAssetsEOY
Total Liabilities BOY89253790TotalLiabilitiesBOY
Total Liabilities EOY98198782TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY140769987NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY132306533NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense114818192Expense
Grants249706Grants
Revenue135129750Revenue
DescriptionTO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. TO PROVIDE HEALTH CARE SERVICES TO THE COMMUNITY THROUGH ITS INPATIENT, OUTPATIENT AND EMERGENCY HOSPITAL CARE AND RELATED MEDICAL SERVICES, CHARITY CARE AND COMMUNITY SERVICE. TOTAL INPATIENT DISCHARGES WERE 5,098 AND 19,306 PATIENT DAYS, OUTPATIENT VISITS APPROXIMATED 41,483 AND 23,012 EMERGENCY VISITS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense4650802Expense
Grants0Grants
Revenue9409396Revenue
DescriptionTO PROVIDE EMERGENCY SERVICES, CANCER TREATMENT AND OTHER ANCILLARY SERVICES TO THE COMMUNITY THROUGH THE OPERATION OF THE VVMC SEDONA CAMPUS. EMERGENCY VISITS WERE 7,276. RADIATION ONCOLOGY PROCEDURES WERE 11,811 MEDICAL IMAGING PROCEDURES 7,401.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense993256Expense
Grants0Grants
Revenue1682565Revenue
DescriptionTO PROVIDE GERIATRIC PSYCHIATRIC SERVICES TO THE COMMUNITY THROUGH THE OPERATION OF THE SENIOR BEHAVIORAL HEALTH UNIT. DISCHARGES WERE 189 AND PATIENT DAYS 1,922.Description
FieldValueIRS element (for citing)
Total Program Service Expense120462250TotalProgramServiceExpense
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 EndowmentsfalseTermOrPermanentEndowments
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 IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
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 EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096239NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
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 Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
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 CORTESE CPANamePerson
Telephone Number9282143545TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1914 N SAN FRANCISCO ST SUITE MAddressLine1
CityFLAGSTAFFCity
StateAZState
ZIP Code86001ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
PAUL HANSON MD
DIRECTOR/CHIEF OF STAFF10.0XX4770054640
RON BARBER
DIRECTOR/SECRETARY9.0XX000
RICHARD CRANMER
DIRECTOR/CHAIR4.0XX000
ALAN EVERETT
DIRECTOR3.0X06560
JAMES LEDBETTER
DIRECTOR2.75X000
SHAWN ORME
DIRECTOR2.5X09690
MATIAS SANDOVAL
DIRECTOR/VICE CHAIR5.0XX06830
RAY SELNA
DIRECTOR/TREASURER4.0XX000
TOM TAYLOR
DIRECTOR4.0X07290
JAMES BLEICHER MD
DIRECTOR/PRESIDENT/CEO30.0XX049803326353
SAMUEL BUTMAN MD
DIRECTOR/VICE CHIEF OF STAFF40.0XX066292115670
JOHN DEMPSEY
NAH EVP LAW & ETHICS6.0X0430982175204
GREGORY KUZMA
VP/CFO6.0X0401576212390
NICK PASLIDIS
CMO (UNTIL 11/28/11)40.0X03561987685
RICK PETERSON
VP SUPPORT SERVICES40.0018464218894X
JENNIFER BREWER
CNO/VP PT CARE SERVICES40.00212702101084X
BARBARA DEMBER
VP PROFESSIONAL SERVICES40.0021155123757X
HARRY ALBERTI MD
CMO/VP MEDICAL AFFAIRS40.0021375922141X
BRUCE PEEK MD
CARDIOLOGIST: INV-INTVL40.0077046621377X
JOHN SCHOR MD
PERIPHERAL/CARDIO SURGEON40.0065086824838X
BRADLEY D WILLIAMS
PHYSICIAN40.0059034325793X
JACK WYLIE
PHYSICIAN40.005677260X
STEPHEN BLAIR FAULKNER
PHYSICIAN40.005480360X
FieldValueIRS element (for citing)
Total Reportable Comp From Org47700TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs6308304TotalReportableCompFrmRltdOrgs
Total Other Compensation675186TotalOtherCompensation
Number Individuals GT100 K79NumberIndividualsGT100K
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
LABCORP OF AMERICAN HOLDINGS
PO BOX 2240BURLINGTONNC272162240LABORATORY SERVICES595488
CAREFUSION SOLUTIONSPYXIS
25082 NETWORK PLACECHICAGOIL606731250MAINTENANCE SERVICES565784
SPECIALISTS HOSPITAL MEDICINE
1140 MONROE AVE NW STE 150GRAND RAPIDSMI49503LOCUM TENANTS429444
MEDICUS HOSPITALISTS SVCS LLC
7 INDUSTRIAL WAY STE 5SALUMNH03079MED STAFFING/CNSLTNG153324
SALLOUM MEDICAL SERVICES PLLC
14632 S 24TH WAYPHOENIXAZ85048PROF. & TECH. SVCS152880
FieldValueIRS element (for citing)
Number Of Contractors GT100 K14NumberOfContractorsGT100K
Fundraising Events57600FundraisingEvents
Government Grants353820GovernmentGrants
All Other Contributions268300AllOtherContributions
Noncash Contributions9000NoncashContributions
Total Contributions679720TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICES REVENUEDescription
Business Code622110BusinessCode
Total Revenue Column144815588TotalRevenueColumn
Related Or Exempt Function Income144815588RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue144815588TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1738501TotalRevenueColumn
Exclusion$1,738,501ExclusionAmount

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)
Real853542Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real853542Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column853542TotalRevenueColumn
Exclusion$853,542ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities928931Securities
Other2727Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other556660Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities928931Securities
Other-553933Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column374998TotalRevenueColumn
Exclusion$374,998ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events49246GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events57600CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses61237FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-11991TotalRevenueColumn
Exclusion-$11,991ExclusionAmount

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
CAFETERIA SALES722320495141495141
GIFT SHOP900099171261171261
ALL OTHER REVENUE900099739721739721
FieldValueIRS element (for citing)
Total Other Revenue1406123TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column149856481TotalRevenueColumn
Related Or Exempt Function Income146221711RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,955,050ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total232973Total
Program Services232973ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total16733Total
Program Services16733ProgramServices

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)
Total3074009Total
Program Services2044951ProgramServices
Management And General1029058ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total58150422Total
Program Services51158544ProgramServices
Management And General6811182ManagementAndGeneral
Fundraising180696Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4091498Total
Program Services3502707ProgramServices
Management And General573478ManagementAndGeneral
Fundraising15313Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7743574Total
Program Services6629227ProgramServices
Management And General1085365ManagementAndGeneral
Fundraising28982Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3914094Total
Program Services3350832ProgramServices
Management And General548613ManagementAndGeneral
Fundraising14649Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total282264Total
Program Services104475ProgramServices
Management And General177789ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total67872Total
Program Services0ProgramServices
Management And General67872ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total11399Total
Program Services0ProgramServices
Management And General11399ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total7632331Total
Program Services4448463ProgramServices
Management And General2871441ManagementAndGeneral
Fundraising312427Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total467310Total
Program Services37245ProgramServices
Management And General427331ManagementAndGeneral
Fundraising2734Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total21825613Total
Program Services19692933ProgramServices
Management And General2114260ManagementAndGeneral
Fundraising18420Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2898983Total
Program Services2550833ProgramServices
Management And General348150ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total448265Total
Program Services184917ProgramServices
Management And General262231ManagementAndGeneral
Fundraising1117Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total993205Total
Program Services826243ProgramServices
Management And General153897ManagementAndGeneral
Fundraising13065Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total10110639Total
Program Services8966911ProgramServices
Management And General1139284ManagementAndGeneral
Fundraising4444Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1453441Total
Program Services1307353ProgramServices
Management And General146088ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
REGISTRATION SERVICES1571118015711180
MEDICAL PURCHASE SERVICES1196161119616100
AIR AMBULANCE PURCHASE SVCS1137805113780500
EXP REIMBURSEMENT TO NAH145616531281425517473980

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total498650Total
Program Services258689ProgramServices
Management And General237233ManagementAndGeneral
Fundraising2728Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total142380012Total
Program Services120462250ProgramServices
Management And General21323187ManagementAndGeneral
Fundraising594575Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4000BOY
EOY4300EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY18951232BOY
EOY15186111EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15221584BOY
EOY15302137EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY6691BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY108445BOY
EOY26196EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2286641BOY
EOY2282843EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY7828814BOY
EOY1558970EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis161932170LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec87900449LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY72641865BOY
EOY74031721EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY104426009BOY
EOY113066922EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY375562BOY
EOY2096092EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8172934BOY
EOY6950023EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY230023777BOY
EOY230505315EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY11510086BOY
EOY13236972EOY

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)
BOY56207691BOY
EOY54059256EOY

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)
BOY698726BOY
EOY401018EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY20837287BOY
EOY30501536EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY89253790BOY
EOY98198782EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY140769987BOY
EOY132306533EOY

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)
BOY140769987BOY
EOY132306533EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY230023777BOY
EOY230505315EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses7476469ReconcilationRevenueExpenses
Reconcilation Other Changes-15939923ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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 OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$11,399GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB11399TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLOBBYING ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II-B, LINE 1FReturnReference
ExplanationVERDE VALLEY MEDICAL CENTER PAID DUES TO THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION. A PERCENTAGE OF THIS AMOUNT OR $11,399 WAS ESTIMATED TO BE ATTRIBUTABLE TO LOBBYING RELATED TO HEALTH CARE ADVOCACY AT THE FEDERAL, STATE, REGIONAL, AND LOCAL LEVELS.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3746702OtherCostOrOtherBasis
Book Value3746702BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis91067701OtherCostOrOtherBasis
Depreciation44826893Depreciation
Book Value46240808BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1007442OtherCostOrOtherBasis
Depreciation164129Depreciation
Book Value843313BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis54864722OtherCostOrOtherBasis
Depreciation39484913Depreciation
Book Value15379809BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11245603OtherCostOrOtherBasis
Depreciation3424514Depreciation
Book Value7821089BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings74031721TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
MINIMUM PENSION LIABILITY$28,667,315
PROFESSIONAL GENERAL LIABILITY$1,834,221
FieldValueIRS element (for citing)
Total Of Amounts30501536TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierASC (740) FOOTNOTEIdentifier
Return ReferenceSCHEDULE D, PART X, LINE 2ReturnReference
ExplanationIN ACCORDANCE WITH ACCOUNTING GUIDANCE, MANAGEMENT HAS REVIEWED ALL OPEN TAX YEARS AND HAS DETERMINED THAT THE CORPORATION HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1COPPER BALLNameOfEvent1
Gross Receipts Event194944GrossReceiptsEvent1
Charitable Contributions Event157600CharitableContributionsEvent1
Gross Revenue Event137344GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Non Cash Prizes Event14537NonCashPrizesEvent1
Rent Facility Costs Event114625RentFacilityCostsEvent1
Food And Beverage Event114800FoodAndBeverageEvent1
Entertainment Event17100EntertainmentEvent1
Other Direct Expenses Event110526OtherDirectExpensesEvent1
Name Of Event2LOVEN 5K RUNNameOfEvent2
Gross Receipts Event211902GrossReceiptsEvent2
Charitable Contributions Event20CharitableContributionsEvent2
Gross Revenue Event211902GrossRevenueEvent2
Cash Prizes Event20CashPrizesEvent2
Non Cash Prizes Event2500NonCashPrizesEvent2
Rent Facility Costs Event20RentFacilityCostsEvent2
Food And Beverage Event22400FoodAndBeverageEvent2
Entertainment Event20EntertainmentEvent2
Other Direct Expenses Event24638OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Food And Beverage Other Events111FoodAndBeverageOtherEvents
Other Direct Expenses Other Events2000OtherDirectExpensesOtherEvents
Gross Receipts Total106846GrossReceiptsTotal
Charitable Contributions Total57600CharitableContributionsTotal
Gross Revenue Total Events49246GrossRevenueTotalEvents
Cash Prizes Total Events0CashPrizesTotalEvents
Non Cash Prizes Total Events5037NonCashPrizesTotalEvents
Rent Facility Costs Total Events14625RentFacilityCostsTotalEvents
Food And Beverage Total Events17311FoodAndBeverageTotalEvents
Entertainment Total Events7100EntertainmentTotalEvents
Other Direct Expenses Total Events17164OtherDirectExpensesTotalEvents
Direct Expense Summary Events61237DirectExpenseSummaryEvents
Net Income Summary-11991NetIncomeSummary

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 Percentage175.DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigentfalseFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense923117TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense923117NetCommunityBenefitExpense
Percent Of Total Expense0.00650PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense19989750TotalCommunityBenefitExpense
Direct Offsetting Revenue12132245DirectOffsettingRevenue
Net Community Benefit Expense7857505NetCommunityBenefitExpense
Percent Of Total Expense0.05520PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense20912867TotalCommunityBenefitExpense
Direct Offsetting Revenue12132245DirectOffsettingRevenue
Net Community Benefit Expense8780622NetCommunityBenefitExpense
Percent Of Total Expense0.06170PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1015237TotalCommunityBenefitExpense
Direct Offsetting Revenue345200DirectOffsettingRevenue
Net Community Benefit Expense670037NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense2246061TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2246061NetCommunityBenefitExpense
Percent Of Total Expense0.01580PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense67219TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense67219NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense292560TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense292560NetCommunityBenefitExpense
Percent Of Total Expense0.00210PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3621077TotalCommunityBenefitExpense
Direct Offsetting Revenue345200DirectOffsettingRevenue
Net Community Benefit Expense3275877NetCommunityBenefitExpense
Percent Of Total Expense0.02310PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense24533944TotalCommunityBenefitExpense
Direct Offsetting Revenue12477445DirectOffsettingRevenue
Net Community Benefit Expense12056499NetCommunityBenefitExpense
Percent Of Total Expense0.08480PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$6,894,850BadDebtExpenseAmount
Amount Attributable To923117AmountAttributableTo
Amount Reimbursed By Medicare65329000AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare85371000CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-20042000MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
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 Line1VERDE VALLEY MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1269 S CANDY LANEAddressLine1
CityCOTTONWOODCity
StateAZState
ZIP Code86326ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1VERDE VALLEY MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent125.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent175.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Lowest Negotiated RatesXLowestNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities7NumberOfOtherFacilities

Other Facilities OtherFacilities (7 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
CAMP VERDE HEALTH CENTER
460 FINNEY FLATS ROADCAMP VERDEAZ86322OFFICE X-RAY LAB PHYSICAL THERAPY
VVMC AMBULATORY CENTER
300 WEST HIGHWAY 89ACOTTONWOODAZ86336SURGERY ENDOSCOPY
VVMC MOB
294 WEST HIGHWAY 89ACOTTONWOODAZ86336PHYSICIAN OFFICES SLEEP LAB
VOC MOB
61 BELL ROCK PLAZASEDONAAZ86351PHYSICIAN OFFICES
EMPLOYED PHYSICIAN OFFICE
450 WILLARD ST STE 101 107COTTONWOODAZ86336PHYSICIAN OFFICE
FAMILY PRACTICE PHYSICIAN OFFICE
199 S CANDY LANE STE 1ACOTTONWOODAZ86326PHYSICIAN OFFICE
VVMC SEDONA CAMPUS
3700 WEST HIGHWAY 89ASEDONAAZ86336OUTPATIENT AND EMERGENCY SERVICES

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
SCHEDULE H, PART I, LINE 3C:FINANCIAL ASSISTANCE INCOME LEVELS ARE BASED ON THE FEDERAL POVERTY GUIDE PUBLISHED IN THE FEBRUARY FEDERAL REGISTER ON AN ANNUAL BASIS. A TIERED METHOD IS UTILIZED FOR DETERMINING WHETHER A PATIENT IS ELIGIBLE FOR 100%, 75%, 50%, 25%, OR 15% WRITE-OFF OF THE SELF PAY BALANCE. OTHER CONSIDERATIONS SUCH AS DISPOSABLE ASSETS ARE CONSIDERED IN THE EVALUATION OF ELIGIBILITY. A DISPOSABLE ASSET MAY BE EXPENSIVE JEWELRY, PLEASURE HORSES, RECREATIONAL VEHICLES, ETC.
SCHEDULE H, PART I, LINE 6A:THE INFORMATION FOR THE COMMUNITY BENEFITS REPORT IS GATHERED BY THE COMMUNITY RELATIONS DEPARTMENT WHICH IS A DEPARTMENT OF NORTHERN ARIZONA HEALTHCARE. FLAGSTAFF MEDICAL CENTER AND VERDE VALLEY MEDICAL CENTER ARE IDENTIFIED SEPARATELY ON THESE REPORTS. THE COMMUNITY BENEFIT REPORT IS AVAILABLE ON THE WEBSITE.
SCHEDULE H, PART I, LINE 7:VERDE VALLEY MEDICAL CENTER USED A COST-TO-CHARGE RATIO, WHERE APPLICABLE, TO CALCULATE THE MOST ACCURATE COST OF CHARITY CARE AND OTHER COMMUNITY BENEFITS REPORTED IN LINE 7.
SCHEDULE H, PART III, LINE 4:THE FOOTNOTE TO THE FINANCIAL STATEMENT 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. THE COSTING METHODOLOGY USED TO DETERMINE THE BAD DEBT COST COMES FROM THE PERCENTAGE CALCULATED IN SCHEDULE H PART I WORKSHEET 2. 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 8:THE ENTIRE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE OUR MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE WHETHER OR NOT THIS SERVICE IS PROVIDED AT A LOSS TO THE HOSPITAL. MEDICARE IS A LARGE PORTION OF THE HOSPITAL'S PAYOR MIX (62%) AND IS A SIGNIFICANT LOSS FOR A 99-BED SOLE COMMUNITY HOSPITAL. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SIGNIFICANT LOSS AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST OF THE MEDICARE BENEFICIARIES. MANY OF THESE PATIENTS WOULD QUALIFY FOR CHARITY CARE IF THEY WERE NOT IN THE MEDICARE PROGRAM. THE MEDICARE AMOUNTS WERE OBTAINED FROM THE PD&R AND COST REPORT.
SCHEDULE H, PART III, LINE 9B:BEFORE PRE-ADMISSION AND IF PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE VERDE VALLEY MEDICAL CENTER'S CASHIER COLLECTS 50% OF THE ESTIMATED LIABILITY. THE REST OF THE 50% IS SET UP ON A 6 MONTH PAYMENT PLAN WITH A SELF PAY REPRESENTATIVE OF THE CENTRAL BUSINESS OFFICE.
SCHEDULE H, PART VI, LINE 2:VERDE VALLEY MEDICAL CENTER ASSESSES COMMUNITY HEALTHCARE NEEDS THROUGH A SURVEY DESIGNED AND ADMINISTERED BY THE PROFESSIONAL RESEARCH CONSULTANTS. 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.NEEDS ASSESSMENT
SCHEDULE H, PART VI, LINE 3:THE VERDE VALLEY MEDICAL CENTER (VVMC) WEBSITE HAS A BILLING CONTACT NUMBER. BEFORE PRE-ADMISSION, PATIENTS ARE CONTACTED BY THE VVMC'S CASHIER. WHEN PATIENTS ARE CONTACTED, THEY ARE EDUCATED OF THE FINANCIAL ASSISTANCE POLICY. VVMC FINANCIAL COUNSELORS ASSIGNED TO EACH NURSING UNIT ARE ABLE TO ANSWER OR ASSIST WITH BILLING QUESTIONS. AT EACH PATIENT REGISTRATION DESK ARE DISPLAYS AND BROCHURES OF THE BILLING INFORMATION, INCLUDING THE FINANCIAL ASSISTANCE POLICY. ACCORDING TO THE POLICY, THE FINANCIAL COUNSELORS ASSESS THE 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 PATIENT DOESN'T QUALIFY FOR CHARITY CARE ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR LONG-TERM PAYMENT PROGRAM. IF THE CHARITY APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE
SCHEDULE H, PART VI, LINE 4:VERDE VALLEY MEDICAL CENTER IS A 99-BED ADULT AND PEDIATRIC, SOLE COMMUNITY HOSPLITAL, AND 11-BED GERIATRIC PSYCHIATRY SOLE COMMUNITY HOSPITAL. THE HOSPITAL IS LOCATED IN COTTONWOOD, ARIZONA BUT THE PRIMARY SERVICE AREA INCLUDES COTTONWOOD, CLARKDALE, JEROME, SEDONA, VILLAGE OF OAK CREEK, RIMROCK, AND CORNVILLE WHICH COVERS APPROXIMATELY A 50 SQUARE MILE SPAN. THE CLOSEST HOSPITAL TO THE NORTH IS FLAGSTAFF MEDICAL CENTER (VVMC AFFILIATE) WHICH IS 70 MILES. THE CLOSEST HOSPITAL TO THE SOUTH IS 40 MILES. THE POPULATION IN THE PRIMARY SERVICE AREA IS APPROXIMATELY 73,000. THE HOSPITAL PAYOR MIX IS AS FOLLOWS: MEDICARE 62%, AHCCCS/MEDICAID 14%, COMMERCIAL/OTHER 19%, AND SELF PAY 5%. VERDE VALLEY MEDICAL CENTER IS THE LARGEST EMPLOYER IN THE COMMUNITY. THE PRIMARY SERVICE AREA DOES NOT HAVE MUCH INDUSTRY AND THE COMMUNITY HAS MANY SMALL BUSINESS ORGANIZATIONS.COMMUNITY INFORMATION
SCHEDULE H, PART VI, LINE 5:VERDE HEALTHCARE INITIATIVE, LLC (VHI) WAS FORMED IN MARCH 2010 AND IS 100% OWNED BY VERDE VALLEY MEDICAL CENTER (VVMC). THE GENERAL PURPOSE OF VHI IS TO BE AN INCUBATOR FOR INNOVATIVE COMMUNITY HEALTH CARE BY PROVIDING FINANCIAL SUPPORT TO SERVICES AND PROGRAMS WHICH PROMOTE AND ADVANCE THE HEALTH OF THE PEOPLE OF COTTONWOOD, VERDE VALLEY, SEDONA AND OTHER GEOGRAPHICAL AREAS SERVED BY VERDE VALLEY MEDICAL CENTER. THE LLC IS FUNDED BY A BOARD APPROVED PERCENTAGE OF NET OPERATING INCOME. ONE OF THE COMPLETED PROJECTS WAS DEVELOPING AN EDUCATION AND EXERCISE REGIMEN WHICH LED TO A DRAMATIC REDUCTION IN CARDIOLOGY READMISSIONS. VHI HAS PUT TOGETHER A SERIES OF COMMUNITY EDUCATION PROJECTS AIMED AT CHANGING HEALTH/LIFESTYLE BEHAVIORS. INCLUDED IN THIS LIST IS A JUVENILE DIABETIC PROGRAM, A FAMILY HEALTH EDUCATION PROGRAM AIMED AT LOW INCOME FAMILIES IN THE BEAVER CREEK SCHOOL DISTRICT, (WHICH WAS CO-VENTURED WITH THE NORTHERN ARIZONA COUNCIL OF GOVERNMENTS - THE PROGRAM CREATED BY THE UCLA MEDICAL CENTER AND JOHNSON AND JOHNSON MEDICAL), AN AREA-WIDE FITNESS PROGRAM DESIGNED BY DR. CHARLES CORBIN, A PROFESSOR AT ARIZONA STATE UNIVERSITY. THIS PROGRAM IS A MULTI-DISCIPLINE PROGRAM ADMINISTERED IN PUBLIC SCHOOLS. VHI ALSO HAS WORKED WITH NORTHERN ARIZONA UNIVERSITY AND THEIR SCHOOL OF DENTAL HYGIENE IN PROVIDING TREATMENT AND ORAL HEALTH EDUCATION TO LOW INCOME FAMILIES. VHI DOES NOT GIVE ANY GRANTS BUT IS WILLING TO WORK WITH EXISTING ORGANIZATIONS TO HELP CHANGE BEHAVIORS. VHI HAS NO PAID STAFF BUT DOES HIRE NEEDED SERVICES ON A CASE BY CASE BASIS. VHI IS GOVERNED BY A THREE-MEMBER BOARD. IN ADDITION, THE VVMC FOUNDATION HAS DESIGNATED COMMUNITY FUNDS AND SUPPORTS THE SCHOOLS, HOUSE OF RUTH, AND VERDE VALLEY SANCTUARY.PROMOTION OF COMMUNITY HEALTH
SCHEDULE H, PART VI, LINE 6:VERDE VALLEY MEDICAL CENTER IS AFFILIATED WITH FLAGSTAFF MEDICAL CENTER. THE BOARD MEMBER MEETINGS ARE COMBINED. THE COMMUNITY BENEFIT REPORT IS SUMMARIZED TOGETHER AND POSTED ON THE HOSPITAL'S WEB SITE. IN THE LAST COUPLE OF YEARS A SYSTEMWIDE QUALITY CARDIOLOGY PROGRAM WAS STARTED AND PHYSICIAN ARE EMPLOYED OR CONTRACTED AT BOTH INSTITIUTIONS TO PROVIDE TIMELY PATIENT CARE.AFFILIATED HEALTH CARE SYSTEM

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (14 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
YAVAPAI HELPLINE
PO BOX 387PRESCOTTAZ863020387273443476501(C)(3)10000FUNDING FOR CENTRAL COMMUNICATION HELP RESOURCE CENTER
VERDE VALLEY CAREGIVERS
345 JORDAN RDSEDONAAZ86336860725787501(C)(3)9091ONGOING SUPPORT FOR SENIOR IN-HOME ASSISTANCE PROG
VERDE VALLEY SANCTUARY
401 N 16THS STCOTTONWOODAZ86326860741314501(C)(3)6500ONGOING SUPPORT TO HELP WOMEN AND CHILDREN WHO ARE VICTIMS OF DOMESTIC VIOLENCE
TRAUMA INTERVENTION PROGRAM OF ARIZONA
PO BOX 25195PRESCOTT VALLEYAZ86312204433209501(C)(3)8360ONGOING SUPPORT FOR VOLUNTEER TRAUMA COUNCELORS VIA SCF
SEDONA SUNRISE CENTER FOR ADULTS
110 INDIAN CLIFFS RDSEDONAAZ86336262252125501(C)(3)8362ONGOING SUPPORT FOR SENIOR DAYCARE CENTER VIA SCF
CORNUCOPIA - HARMONY HEALTH
PO BOX 126CORNUCOPIAWI54827860990310501(C)(3)5919HARMONY HEALTH PLAN VIA SEDONA COMMUNITY FOUNDATION
CITY OF COTTONWOOD
827 N MAINCOTTONWOODAZ86326866007877GOVERNMENT10000LOOKIN' GOOD COTTONWOOD SPONSORSHIP
N ARIZONA TENNIS ASSOCIATION
1016 W UNIV AVE STE 204FLAGSTAFFAZ86001860995753501(C)(3)6000TITLE SPONSORSHIP BRUCE HORNSBY FUNDRAISING CONCERT
CAMP VERDE UNITED CHRISTIAN SCHOOL
903 FINNIE FLAT RDCAMP VERDEAZ86322860793544SCHOOL5700FUNDING FOR PHYSICAL EDUCATION AND NUTRITION PROGRAM
VERDE VALLEY SENIOR CENTER
500 E CHERRY STCOTTONWOODAZ86326860328194501(C)(3)7100FUNDING TO BUILD GREENHOUSE IN COTTONWOOD
MINGUS UNION HIGH SCHOOL
1801 E FIR STCOTTONWOODAZ86326866006215SCHOOL24181FACILITATE CONTINUING GENERAL STUDIES
COTTONWOOD OAK CREEK SCHOOL DISTRICT
1 N WILLARD STCOTTONWOODAZ86326866000563SCHOOL9760PROGRAM ASSISTANCE
YAVAPAI COMMUNITY COLLEGE
1100 E SHELDONPRESCOTTAZ86301237232985SCHOOL28000FACILITATE EXPANSION OF NURSING PROGRAM
YAVAPAI COUNTY WELLNESS CLINIC
1090 COMMERCE DRIVEPRESCOTTAZ86305866000561501(C)(3)94000PROVIDE LAB & MEDICAL IMAGING SERVICES FOR LOW INCOME
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants14TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSTUDENT LOANSTypeOfGrant
Number Of Recipients4NumberOfRecipients
Amount Of Cash Grant16733AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTSIdentifier
Return ReferenceSCHEDULE I, PART I, LINE 2ReturnReference
ExplanationYAVAPAI COLLEGE - MONITOR SCHOOL PROGRAM AND MAKE SURE THEY HAVE THE APPROPRIATE INSTRUCTORS AND OTHER EMPLOYEES PER THE AGREEMENT; YAVAPAI COMMUNITY WELLNESS CENTER - PATIENT'S INCOMES ARE SCREENED BY THE COUNTY FOR THOSE QUALIFIED TO RECEIVE FREE SERVICES, PATIENTS ARE IDENTIFIED ON PRESCRIPTIONS FOR LAB AND RADIOLOGY SERVICES, THEY ARE REGISTERED UNDER THE COUNTY AND TOTAL DOLLARS USED IS ACCUMULATED IN THE SYSTEM; STUDENT LOANS - STUDENTS ARE CHECKED EACH SEMESTER TO MAKE SURE THEY ARE STILL IN THE PROGRAM AND WHEN THEY GRADUATE THEY ARE TO BE EMPLOYED OR PAYBACK THE LOAN WHICH IS MONITORED BY THE EDUCATION DEPARTMENT AND HUMAN RESOURCES.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)

Base 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
JAMES BLEICHER MD
037001101280220009800016553052438600
JOHN DEMPSEY
0328790094289079030158651016553060618600
GREGORY KUZMA
0330585070991000201289011101061396600
RICK PETERSON
0157114027057047103556015338020353600
JENNIFER BREWER
017928603341600089723011361031378600
BARBARA DEMBER
01801070314440007204016553023530800
HARRY ALBERTI MD
01999920137670006543015598023590000
BRUCE PEEK MD
06934100770560009800011577079184300
SAMUEL BUTMAN MD
05500140112907000980005870067859100
JOHN SCHOR MD
047418501766830009800015038067570600
BRADLEY D WILLIAMS
05555780347650009800015993061613600
JACK WYLIE
0540010027716000000056772600
STEPHEN BLAIR FAULKNER
03360860211950000000054803600
NICK PASLIDIS
0279955062360013883018960578903638830

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUPPLEMENTAL COMPENSATION INFORMATIONSCHEDULE J, PART I, LINE 1 A/BALL COMPENSATION, BENEFITS AND REIMBURSEMENTS ARE PAID BY NORTHERN ARIZONA HEALTHCARE CORPORATION, THE PARENT ORGANIZATION. BOARD MEMBER AND OFFICERS BUSINESS TRAVEL EXPENSES, SUCH AS AIRLINE AND MEALS, FOR COMPANIONS WERE PAID AND REPORTED ON A W-2 OR 1099. GROSS UP OF TAXES IS DONE ON ALL EMPLOYEE GIFT CERTIFICATES OF $25 OR MORE. THE BOARD MEMBER AND OFFICER BUSINESS TRAVEL EXPENSES ARE APPROVED BY NEXT HIGHEST LEVEL. AMOUNTS PAID BY THE PARENT (NAH) FOR "COMPANION TRAVEL" WERE FOR SPOUSES OF THE FOLLOWING DIRECTORS: SHAWN ORME: $548 RAY SELNA: $440 TOM TAYLOR: $729
SUPPLEMENTAL COMPENSATION INFORMATIONSCHEDULE J, PART I, LINE 3CEO COMPENSATION IS DERIVED BY A RELATED ENTITY - NORTHERN ARIZONA HEALTHCARE CORPORATION.
SCHEDULE J, PART IITHE 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. FOR THE CURRENT YEAR, THE INCREASES WERE SUBSTANTIALLY MORE THAN NORMAL DUE TO A DECREASE IN THE DISCOUNT RATE USED IN THE ACTUARIAL ANALYSIS AS FOLLOWS: INCREASE DUE INCREASE DUE TO BENEFIT TO DECREASE IN ACCRUAL DISCOUNT RATE TOTAL JOHN J. DEMPSEY 57,015 101,636 158,651 GREGORY KUZMA 43,310 157,979 201,289 JENNIFER BREWER 28,252 61,471 89,723

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancingCUSIP NumberCUSIPNumber
INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY
8603760992008-07-2511393572SEE PART VIfalsefalsefalse
INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY
8603760992009-01-0832468925SEE PART VIfalsefalsefalse985900BTS
INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY
8603760992011-10-1213829141SEE PART VIfalsefalsefalse985900CX5

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Amount 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
00113935720011392216001356000truefalsetruetrue
00324689250032039951363004065970000truefalsetruetrue
0013829141001369553513360600000truefalsetruetrue2011

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning 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 UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsetruetruefalse0.000000.000000.00000true
falsefalsetruetruefalse0.000000.000000.00000true
falsefalsefalsefalse0.009700.000000.00970true

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
0
falsetruefalsefalse0falsetrue
0
falsetruefalsefalse0falsetrue
0
falsefalsefalsefalse0falsefalse
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSEE SCHEDULE OIdentifier
Return Reference0ReturnReference

Schedule L IRS990ScheduleL

FieldValueIRS element (for citing)
Total Balance Due0TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
CELESTE CORREA MD
HARRY ALBERTI, MD/SPOUSE200226EMPLOYEE COMPENSATIONfalse
LEDBETTER LAW FIRM
JAMES LEDBETTER, DIRECTOR118991LEGAL SERVICESfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSION STATEMENTFORM 990, PART III, LINE 1TO PROVIDE PATIENTS WITH EXCEPTIONAL CARE WHILE TRANSFORMING THE HEALTH OF THE COMMUNITIES WE SERVE.
VOLUNTEER SERVICESFORM 990, PART I, LINE 6VOLUNTEERS WORK IN ALMOST EVERY DEPARTMENT IN THE HOSPITAL AND AT OUR OFFSITE LOCATIONS, SUCH AS VVMC SEDONA CAMPUS, CAMP VERDE, VILLAGE OF OAK CREEK. THEY PERFORM CLERICAL AND RECEPTION DUTIES IN MANY DEPARTMENTS, SERVE AS PATIENT AND VISITOR GREETERS, SUPPLY DISTRIBUTION, LANDSCAPING, NUTRITIONAL SERVICES - PASS TRAYS, PARTICIPATE IN VARIOUS ACTIVITIES WITH THE SENIOR BEHAVIORAL HEALTH PATIENTS, LIBRARY, TRANSPORT, AND MAKE PILLOWS AND TEDDY BEARS (CRAFTS).
DESCRIPTION OF THE MEMBERS OF THE ORGANIZATION AND THEIR RIGHTSFORM 990, PART VI, LINE 6NORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE CORPORATE MEMBER OF VERDE VALLEY MEDICAL CENTER.
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTSFORM 990, PART VI, LINE 7ATHE VERDE VALLEY MEDICAL CENTER (VVMC) GOVERNANCE COMMITTEE NOMINATES FOR POSITIONS ON THE VVMC BOARD OF DIRECTORS. DIRECTORS ARE ELECTED BY THE BOARD OF DIRECTORS OF THE SOLE CORPORATE MEMBER, NORTHERN ARIZONA HEALTHCARE CORPORATION (NAHC) FROM THE NOMINATIONS THAT HAVE BEEN PROVIDED. NAHC ELECTS THOSE PERSONS NOMINATED UNLESS THE BOARD OF DIRECTORS OF THE NAHC BY A SUPER MAJORITY VOTE DETERMINES THAT A NOMINEE'S ELECTION WOULD BE DETRIMENTAL TO THE BEST INTERESTS OF VVMC OR NAHC.
DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTSFORM 990, PART VI, LINE 7BAS SOLE CORPORATE MEMBER, NORTHERN ARIZONA HEALTHCARE CORPORATION (NAHC) APPROVES THE BOARD OF DIRECTORS THAT ARE ELECTED BY THIS ENTITY. ALSO AS SOLE CORPORATE MEMBER, NAHC HAS RESERVED THE RIGHT AND AUTHORITY TO APPROVE OR DISAPPROVE THOSE ACTS OR POWERS AS SET FORTH IN THE "RESERVED POWERS CHART" THAT IS PART OF THE BYLAWS.
DESCRIPTION OF 990 REVIEW PROCESSFORM 990, PART VI, LINE 11BTHE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM BASED ON DATA GATHERED BY THE CONTROLLER AND THE ORGANIZATION'S FINANCIAL OPERATIONS GROUP. THE CFO REVIEWS THE DRAFT FORM 990 AND PROVIDES ADDITIONAL COMMENTS. THE FINAL DRAFT VERSION OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AND KEY OFFICERS AT A BOARD MEETING HELD PRIOR TO THE MAY 15 DUE DATE FOR THE FORM 990. A REPRESENTATIVE FROM THE ACCOUNTING FIRM ATTENDS THE MEETING AND EXPLAINS SOME OF THE SIGNIFICANT DISCLOSURES IN THE FORM 990. ANY ADDITIONAL COMMENTS SUGGESTED BY THE GOVERNING BODY ARE THEN INCORPORATED INTO THE FINAL VERSION OF THE FORM 990 TO BE FILED WITH THE IRS BY THE FINAL DUE DATE. IF ANY SUGGESTED CHANGES ARE MATERIAL OR SIGNIFICANT, AN ADDITIONAL DRAFT IS DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTFORM 990, PART VI, LINE 12CPOLICY IS REVIEWED ANNUALLY AND REQUIRES THEY REPORT CHANGES IN CIRCUMSTANCES - NEW JOB/POSITION OR BUSINESS, SIGNIFICANT PURCHASE/SALE OF PROPERTY, SIGNIFICANT INVESTMENT CHANGE. THE BOARD DIRECTORS AND CEO FILL OUT THE BOARD CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS REVIEWED BY THE LEGAL DEPARTMENT. THE RESTRICTIONS IMPOSED WOULD DEPEND WHAT THE CONFLICT IS; HOWEVER, IF A DISCUSSION PURSUES AND A BOARD MEMBER HAS A CONFLICT IDENTIFIED BY HIM AND OTHERS, THE DIRECTOR WILL LEAVE THE ROOM. THE DIRECTORS AND VPS ALSO HAVE A POLICY AND QUESTIONNAIRE THAT IS FILLED OUT ANNUALLY. ANY YES RESPONSE IS SIGNALED BY SYSTEM TO SEND TO LEGAL FOR REVIEW.
DESCRIPTION OF COMPENSATION PROCESSFORM 990, PART VI, LINES 15A & 15BDETERMINATION OF CEO SALARY IS GUIDED BY INDEPENDENT PERSONS, INVOLVING A BOARD-DESIGNATED COMPENSATION COMMITTEE THAT MAKES A RECOMMENDATION TO THE BOARD; BASED UPON BOARD DEVELOPED AND APPROVED COMPENSATION PHILOSOPHY; DERIVED FROM NATIONWIDE COMPARABLE DATA THAT IS COLLECTED BY THE INDEPENDENT PERSONS; APPROVED BY ENTIRE BOARD OF DIRECTORS AFTER DELIBERATION. VICE PRESIDENT COMPENSATION IS GUIDED BY INDEPENDENT PERSONS; BASED UPON BOARD DEVELOPED AND APPROVED COMPENSATION PHILOSOPHY; DERIVED FROM NATIONWIDE COMPARABLE DATA THAT IS COLLECTED BY THE INDEPENDENT PERSONS; DETERMINED BY THE VP'S SUPERVISOR. THE LAST TIME THE BOARD REVIEWED AND DOCUMENTED THE COMPENSATION WAS IN AUGUST 2012.
AVAILABILITY OF CERTAIN DOCUMENTS TO THE GENERAL PUBLICFORM 990, PART VI, LINE 19THE 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.
HOURS DEVOTED TO RELATED ORGANIZATIONSFORM 990, PART VIIALAN EVERETT SERVES ON THE BOARD OF NAHC AND VERDE VALLEY MEDICAL CENTER (VVMC). HE DEVOTED 3 HOURS PER WEEK TO EACH ORGANIZATION. JAMES LEDBETTER SERVES ON THE BOARD OF NAHC AND VVMC. HE DEVOTED 2.75 HOURS PER WEEK TO EACH ORGANIZATION. SHAWN ORME SERVES ON THE BOARD OF NAHC AND VVMC. SHE DEVOTED 2.50 HOURS PER WEEK TO EACH ORGANIZATION. MATIAS SANDOVAL SERVES ON THE BOARD OF NAHC AND VVMC. HE DEVOTED 5 HOURS PER WEEK TO EACH ORGANIZATION. GREGORY KUZMA IS THE VP AND CHIEF FINANCIAL OFFICER OF NAHC, FMC AND VVMC. HE DEVOTED 20 HOURS PER WEEK TO NAHC, 14 HOURS TO FMC, AND 6 HOURS PER WEEK TO VVMC. JAMES BLEICHER IS CO-CEO OF NAHC AND PRESIDENT AND CHIEF EXECUTIVE OFFICER OF VVMC. HE DEVOTES 10 HOURS PER WEEK TO NAHC AND 30 HOURS PER WEEK TO VVMC. JOHN DEMPSEY IS THE EXECUTIVE VP OF LAW & ETHICS OF NAHC, FMC AND VVMC. HE DEVOTED 20 HOURS PER WEEK TO NAHC, 14 HOURS TO FMC, AND 6 HOURS PER WEEK TO VVMC. TOM TAYLOR SERVES ON THE BOARDS OF BOTH NAH AND VVMC. HE DEVOTED 4 HOURS PER WEEK TO EACH ORGANIZATION. ALL THEIR COMPENSATION IS PAID BY NAHC.
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 5UNREALIZED GAIN/LOSS $ (507,179) NET ASSET TRANSFERS TO/FROM AFFILIATE (1,271,862) DECREASE IN UNFUNDED PENSION LIABILITY (14,160,000) ROUNDING (882) ------------- TOTAL (15,939,923) =============
SUPPLEMENTAL INFORMATIONSCHEDULE K, PART ILINE 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 (FMC) AND $32,468,925 TO VERDE VALLEY MEDICAL CENTER. THE 2008B BONDS WERE ALSO USED, IN PART, TO FINANCE "NEW MONEY" PROJECTS. $10,073,432.20 WAS USED FOR FMC 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 $65,111,905 TO FLAGSTAFF MEDICAL CENTER (FMC) AND $13,811,616 TO VERDE VALLEY MEDICAL CENTER.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1VERDE HEALTHCARE INITIATIVE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1269 SOUTH CANDY LANEAddressLine1
CityCOTTONWOODCity
StateAZState
ZIP Code86326ZIPCode
FieldValueIRS element (for citing)
EIN272388245EIN
Primary ActivitiesHEALTHCAREPrimaryActivities
Legal Domicile StateAZLegalDomicileState
Total Income55255TotalIncome
EOY Assets6790329EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1VVMCBusinessNameLine1

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
FLAGSTAFF MEDICAL CENTER
PO BOX 1268FLAGSTAFFAZ86002860110232HEALTHCAREAZ501(C)(3)3NAHtrue
NORTHERN ARIZONA HEALTHCARE CORPORATION
POST OFFICE BOX 1268FLAGSTAFFAZ86002742410946HEALTHCAREAZ501(C)(3)9NAfalse

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1ALLIANCE MED LABBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1268AddressLine1
CityFLAGSTAFFCity
StateAZState
ZIP Code86002ZIPCode
FieldValueIRS element (for citing)
EIN200584165EIN
Primary ActivityLAB SERVICESPrimaryActivity
Legal Domicile StateAZLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1FMCBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income0ShareOfTotalIncome
Share Of EOY Assets0ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
Code V$0CodeVAmount
General Or Managing PartnerfalseGeneralOrManagingPartner
Percentage Ownership0.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1FLAGSTAFF MEDICAL CENTER-APBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeOTransactionType
Amount Involved14781602AmountInvolved
Method Of Amt DeterminationCOSTMethodOfAmtDetermination

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