2012-05-15T11:37:20-05:00 2011-06-30 BEACHFLEISCHMAN PC PO BOX 64130 TUCSON AZ 857284130 990 2010-07-01 860492210 UNIVERSITY MEDICAL CENTER CORPORATION UNIV 5206942700 1501 N CAMPBELL AVENUE TUCSON AZ 85724 MISTY D HANSEN 5206942700 2012-05-11 1 KAREN K MCCLOSKEY CPA 5203214600 2010 2016-02-24 21:20:13Z THE UNIVERSITY OF ARIZONA MEDICAL CENTER CORPORATION JODI MANSFIELD 1501 N CAMPBELL AVENUE TUCSON AZ 85724 770561884 0 X WWW.UAHEALTH.COM X 1984 AZ ADVANCING HEALTH AND WELLNESS THROUGH EDUCATION, RESEARCH, AND PATIENT CARE. 8 5 4984 633 939263 275910 4320957 10547083 557694728 602207108 922647 4465640 5991919 189049 568930251 617408880 11615263 24943132 0 0 252023153 256459200 0 0 279571 290010524 315797463 553648940 597199795 15281311 20209085 611605726 598726338 399057687 361542044 212548039 237184294 X ADVANCING HEALTH AND WELLNESS THROUGH EDUCATION, RESEARCH, AND PATIENT CARE. 0 0 543343055 24943132 601405631 THE UNIVERSITY OF ARIZONA MEDICAL CENTER IS COMMITTED TO DELIVERING LEADING-EDGE PATIENT CARE TO PATIENTS AND THEIR FAMILIES IN A SUPPORTIVE AND CARING ENVIRONMENT. WE OFFER A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES, INCLUDING ONCOLOGY, CARDIOVASCULAR SERVICES, PEDIATRIC SERVICES, TRANSPLANT PROGRAMS, AND TRAUMA AND EMERGENCY SERVICES. OPERATING AS THE SOLE LEVEL 1 TRAUMA CENTER IN SOUTHERN ARIZONA SINCE 2003, EMERGENCY MEDICINE PROVIDES TRAUMA CARE TO ALL OF SOUTHERN ARIZONA. THE UNIVERSITY OF ARIZONA MEDICAL CENTER'S ONCOLOGY PROGRAM OFFERS A MULTI-DISCIPLINARY CARE TO PATIENTS ACROSS ARIZONA, EXCELLING IN GROUND-BREAKING RESEARCH, EDUCATION, AND OUTREACH PROGRAMS. OUR FACILITIES INCLUDE AN OUTPATIENT CLINICAL FACILITY; A "ONE STOP" CENTER WHERE PATIENTS RECEIVE A VARIETY OF SUPPORT SERVICES AS WELL AS LEADING-EDGE CANCER THERAPIES. IN 2010, THE UNIVERSITY OF ARIZONA MEDICAL CENTER OPENED THE DIAMOND CHILDREN'S MEDICAL CENTER, A FACILITY DESIGNED TO PROVIDE THE MOST ADVANCED PEDIATRIC HEALTH CARE POSSIBLE WHILE MAINTAINING A COMFORTABLE, HEALING, ATMOSPHERE FOR CHILDREN AND THEIR FAMILIES. 543343055 1 1 0 1 0 0 1 0 1 1 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 328 2 1 4984 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 8 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 AZ X X DONELLA FONES 5206942700 1501 N CAMPBELL AVENUE TUCSON AZ 85724 KEVIN J BURNS 40.00 X X 924768 0 29020 LEO J BRENNAN 1.00 X 0 0 0 WILLIAM M CRIST MD 1.00 X 0 654367 39283 JUDY GIGNAC 1.00 X 0 0 0 LINDA MAZON GUTIERREZ 1.00 X 0 0 0 EDMUND L JENKINS 1.00 X 0 0 0 DAVID LABINER MD 1.00 X 0 305592 39020 BARBARA PECK 1.00 X 0 0 0 MISTY D HANSEN 40.00 X 393322 0 63123 GREGORY PIVIROTTO 40.00 X 3485500 0 8007 HENRY WELLS 5.00 X 0 112000 0 VICTORIA D BEGAN 40.00 X 324934 0 50967 JUDY DYE 40.00 X 507024 0 20644 MARTHA G ENRIQUEZ 40.00 X 348679 0 54390 MARIA A KLEMMEDSON 40.00 X 266516 0 44942 KAREN D MLAWSKY 40.00 X 391523 0 67052 MARJORIE N SISSON 40.00 X 182865 0 35743 KENT D ROLLINS 5.00 X 381759 0 17515 DR MICHAEL J DARRAGH 40.00 X 308461 0 33889 DR SAMIR Y DAHDAL 40.00 X 375156 0 22935 DR ROBERT B DZIOBA 40.00 X 619220 0 28820 DR GERALD A WOLFF 40.00 X 278416 0 22468 8788143 1071959 577818 207 0 1 0 UNIVERSITY OF ARIZONA 888 N EUCLID TUCSON AZ 85719 HEALTH CARE PROFESSIONALS 26289509 THE UNIVERSITY OF ARIZONA PHYSICIANS 2701 E ELVIRA ROAD TUCSON AZ 85756 HEALTH CARE PROFESSIONALS 20120500 ARAMARK CORPORATION PO BOX 651009 CHARLOTTE NC 28265 FOOD SERVICE 9266729 AM RED CROSS 222 S CHERRY AVENUE TUCSON AZ 52406 BLOOD PROCESSING SERVICES 6491563 PHILIPS MEDICAL SYSTEMS 3000 ROAD MS 0400 ANDOVER MA 01810 EQUIPMENT MAINTENANCE 2737755 43 6359477 4187606 4223544 10547083 NET PATIENT REVENUE 621500 585120333 584318856 801477 TEACHING SERVICES 611600 8622210 8622210 OTHER OPERATING INCOME 812930 6301521 6301521 SERVICES TO OTHER ORGA 722320 2163044 2163044 602207108 1598925 1598925 657309 657309 92883 41620 51263 51263 51263 155290754 30036 153111384 2179370 30036 2209406 2209406 PARKING REVENUE 812930 137786 137786 137786 617408880 601405631 939263 4516903 24927112 24927112 16020 16020 9287661 9287661 210855479 194203478 16652001 10481235 9585197 896038 9993279 8183872 1809407 15841546 14773714 1067832 769826 769826 258288 258288 95603252 89462013 6078704 62535 3028512 17479 2796932 214101 2886317 1596818 1288685 814 6616357 323897 6292460 6009807 6008824 983 299251 210387 88864 439097 251781 187316 15015702 15015693 9 28479943 24482786 3997157 8070690 4001 8066689 SUPPLIES 128036846 127700473 335732 641 EQUIPMENT MAINTENANCE 11327732 10840031 487701 OTHER 8901077 6451818 2447779 1480 TAXES ON UBTI 54766 54766 597199795 543343055 53577169 279571 930579 4138172 77502623 87992348 2766 277 12300070 11973313 4901321 8280330 611571459 290973593 313029974 320597866 116841478 121280038 1106765 567958 84990150 43896036 611605726 598726338 93566691 57626747 7050431 463987 279912369 275705541 3381595 1112878 15146601 26632891 399057687 361542044 X 0 0 0 0 212548039 237184294 212548039 237184294 611605726 598726338 X 20209085 4427170 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 35645 238409 35645 238409 597164150 1203787208 597199795 1204025617 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 39823 72887 117887 238409 469006 250000 250000 250000 250000 1000000 1500000 4050 299815 X 0 1334053 195923 394044 1135932 1331702 24506 -22155 1334053 362534 919177 49991 1331702 1.00000 0 1 1 11521199 11521199 398960585 141853097 257107488 2702915 2303983 398932 198386760 146816513 51570247 320597866 ASSETS HELD BY TRUSTEE 34548662 ART 299815 DUE FROM THE UNIVERSITY OF ARIZONA HEALTH NETWORK 3095701 OTHER ASSETS 5951858 43896036 DUE TO THIRD PARTY 1031535 OTHER LONG TERM RESERVES 894364 WORKMAN'S COMP RESERVE 2122582 OTHER LIABILITIES 17578879 DUE FROM THE UNIVERSITY OF ARIZONA PHYSICIANS 5005531 26632891 PART III, LINE 4: UNIVERSITY MEDICAL CENTER CORPORATION'S ART COLLECTION PROMOTES AN ATMOSPHERE OF HEALING FOR PATIENTS AND THEIR LOVED ONES. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: UNIVERSITY MEDICAL CENTER FOUNDATION'S ENDOWMENT FUNDS ARE PROGRAM SUPPORT FOR VARIOUS DEPARTMENTS AT THE UNIVERSITY OF ARIZONA MEDICAL CENTER. CENTRAL AMERICA AND THE CARRIBEAN 0 1 PROGRAM SERVICE CAPTIVE INSURANCE 15213000 0 1 0 0 0 1 15213000 0 15213000 1 0 1 1 1 0 METHOD USED TO ACCCOUNT FOR EXPENDITURES: SCHEDULE F, PART I, LINE 3: AMOUNT SHOWN REFLECTS TOTAL ASSETS OF UMCC INSURANCE FUNDING LIMITED, AN OFFSHORE CAPTIVE INSURANCE COMPANY. 1 1 X 1 X 1 X 1 0 0 18341197 8216763 10124434 0.01700 151053398 140047406 11005992 0.01840 169394595 148264169 21130426 0.03540 604266 604266 0.00100 24240628 13995840 10244788 0.01720 22974772 20201767 2773005 0.00460 132659 132659 0.00020 24943132 24943132 0.04180 72895457 34197607 38697850 0.06480 242290052 182461776 59828276 0.10020 70003 70003 0.00010 515703 515703 0.00090 26329 26329 0.00000 612035 612035 0.00100 0 2819413 108380176 105263030 3117146 X 1 1 1 UNIVERSITY OF ARIZONA MEDICAL CENTER IMAGING CENTER LEASING 0.50000 0.00000 0.00000 12 1 UAMC-UNIVERSITY CAMPUS

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X X X X X X 2 UAMC-HOME HEALTH SERVICE

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HOME HEALTH/INFUSION 3 UAMC-ALVERNON CLINIC

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OUTPATIENT PHYSICIAN CLINIC DIAGNOSTIC TESTING 4 UAMC-NORTH CAMPUS

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ONCOLOGY SERVICES 5 UAMC-GREEN VALLEY PHYSICIAN CLINIC

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OUTPATIENT PHYSICIAN CLINIC 6 UAMC-NORTH HILLS CLINIC

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OUTPATIENT PHYSICIAN CLINIC 8 UAMC-PANTANO CLINIC

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OUTPATIENT PHYSICIAN CLINIC 9 UAMC-IMAGING CENTER

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DIAGNOSTIC CENTER 10 UAMC-PHOENIX TRANSPLANT CLINIC

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DIAGNOSTIC TESTING 11 UAMC-UNIVERSITY CAMPUS SURGERY

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OUTPATIENT PHYSICIAN CLINIC 12 UAMC-UNI CAMPUS PEDIATRICS CLINIC

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OUTPATIENT PHYSICIAN CLINIC NA 1 PART II, COMMUNITY BUILDING ACTIVITIES: THE UNIVERSITY OF ARIZONA MEDICAL CENTER IS COMMITTED TO THE COMMUNITY IT SERVES AS WELL AS THE PROMOTION OF PUBLIC HEALTH. THE UNIVERSITY OF ARIZONA MEDICAL CENTER SUPPORTS MANY LOCAL CHARITABLE ORGANIZATIONS, INCLUDING TUCSON FESTIVAL OF BOOKS, AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, JUVENILE DIABETES RESEARCH FOUNDATION AND OTHERS NOT ONLY WITH FINANCIAL CONTRIBUTIONS BUT WITH HOSPITAL VOLUNTEERS AS WELL. IN NOVEMBER OF 2011 THE ORGANIZATION SPONSORED THE 29TH ANNUAL EL TOUR DE TUCSON, A 109 MILE BIKE RIDE AND IMPORTANT TUCSON COMMUNITY EVENT PROMOTING HEALTH AND WELLNESS. IN ADDITION, THE UNIVERSITY OF ARIZONA MEDICAL CENTER PARTICIPATES IN A VARIETY OF HEALTH FAIRS, PROVIDING FREE SCREENINGS, SUCH AS BLOOD PRESSURE CHECKS, AS WELL AS CPR INSTRUCTION. PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE FOR PATIENT ACCOUNTS RECEIVABLE: "PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF ESTIMATED ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS. ESTIMATED ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND UNCOLLECTIBLE ACCOUNTS ARE APPROXIMATELY $211,907,000 AS OF JUNE 30, 2011."BAD DEBT EXPENSE IS NOT INCLUDED AS PART OF COMMUNITY BENEFIT. FINANCIAL COUNSELORS ASSIST PATIENTS WITH CHARITY CARE APPLICATIONS AND UNINSURED DISCOUNT PROGRAM. PART III, LINE 9B: IF SUBSEQUENT EVENTS REVEAL FINANCIAL HARDSHIP, PATIENTS MAY APPLY FOR CHARITY CARE AND RECEIVE DISCOUNTS BASED ON THEIR FINANCIAL CIRCUMSTANCES. PART VI, LINE 2, NEEDS ASSESSMENTS: THE UNIVERSITY OF ARIZONA MEDICAL CENTER'S COMMUNITY NEEDS ASSESSMENT IS PREPARED THROUGH ITS INTERNAL CONSULTING DEPARTMENT WHICH SERVES AS A BASIS FOR ITS STRATEGIC PLANS AND SUBSEQUENT BUSINESS PLANS TO ALLOCATE RESOURCES, IMPROVE AND DEVELOP EXISTING SERVICES, IMPLEMENT NEW PROGRAMS, AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. FOR EXAMPLE, IN RESPONSE TO RISING INCIDENCE OF DIABETES IN SOUTHERN ARIZONA, UMCC ENTERED INTO THE ARIZONA DIABETES ALLIANCE, A UNIQUE PARTNERSHIP WITH THE UNIVERSITY OF ARIZONA, AND CARONDELET HEALTHCARE NETWORK, PIMA COUNTY. THE ARIZONA DIABETES ALLIANCE WAS FORMED TO COORDINATE A REGIONAL INITIATIVE TO PREVENT DIABETES AND IMPROVE THE LIVES OF INDIVIDUALS LIVING WITH DIABETES. PART VI, LINE 3, PATIENT EDUCATION OF ELIGIBILITY: THE UNIVERSITY OF ARIZONA MEDICAL CENTER PROVIDES HEALTH CARE SERVICES FREE OR AT A REDUCED CHARGE TO INDIVIDUALS WHO MEET CERTAIN FINANCIAL CRITERIA. ALL PATIENTS IN NEED OF EMERGENCY SERVICES ARE ACCEPTED REGARDLESS OF THEIR ABILITY TO PAY. WE ALSO OFFER SUBSTANTIAL DISCOUNTS TO INDIVIDUALS WHO LACK INSURANCE OR WHOSE INSURANCE COVERAGE MAY NOT COVER CERTAIN SERVICES UNDER ITS POLICY FOR THE UNINSURED AND UNDERINSURED. UNDER THIS PROGRAM, PATIENTS ARE CHARGED NO MORE THAN THE RATE THE CORPORATION RECEIVED UNDER THE MEDICARE PROGRAM. IN ADDITION, FINANCIAL COUNSELORS ASSIST PATIENTS WITH THE ORGANIZATION'S CHARITY CARE APPLICATION AS WELL AS APPLYING FOR OTHER FEDERAL, STATE, AND LOCAL MEDICAL ASSISTANCE PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE. PART VI, LINE 4, COMMUNITY INFORMATION: THE UNIVERSITY OF ARIZONA MEDICAL CENTER PROVIDES TERTIARY HEALTHCARE AND IS A MAJOR REFERRAL CENTER FOR THE STATE AND OTHER SOUTHWESTERN STATES. THE HOSPITAL IS ONE OF EIGHT NON-FEDERAL ACUTE CARE HOSPITALS IN METROPOLITAN TUCSON, WHICH CONSISTS OF THE CITY OF TUCSON AND IMMEDIATELY SURROUNDING AREAS (HEREINAFTER REFERRED TO AS "METROPOLITAN TUCSON"). THE CITY OF TUCSON IS THE SECOND LARGEST CITY IN ARIZONA AND THE ONLY METROPOLITAN AREA IN PIMA COUNTY, ARIZONA. PIMA COUNTY COVERS 9,184 SQUARE MILES, INCLUDING DIVERSE CHANGES IN ELEVATION, TOPOGRAPHY, AND CLIMATE. SEVERAL NATIVE AMERICAN TRIBAL NATIONS HAVE RESERVATION LANDS IN THE COUNTY WHICH TOGETHER TOTAL 42.1% OF PIMA COUNTY LAND. ACCORDING TO 2007 POPULATION PROJECTIONS BY THE CITY OF TUCSON DEPARTMENT OF URBAN PLANNING & DESIGN, IT IS ESTIMATED THAT THE PIMA COUNTY AREA HAS APPROXIMATELY 1,000,000 RESIDENTS IN 2008 AND WILL EXCEED 1,100,100 BY 2012. TUCSON IS LOCATED APPROXIMATELY 60 MILES NORTH OF THE U.S.-MEXICO BORDER. PIMA COUNTY, WHICH ACCOUNTS FOR APPROXIMATELY 15% OF THE STATE'S POPULATION HAS A CROSS SECTION OF EMPLOYERS WITH HEAVY EMPHASIS IN SERVICES, TRADE, GOVERNMENT, MILITARY, MINING, AND MANUFACTURING. METROPOLITAN TUCSON ACCOUNTS FOR APPROXIMATELY 54% OF THE POPULATION IN PIMA COUNTY. PART VI, LINE 5, PROMOTION OF COMMUNITY HEALTH: THE UNIVERSITY OF ARIZONA MEDICAL CENTER IS THE ONLY LEVEL ONE TRAUMA CENTER IN SOUTHERN ARIZONA AND AS SUCH TAKES A LEADERSHIP ROLE IN IMPROVING SYSTEMS OF CARE FOR TRAUMA PATIENTS. TRAUMA EDUCATION, INJURY PREVENTION, AND DISASTER PREPAREDNESS EFFORTS IN THE REGION ARE OFTEN LED BY STAFF AT THE UNIVERSITY OF ARIZONA MEDICAL CENTER, WHO HAVE SPENT HUNDREDS OF HOURS PROVIDING PROFESSIONAL AND COMMUNITY WIDE EDUCATION.CONSISTENT WITH ITS NONPROFIT STATUS, THE UNIVERSITY OF ARIZONA MEDICAL CENTER USES SURPLUS REVENUES TO REINVEST IN FACILITIES, TECHNOLOGY, AND MEDICAL SERVICES FOR THE COMMUNITY. IN FY 2010, THE UNIVERSITY OF ARIZONA MEDICAL CENTER OPENED THE UNIVERSITY OF ARIZONA MEDICAL CENTER-DIAMOND CHILDREN'S WHICH PROVIDES THE MOST ADVANCE PEDIATRIC HEALTH CARE POSSIBLE WHILE MAINTAINING A COMFORTABLE, HEALING ATMOSPHERE FOR CHILDREN AND THEIR FAMILIES. 1 PERIMETER CYCLING 2609 E BROADWAY TUCSON AZ 85716 860830696 501(C)(3) 186652 TO PROMOTE AWARENESS OF HEALTH BENEFITS OF CYCLING TO GENERAL PUBLIC TUCSON FESTIVAL OF BOOKS PO BOX 210019 TUCSON AZ 85721 262145432 501(C)(3) 105000 PROMOTION OF LITERACY AMERICAN HEART ASSOCIATION 710 2ND AVENUE SEATTLE WA 98014 135613797 501(C)(3) 65100 MEDICAL RESEARCH AMERICAN CANCER SOCIETY 1636 N SWAN 151 TUCSON AZ 85712 131788491 501(C)(3) 62500 RESEARCH, TREATMENT, AND PREVENTION OF CANCER RONALD MCDONALD HOUSE CHARITIES OF SOUTHERN ARIZONA PO BOX 40725 TUCSON AZ 85717 953526934 501(C)(3) 50000 SUPPORT FOR CHILDREN AND FAMILIES BEING EVALUATED AND TREATED FOR SERIOUS ILLNESSES PGA TOUR INC 100 PGA TOUR BLVD POINT VEDRA BEACH FL 32082 520999206 501(C)(3) 47000 GENERAL SUPPORT SUSAN G KOMEN BREAST CANCER FOUNDATION 4574 E BROADWAY TUCSON AZ 85711 752844652 501(C)(3) 35000 BREAST CANCER RESEARCH ARIZONA HEALTH INFORMATION NETWORK PO BOX 245080 TUCSON AZ 85724 860746437 501(C)(3) 34885 SUPPORT HEALTHCARE IN ARIZONA AMERICAN LIVER FOUNDATION 75 MAIDEN LANE 603 NEW YORK NY 10038 362883000 501(C)(3) 22000 RESEARCH THE CAUSE, TREATMENT, PREVENTION, AND CURE OF LIVER DISEASE INTERFAITH COMMUNITY SERVICES 2820 W INA ROAD TUCSON AZ 85741 860520997 501(C)(3) 15000 MATERIAL ASSISTANCE TO POOR AND NEEDY UNIVERSITY MEDICAL CENTER FOUNDATION 1501 N CAMPBELL AVENUE TUCSON AZ 85724 860572438 501(C)(3) 2904614 SOLICIT AND ADMINISTER SUPPORT FOR THE UNIVERSITY OF ARIZONA MEDICAL CENTER UNIVERSITY PHYSICIANS HEALTHCARE 2701 E ELVIRA ROAD TUCSON AZ 85756 942958258 501(C)(3) 12130579 SUPPORT UNIVERSITY OF ARIZONA THE TELEMEDICINE PROGRAM PO BOX 245105 TUCSON AZ 85724 742652689 501(C)(3) 12500 TELEMEDICINE PROGRAM CASA DE LOS NINOS 1101 N 4TH AVENUE TUCSON AZ 85705 860314595 501(C)(3) 10000 1854 FMV MEDICAL SUPPLIES CHILD ABUSE PREVENTION MARCH OF DINES 3550 N CENTRAL AVENUE TUCSON AZ 85012 131846366 501(C)(3) 11500 MEDICAL RESEARCH FOR PREVENTION AND AMELIORATION OF BIRTH DEFECTS STEVEN M GOOTTER FOUNDATION PO BOX 64583 TUCSON AZ 85728 203798976 501(C)(3) 10000 MEDICAL RESEARCH AMERICAN ACADEMY OF PEDIATRICS 141 NORTHWEST POINT BLVD ELK GROVE VILLAGE IL 60007 362275597 501(C)(3) 10000 PEDIATRIC RESEARCH, SUPPORT FOR PEDIATRIC MEDICINE TUCSON NURSES WEEK FOUNDATION PO BOX 65085 TUCSON AZ 85728 860771880 501(C)(3) 10000 NURSING EDUCATION NEW PARENTS NETWORK INC PO BOX 64237 TUCSON AZ 85728 742544881 501(C)(3) 10000 PARENTING EDUCATION AMERICAN LUNG ASSOCIATION 2819 E BROADWAY TUCSON AZ 85716 860111676 501(C)(3) 5100 SAVE LIVES BY IMPROVING LUNG HEALTH AND PREVENTING LUNG DISEASE UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE 888 N EUCLID TUCSON AZ 85719 742652689 9182105 MISSION SUPPORT FOR THE UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE 20 1 NON-CASH 703 16020 FMV PRESCRIPTION DRUGS FROM OUTPATIENT PHARMACY, RENT PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE MISSION OF THE UNIVERSITY OF ARIZONA MEDICAL CENTER INCLUDES SUPPORT OF LOCAL COMMUNITIES BY PARTICIPATING IN AND SPONSORING CHARITABLE AND SERVICE ORGANIZATIONS. OUR GRANT AND SPONSORSHIP COMMITTEE MEETS MONTHLY TO REVIEW GRANT REQUESTS AND DETERMINES THE HIGHEST AND BEST USE OF OUR GRANT FUNDS WITHIN OUR SERVICE AREAS AND LOCAL COMMUNITIES. THE UNIVERSITY OF ARIZONA MEDICAL CENTER PROMOTES INVESTING IN OUR COMMUNITY IN MULTIPLE WAYS, INCLUDING FINANCIAL CONTRIBUTIONS THROUGH GRANTS AND INVOLVING OUR EMPLOYEES IN SERVICE PROGRAMS AND ACTIVITIES. X X X X X X 1 1 0 0 0 0 0 0 0 KEVIN J BURNS 545041 0 373960 0 5767 0 19487 0 9533 0 953788 0 0 0 WILLIAM M CRIST MD 0 647509 0 0 0 6858 0 17150 0 22133 0 693650 0 0 DAVID LABINER MD 0 224138 0 0 0 81454 0 20151 0 18869 0 344612 0 0 MISTY D HANSEN 281311 0 109746 0 2265 0 53763 0 9360 0 456445 0 0 0 GREGORY PIVIROTTO 132593 0 2741142 0 611765 0 0 0 8007 0 3493507 0 0 0 VICTORIA D BEGAN 161791 0 73580 0 89563 0 39354 0 11613 0 375901 0 0 0 JUDY DYE 211908 0 148843 0 146273 0 14951 0 5693 0 527668 0 0 0 MARTHA G ENRIQUEZ 220843 0 121321 0 6515 0 45106 0 9284 0 403069 0 0 0 MARIA A KLEMMEDSON 172792 0 88615 0 5109 0 39269 0 5673 0 311458 0 0 0 KAREN D MLAWSKY 255809 0 132940 0 2774 0 59853 0 7199 0 458575 0 0 0 MARJORIE N SISSON 155238 0 27072 0 555 0 24065 0 11678 0 218608 0 0 0 KENT D ROLLINS 218427 0 145976 0 17356 0 15522 0 1993 0 399274 0 0 0 DR MICHAEL J DARRAGH 258605 0 49308 0 548 0 22026 0 11863 0 342350 0 0 0 DR SAMIR Y DAHDAL 374787 0 0 0 369 0 21505 0 1430 0 398091 0 0 0 DR ROBERT B DZIOBA 586191 0 25000 0 8029 0 19487 0 9333 0 648040 0 0 0 DR GERALD A WOLFF 254863 0 18374 0 5179 0 18366 0 4102 0 300884 0 0 0 PART I, LINES 4A-B GREGORY PIVIROTTO RECEIVED A SEVERANCE PAYMENT OF $3,337,638. THE FOLLOWING PEOPLE PARTICIPATED AND RECEIVED PAYMENTS FROM A NON QUALIFIED RETIREMENT PLAN: KEVIN J. BURNS $105,653, GREGORY PIVIROTTO $596,496, JUDY A. DYE $175,223, KENT D. ROLLINS $42,453, VICTORIA A. BEGAN $114,506, MISTY D. HANSEN $34,375, KAREN D. MLAWKSY $44,000, MARTHA G. ENRIQUEZ $31,095, MARIA A. KLEMMEDSON $25,650, MARJORIE N. SISSON $12,375. SUPPLEMENTAL INFORMATION PART III UNIVERSITY MEDICAL CENTER CORPORATION 860492210 914446AVI 2005-11-10 139802720 FINANCE CONSTRUCTION 0 0 0 UNIVERSITY MEDICAL CENTER CORPORATION 860492210 914446AS8 2004-03-03 53188604 FINANCE CONSTRUCTION 0 0 0 UNIVERSITY MEDICAL CENTER CORPORATION 860492210 914446BF5 2009-05-28 60172570 FINANCE CONSTRUCTION 0 0 0 11085750 1036763 127680207 2010 0 0 1 1 4294750 20992549 716470 27184835 2007 1 1 1 1 4187277 868287 55117006 2010 0 0 1 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 BAYERISCHE LANDESBANK 3.000000000000 0 0 0 X 2 4050 FMV X 1002 FMV X 75314 FMV X 5 3768691 FMV X 1 116243 FMV X 50 252859 FMV X AUCTION ITEMS 3 5395 FMV 0 0 0 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART VI, SECTION A, LINE 6 THE UNIVERSITY OF ARIZONA HEALTH NETWORK IS THE SOLE MEMBER OF THE UNIVERSITY OF ARIZONA MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A THE UNIVERSITY OF ARIZONA HEALTH NETWORK, AS THE SOLE MEMBER OF THE UNIVERSITY OF ARIZONA MEDICAL CENTER, ELECTS THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE UNIVERSITY OF ARIZONA HEALTH NETWORK, AS THE SOLE MEMBER OF THE UNIVERSITY OF ARIZONA MEDICAL CENTER, APPROVES AND/OR RATIFIES SIGNIFICANT DECISIONS MADE BY THE UNIVERSITY OF ARIZONA MEDICAL CENTER GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE UNIVERSITY OF ARIZONA MEDICAL CENTER'S FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER, CHIEF EXECUTIVE OFFICER, AND BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE UMCC BOARD OF DIRECTORS HAS ADOPTED WRITTEN CONFLICT OF INTEREST POLICIES WHICH ESTABLISH PROCEDURES FOR THE IDENTIFICATION AND DISCLOSURE OF CONFLICTS OF INTEREST. UNDER THESE POLICIES, CONFLICTED DIRECTORS, OFFICERS AND EMPLOYEES ARE TO REFRAIN FROM PARTICIPATING IN ANY DECISION OR ACTION BY UMCC INVOLVING THE CONFLICT. DIRECTORS AND MEMBERS OF SENIOR MANAGEMENT OF UMCC ARE REQUIRED ANNUALLY TO REVIEW UMCC'S CONFLICT OF INTEREST POLICY AND COMPLETE AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE. FORM 990, PART VI, SECTION B, LINE 15 THE UNIVERSITY OF ARIZONA MEDICAL CENTER HIRES A THIRD PARTY CONSULTANT TO REVIEW COMPENSATION AND BENEFITS. IN ADDITION, THE UNIVERSITY OF ARIZONA MEDICAL CENTER COMPLETES A SURVEY COMPARING THE COMPENSATION PACKAGES TO SIMILAR ORGANIZATIONS. THE CHIEF FINANCIAL OFFICER AND CHIEF EXECUTIVE OFFICER HAVE WRITTEN EMPLOYMENT CONTRACTS THAT ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE AND BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 POLICIES ARE POSTED ON THE UNIVERSITY OF ARIZONA MEDICAL CENTER'S INTRANET. GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 4,427,170. 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