VERDE VALLEY MEDICAL CENTER: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
VERDE VALLEY MEDICAL CENTER (EIN 86-0100882)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-11
IRS object ID
201241329349302194
Schema version
2010v3.7
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)
Timestamp2012-05-11T13:30:51-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

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 Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN860100882EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1VERDE VALLEY MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
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 Signed2012-05-11DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone6023223000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

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 Receipts150690096GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.VERDEVALLEYMEDICALCENTER.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1939YearFormation
State Legal DomicileAZStateLegalDomicile
Activity Or Mission DescriptionTO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers363TotalNbrVolunteers
Total Gross UBI-517TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year979872ContributionsGrantsPriorYear
Contributions Grants Current Year578407ContributionsGrantsCurrentYear
Program Service Revenue Prior Year156286757ProgramServiceRevenuePriorYear
Program Service Revenue CY146151007ProgramServiceRevenueCY
Investment Income Prior Year1303128InvestmentIncomePriorYear
Investment Income Current Year-196191InvestmentIncomeCurrentYear
Other Revenue Prior Year1912659OtherRevenuePriorYear
Other Revenue Current Year1914509OtherRevenueCurrentYear
Total Revenue Prior Year160482416TotalRevenuePriorYear
Total Revenue Current Year148447732TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year371716GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY567899GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year70055134SalariesEtcPriorYear
Salaries Etc Current Year76129119SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year131327TotalFundrsngExpCurrentYear
Other Expense Prior Year72561540OtherExpensePriorYear
Other Expenses Current Year62456669OtherExpensesCurrentYear
Total Expenses Prior Year142988390TotalExpensesPriorYear
Total Expenses Current Year139153687TotalExpensesCurrentYear
Revenues Less Expenses Prior Year17494026RevenuesLessExpensesPriorYear
Revenues Less Expenses CY9294045RevenuesLessExpensesCY
Total Assets BOY216883460TotalAssetsBOY
Total Assets EOY230023777TotalAssetsEOY
Total Liabilities BOY94283757TotalLiabilitiesBOY
Total Liabilities EOY89253790TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY122599703NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY140769987NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense110638618Expense
Grants567899Grants
Revenue132895907Revenue
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 5,014 AND 20,056 PATIENT DAYS, OUTPATIENT VISITS APPROXIMATED 43,869 AND 23,885 EMERGENCY VISITS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense8723393Expense
Grants0Grants
Revenue12081000Revenue
DescriptionTO PROVIDE EMERGENCY SERVICES, CANCER TREATMENT AND OTHER ANCILLARY SERVICES TO THE COMMUNITY THROUGH THE OPERATION OF THE VVMC SEDONA CAMPUS. EMERGENCY VISITS WERE 6,306. RADIATION ONCOLOGY PROCEDURES WERE 10,182. MEDICAL IMAGING PROCEDURES 7,401.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense2180849Expense
Grants0Grants
Revenue2255000Revenue
DescriptionTO PROVIDE GERIATRIC PSYCHIATRIC SERVICES TO THE COMMUNITY THROUGH THE OPERATION OF THE SENIOR BEHAVIORAL HEALTH UNIT. DISCHARGES WERE 173 AND PATIENT DAYS 2,208.Description
FieldValueIRS element (for citing)
Total Program Service Expense121542860TotalProgramServiceExpense
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 DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
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 With1096206NumberFormsTransmittedWith1096
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 Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
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 Line1917 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
HARRY ALBERTI MD
DIRECTOR/CHIEF OF STAFF40.0XX02245620
RON BARBER
DIRECTOR/SECRETARY7.0XX000
RICHARD CRANMER
DIRECTOR/VICE CHAIR2.0XX000
ALAN EVERETT
DIRECTOR3.0X07090
JAMES LEDBETTER
DIRECTOR2.75X018420
KEN MOLL
DIRECTOR5.0X000
SHAWN ORME
DIRECTOR2.5X04650
MATIAS SANDOVAL
DIRECTOR/CHAIR5.0XX010720
RAY SELNA
DIRECTOR/TREASURER2.0XX000
TOM TAYLOR
DIRECTOR2.0X07370
PAUL HANSON MD
DIRECTOR/VICE CHIEF STAFF1.0XX0477000
JAMES BLEICHER MD
DIRECTOR/PRESIDENT/CEO20.0XX048332433524
JOHN DEMPSEY
DIRECTOR/NAH EVP LAW & ETHICS20.0XX048185866284
GREGORY KUZMA
VP/CFO11.0X035568351215
NICK PASLIDIS
CMO40.0X0999157942
RICK PETERSON
VP SUPPORT SERVICES40.0017557124769X
JENNIFER BREWER
CNO & VP PT CARE SERVICES40.0019835038304X
BARBARA DEMBER
VP ANCILLARY SERVICES40.0026027630955X
JAMES DWYER MD
CARDIOLOGIST: INV-INTVL40.0080301725542X
BRUCE PEEK MD
CARDIOLOGIST: INV-INTVL40.0083425227024X
SAMUEL BUTMAN
CARDIOLOGIST: INV-INTVL40.0061026519635X
JOHN SCHOR MD
PERIPHERAL/CARDIO SURGEON40.0069891824708X
DIANA ENNES
PHYSICIAN40.0045861124556X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs5737127TotalReportableCompFrmRltdOrgs
Total Other Compensation374458TotalOtherCompensation
Number Individuals GT100 K90NumberIndividualsGT100K
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
SPECIALISTS HOSPITAL MEDICINE
1140 MONROE NW STE 150GRAND RAPIDSMI49503LOCUM TENANTS618903
LABCORP OF AMERICAN HOLDINGS
PO BOX 2240BURLINGTONNC272162240LAB SERVICES511755
MEDICUS HOSPITALISTS SVCS LLC
7 INDUSTRIAL WAY STE 5SALEMNH03079LOCUM TENANTS305297
VERITAS MEDICAL SOLUTIONS LLC
5 GREAT VALLEY PARKWAYMALVERNPA19355MEDICAL SUPPLIES184950
SOUTHWEST MOBILE LITHOTRIPSY
100 W THIRD AVE SUITE 350COLUMBUSOH43201LITHOTRIPSY & LASER173000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Fundraising Events47000FundraisingEvents
Government Grants370783GovernmentGrants
All Other Contributions160624AllOtherContributions
Total Contributions578407TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICES REVENUEDescription
Business Code622110BusinessCode
Total Revenue Column146151007TotalRevenueColumn
Related Or Exempt Function Income146151007RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue146151007TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column760207TotalRevenueColumn
Exclusion$760,207ExclusionAmount

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)
Real849721Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real849721Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column849721TotalRevenueColumn
Exclusion$849,721ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1218169Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2178769Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1218169Securities
Other-2178769Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-956398TotalRevenueColumn
Exclusion-$956,398ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events48000GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events47000CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses63595FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-15595TotalRevenueColumn
Exclusion-$15,595ExclusionAmount

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 IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA SALES722310484771484771
ALLIANCE MEDICAL LAB621511130528131045-517
GIFT SHOP900099169699169699

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column295385TotalRevenueColumn
Related Or Exempt Function Income295385RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1080383TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column148447732TotalRevenueColumn
Related Or Exempt Function Income147231907RelatedOrExemptFunctionIncome
Unrelated Business Revenue-517UnrelatedBusinessRevenue
Exclusion$637,935ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total552292Total
Program Services552292ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total15607Total
Program Services15607ProgramServices

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)
Total3167159Total
Program Services2332101ProgramServices
Management And General835058ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total57088015Total
Program Services51155733ProgramServices
Management And General5865008ManagementAndGeneral
Fundraising67274Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total5309781Total
Program Services4770762ProgramServices
Management And General532724ManagementAndGeneral
Fundraising6295Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6881071Total
Program Services6202095ProgramServices
Management And General670769ManagementAndGeneral
Fundraising8207Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3683093Total
Program Services3300366ProgramServices
Management And General378387ManagementAndGeneral
Fundraising4340Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total379773Total
Program Services163932ProgramServices
Management And General215841ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total61390Total
Management And General61390ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total12351Total
Management And General12351ManagementAndGeneral

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)
Total5751892Total
Program Services4811672ProgramServices
Management And General932501ManagementAndGeneral
Fundraising7719Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total290611Total
Management And General290147ManagementAndGeneral
Fundraising464Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total21848230Total
Program Services19880363ProgramServices
Management And General1955274ManagementAndGeneral
Fundraising12593Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2611815Total
Program Services2385373ProgramServices
Management And General222207ManagementAndGeneral
Fundraising4235Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total506279Total
Program Services293181ProgramServices
Management And General211976ManagementAndGeneral
Fundraising1122Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total1410014Total
Program Services1122481ProgramServices
Management And General283675ManagementAndGeneral
Fundraising3858Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total9811307Total
Program Services8375181ProgramServices
Management And General1421218ManagementAndGeneral
Fundraising14908Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total915972Total
Program Services761753ProgramServices
Management And General154219ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServicesFundraisingFundraising
REGISTRATION SERVICES15927661592766
MEDICAL PURCHASE SERVICES15694041569404
AIR AMBULANCE PURCHASE SVCS11116831111683
EXP REIMBURSEMENT TO NAH14297345171568112581664
ALL OTHER EXPENSES285837128308157217312

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total139153687Total
Program Services121542860ProgramServices
Management And General17479500ManagementAndGeneral
Fundraising131327Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3200BOY
EOY4000EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7948027BOY
EOY18951232EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY13647BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY14693838BOY
EOY15221584EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY61508BOY
EOY6691EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY582998BOY
EOY108445EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2333052BOY
EOY2286641EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY8014606BOY
EOY7828814EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis152203001LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec79561136LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY73174973BOY
EOY72641865EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY103037437BOY
EOY104426009EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY58325BOY
EOY375562EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6961849BOY
EOY8172934EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY216883460BOY
EOY230023777EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10697523BOY
EOY11510086EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY59978567BOY
EOY56207691EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY185130BOY
EOY698726EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY23422537BOY
EOY20837287EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY94283757BOY
EOY89253790EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY122599703BOY
EOY140769987EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY122599703BOY
EOY140769987EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY216883460BOY
EOY230023777EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses9294045ReconcilationRevenueExpenses
Reconcilation Other Changes8876239ReconcilationOtherChanges
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$12,351GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB12351TotalLobbyingExpendituresIIB
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 $12,351 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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3281297OtherCostOrOtherBasis
Book Value3281297BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis88039435OtherCostOrOtherBasis
Depreciation40617150Depreciation
Book Value47422285BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis560000OtherCostOrOtherBasis
Depreciation63797Depreciation
Book Value496203BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis50947898OtherCostOrOtherBasis
Depreciation35778968Depreciation
Book Value15168930BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9374371OtherCostOrOtherBasis
Depreciation3101221Depreciation
Book Value6273150BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings72641865TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
MINIMUM PENSION LIABILITY$18,542,467
PROFESSIONAL GENERAL LIABILITY$2,294,820
FieldValueIRS element (for citing)
Total Of Amounts20837287TotalOfAmounts

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 Event195000GrossReceiptsEvent1
Charitable Contributions Event147000CharitableContributionsEvent1
Gross Revenue Event148000GrossRevenueEvent1
Other Direct Expenses Event163595OtherDirectExpensesEvent1
Total Number Of Other Events0TotalNumberOfOtherEvents
Gross Receipts Total95000GrossReceiptsTotal
Charitable Contributions Total47000CharitableContributionsTotal
Gross Revenue Total Events48000GrossRevenueTotalEvents
Other Direct Expenses Total Events63595OtherDirectExpensesTotalEvents
Direct Expense Summary Events63595DirectExpenseSummaryEvents
Net Income Summary-15595NetIncomeSummary

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 Expense425142TotalCommunityBenefitExpense
Net Community Benefit Expense425142NetCommunityBenefitExpense
Percent Of Total Expense0.00310PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense24814779TotalCommunityBenefitExpense
Direct Offsetting Revenue19661000DirectOffsettingRevenue
Net Community Benefit Expense5153779NetCommunityBenefitExpense
Percent Of Total Expense0.03700PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense25239921TotalCommunityBenefitExpense
Direct Offsetting Revenue19661000DirectOffsettingRevenue
Net Community Benefit Expense5578921NetCommunityBenefitExpense
Percent Of Total Expense0.04010PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1056813TotalCommunityBenefitExpense
Direct Offsetting Revenue489630DirectOffsettingRevenue
Net Community Benefit Expense567183NetCommunityBenefitExpense
Percent Of Total Expense0.00410PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense1794254TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1794254NetCommunityBenefitExpense
Percent Of Total Expense0.01290PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense223945TotalCommunityBenefitExpense
Direct Offsetting Revenue3650DirectOffsettingRevenue
Net Community Benefit Expense220295NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3075012TotalCommunityBenefitExpense
Direct Offsetting Revenue493280DirectOffsettingRevenue
Net Community Benefit Expense2581732NetCommunityBenefitExpense
Percent Of Total Expense0.01860PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense28314933TotalCommunityBenefitExpense
Direct Offsetting Revenue20154280DirectOffsettingRevenue
Net Community Benefit Expense8160653NetCommunityBenefitExpense
Percent Of Total Expense0.05870PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$3,895,821BadDebtExpenseAmount
Amount Attributable To379607AmountAttributableTo
Amount Reimbursed By Medicare41007640AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare44503669CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-3496029MedicareSurplusOrShortfall

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

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 SLEEP LAB
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 (59%) 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 2011 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 FINANCIAL ASSISTANCE POLICY.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE
SCHEDULE H, PART VI, LINE 4:VERDE VALLEY MEDICAL CENTER IS A 99-BED ADULT AND PEDIATRIC 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 59%, AHCCCS/MEDICAID 18%, COMMERCIAL 17%, SELF PAY 3%, AND OTHER 3%. 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 NEW CORPORATION IS FUNDED BY A BOARD APPROVED PERCENTAGE OF NET OPERATING INCOME. ONE OF THE PROJECTS THIS CORPORATION IS WORKING ON IS ASSESSING CARDIOLOGY READMISSIONS TO DETERMINE IF ANY QUALITY PROCESS IMPROVEMENT CAN BE INITIATED. IN ADDITION, THE VVMC FOUNDATION HAS DESIGNATED COMMUNITY FUNDS AND SUPPORTS THE SCHOOLS, HOUSE OF RUTH, AND VERDE VALLEY SANCTUARY. THEY ALSO DONATE EQUIPMENT TO THE VARIOUS AMBULANCE COMPANIES AND DONATED MONEY FOR THE SWIM TEAM TO PURCHASE A SCORE BOARD (PROMOTING COMMUNITY HEALTH). THE VHI HAS STARTED A DIABETIC INSTRUCTION PROJECT. THE VHI ALSO HAD THE NORTHERN AZ COUNCIL OF GOVERNMENTS DO HEALTH AND DENTAL CARE TRAINING FOR HEAD START PARENTS IN THE BEAVER CREEK COMMUNITY. THIS WILL HELP THE PARENTS BE BETTER CAREGIVERS TO THEIR CHILDREN AND CONTRIBUTE TO THE REDUCTION OF INCREASING HEALTH CARE COSTS IN THE UNITED STATES.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 YEARS A SYSTEM-WIDE QUALITY CARDIOLOGY PROGRAM WAS STARTED AND PHYSICIANS COVERED BOTH INSTITUTIONS TO PROVIDE TIMELY PATIENT CARE.AFFILIATED HEALTH CARE SYSTEM

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
YAVAPAI COMMUNITY COLLEGE
1100 E SHELDONPRESCOTTAZ86301237232985SCHOOL200000FACILITATE EXPANSION OF NURSING PROGRAM
YAVAPAI COUNTY WELLNESS CLINIC
1090 COMMERCE DRIVEPRESCOTTAZ86305866000561GOVT110405PROVIDE LAB & MED
Prescott Free Clinic Inc
1090 Commerce DrivePrescottAZ86305860744955501(C)(3)12500PROVIDE MEDICAL SVCS
NAU Foundation
PO Boxes 1222FlagstaffAZ86002866004791501(C)(3)25000SUPPORT NURSING
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
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 Grant15607AmountOfCashGrant

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)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
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 (12 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
HARRY ALBERTI MD
022456200000000022456200
JAMES BLEICHER MD
035699901229780334709800023724051684800
JOHN DEMPSEY
0374144058174049540048153018131054814200
GREGORY KUZMA
031105604462700034065017150040689800
RICK PETERSON
01580440175270006884017885020034000
JENNIFER BREWER
017584702249508023929014375023665400
JAMES DWYER MD
0800031000298607362018180082855900
BRUCE PEEK MD
07623830718690009800017224086127600
SAMUEL BUTMAN
0549993060272000980009835062990000
JOHN SCHOR MD
048825102106670007594017114072362600
BARBARA DEMBER
01770720776220558207927023028029123100
DIANA ENNES
0458611000009800014756048316700

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL COMPENSATION INFORMATIONIdentifier
ExplanationLINE 1A/B: ALL COMPENSATION, BENEFITS AND REIMBURSEMENTS ARE PAID BY NORTHERN ARIZONA HEALTHCARE, THE PARENT ORGANIZATION. BOARD MEMBER AND OFFICER 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. LINE 3: CEO COMPENSATION IS DERIVED BY A RELATED ENTITY - NORTHERN ARIZONA HEALTHCARE.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancingCUSIP NumberCUSIPNumber
INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY
8603760992008-07-2511393572SEE PART Vfalsefalsefalse
INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY
8603760992009-01-0832468925SEE PART Vfalsefalsefalse985900BT5

Form990 Schedule K Part II Form990ScheduleKPartII (2 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 MaintaindAdequateBooksAndRecdsMaintaind
0011393572000135600000truefalsetruetrue
003246892500041143500000truefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsetruefalsetrue0.000000.000000.00000true
falsefalsetruefalsetrue0.000000.000000.00000true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsetruefalsefalsefalsetrue
falsetruefalsefalsefalsetrue

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
IdentifierSEE SCHEDULE OIdentifier

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonCELESTE CORREA MDNamePerson
FieldValueIRS element (for citing)
RelationshipHARRY ALBERTI, MD/SPOUSERelationship
Amount Of Transaction200226AmountOfTransaction
Description Of TransactionEMPLOYEE COMPENSATIONDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSION STATEMENTFORM 990, PART III, LINE 1TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. TO PROVIDE HEALTH CARE SERVICES TO THE COMMUNITY THROUGH ITS HOSPITAL CARE AND RELATED MEDICAL SERVICES, CHARITY CARE AND COMMUNITY SERVICE.
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 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.
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, LINE 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 JANUARY 2010.
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 VIIJOHN DEMPSEY DEVOTED 20 HOURS PER WEEK TO VERDE VALLEY MEDICAL CENTER (VVMC) AND 20 HOURS PER WEEK TO NORTHERN ARIZONA HEALTHCARE (NAH). GREG KUZMA DEVOTED 11 HOURS PER WEEK TO VVMC; 20 HOURS PER WEEK TO FLAGSTAFF MEDICAL CENTER (FMC); AND 20 HOURS PER WEEK TO NAH. JAMES BLEICHER DEVOTED 20 HOURS PER WEEK TO VVMC AND 20 HOURS PER WEEK TO NAH. TAYLOR, EVERETT, LEDBETTER, ORME, AND SANDOVAL EACH SERVED ON THE BOARDS OF BOTH NAH AND VVMC. EACH DEVOTED HOURS TO BOTH ENTITIES.
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 5UNREALIZED GAIN $5,004,564 NET ASSET TRANSFERS TO/FROM AFFILIATE (496,000) DECREASE IN UNFUNDED PENSION LIABILITY 4,366,000 ROUNDING 1,675 ---------- TOTAL $8,876,239 ==========
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.

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 Income10000TotalIncome
EOY Assets5510000EOYAssets

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/BusinessNameLine1
FLAGSTAFF MEDICAL CENTER
PO BOX 1268FLAGSTAFFAZ86002860110232HEALTHCAREAZ501(C)(3)3NAH
NORTHERN ARIZONA HEALTHCARE CORPORATION
POST OFFICE BOX 1268FLAGSTAFFAZ86002742410946HEALTHCAREAZ501(C)(3)7NA

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 Income131045ShareOfTotalIncome
Share Of EOY Assets0ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
Code V-$517CodeVAmount
General Or Managing PartnerfalseGeneralOrManagingPartner
Percentage Ownership0.28000PercentageOwnership
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 OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgtrueSaleOfAssetsToOtherOrg
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 (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
FLAGSTAFF MEDICAL CENTER
O15111010
ALLIANCE MEDICAL LAB
R268924

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