2012-05-11T13:30:51-05:00 2011-06-30 ERNST & YOUNG US LLP TWO NORTH CENTRAL AVENUE STE 2300 PHOENIX AZ 85004 990 2010-07-01 860100882 VERDE VALLEY MEDICAL CENTER VERD 9286396442 269 SOUTH CANDY LANE COTTONWOOD AZ 86326 GREG KUZMA 2012-05-11 6023223000 2010 2016-02-24 21:20:13Z JAMES BLEICHER 269 SOUTH CANDY LANE COTTONWOOD AZ 86326 150690096 false X WWW.VERDEVALLEYMEDICALCENTER.COM X 1939 AZ TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 13 8 0 363 -517 0 979872 578407 156286757 146151007 1303128 -196191 1912659 1914509 160482416 148447732 371716 567899 0 0 70055134 76129119 0 0 131327 72561540 62456669 142988390 139153687 17494026 9294045 216883460 230023777 94283757 89253790 122599703 140769987 X SEE SCHEDULE O false false 110638618 567899 132895907 TO 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. 8723393 0 12081000 TO 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. 2180849 0 2255000 TO PROVIDE GERIATRIC PSYCHIATRIC SERVICES TO THE COMMUNITY THROUGH THE OPERATION OF THE SENIOR BEHAVIORAL HEALTH UNIT. DISCHARGES WERE 173 AND PATIENT DAYS 2,208. 121542860 true true false true false false false false false false true false false false true true false true false false false false false false true false true true true true true true false false false false false true false false true false false false false false true true true true false false true 206 0 true 0 false false false false false true true false false false false X 13 8 false false false false true true true true true false false true true true true true true true true true true AZ X JOHN CORTESE CPA 9282143545 917 N SAN FRANCISCO ST SUITE M FLAGSTAFF AZ 86001 X HARRY ALBERTI MD 40.0 X X 0 224562 0 RON BARBER 7.0 X X 0 0 0 RICHARD CRANMER 2.0 X X 0 0 0 ALAN EVERETT 3.0 X 0 709 0 JAMES LEDBETTER 2.75 X 0 1842 0 KEN MOLL 5.0 X 0 0 0 SHAWN ORME 2.5 X 0 465 0 MATIAS SANDOVAL 5.0 X X 0 1072 0 RAY SELNA 2.0 X X 0 0 0 TOM TAYLOR 2.0 X 0 737 0 PAUL HANSON MD 1.0 X X 0 47700 0 JAMES BLEICHER MD 20.0 X X 0 483324 33524 JOHN DEMPSEY 20.0 X X 0 481858 66284 GREGORY KUZMA 11.0 X 0 355683 51215 NICK PASLIDIS 40.0 X 0 99915 7942 RICK PETERSON 40.0 X 0 175571 24769 JENNIFER BREWER 40.0 X 0 198350 38304 BARBARA DEMBER 40.0 X 0 260276 30955 JAMES DWYER MD 40.0 X 0 803017 25542 BRUCE PEEK MD 40.0 X 0 834252 27024 SAMUEL BUTMAN 40.0 X 0 610265 19635 JOHN SCHOR MD 40.0 X 0 698918 24708 DIANA ENNES 40.0 X 0 458611 24556 0 5737127 374458 90 false true false SPECIALISTS HOSPITAL MEDICINE 1140 MONROE NW STE 150 GRAND RAPIDS MI 49503 LOCUM TENANTS 618903 LABCORP OF AMERICAN HOLDINGS PO BOX 2240 BURLINGTON NC 272162240 LAB SERVICES 511755 MEDICUS HOSPITALISTS SVCS LLC 7 INDUSTRIAL WAY STE 5 SALEM NH 03079 LOCUM TENANTS 305297 VERITAS MEDICAL SOLUTIONS LLC 5 GREAT VALLEY PARKWAY MALVERN PA 19355 MEDICAL SUPPLIES 184950 SOUTHWEST MOBILE LITHOTRIPSY 100 W THIRD AVE SUITE 350 COLUMBUS OH 43201 LITHOTRIPSY & LASER 173000 5 47000 370783 160624 578407 PATIENT SERVICES REVENUE 622110 146151007 146151007 146151007 760207 760207 0 0 849721 849721 849721 849721 1218169 2178769 1218169 -2178769 -956398 -956398 48000 47000 63595 -15595 -15595 0 0 CAFETERIA SALES 722310 484771 484771 ALLIANCE MEDICAL LAB 621511 130528 131045 -517 GIFT SHOP 900099 169699 169699 295385 295385 1080383 148447732 147231907 -517 637935 552292 552292 15607 15607 0 0 3167159 2332101 835058 0 57088015 51155733 5865008 67274 5309781 4770762 532724 6295 6881071 6202095 670769 8207 3683093 3300366 378387 4340 0 379773 163932 215841 61390 61390 12351 12351 0 0 5751892 4811672 932501 7719 290611 290147 464 21848230 19880363 1955274 12593 0 0 2611815 2385373 222207 4235 506279 293181 211976 1122 0 0 1410014 1122481 283675 3858 0 9811307 8375181 1421218 14908 915972 761753 154219 REGISTRATION SERVICES 1592766 1592766 MEDICAL PURCHASE SERVICES 1569404 1569404 AIR AMBULANCE PURCHASE SVCS 1111683 1111683 EXP REIMBURSEMENT TO NAH 14297345 12581664 1715681 ALL OTHER EXPENSES 285837 157217 128308 312 139153687 121542860 17479500 131327 3200 4000 7948027 18951232 13647 0 14693838 15221584 61508 6691 582998 108445 2333052 2286641 8014606 7828814 152203001 79561136 73174973 72641865 103037437 104426009 58325 375562 6961849 8172934 216883460 230023777 10697523 11510086 59978567 56207691 185130 698726 23422537 20837287 94283757 89253790 X 122599703 140769987 122599703 140769987 216883460 230023777 X 9294045 8876239 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 12351 false false false 12351 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1F VERDE 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. 3281297 3281297 88039435 40617150 47422285 560000 63797 496203 50947898 35778968 15168930 9374371 3101221 6273150 72641865 0 MINIMUM PENSION LIABILITY 18542467 PROFESSIONAL GENERAL LIABILITY 2294820 20837287 ASC (740) FOOTNOTE SCHEDULE D, PART X, LINE 2 IN ACCORDANCE WITH ACCOUNTING GUIDANCE, MANAGEMENT HAS REVIEWED ALL OPEN TAX YEARS AND HAS DETERMINED THAT THE CORPORATION HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS. COPPER BALL 95000 47000 48000 63595 0 95000 47000 48000 63595 63595 -15595 true true X true X 125. true X 175. false true true false true true 425142 425142 0.00310 24814779 19661000 5153779 0.03700 25239921 19661000 5578921 0.04010 1056813 489630 567183 0.00410 1794254 0 1794254 0.01290 223945 3650 220295 0.00160 3075012 493280 2581732 0.01860 28314933 20154280 8160653 0.05870 false 3895821 379607 41007640 44503669 -3496029 X true true 1 1 VERDE VALLEY MEDICAL CENTER

269 S CANDY LANE COTTONWOOD AZ 86326

X X VERDE VALLEY MEDICAL CENTER 1 7 CAMP VERDE HEALTH CENTER

460 FINNEY FLATS ROAD CAMP VERDE AZ 86322

OFFICE X-RAY LAB PHYSICAL THERAPY VVMC AMBULATORY CENTER

300 WEST HIGHWAY 89A COTTONWOOD AZ 86336

SURGERY ENDOSCOPY VVMC MOB

294 WEST HIGHWAY 89A COTTONWOOD AZ 86336

PHYSICIAN OFFICES SLEEP LAB VOC MOB

61 BELL ROCK PLAZA SEDONA AZ 86351

PHYSICIAN OFFICES SLEEP LAB EMPLOYED PHYSICIAN OFFICE

450 WILLARD ST STE 101 107 COTTONWOOD AZ 86336

PHYSICIAN OFFICE FAMILY PRACTICE PHYSICIAN OFFICE

199 S CANDY LANE STE 1A COTTONWOOD AZ 86326

PHYSICIAN OFFICE VVMC SEDONA CAMPUS

3700 WEST HIGHWAY 89A SEDONA AZ 86336

OUTPATIENT AND EMERGENCY SERVICES 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: NEEDS ASSESSMENT 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. SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE 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. SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION 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. SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH 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. SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM 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. true YAVAPAI COMMUNITY COLLEGE 1100 E SHELDON PRESCOTT AZ 86301 237232985 SCHOOL 200000 FACILITATE EXPANSION OF NURSING PROGRAM YAVAPAI COUNTY WELLNESS CLINIC 1090 COMMERCE DRIVE PRESCOTT AZ 86305 866000561 GOVT 110405 PROVIDE LAB & MED Prescott Free Clinic Inc 1090 Commerce Drive Prescott AZ 86305 860744955 501(C)(3) 12500 PROVIDE MEDICAL SVCS NAU Foundation PO Boxes 1222 Flagstaff AZ 86002 866004791 501(C)(3) 25000 SUPPORT NURSING 4 0 STUDENT LOANS 4 15607 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS SCHEDULE I, PART I, LINE 2 YAVAPAI 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. X X X X false false false false false false false false false HARRY ALBERTI MD 0 224562 0 0 0 0 0 0 0 0 0 224562 0 0 JAMES BLEICHER MD 0 356999 0 122978 0 3347 0 9800 0 23724 0 516848 0 0 JOHN DEMPSEY 0 374144 0 58174 0 49540 0 48153 0 18131 0 548142 0 0 GREGORY KUZMA 0 311056 0 44627 0 0 0 34065 0 17150 0 406898 0 0 RICK PETERSON 0 158044 0 17527 0 0 0 6884 0 17885 0 200340 0 0 JENNIFER BREWER 0 175847 0 22495 0 8 0 23929 0 14375 0 236654 0 0 JAMES DWYER MD 0 800031 0 0 0 2986 0 7362 0 18180 0 828559 0 0 BRUCE PEEK MD 0 762383 0 71869 0 0 0 9800 0 17224 0 861276 0 0 SAMUEL BUTMAN 0 549993 0 60272 0 0 0 9800 0 9835 0 629900 0 0 JOHN SCHOR MD 0 488251 0 210667 0 0 0 7594 0 17114 0 723626 0 0 BARBARA DEMBER 0 177072 0 77622 0 5582 0 7927 0 23028 0 291231 0 0 DIANA ENNES 0 458611 0 0 0 0 0 9800 0 14756 0 483167 0 0 SUPPLEMENTAL COMPENSATION INFORMATION LINE 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. INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY 860376099 2008-07-25 11393572 SEE PART V false false false INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY 860376099 985900BT5 2009-01-08 32468925 SEE PART V false false false 0 0 11393572 0 0 0 1356 0 0 0 0 0 true false true true 0 0 32468925 0 0 0 411435 0 0 0 0 0 true false true true false false true false true 0.00000 0.00000 0.00000 true false false true false true 0.00000 0.00000 0.00000 true false true false false false true false true false false false true SEE SCHEDULE O CELESTE CORREA MD HARRY ALBERTI, MD/SPOUSE 200226 EMPLOYEE COMPENSATION false ORGANIZATION'S MISSION STATEMENT FORM 990, PART III, LINE 1 TO 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 SERVICES FORM 990, PART I, LINE 6 VOLUNTEERS 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 RIGHTS FORM 990, PART VI, LINE 6 NORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE CORPORATE MEMBER OF VERDE VALLEY MEDICAL CENTER. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, LINE 7A THE 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 RIGHTS FORM 990, PART VI, LINE 7B AS 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 PROCESS FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM BASED ON DATA GATHERED BY THE CONTROLLER AND THE ORGANIZATION'S FINANCIAL OPERATIONS GROUP. THE 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 INTEREST FORM 990, PART VI, LINE 12C POLICY 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 PROCESS FORM 990, PART VI, LINE 15A & 15B DETERMINATION 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 PUBLIC FORM 990, PART VI, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE ARIZONA DEPARTMENT OF HEALTH SERVICES. IN ADDITION, THEY ARE AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) AS PART OF THE ORGANIZATION'S CONTINUING DISCLOSURE DOCUMENTS THAT ARE REQUIRED BY ITS PUBLIC DEBT REQUIREMENTS. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII JOHN 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 ASSETS FORM 990, PART XI, LINE 5 UNREALIZED 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 INFORMATION SCHEDULE K, PART I LINE 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. VERDE HEALTHCARE INITIATIVE LLC 269 SOUTH CANDY LANE COTTONWOOD AZ 86326 272388245 HEALTHCARE AZ 10000 5510000 VVMC FLAGSTAFF MEDICAL CENTER PO BOX 1268 FLAGSTAFF AZ 86002 860110232 HEALTHCARE AZ 501(C)(3) 3 NAH NORTHERN ARIZONA HEALTHCARE CORPORATION POST OFFICE BOX 1268 FLAGSTAFF AZ 86002 742410946 HEALTHCARE AZ 501(C)(3) 7 NA ALLIANCE MED LAB PO BOX 1268 FLAGSTAFF AZ 86002 200584165 LAB SERVICES AZ FMC RELATED 131045 0 false -517 false 0.28000 false false false true true true false false false false false true false true true true true true FLAGSTAFF MEDICAL CENTER O 15111010 ALLIANCE MEDICAL LAB R 268924