VERDE VALLEY MEDICAL CENTER: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
VERDE VALLEY MEDICAL CENTER (EIN 86-0100882)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201131339349305608
Schema version
2009v1.7
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)
Timestamp2011-05-13T16:55:54-04:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

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 Date2009-07-01TaxPeriodBeginDate

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)
NameGREGORY KUZMAName
TitleVICE PRESIDENT/CFOTitle
Date Signed2011-05-13DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone6023223000Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
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 Receipts160684987GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
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 Members9NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers361TotalNbrVolunteers
Total Gross UBI-182TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1435005ContributionsGrantsPriorYear
Contributions Grants Current Year979872ContributionsGrantsCurrentYear
Program Service Revenue Prior Year150191383ProgramServiceRevenuePriorYear
Program Service Revenue CY156286757ProgramServiceRevenueCY
Investment Income Prior Year2223246InvestmentIncomePriorYear
Investment Income Current Year1303128InvestmentIncomeCurrentYear
Other Revenue Prior Year166992OtherRevenuePriorYear
Other Revenue Current Year1912659OtherRevenueCurrentYear
Total Revenue Prior Year154016626TotalRevenuePriorYear
Total Revenue Current Year160482416TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year308686GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY371716GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year63071487SalariesEtcPriorYear
Salaries Etc Current Year70055134SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year123959TotalFundrsngExpCurrentYear
Other Expense Prior Year72195580OtherExpensePriorYear
Other Expenses Current Year72561540OtherExpensesCurrentYear
Total Expenses Prior Year135575753TotalExpensesPriorYear
Total Expenses Current Year142988390TotalExpensesCurrentYear
Revenues Less Expenses Prior Year18440873RevenuesLessExpensesPriorYear
Revenues Less Expenses CY17494026RevenuesLessExpensesCY
Total Assets BOY200158675TotalAssetsBOY
Total Assets EOY216883460TotalAssetsEOY
Total Liabilities BOY93957462TotalLiabilitiesBOY
Total Liabilities EOY94283757TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY106201213NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY122599703NetAssetsOrFundBalancesEOY
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense117076638Expense
Grants371716Grants
Revenue142424131Revenue
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 4,776 AND 19,022 PATIENT DAYS, OUTPATIENT VISITS APPROXIMATED 29,000 AND 23,752 EMERGENCY VISITS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense8084087Expense
Grants0Grants
Revenue11789792Revenue
DescriptionTO PROVIDE EMERGENCY SERVICES, CANCER TREATMENT AND OTHER ANCILLARY SERVICES TO THE COMMUNITY THROUGH THE OPERATION OF THE VVMC SEDONA CAMPUS. EMERGENCY VISITS WERE 5,969. RADIATION ONCOLOGY PROCEDURES WERE 13,873. MEDICAL IMAGING PROCEDURES 6,683.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1981876Expense
Grants0Grants
Revenue2072834Revenue
DescriptionTO PROVIDE GERIATRIC PSYCHIATRIC SERVICES TO THE COMMUNITY THROUGH THE OPERATION OF THE SENIOR BEHAVIORAL HEALTH UNIT. DISCHARGES WERE 168 AND PATIENT DAYS 2,101.Description
FieldValueIRS element (for citing)
Total Program Service Expense127142601TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
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
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 MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096189NumberFormsTransmittedWith1096
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
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
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 PersonJENNIE CARNES CONTROLLERNamePerson
Telephone Number9286396442TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
HARRY ALBERTI MD
CHIEF OF STAFF40.0XX212001188189134
RON BARBER
DIRECTOR-SECRETARY7.0XX20000
RICHARD CRANMER
DIR/VICE CHAIR AS OF 1/20102.0XX20000
ALAN EVERETT
DIRECTOR6.0X25800
JAMES LEDBETTER
DIRECTOR6.0X25800
KEN MOLL
CHAIR THRU 12/09/DIRECTOR5.0XX20000
SHAWN ORME
DIRECTOR2.0X33000
MATIAS SANDOVAL
VICE CHAIR/CHAIR AS OF 12/095.0XX29800
RAY SELNA
DIRECTOR-TREASURER2.0XX20000
TOM TAYLOR
DIRECTOR4.0X19900
KEVIN WILSON MD
PAST CHIEF OF STAFF1.0XX1720000
VINCENT FURREY MD
VICE CHIEF STAFF (THRU 1/10)2.0XX28325151500
PAUL HANSON MD
VICE CHIEF STAFF (AS OF 1/10)1.0XX240000
JAMES BLEICHER MD
INT CMO/PRES&CEO AS OF 2/4/1040.0XX032945933999
JOHN DEMPSEY
NAH EVP LAW & ETHICS28.0XX046993998415
GREGORY KUZMA
VP/CFO11.0X0383053114249
RICK PETERSON
VP SUPPORT SERVICES40.0019165625345X
JENNIFER BREWER
CNO & VP PT CARE SERVICES40.0015801543979X
JAMES DWYER MD
CARDIOLOGIST: INV-INTVL40.0080421811161X
BRUCE PEEK MD
CARDIOLOGIST: INV-INTVL40.0082384123102X
SAMUEL BUTMAN
CARDIOLOGIST: INV-INTVL40.0067131823610X
EDWARD REINEBERG MD
ANESTHESIOLOGIST40.0054915323800X
JOHN SCHOR MD
PERIPHERAL/CARDIO SURGEON40.0053092026404X
CELESTE CORREA MD
DIRECTOR (THRU APR 2009)0.001059783901X
JAMES ARTHUR MD
PAST CF STAFF (THRU SEPT 2008)0.0120014919715526X
JAMES SINEK
FORMER PRES (THRU JAN 2008)0.002118130X
FieldValueIRS element (for citing)
Total Reportable Comp From Org72468TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs5512528TotalReportableCompFrmRltdOrgs
Total Other Compensation452625TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LABCORP OF AMERICAN HOLDINGS
PO BOX 2240BURLINGTONNC272162240LAB SERVICES295677
DAVID CROWELL MD
2045 QUAIL RUNCOTTONWOODAZ86326ANESTHESIOLOGY SVCS151333
SOUTHWEST MOBILE LITHOTRIPSY
100 W THIRD AVE SUITE 350COLUMBUSOH43201LITHOTRIPSY & LASER139275
TEAMSTAFF RX
PO BOX 70872PHILADELPHIAPA191765872NURSING SERVICES122793
PATHOLOGY ASSOCIATES OF NORTHERN AZ
809 RIORDAN RD STE 202FLAGSTAFFAZ86001PATHOLOGY SERVICES101478
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
Fundraising Events60217FundraisingEvents
Government Grants459752GovernmentGrants
All Other Contributions459903AllOtherContributions
Total Contributions979872TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
HOSPITAL SERVICES622110142424131142424131
VVMC SEDONA CAMPUS6221101178979211789792
SENIOR BEHAVIORAL HEALTH90009920728342072834
FieldValueIRS element (for citing)
Total Program Service Revenue156286757TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column909817TotalRevenueColumn
Exclusion$909,817ExclusionAmount

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)
Real704832Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real704832Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column704832TotalRevenueColumn
Exclusion$704,832ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities450026Securities
Other87149Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other143864Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities450026Securities
Other-56715Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column393311TotalRevenueColumn
Exclusion$393,311ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events13500GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events60217CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses58707FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-45207TotalRevenueColumn
Exclusion-$45,207ExclusionAmount

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 ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA SALES722310529980$529,980
ALLIANCE MEDICAL LAB621511217490$217,672-182
PURCHASE DISCOUNTS900099191305191305

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column314259TotalRevenueColumn
Related Or Exempt Function Income314259RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1253034TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column160482416TotalRevenueColumn
Related Or Exempt Function Income156792321RelatedOrExemptFunctionIncome
Unrelated Business Revenue-182UnrelatedBusinessRevenue
Exclusion$2,710,405ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total355004Total
Program Services355004ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total16712Total
Program Services16712ProgramServices

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)
Total994607Total
Program Services466661ProgramServices
Management And General527946ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total53755788Total
Program Services48790444ProgramServices
Management And General4905062ManagementAndGeneral
Fundraising60282Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4640003Total
Program Services4224529ProgramServices
Management And General410234ManagementAndGeneral
Fundraising5240Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7080485Total
Program Services6463493ProgramServices
Management And General608959ManagementAndGeneral
Fundraising8033Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3584251Total
Program Services3253179ProgramServices
Management And General327053ManagementAndGeneral
Fundraising4019Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total34256Total
Management And General34256ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total73819Total
Management And General73819ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total14628Total
Management And General14628ManagementAndGeneral

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)
Total5016232Total
Program Services4076012ProgramServices
Management And General932501ManagementAndGeneral
Fundraising7719Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total276573Total
Management And General273062ManagementAndGeneral
Fundraising3511Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total22123315Total
Program Services20197288ProgramServices
Management And General1914399ManagementAndGeneral
Fundraising11628Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2097781Total
Program Services1784887ProgramServices
Management And General309133ManagementAndGeneral
Fundraising3761Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total307750Total
Program Services237301ProgramServices
Management And General69500ManagementAndGeneral
Fundraising949Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total1422071Total
Program Services1132079ProgramServices
Management And General286101ManagementAndGeneral
Fundraising3891Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total9792238Total
Program Services8358903ProgramServices
Management And General1418456ManagementAndGeneral
Fundraising14879Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1693215Total
Program Services1481421ProgramServices
Management And General211794ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBT126681611266816100
REGISTRATION PURCHASED SRVS1673796016737960
MEDICAL PURCHASED SERVICES1616275161627500
AIR AMBULANCE PURCHASED SRV1102507110250700
EXP REIMBURSEMENT TO NAH123185461082072014978260

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total330377Total
Program Services97025ProgramServices
Management And General233305ManagementAndGeneral
Fundraising47Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total142988390Total
Program Services127142601ProgramServices
Management And General15721830ManagementAndGeneral
Fundraising123959Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY7619BOY
EOY3200EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7528596BOY
EOY7948027EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY309648BOY
EOY13647EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15921824BOY
EOY14693838EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY199140BOY
EOY61508EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1151157BOY
EOY582998EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2046647BOY
EOY2333052EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY8190454BOY
EOY8014606EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis147494145LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec74319172LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY74087460BOY
EOY73174973EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY87941129BOY
EOY103037437EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY58325EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2775001BOY
EOY6961849EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY200158675BOY
EOY216883460EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY11005341BOY
EOY10697523EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY61715265BOY
EOY59978567EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY241785BOY
EOY185130EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY20995071BOY
EOY23422537EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY93957462BOY
EOY94283757EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY106201213BOY
EOY122599703EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY106201213BOY
EOY122599703EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY200158675BOY
EOY216883460EOY
FieldValueIRS element (for citing)
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$14,628GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB14628TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPART II-B, LINE 1FIdentifier
ExplanationVERDE VALLEY MEDICAL CENTER PAID DUES TO THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION. A PERCENTAGE OF THIS AMOUNT OR $10,728 WAS ESTIMATED TO BE ATTRIBUTABLE TO LOBBYING RELATED TO HEALTH CARE ADVOCACY AT THE FEDERAL, STATE, REGIONAL, AND LOCAL LEVELS. VERDE VALLEY MEDICAL CENTER ALSO PAID $3,900 IN LOBBYING EXPENSES TO SUPPORT "VOTE YES ON 100", A PROPOSITION TO PASS A TEMPORARY INCREASE IN ARIZONA SALES TAX MEANT TO PROTECT EDUCATION, PUBLIC SAFETY, AND HEALTHCARE.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 Basis3201608OtherCostOrOtherBasis
Book Value3201608BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis86180050OtherCostOrOtherBasis
Depreciation36471422Depreciation
Book Value49708628BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis50295585OtherCostOrOtherBasis
Depreciation35065620Depreciation
Book Value15229965BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7816902OtherCostOrOtherBasis
Depreciation2782130Depreciation
Book Value5034772BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings73174973TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
MINIMUM PENSION LIABILITY$20,583,850
MALPRACTICE RESERVE$2,835,180
GIFT ANNUITY$3,507
FieldValueIRS element (for citing)
Total Of Amounts23422537TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE D, PART X, LINE 2Identifier
ExplanationMANAGEMENT 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 Event173717GrossReceiptsEvent1
Charitable Contributions Event160217CharitableContributionsEvent1
Gross Revenue Event113500GrossRevenueEvent1
Food And Beverage Event117557FoodAndBeverageEvent1
Entertainment Event14950EntertainmentEvent1
Other Direct Expenses Event136200OtherDirectExpensesEvent1
Total Number Of Other Events0TotalNumberOfOtherEvents
Gross Receipts Total73717GrossReceiptsTotal
Charitable Contributions Total60217CharitableContributionsTotal
Gross Revenue Total Events13500GrossRevenueTotalEvents
Food And Beverage Total Events17557FoodAndBeverageTotalEvents
Entertainment Total Events4950EntertainmentTotalEvents
Other Direct Expenses Total Events36200OtherDirectExpensesTotalEvents
Direct Expense Summary Events58707DirectExpenseSummaryEvents
Net Income Summary-45207NetIncomeSummary

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 Percentage175.FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
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 Expense119015TotalCommunityBenefitExpense
Net Community Benefit Expense119015NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense24614781TotalCommunityBenefitExpense
Direct Offsetting Revenue21559000DirectOffsettingRevenue
Net Community Benefit Expense3055781NetCommunityBenefitExpense
Percent Of Total Expense0.02340PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense16577TotalCommunityBenefitExpense
Net Community Benefit Expense16577NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense24750373TotalCommunityBenefitExpense
Direct Offsetting Revenue21559000DirectOffsettingRevenue
Net Community Benefit Expense3191373NetCommunityBenefitExpense
Percent Of Total Expense0.02440PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1569850TotalCommunityBenefitExpense
Direct Offsetting Revenue418151DirectOffsettingRevenue
Net Community Benefit Expense1151699NetCommunityBenefitExpense
Percent Of Total Expense0.00880PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense414159TotalCommunityBenefitExpense
Net Community Benefit Expense414159NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense70369TotalCommunityBenefitExpense
Net Community Benefit Expense70369NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2054378TotalCommunityBenefitExpense
Direct Offsetting Revenue418151DirectOffsettingRevenue
Net Community Benefit Expense1636227NetCommunityBenefitExpense
Percent Of Total Expense0.01250PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense26804751TotalCommunityBenefitExpense
Direct Offsetting Revenue21977151DirectOffsettingRevenue
Net Community Benefit Expense4827600NetCommunityBenefitExpense
Percent Of Total Expense0.03690PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$3,398,868BadDebtExpenseAmount
Amount Reimbursed By Medicare43173901AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare47666303CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4492402MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part V Form990ScheduleHPartV (8 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalEr24 HoursEr24HoursEr OtherErOtherOtherOther
VERDE VALLEY MEDICAL CENTER
269 S CANDY LANECOTTONWOODAZ86326XX
VVMC SEDONA CAMPUS
3700 WEST HIGHWAY 89ASEDONAAZ86336XX
CAMP VERDE HEALTH CENTER
460 FINNEY FLATS ROADCAMP VERDEAZ96322XOFFICE; LAB XRAY; PT
VVMC AMBULATORY CENTER
300 WEST HIGHWAY 89ACOTTONWOODAZ86336XSURGERY; ENDOSCOPY
VVMC MOB
294 WEST HIGHWAY 89ACOTTONWOODAZ86336XPHYSICIAN OFFICES; SLEEP LAB
VOC MOB
61 BELL ROCK PLAZASEDONAAZ86351XPHYSICIAN OFFICES
EMPLOYED PHYSICIAN OFFICE
450 WILLARD ST STE 101 107COTTONWOODAZ86336XPHYSICIAN OFFICE
FAMILY PRACTICE PHYSICIAN OFFICE
199 S CANDY LANE STE 1ACOTTONWOODAZ86326XPHYSICIAN OFFICE

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaCHARITY CARE INCOME LEVELS ARE BASED ON THE FEDERAL POVERTY GUIDE PUBLISHED IN THE FEBRUARY FEDERAL REGISTER ON AN ANNUAL BASIS. A TIERED METHOD IS UTILIZED FOR DETERMINING WHETHER A PATIENT IS ELIGIBLE FOR 100%, 75%, 50%, 25%, OR 15% WRITE-OFF OF THE SELF PAY BALANCE. 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.IncomeBasedCriteria
Annual Community Benefit ExplnTHE 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.AnnualCommunityBenefitExpln
Costing Method UsedVERDE 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.CostingMethodUsed
Percent Of Total Expense ExplnBAD DEBT EXPENSE OF $12,668,161 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR THE PURPOSE OF CALCULATING THE PERCENTAGE OF NET COMMUNITY BENEFIT.PercentOfTotalExpenseExpln
Bad Debt FootnoteTHE 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.BadDebtFootnote
Shortfall As Community BenefitTHE ENTIRE $4,492,402 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 (61%) 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.ShortfallAsCommunityBenefit
Debt Collection PolicyACCORDING TO OUR CHARITY CARE POLICY, THE FINANCIAL COUNSELORS ASSESS THE PATIENTS ABILITY TO PAY AT TIME OF ADMISSION/REGISTRATION. IF THE PATIENT STATES THAT THEY ARE UNABLE TO PAY OUT-OF-POCKET EXPENSES, A DETERMINATION IS MADE WHETHER COVERAGE IS AVAILABLE THROUGH AHCCCS OR OTHER MEDICAID PROGRAMS. IF NO OUTSIDE ASSISTANCE IS AVAILABLE, AN APPLICATION IS GIVEN TO THE PATIENT TO BE SUBMITTED FOR CHARITY CARE CONSIDERATION. IF PATIENT DOESN'T QUALIFY FOR CHARITY CARE ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR LONG-TERM PAYMENT PROGRAM. IF THE CHARITY APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT.DebtCollectionPolicy
Needs AssessmentVERDE VALLEY MEDICAL CENTER ASSESSES COMMUNITY HEALTHCARE NEEDS THROUGH A SURVEY DESIGNED AND ADMINISTERED BY THE PROFESSIONAL RESEARCH CONSULTANTS. THIS SURVEY WAS LAST CONDUCTED IN 2010 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.NeedsAssessment
Patient Education AssistanceACCORDING TO OUR CHARITY CARE POLICY, THE FINANCIAL COUNSELORS ASSESS THE PATIENTS ABILITY TO PAY AT TIME OF ADMISSION/REGISTRATION. IF THE PATIENT STATES THAT THEY ARE UNABLE TO PAY OUT-OF-POCKET EXPENSES, A DETERMINATION IS MADE WHETHER COVERAGE IS AVAILABLE THROUGH AHCCCS OR OTHER MEDICAID PROGRAMS. IF NO OUTSIDE ASSISTANCE IS AVAILABLE, AN APPLICATION IS GIVEN TO THE PATIENT TO BE SUBMITTED FOR CHARITY CARE CONSIDERATION. IF PATIENT DOESN'T QUALIFY FOR CHARITY CARE ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR LONG-TERM PAYMENT PROGRAM. IF THE CHARITY APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT.PatientEducationAssistance
Community InformationVERDE 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 60%, AHCCCS/MEDICAID 19%, COMMERCIAL 17%, SELF PAY 2%, AND OTHER 2%. 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.CommunityInformation
Other InformationVERDE 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.OtherInformation
Affiliated Health Care SystemVERDE 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 SYSTEMWIDE QUALITY CARDIOLOGY PROGRAM WAS STARTED AND PHYSICIANS COVERED BOTH INSTITUTIONS TO PROVIDE TIMELY PATIENT CARE.AffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1Address Line2AddressUS/AddressLine2CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantIRC SectionIRCSection
COTTONWOOD CLIPPER SWIM TEAM
PMB 253989 S MAIN ST ACOTTONWOODAZ8632686068828220000FACILITATE WELLNESS TRAINING
CAMP VERDE UNITED CHRISTIAN SCHOOL
903 W FINNIE FLATS RDCAMP VERDEAZ863238607935448600FACILITATE CONTINUING GENERAL STUDIESSCHOOL
MINGUS UNION HIGH SCHOOL
1801 E FIR AVENUECOTTONWOODAZ863268660062156480FACILITATE CONTINUING GENERAL STUDIESSCHOOL
YAVAPAI COMMUNITY COLLEGE
1100 E SHELDONPRESCOTTAZ86301237232985201000FACILITATE EXPANSION OF NURSING PROGRAMSCHOOL
YAVAPAI COUNTY WELLNESS CLINIC
1090 COMMERCE DRIVEPRESCOTTAZ8630586600056161792PROVIDE LAB & MEDICAL IMAGING SERVICES FOR LOW INCOMEGOVT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSTUDENT LOANSTypeOfGrant
Number Of Recipients4NumberOfRecipients
Amount Of Cash Grant16712AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPART I, LINE 2Identifier
Return ReferenceDESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTSReturnReference
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; COTTONWOOD CLIPPER SWIM TEAM, CAMP VERDE UNITED CHRISTIAN SCHOOL, AND MINGUS UNION HIGH SCHOOL - CONTRIBUTION GIVEN TO SUPPORT OVERALL MISSION, NO ADDITIONAL MONITORING DONE; 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)
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymenttrueSeverancePayment
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 (13 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
GREGORY KUZMA
0313870042828026355097679016570049730200
JAMES BLEICHER MD
02613600639690413009800024199036345800
RICK PETERSON
01564040352520006796018549021700100
JENNIFER BREWER
0119966027419010630028311015668020199400
JAMES DWYER MD
080003000041880490006261081537900
BRUCE PEEK MD
0823841000009800013302084694300
SAMUEL BUTMAN
06113180600000009800013810069492800
EDWARD REINEBERG MD
0549153000009800014000057295300
JOHN SCHOR MD
04318530990670009800016604055732400
CELESTE CORREA MD
08097802500000080803093010987900
JAMES ARTHUR MD
0149197001200003089012437120016472300
JAMES SINEK
000002118130000021181300
JOHN DEMPSEY
0363677088476017786080660017755056835400

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL COMPENSATION INFORMATIONIdentifier
ExplanationLINE 1A: BOARD MEMBER AND OFFICER BUSINESS TRAVEL EXPENSES, SUCH AS AIRLINE AND MEALS, FOR SPOUSES WERE PAID AND INFORMATION GATHERED FOR W-2 AND 1099 REPORTING. 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 AZ HEALTHCARE - BY THE FOLLOWING METHODS: COMPENSATION COMMITTEE, WRITTEN CONTRACT, INDEPENDENT CONSULTANT, COMPENSATION SURVEY, RECOMMENDATION OF COMPENSATION COMMITTEE TO BOARD FOR APPROVAL. LINE 4A: SEVERANCE PAY TO JAMES SINEK TOTALED $211,813 IN CALENDAR 2009 (FINAL PAYMENT IN JULY 2009).Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerCUSIP NumberCUSIPNumber
INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY
8603760992008-07-2511393572SEE SCHEDULE Ofalsefalse
INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY
8603760992009-01-0832468925SEE SCHEDULE Ofalsefalse985900BT5

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundAmount DefeasedAmountDefeasedAmount UnspentAmountUnspentIssuance Costs From ProceedsIssuanceCostsFromProceedsWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
11393572000135600truefalsetruetrue
3246892500041143500truefalsetruetrue

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

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonJAMES ARTHUR MDNamePerson
Purpose Of LoanRECRUITMENT LOANPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$60,000OriginalPrincipalAmount
Balance Due21740BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due21740TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
LEDBETTER LAW FIRM
LEDBETTER / PARTNER291941LEGAL SERVICES TO NAH ENTITIESfalse
THE COTTONWOOD GROUP
ARTHUR / OWNER116700RENTAL PAYMENTSfalse
CAPSTONE HEALTH PLAN
KUZMA / BOARD MEMBER494348INSURANCE PAYORfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FORM 990, PART I, LINE 1 AND PART III LINE 1ORGANIZATION MISSION STATEMENTTO 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.
FORM 990, PART I, LINE 6VOLUNTEER SERVICESVOLUNTEERS 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).
FORM 990, PART VI, LINE 6DESCRIPTION OF THE MEMBERS OF THE ORGANIZATION AND THEIR RIGHTSNORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE CORPORATE MEMBER OF VERDE VALLEY MEDICAL CENTER.
FORM 990, PART VI, LINE 7ADESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTSTHE 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. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS 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.
FORM 990, PART VI, LINE 11ADESCRIPTION OF 990 REVIEW PROCESSTHE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM BASED ON DATA GATHERED BY THE CONTROLLER AND THE ORGANIZATION'S FINANCIAL OPERATIONS GROUP. THE CFO REVIEWS THE DRAFT FORM 990 AND PROVIDES ADDITIONAL COMMENTS. THE FINAL DRAFT VERSION OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AND KEY OFFICERS AT A BOARD MEETING HELD PRIOR TO THE MAY 15 DUE DATE FOR THE FORM 990. A REPRESENTATIVE FROM THE ACCOUNTING FIRM ATTENDS THE MEETING AND EXPLAINS SOME OF THE SIGNIFICANT DISCLOSURES IN THE FORM 990. ANY ADDITIONAL COMMENTS SUGGESTED BY THE GOVERNING BODY ARE THEN INCORPORATED INTO THE FINAL VERSION OF THE FORM 990 TO BE FILED WITH THE IRS BY THE FINAL DUE DATE. IF ANY SUGGESTED CHANGES ARE MATERIAL OR SIGNIFICANT, AN ADDITIONAL DRAFT IS DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING.
FORM 990, PART VI, LINE 12CDESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTPOLICY 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.
FORM 990, PART VI, LINE 15A & 15BDESCRIPTION OF COMPENSATION PROCESSDETERMINATION 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.
FORM 990, PART VI, LINE 19AVAILABILITY OF CERTAIN DOCUMENTS TO THE GENERAL PUBLICTHE 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.
FORM 990, PART VII / SCHEDULE J-2HOURS DEVOTED TO RELATED ORGANIZATIONSJOHN DEMPSEY 28 HOURS PER WEEK TO VERDE VALLEY MEDICAL CENTER AND 12 HOURS PER WEEK TO NORTHERN ARIZONA HEALTHCARE. GREG KUZMA DEVOTED 11 HOURS PER WEEK TO VERDE VALLEY MEDICAL CENTER; 28 HOURS PER WEEK TO FLAGSTAFF MEDICAL CENTER; AND 1 HOUR PER WEEK TO NORTHERN ARIZONA HEALTHCARE.
SCHEDULE K, PART ISUPPLEMENTAL INFORMATIONLINE 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.
FORM 990, SCHEDULE R, PART V, LINE 2TRANSACTIONS WITH RELATED ORGANIZATIONSTHE AMOUNTS REPORTED ON SCHEDULE R, PART V, LINE 2 ARE DETERMINED USING THE ACCRUAL METHOD OF ACCOUNTING.

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 Income0TotalIncome
EOY Assets5500000EOYAssets

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 1268FLAGSTAFFAZ860021268860110232HEALTHCAREAZ501(C)(3)3NAH
NORTHERN ARIZONA HEALTHCARE CORPORATION
POST OFFICE BOX 1268FLAGSTAFFAZ860021268742410946HEALTHCAREAZ501(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 Income217672ShareOfTotalIncome
Share Of EOY Assets7980ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
Code V-$182CodeVAmount
General Or Managing PartnerfalseGeneralOrManagingPartner
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 OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
FLAGSTAFF MEDICAL CENTER
L122850
FLAGSTAFF MEDICAL CENTER
F80105

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