2011-05-13T16:55:54-04:00 2010-06-30 ERNST & YOUNG US LLP TWO NORTH CENTRAL AVENUE STE 2300 PHOENIX AZ 85004 990 2009-07-01 860100882 VERDE VALLEY MEDICAL CENTER VERD 9286396442 269 SOUTH CANDY LANE COTTONWOOD AZ 86326 GREGORY KUZMA 2011-05-13 6023223000 2009 2016-02-24 21:20:13Z JAMES BLEICHER 269 SOUTH CANDY LANE COTTONWOOD AZ 86326 160684987 false X WWW.VERDEVALLEYMEDICALCENTER.COM X 1939 AZ TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 13 9 0 361 -182 0 1435005 979872 150191383 156286757 2223246 1303128 166992 1912659 154016626 160482416 308686 371716 0 0 63071487 70055134 0 0 123959 72195580 72561540 135575753 142988390 18440873 17494026 200158675 216883460 93957462 94283757 106201213 122599703 SEE SCHEDULE O false false 117076638 371716 142424131 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 4,776 AND 19,022 PATIENT DAYS, OUTPATIENT VISITS APPROXIMATED 29,000 AND 23,752 EMERGENCY VISITS. 8084087 0 11789792 TO 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. 1981876 0 2072834 TO PROVIDE GERIATRIC PSYCHIATRIC SERVICES TO THE COMMUNITY THROUGH THE OPERATION OF THE SENIOR BEHAVIORAL HEALTH UNIT. DISCHARGES WERE 168 AND PATIENT DAYS 2,101. 127142601 true true false true false false false false false true false true false false false false false false true false true true true true true false false false false false true false false false true false false false false true true true false false true 189 0 true 0 false false false false false true true false false false 13 9 false false false false true true true true true false false true true true true true true true true true true AZ X JENNIE CARNES CONTROLLER 9286396442 269 SOUTH CANDY LANE COTTONWOOD AZ 86326 HARRY ALBERTI MD 40.0 X X 21200 118818 9134 RON BARBER 7.0 X X 200 0 0 RICHARD CRANMER 2.0 X X 200 0 0 ALAN EVERETT 6.0 X 258 0 0 JAMES LEDBETTER 6.0 X 258 0 0 KEN MOLL 5.0 X X 200 0 0 SHAWN ORME 2.0 X 330 0 0 MATIAS SANDOVAL 5.0 X X 298 0 0 RAY SELNA 2.0 X X 200 0 0 TOM TAYLOR 4.0 X 199 0 0 KEVIN WILSON MD 1.0 X X 17200 0 0 VINCENT FURREY MD 2.0 X X 28325 15150 0 PAUL HANSON MD 1.0 X X 2400 0 0 JAMES BLEICHER MD 40.0 X X 0 329459 33999 JOHN DEMPSEY 28.0 X X 0 469939 98415 GREGORY KUZMA 11.0 X 0 383053 114249 RICK PETERSON 40.0 X 0 191656 25345 JENNIFER BREWER 40.0 X 0 158015 43979 JAMES DWYER MD 40.0 X 0 804218 11161 BRUCE PEEK MD 40.0 X 0 823841 23102 SAMUEL BUTMAN 40.0 X 0 671318 23610 EDWARD REINEBERG MD 40.0 X 0 549153 23800 JOHN SCHOR MD 40.0 X 0 530920 26404 CELESTE CORREA MD 0.0 X 0 105978 3901 JAMES ARTHUR MD 0.0 X 1200 149197 15526 JAMES SINEK 0.0 X 0 211813 0 72468 5512528 452625 0 true true false LABCORP OF AMERICAN HOLDINGS PO BOX 2240 BURLINGTON NC 272162240 LAB SERVICES 295677 DAVID CROWELL MD 2045 QUAIL RUN COTTONWOOD AZ 86326 ANESTHESIOLOGY SVCS 151333 SOUTHWEST MOBILE LITHOTRIPSY 100 W THIRD AVE SUITE 350 COLUMBUS OH 43201 LITHOTRIPSY & LASER 139275 TEAMSTAFF RX PO BOX 70872 PHILADELPHIA PA 191765872 NURSING SERVICES 122793 PATHOLOGY ASSOCIATES OF NORTHERN AZ 809 RIORDAN RD STE 202 FLAGSTAFF AZ 86001 PATHOLOGY SERVICES 101478 6 60217 459752 459903 979872 HOSPITAL SERVICES 622110 142424131 142424131 VVMC SEDONA CAMPUS 622110 11789792 11789792 SENIOR BEHAVIORAL HEALTH 900099 2072834 2072834 156286757 909817 909817 0 0 704832 704832 704832 704832 450026 87149 0 143864 450026 -56715 393311 393311 13500 60217 58707 -45207 -45207 0 0 CAFETERIA SALES 722310 529980 529980 ALLIANCE MEDICAL LAB 621511 217490 -182 217672 PURCHASE DISCOUNTS 900099 191305 191305 314259 314259 1253034 160482416 156792321 -182 2710405 355004 355004 16712 16712 0 0 994607 466661 527946 0 53755788 48790444 4905062 60282 4640003 4224529 410234 5240 7080485 6463493 608959 8033 3584251 3253179 327053 4019 0 34256 34256 73819 73819 14628 14628 0 0 5016232 4076012 932501 7719 276573 273062 3511 22123315 20197288 1914399 11628 0 0 2097781 1784887 309133 3761 307750 237301 69500 949 0 0 1422071 1132079 286101 3891 0 9792238 8358903 1418456 14879 1693215 1481421 211794 BAD DEBT 12668161 12668161 0 0 REGISTRATION PURCHASED SRVS 1673796 0 1673796 0 MEDICAL PURCHASED SERVICES 1616275 1616275 0 0 AIR AMBULANCE PURCHASED SRV 1102507 1102507 0 0 EXP REIMBURSEMENT TO NAH 12318546 10820720 1497826 0 330377 97025 233305 47 142988390 127142601 15721830 123959 7619 3200 7528596 7948027 309648 13647 15921824 14693838 199140 61508 1151157 582998 2046647 2333052 8190454 8014606 147494145 74319172 74087460 73174973 87941129 103037437 0 58325 2775001 6961849 200158675 216883460 11005341 10697523 61715265 59978567 241785 185130 20995071 23422537 93957462 94283757 X 106201213 122599703 106201213 122599703 200158675 216883460 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 14628 false false false 14628 false PART II-B, LINE 1F VERDE 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. 3201608 3201608 86180050 36471422 49708628 50295585 35065620 15229965 7816902 2782130 5034772 73174973 0 MINIMUM PENSION LIABILITY 20583850 MALPRACTICE RESERVE 2835180 GIFT ANNUITY 3507 23422537 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS REVIEWED ALL OPEN TAX YEARS AND HAS DETERMINED THAT THE CORPORATION HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS. COPPER BALL 73717 60217 13500 17557 4950 36200 0 73717 60217 13500 17557 4950 36200 58707 -45207 true true X true X 175. true X false true true false true true 119015 119015 0.00090 24614781 21559000 3055781 0.02340 16577 16577 0.00010 24750373 21559000 3191373 0.02440 1569850 418151 1151699 0.00880 414159 414159 0.00320 70369 70369 0.00050 2054378 418151 1636227 0.01250 26804751 21977151 4827600 0.03690 false 3398868 43173901 47666303 -4492402 X true true VERDE VALLEY MEDICAL CENTER

269 S CANDY LANE COTTONWOOD AZ 86326

X X VVMC SEDONA CAMPUS

3700 WEST HIGHWAY 89A SEDONA AZ 86336

X X CAMP VERDE HEALTH CENTER

460 FINNEY FLATS ROAD CAMP VERDE AZ 96322

X OFFICE; LAB XRAY; PT VVMC AMBULATORY CENTER

300 WEST HIGHWAY 89A COTTONWOOD AZ 86336

X SURGERY; ENDOSCOPY VVMC MOB

294 WEST HIGHWAY 89A COTTONWOOD AZ 86336

X PHYSICIAN OFFICES; SLEEP LAB VOC MOB

61 BELL ROCK PLAZA SEDONA AZ 86351

X PHYSICIAN OFFICES EMPLOYED PHYSICIAN OFFICE

450 WILLARD ST STE 101 107 COTTONWOOD AZ 86336

X PHYSICIAN OFFICE FAMILY PRACTICE PHYSICIAN OFFICE

199 S CANDY LANE STE 1A COTTONWOOD AZ 86326

X PHYSICIAN OFFICE CHARITY 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. 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. 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. BAD 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. 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. THE 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. ACCORDING 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. 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 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. ACCORDING 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. 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 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. 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. 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 SYSTEMWIDE QUALITY CARDIOLOGY PROGRAM WAS STARTED AND PHYSICIANS COVERED BOTH INSTITUTIONS TO PROVIDE TIMELY PATIENT CARE. true COTTONWOOD CLIPPER SWIM TEAM PMB 253 989 S MAIN ST A COTTONWOOD AZ 86326 860688282 20000 FACILITATE WELLNESS TRAINING CAMP VERDE UNITED CHRISTIAN SCHOOL 903 W FINNIE FLATS RD CAMP VERDE AZ 86323 860793544 SCHOOL 8600 FACILITATE CONTINUING GENERAL STUDIES MINGUS UNION HIGH SCHOOL 1801 E FIR AVENUE COTTONWOOD AZ 86326 866006215 SCHOOL 6480 FACILITATE CONTINUING GENERAL STUDIES YAVAPAI COMMUNITY COLLEGE 1100 E SHELDON PRESCOTT AZ 86301 237232985 SCHOOL 201000 FACILITATE EXPANSION OF NURSING PROGRAM YAVAPAI COUNTY WELLNESS CLINIC 1090 COMMERCE DRIVE PRESCOTT AZ 86305 866000561 GOVT 61792 PROVIDE LAB & MEDICAL IMAGING SERVICES FOR LOW INCOME 4 1 STUDENT LOANS 4 16712 PART I, LINE 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS 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; 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. X X true true true false false false false false false false false GREGORY KUZMA 0 313870 0 42828 0 26355 0 97679 0 16570 0 497302 0 0 JAMES BLEICHER MD 0 261360 0 63969 0 4130 0 9800 0 24199 0 363458 0 0 RICK PETERSON 0 156404 0 35252 0 0 0 6796 0 18549 0 217001 0 0 JENNIFER BREWER 0 119966 0 27419 0 10630 0 28311 0 15668 0 201994 0 0 JAMES DWYER MD 0 800030 0 0 0 4188 0 4900 0 6261 0 815379 0 0 BRUCE PEEK MD 0 823841 0 0 0 0 0 9800 0 13302 0 846943 0 0 SAMUEL BUTMAN 0 611318 0 60000 0 0 0 9800 0 13810 0 694928 0 0 EDWARD REINEBERG MD 0 549153 0 0 0 0 0 9800 0 14000 0 572953 0 0 JOHN SCHOR MD 0 431853 0 99067 0 0 0 9800 0 16604 0 557324 0 0 CELESTE CORREA MD 0 80978 0 25000 0 0 0 808 0 3093 0 109879 0 0 JAMES ARTHUR MD 0 149197 0 0 1200 0 0 3089 0 12437 1200 164723 0 0 JAMES SINEK 0 0 0 0 0 211813 0 0 0 0 0 211813 0 0 JOHN DEMPSEY 0 363677 0 88476 0 17786 0 80660 0 17755 0 568354 0 0 SUPPLEMENTAL COMPENSATION INFORMATION LINE 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). INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY 860376099 2008-07-25 11393572 SEE SCHEDULE O false false INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY 860376099 985900BT5 2009-01-08 32468925 SEE SCHEDULE O false false 11393572 0 0 0 1356 0 0 true false true true 32468925 0 0 0 411435 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 JAMES ARTHUR MD RECRUITMENT LOAN X 60000 21740 false true true 21740 LEDBETTER LAW FIRM LEDBETTER / PARTNER 291941 LEGAL SERVICES TO NAH ENTITIES false THE COTTONWOOD GROUP ARTHUR / OWNER 116700 RENTAL PAYMENTS false CAPSTONE HEALTH PLAN KUZMA / BOARD MEMBER 494348 INSURANCE PAYOR false FORM 990, PART I, LINE 1 AND PART III LINE 1 ORGANIZATION MISSION STATEMENT 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. FORM 990, PART I, LINE 6 VOLUNTEER SERVICES 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). FORM 990, PART VI, LINE 6 DESCRIPTION OF THE MEMBERS OF THE ORGANIZATION AND THEIR RIGHTS NORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE CORPORATE MEMBER OF VERDE VALLEY MEDICAL CENTER. FORM 990, PART VI, LINE 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS 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. 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 11A DESCRIPTION OF 990 REVIEW PROCESS 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 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 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST 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. FORM 990, PART VI, LINE 15A & 15B DESCRIPTION OF COMPENSATION PROCESS 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. FORM 990, PART VI, LINE 19 AVAILABILITY OF CERTAIN DOCUMENTS TO THE GENERAL PUBLIC 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. FORM 990, PART VII / SCHEDULE J-2 HOURS DEVOTED TO RELATED ORGANIZATIONS JOHN 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 I SUPPLEMENTAL INFORMATION 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. FORM 990, SCHEDULE R, PART V, LINE 2 TRANSACTIONS WITH RELATED ORGANIZATIONS THE AMOUNTS REPORTED ON SCHEDULE R, PART V, LINE 2 ARE DETERMINED USING THE ACCRUAL METHOD OF ACCOUNTING. VERDE HEALTHCARE INITIATIVE LLC 269 SOUTH CANDY LANE COTTONWOOD AZ 86326 272388245 HEALTHCARE AZ 0 5500000 VVMC FLAGSTAFF MEDICAL CENTER PO BOX 1268 FLAGSTAFF AZ 860021268 860110232 HEALTHCARE AZ 501(C)(3) 3 NAH NORTHERN ARIZONA HEALTHCARE CORPORATION POST OFFICE BOX 1268 FLAGSTAFF AZ 860021268 742410946 HEALTHCARE AZ 501(C)(3) 7 NA ALLIANCE MED LAB PO BOX 1268 FLAGSTAFF AZ 86002 200584165 LAB SERVICES AZ FMC RELATED 217672 7980 false -182 false false false false true true true false false false false false true false true true true false false FLAGSTAFF MEDICAL CENTER L 122850 FLAGSTAFF MEDICAL CENTER F 80105