TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) Clifford M Morgan MD Trustee	5.0	X		0	0
(2) Gary Spiker Trustee	5.0	X		0	0
(3) Joe Jackson Chairman	5.0	X	X	0	0
(4) John MacKenzie DO Vice-Chairman	5.0	X	X	0	0
(5) Linda Medina RN Trustee	5.0	X		0	0
(6) Mike Shaffer Treasurer	5.0	X	X	0	0
(7) Oren Thompson Trustee	5.0	X		0	0
(8) Paula Kneisl Trustee	5.0	X		0	0
(9) Pete Kriger Trustee	5.0	X		0	0
(10) Steve Binkley Secretary	5.0	X	X	0	0
(11) David Woodcock CIO	40.0		X	102,057	8,662
(12) John R Amos EC Administrator	40.0		X	210,636	44,395
(13) Joseph H Goldberger CMO	40.0		X	149,842	18,118
(14) Larry P Burns COO	40.0		X	205,979	38,219
(15) Margaret E Taylor CNO	40.0		X	246,999	22,143
(16) Mohammad Rahman CIO	40.0		X	54,150	9,085
(17) Timothy J Barnett CEO	39.0		X	556,915	245,795

(A) Name and business address	(B) Description of services	(C) Compensation
Phoenix Cardiac Surgery PC 3131 E Clarendon Ave Suite 102 PHOENIX,AZ850167069	Medical/Healthcare	1,053,648
Prescott Anesthesia LLC 1003 Willow Creek Road PRESCOTT,AZ863011668	Medical/Healthcare	850,000
NAZ Hospitalists 1003 Willow Creek Road PRESCOTT,AZ86301	Medical/Healthcare	720,405
Center for Orthopediac Research E 3010 W Auga Fria Suite 100 PHOENIX,AZ85027	Medical/Healthcare	659,722
TF Reilly Builders 142 S Alarcon St PRESCOTT,AZ86303	Contractor	473,842
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 28

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21	297,902	297,902
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	2,622,558	2,281,625	338,310	2,623
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	89,999,626	78,299,674	11,609,952	90,000
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	2,354,307	2,048,247	303,706	2,354
9	Other employee benefits .......	13,539,897	11,779,710	1,746,647	13,540
10	Payroll taxes ...........	6,945,230	6,042,350	895,935	6,945
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	178,698	155,467	23,231
c	Accounting ...........	172,410	149,997	22,413
d	Lobbying ...........	26,350		26,350
e	Professional fundraising. See Part IV, line 17..	220,800			220,800
f	Investment management fees ......	0
g	Other ..........	14,434,370	10,114,330	4,266,679	53,361
12	Advertising and promotion ....	366,892	4,979	361,913
13	Office expenses .......	43,007,596	40,058,654	2,782,209	166,733
14	Information technology ......	3,054,895	2,657,759	397,136
15	Royalties ..	0
16	Occupancy ...........	2,994,180	2,604,937	386,249	2,994
17	Travel ............	196,598	76,432	116,227	3,939
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	138,877	69,361	69,121	395
20	Interest ...........	4,892,546	4,256,515	636,031
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	9,610,259	8,360,925	1,249,334
23	Insurance ..............	1,690,421	1,470,667	218,064	1,690
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	REPAIRS & MAINTENANCE	5,472,483	4,094,356	1,378,127	0
b	MINOR EQUIPMENT	2,127,414	1,416,836	710,713	-135
c	BAD DEBT EXPENSE	15,517,446	15,517,446	0	0
d	OTHER	1,044,643	931,764	111,808	1,071
e
f	All other expenses
25	Total functional expenses. Add lines 1 through 24f	220,906,398	192,689,933	27,650,155	566,310
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	36,427,267	1	52,002,666
2	Savings and temporary cash investments .......	44,267,122	2	37,765,541
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	35,883,947	4	31,511,810
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	446,290	5	432,419
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............	1,085,114	7	1,639,398
8	Inventories for sale or use ..............	4,375,242	8	4,346,513
9	Prepaid expenses and deferred charges ............	2,594,331	9	2,237,323
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	228,727,707
b	Less: accumulated depreciation. .....	10b	86,506,380	137,243,218	10c	142,221,327
11	Investments—publicly traded securities ..........	9,908,774	11	5,532,406
12	Investments—other securities. See Part IV, line 11 ......	3,558,177	12	3,508,176
13	Investments—program-related. See Part IV, line 11 ..	3,411,754	13	6,193,846
14	Intangible assets .........	0	14	371,743
15	Other assets. See Part IV, line 11 ...........	4,453,004	15	4,202,829
16	Total assets. Add lines 1 through 15 (must equal line 34)...	283,654,240	16	291,965,997
	17	Accounts payable and accrued expenses .	18,056,171	17	15,418,289
18	Grants payable ..........		18
19	Deferred revenue ..........	1,863,911	19	1,929,735
20	Tax-exempt bond liabilities ..........	119,045,000	20	116,300,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	3,358,067	23	3,141,737
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	1,825,821	25	1,897,774
26	Total liabilities. Add lines 17 through 25.....	144,148,970	26	138,687,535
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	139,339,321	27	153,247,713
28	Temporarily restricted net assets .....	165,949	28	30,749
29	Permanently restricted net assets .....		29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	139,505,270	33	153,278,462
34	Total liabilities and net assets/fund balances .....	283,654,240	34	291,965,997

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

Yavapai Community Hospital Association

Employer identification number

86-0098923

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

Yavapai Community Hospital Association

Employer identification number

86-0098923

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization Yavapai Community Hospital Association
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization Yavapai Community Hospital Association
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
Yavapai Community Hospital Association

Employer identification number

86-0098923

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below.
SchCMd Bullet

Attach to Form 990 or Form 990-EZ. SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Yavapai Community Hospital Association

Employer identification number

86-0098923

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities .................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2010

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check if the filing organization belongs to an affiliated group.
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated Group Totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots non-taxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2010

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Yes

26,350

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? If "Yes," describe in Part IV ..........................

Total. lines 1c through 1i ...................................

26,350

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
LOBBYING EXPENSE	PART II-B, LINE 1G	YAVAPAI COMMUNITY HOSPITAL ASSOCIATION RECEIVED CORRESPONDANCE FROM THE ARIZONA HOSPITAL ASSOCIATION REGARDING THEIR MEMBERSHIP DUES. A PORTION OF THEIR DUES WERE ATTRIBUTABLE TO LOBBYING.

Schedule C (Form 990 or 990EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Yavapai Community Hospital Association

Employer identification number

86-0098923

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back
1a	Beginning of year balance ....	165,949	226,473	240,410
b	Contributions ........	-102,126	45,530	29,908
c	Investment earnings or losses ...	51	174	35,933
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	33,125	106,228	79,778
f	Administrative expenses ....
g	End of year balance ......	30,749	165,949	226,473

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

0 %

Permanent endowment: SchDMd Bullet

0 %

Term endowment: SchDMd Bullet

100.000 %

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	5,847,387		5,847,387
b	Buildings ................	128,358,405	21,386,731	106,971,674
c	Leasehold improvements ............	12,628,293	6,237,982	6,390,311
d	Equipment ................	61,363,450	43,791,740	17,571,710
e	Other .................	20,530,172	15,089,927	5,440,245
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........				142,221,327

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes		0
ACCRUED BOND INTEREST		1,750,989
SERP LIABILITY		146,785







Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		1,897,774
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1	234,489,125
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	220,906,398
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	13,582,727
4	Net unrealized gains (losses) on investments ..........................	4	117,800
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8	72,665
9	Total adjustments (net). Add lines 4 - 8 .............................	9	190,465
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	13,773,192

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	233,856,373
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	117,800
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d	291,737
e	Add lines 2a through 2d .....................			2e	409,537
3	Subtract line 2e from line 1.....................			3	233,446,836
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV): ...........	4b	1,042,289
c	Add lines 4a and 4b.......................			4c	1,042,289
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......			5	234,489,125

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............			1	220,083,181
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d	201,313
e	Add lines 2a through 2d......................			2e	201,313
3	Subtract line 2e from line 1.....................			3	219,881,868
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV): ............	4b	1,024,530
c	Add lines 4a and 4b.......................			4c	1,024,530
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......			5	220,906,398

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
PART V QUESTION 4	ENDOWMENT FUND INTENDED USES	TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY THE ORGANIZATION HAS BEEN LIMITED BY DONORS TO SPECIFIED TIME PERIOD OR PURPOSE.
PART XI LINE 8	OTHER CHANGES TO NET ASSETS	CHANGE IN SPLIT INTEREST AGREEMENT (17,759) TIMING AND BOOK/TAX DIFFERENCES ON INVESTMENT IN EQUITY INVESTEES 90,424 TOTAL OTHER CHANGES 72,665
PART XII LINE 2D	OTHER REVENUE ON BOOKS NOT ON RETURN	GIFT SHOP COST OF GOODS SOLD 143,789 TIMING AND BOOK/TAX DIFFERENCES ON INVESTMENT IN EQUITY INVESTEES 90,424 SPECIAL EVENT EXPENSE 57,524 TOTAL 291,737
PART XIII LINE 2D	OTHER EXPENSE ON BOOKS NOT ON RETURN	GIFT SHOP COST OF GOODS SOLD 143,789 SPECIAL EVENT EXPENSE 57,524 TOTAL 201,313
PART XII LINE 4B	OTHER REVENUE ON RETURN NOT ON BOOKS	CHANGE IN SPLIT INTEREST AGREEMENT 17,759 INCOME ELIMINATIONS RECLASSED FROM EXPENSE 1,024,530 TOTAL 1,042,289
PART XIII LINE 4B	OTHER EXPENSE ON RETURN NOT ON BOOKS	INCOME ELIMINATIONS RECLASSED FROM EXPENSE 1,024,530
PART X, LINE 2	UNCERTAIN TAX POSITIONS	Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization
Yavapai Community Hospital Association

Employer identification number

86-0098923

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and e-mail solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.

(i) Name and address of individual or entity (fundraiser)	(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
	(ii) Activity	Yes	No	(iv) Gross receipts from activity		(vi) Amount paid to (or retained by) organization
CCS Fundraising 461 5th Ave NY NY 461 Fifth Ave New York, NY10017	Fundraising		No	477,042	262,800	214,242
Total .................				477,042	262,800	214,242

List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2010

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.

		(a) Event #1 GOLF TOURNAMENT (event type)	(d) Total Events (Add col. (a) through col. (c))
1	Gross receipts . . .	33,864	33,864
2	Less: Charitable contributions . . .
3	Gross income (line 1 minus line 2) . . .	33,864	33,864
4	Cash prizes . . .
5	Non-cash prizes . .	2,643	2,643
6	Rent/facility costs . .	4,680	4,680
7	Food and beverages . .	2,016	2,016
8	Entertainment . . .
9	Other direct expenses .	48,185	48,185
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........		57,524
11	Net income summary. Combine lines 3 and 10 in column (d)............		-23,660

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (Add col. (a) through col. (c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," Explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," Explain:

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ...........................

YesNo

Schedule G (Form 990 or 990-EZ) 2010

Page 3

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Provide the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)

Identifier	ReturnReference	Explanation

Schedule G (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Yavapai Community Hospital Association

Employer identification number

86-0098923

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

Yes

If "Yes," does the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..	865,889		865,889	0.420 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .	30,437,680	25,190,233	5,247,447	2.520 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....
dTotal Charity Care and Means-Tested Government Programs .....	31,303,569	25,190,233	6,113,336	2.940 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	671,235	7,680	663,555	0.320 %
f Health professions education (from Worksheet 5) ..	55,272		55,272	0.030 %
g Subsidized health services (from Worksheet 6) ..	15,551	4,715	10,836	0.010 %
h Research (from Worksheet 7)
i Cash and in-kind contributions to community groups (from Worksheet 8) ..	305,498		305,498	0.150 %
jTotal Other Benefits ...	1,047,556	12,395	1,035,161	0.510 %
kTotal. Add lines 7d and 7j. ..	32,351,125	25,202,628	7,148,497	3.450 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	1		1,915	1,915	0 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	2	225	2,115	2,115	0 %
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	3	225	4,030	4,030	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense (at cost).....

4,954,805

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

60,327,085

Enter Medicare allowable costs of care relating to payments on line 5.....

97,388,773

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-37,061,688

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Yes

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
1Prescott Med Imaging	Medical imaging center	50.000 %	0 %	50.000 %
2Prescott Outpatient	Outpatient surgery center	20.000 %	0 %	80.000 %
3Surgery Center
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?2 Name and address		Other (Describe)
1	Yavapai Regional Medical Center - West 1003 Willow Creek Road Prescott,AZ86301	X	X	X
2	Yavapai Regional Medical Center - East 7700 E Florentine Road Prescott Valley,AZ86314	X	X	X

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:Yavapai Regional Medical Center - West

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9
	If “Yes,” indicate the FPG family income limit for eligibility for free care: %

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: %
11	Explained the basis for calculating amounts charged to patients?.................		11
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:Yavapai Regional Medical Center - East

Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9
	If “Yes,” indicate the FPG family income limit for eligibility for free care: %

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: %
11	Explained the basis for calculating amounts charged to patients?.................		11
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?9
Name and address		Type of Facility (Describe)
1	YRMC - Del E Webb Outpatient Center 3262 Windsong Road Prescott Valley,AZ86314	Outpatient diagnostics, Rehabilitation, laboratory, & home health
2	YRMC - Del E Webb Outpatient Center 3262 Windsong Road Prescott Valley,AZ86314	Outpatient diagnostics, Rehabilitation, laboratory, & home health
3	YRMC - Del E Webb Outpatient Center 3262 Windsong Road Prescott Valley,AZ86314	Outpatient diagnostics, Rehabilitation, laboratory, & home health
4	YRMC - Del E Webb Outpatient Center 3262 Windsong Road Prescott Valley,AZ86314	Outpatient diagnostics, Rehabilitation, laboratory, & home health
5	YRMC - Del E Webb Outpatient Center 3262 Windsong Road Prescott Valley,AZ86314	Outpatient diagnostics, Rehabilitation, laboratory, & home health
6	YRMC - Del E Webb Outpatient Center 3262 Windsong Road Prescott Valley,AZ86314	Outpatient diagnostics, Rehabilitation, laboratory, & home health
7	YRMC - Del E Webb Outpatient Center 3262 Windsong Road Prescott Valley,AZ86314	Outpatient diagnostics, Rehabilitation, laboratory, & home health
8	YRMC - Del E Webb Outpatient Center 3262 Windsong Road Prescott Valley,AZ86314	Outpatient diagnostics, Rehabilitation, laboratory, & home health
9	YRMC - Del E Webb Outpatient Center 3262 Windsong Road Prescott Valley,AZ86314	Outpatient diagnostics, Rehabilitation, laboratory, & home health
10

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
SCHEDULE H, PART I, LINE 7, COLUMN F	BAD DEBT EXPENSE	Total bad debt expense removed from the denominator prior to the percentage calculation = 15,517,446.
SCHEDULE H, PART I, LINE 7	CALCULATION OF COMMUNITY BENEFIT EXPENSES	The organization used a cost-to charge ratio for line 7a. The cost-to-charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. The organization used a cost accounting amount for the unreimbursed Medicaid on line 7b that related to the MSO. The hospital's unreimbursed medicaid was determined using the cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. The information for lines 7e through 7h was derived from information in the general ledger and other financial data related specifically to the various types of community benefits.
SCHEDULE H, PART III, LINE 4	BAD DEBT EXPENSE	The Organization reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients, and others. The Organization provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information, and existing economic conditions. As a service to the patient, the Organization bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. The cost to charge ratio calculated on the organization's cost report was applied to bad debt expense to reduce the gross amount to cost. The hospital recognizes its responsibility to provide for the needs of the community, regardless of patients' ability to pay. In many cases, patients are unwilling or unable to pay after services have been provided, eventually resulting in bad debt. Nevertheless, if these services were not provided by the organization, the healthcare needs of these patients might not otherwise be fulfilled within the community. Therefore, the organization believes that the services not paid for should be included in community benefit.
SCHEDULE H, PART III, LINE 8	MEDICARE	The shortfall from Medicare should be considered community benefit to the extent that the organization could not reasonably reduce its costs to a lower level. While hard to project the potential savings from various possible cost cutting measures, it is reasonable to assume that at least 50% of the shortfall might not otherwise be recovered through savings measures. Because the organization is committed to meeting the needs of the community, any patient that presents for medical treatment who is covered under Medicare will be served, despite the potential detrimental impact on the organization's financials. With respect to the source used to determine the Medicare allowable cost on line 6, the following lines from the Medicare cost report were used: Line 53 (total program inpatient operating cost excluding capital related, non-physician anesthetist, and medical education costs) and line 104 (net charges for ancillary service cost centers).
SCHEDULE H, PART VI	NEEDS ASSESSMENT	YRMC uses several measures by which to assess community health needs. One measure is out migration by service. As an example, prior to opening our cardiovascular surgery program in 2007, we saw many hundreds of people leaving our community to go to Phoenix - 100 miles away - for open heart surgery. This was an indication of a need in our community that required YRMC's focused attention and efforts that culminated in The Heart Center at YRMC. YRMC constantly monitors volume and utilization data in its service lines to help determine level of need in the community for each service line. When volume figures vary from anticipated volume, YRMC carefully explores reasons behind those variances and addresses them appropriately. For example, if a drop in surgical volume is related to a need for more general surgeons, efforts ensue to recruit additional surgeons. YRMC also spends a great deal of time listening to the community by way of focus groups, community involvement by senior management, patient survey feedback, and community outreach efforts. As our CEO has stated, "We learn more by listening than by talking." YRMC is regarded by the community as a key resource and an asset. Consequently, community members feel very comfortable and free in sharing their perceptions and perspectives. YRMC also engages National Research Corporation (NRC) to conduct community needs assessment research. The study objectives include the following: a. Measure and evaluate health status and healthcare utilization within the community. b. Identify the prevalence of chronic conditions within various demographic segments within the community. c. Profile high-risk populations. d. Identify gaps in care and preventive health behaviors among various demographic segments within the community.
SCHEDULE H, PART VI	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	When patients present for admission, they are asked to review and initial a patient consent form. The patient consent form contains a paragraph entitled "Financial Assistance Programs." This paragraph indicates that the patient may be considered for financial assistance if eligibility criteria are met. The patient is required to initial a box next to the paragraph indicating they have read it and consent. This same form also contains language regarding the assignment of benefits if eligible for Medicare. In addition to the above, patients may work directly with patient financial services at the hospital to make payment arrangements or apply for financial assistance. Education regarding assistance generally occurs as the need arises.
SCHEDULE H, PART VI	COMMUNITY INFORMATION	YRMC serves the rural communities in the western portion of Yavapai County in northern Arizona. YRMC's serves approximately 175,000 men, women and children living in an area larger than the state of New Jersey. Prescott is the Yavapai county seat and has been a very popular retirement area for many years. Consequently, the demographics of YRMC's service area is skewed towards the Medicare population. In fact, more than 21% of the population is over the age of 65. This region's economy is based primarily on the service industry. There are no large corporate headquarters or major presence here. YRMC is a major employer in the County with over 1,600 employees.
SCHEDULE H, PART VI	PROMOTION OF COMMUNITY HEALTH	The hospital is dedicated to meeting community needs and promoting the general health of the population. Recently, for example, it completed construction and opened a new women's pavilion and family birthing center, not because it believed that this would be a profitable service line (70% of admits to OB are on the state's medicaid program) but because it understood there was a community need for expanded services. And in further support of the health of the community, the hospital plans to finish construction of a new breast care center in 2011. In addition, the hospital is actively recruiting physicians to the community and has recently implemented an employed physician model in order to further assist the community in addressing a severe shortage of physicians. The hospital's board of directors is community based and selected by a council of electors comprised of representatives from various government and community agencies and non-profits groups from throughout the hospital's service area. The hospital invests and utilizes any excess funds from operations as a safeguard for potential financial challenges and to fund future capital needs.
SCHEDULE H, PART III, LINE 9B	DEBT COLLECTION POLICIES	If it was not known at the point of service that the patient had the inability to pay, the patient may be screened: 1) by phone or 2) in person by the Customer Service Representative. The Customer Service Representative will utilize the Financial Assistance worksheet to determine the patient's ability/inability to pay. If the determination indicates the patient has the ability to pay, other options for payments will be explained. If there is no ability to pay then the application will be submitted for consideration.
SCHEDULE H PART I LINE 4	Financial Assistance Policy	While the organization's written policy does not provide free or discounted care to the medically indigent, the practice has been to address the needs of the medically indigent on a case by case basis and to document these practices in memo form.
SCHEDULE H PART II	Community Building Activities	As mentioned in the Part VI narrative regarding promotion of community health the hospital is dedicated to promoting the general health of the population. The activities in Part II contribute to the vitality of the community which is one of many factors that impact the health of the community and provides a benefit of our community.

Schedule H (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
Yavapai Community Hospital Association

Employer identification number
86-0098923

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) Yavapai Regional Medical Center Foundation1003 Willow Creed Road Prescott,AZ86301	86-1038463	501(c)(3)	297,902	Healthcare

Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image

Enter total number of other organizations ................................ . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2010

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
PART I QUESTION 2	GRANT MONITORING PROCESS	Generally, grants are made to the YRMC Foundation (the Foundation), a supporting organization of the Hospital. All grants reported on the Hospital's 990 represent funds originally intended for the Foundation but payable to the order of YRMC. These funds are deposited with the Foundation, but an entry is recorded to recognize receipt of the contribution by the Hospital. An entry is then made to record the grant to recognize the deposit of funds with the Foundation.

Schedule I (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Yavapai Community Hospital Association

Employer identification number

86-0098923

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported in prior Form 990 or Form 990-EZ
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) John R Amos	(i) (ii)	157,486 0	15,000 0	38,150 0	30,549 0	13,846 0	255,031 0	2,958 0
(2) Joseph H Goldberger	(i) (ii)	144,299 0	0 0	5,543 0	15,547 0	2,571 0	167,960 0	0 0
(3) Larry P Burns	(i) (ii)	144,218 0	15,000 0	46,761 0	27,813 0	10,406 0	244,198 0	23,124 0
(4) Margaret E Taylor	(i) (ii)	206,948 0	15,000 0	25,051 0	11,737 0	10,406 0	269,142 0	3,959 0
(5) Mark Timm	(i) (ii)	114,407 0	10,000 0	34,202 0	14,759 0	14,023 0	187,391 0	10,695 0
(6) Robert Stomel	(i) (ii)	347,574 0	0 0	0 0	6,928 0	9,019 0	363,521 0	0 0
(7) Roberta Nicol	(i) (ii)	126,451 0	10,000 0	35,642 0	25,301 0	10,406 0	207,800 0	3,996 0
(8) Sergio Soto	(i) (ii)	320,073 0	0 0	0 0	8,062 0	6,391 0	334,526 0	0 0
(9) Timothy J Barnett	(i) (ii)	399,715 0	30,000 0	127,200 0	233,361 0	12,434 0	802,710 0	26,750 0
(10) Allen Gardner	(i) (ii)	234,238 0	0 0	0 0	6,225 0	10,889 0	251,352 0	0 0
(11) Baldwin Stutts	(i) (ii)	505,658 0	24,281 0	0 0	7,350 0	9,829 0	547,118 0	0 0
(12) Brian L Hoefle	(i) (ii)	177,443 0	15,000 0	77,197 0	33,947 0	10,782 0	314,369 0	36,696 0
(13) Jerome Robinson	(i) (ii)	247,329 0	0 0	0 0	6,501 0	15,354 0	269,184 0	0 0

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
Names, Amounts, and Details of Arrangements	Part I, Line 4b	The following individuals participated in or received payment from a non-qualified supplemental retirement plan and/or severance agreement: Tim Barnett, CEO - $26,749.71 457f redemption, participation in SERP Larry Burns - participation in 457f - $23,124.03 Margaret Taylor - $3,958.91 457f redemption Brian Hoefle - participation in 457f - $36,695.90 John Amos - $2,958.41 457f redemption Roberta Nicol - $3,996.29 457f redemption Mark Timm - $10,694.73 457f redemption David Woodcock - $17,456.17 457f redemption and $36,842.33 severance payment
Officer and Key Employee Compensation	Part I, Line 3	Under the direction of the Hospital Board of Directors, an independent consultant was selected to perform a market equity analysis for the CEO compensation and benefit package. Integrated Healthcare Strategies (IHS) was retained to conduct a total compensation review, including an analysis of all elements of CEO total compensation, including salary, incentives, benefits, and perquisites compared to market practices. They provided the Hospital Human Resources Committee (a subcommittee of the hospital board) with a comprehensive description and valuation of all cash compensation and benefit practices and assessed compensation for competitiveness and compliance with regulatory requirements. In addition, they provided appropriate recommendations for modifying the total compensation program. Changes to the CEO total compensation were then approved by the Hospital Board of Directors.
Non-Fixed Payments	Part I, Line 7	The hospital provided performance awards to its executive team in 2010. While the performance awards provided rewarded outstanding performance, they were not contingent on achieving a stated revenue or net earnings amount and were solely at the discretion of the hospital's CEO.

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
Yavapai Community Hospital Association

Employer identification number
86-0098923

Part I

Bond Issues

(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	(g) Defeased		(h) On Behalf of Issuer		(i) Pool financing
(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	Yes	No	Yes	No	Yes	No
A	THE INDUST DEV'T AUTH OF THE COUNTY OF YAVAPAI	86-0376099	985900bl2	08-28-2003	41,494,716	CONSTRUCT HOSPITAL		X		X		X
B	THE INDUST DEV'T AUTH OF THE COUNTY OF YAVAPAI	86-0376099	985900BM0	02-06-2008	20,400,000	REFUND 2003 BONDS & PURCH EQUIP		X		X		X
C	THE INDUST DEV'T AUTH OF THE COUNTY OF YAVAPAI	86-0376099	958900BR9	05-08-2008	29,577,215	CONSTRUCTION & PURCH EQUIP		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired. . . . .	2,315,000		0		0
2 Amount of bonds defeased . . . .	0		0		0
3 Total proceeds of issue . . . .	42,904,476		20,400,000		30,519,966
4 Gross proceeds in reserve funds . .	4,414,892		0		2,182,948
5 Capitalized interest from proceeds.	3,626,111		0		2,572,535
6 Proceeds in refunding escrow. . . . .	0		17,895,587		0
7 Issuance costs from proceeds . . .	584,908		348,890		459,950
8 Credit enhancement from proceeds.	865,715		155,113		0
9 Working capital expenditures from proceeds . .	0		0		0
10 Capital expenditures from proceeds . .	35,158,097		1,969,675		20,542,823
11 Other spent proceeds . .	0		0		0
12 Other unspent proceeds. . .	0		0		4,398,714
13 Year of substantial completion . . .	2006		2008
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue?		X	X		X
15 Were the bonds issued as part of an advance refunding issue?		X		X		X
16 Has the final allocation of proceeds been made? . .	X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .	X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .		X		X		X

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2010

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use?		X		X		X
b Are there any research agreements that may result in private business use of bond-financed property? . .		X		X		X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . .	0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .	0 %		0 %		0 %
6 Total of lines 4 and 5 . . .. . . . . .	0 %		0 %		0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities?	X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .		X		X		X
2 Is the bond issue a variable rate issue?		X	X			X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?		X		X		X
b Name of provider .
c Term of hedge . .
d Was the hedge superintegrated? .
e Was a hedge terminated? .
4a Were gross proceeds invested in a GIC? .		X		X		X
b Name of provider .
c Term of GIC . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .
5 Were any gross proceeds invested beyond an available temporary period? .		X		X		X
6 Did the bond issue qualify for an exception to rebate? . . .		X		X		X

Schedule K (Form 990) 2010

Page 3

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation

Schedule K (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Yavapai Community Hospital Association

Employer identification number

86-0098923

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(b) Description of transaction	(c) Corrected?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose	(b) Loan to or from the organization?		(c)Original principal amount	(d)Balance due	(e) In default?		(f) Approved by board or committee?		(g)Written agreement?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No
(1) BALDWIN S STUTTS PHYSICIAN LOAN		X	401,290	387,419		No		No	Yes
(2) BALDWIN S STUTTS PHYSICIAN LOAN		X	45,000	45,000		No		No	Yes




Total ............... $				432,419

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b)Relationship between interested person and the organization	(c)Amount of grant or type of assistance

For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2010

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

Yavapai Community Hospital Association

Employer identification number

86-0098923

Identifier	Return Reference	Explanation
Members or Stockholders who can elect members of the governing body, etc.	Form 990, Part VI, Question 7a & 7b	The council of electors (the council) is charged with the responsibility of selecting individuals from the community to serve on the Association's Board of Trustees. The council is composed of publicly elected officials and representatives from selected government and non-profit organizations from throughout the community. Members must approve amendments to the Bylaws or Articles of Incorporation.
Process to Review the Form 990	Form 990, Part VI, Question 11b	The completed 990 is presented to the Audit Committee of the Board of Trustees in a special session for review prior to filing. The committee has the opportunity to review the form in detail during this meeting and to ask questions of the preparer. The committee then presents the results of their review to the full Board of Trustees and obtains final approval for filing from the Board. The full Board is also given the opportunity to review a copy of the 990.
Process for Monitoring Compliance with Conflict of Interest Policy	Form 990, Part VI, Question 12c	In January of each year, a Conflict of Interest form and the related policy are sent to each member of the Board of Trustees, officers and directors of the association, managers and key employees, all other exempt employees, members of professional advisory committees, and the medical executive committee. Recipients are asked to review the policy and sign the form each year at this time. In addition, all exempt new hires are asked to review the policy and sign the conflict of interest statement. The returned forms are reviewed and kept on file if no conflict has been identified. If conflicts are identified, the forms are sent to the CEO for review. During discussions at board meetings, those with conflicts identified through this process are excused from discussion and voting on the related matter.
Review of CEO or Top Mgmt Official Compensation	Form 990, Part VI, Question 15a	Under the direction of the Hospital Board of Directors, an independent consultant was selected to perform a market equity analysis for the CEO compensation and benefit package. On an annual basis, including 2010, Integrated Healthcare Strategies (IHS) is retained to conduct a total compensation review, including an analysis of all elements of CEO total compensation, including salary, incentives, benefits and perquisites compared to market practices. They provide the Hospital Human Resources Committee (a subcommittee of the hospital board) with a comprehensive description and valuation of all cash compensation and benefit practices and assess compensation for competitiveness and compliance with regulatory requirements. In addition, IHS provides appropriate recommendations for modifying the total compensation program. Changes to the CEO total compensation, if any, are approved by the Hospital Board of Directors.
Review of Other Officer or Key Employees Compensation	Form 990, Part VI, Question 15b	In 2008 under the direction of the CEO, Integrated Healthcare Strategies (IHS) was also retained to perform the same total compensation review for the additional nine hospital officers and key employees of the organization. IHS presented its study findings to the CEO. Afterwards, the CEO presented the consultant recommendations to the Hospital Board of Directors who approved changes to the total compensation packages.
Public Disclosure of Documents	Form 990, Part VI, Question 19	The financial statements are summarized in the annual report published on the hospital internet site. The organization's governing documents, conflict of interest policy, and financial statements are made available to the public upon request.
Program Service Description	Part III, Line 4a	Yavapai Regional Medical Center (YRMC) provides help, health, and hope to every man, woman, and child living in our region through high quality inpatient and outpatient services as well as a wide range of valuable community outreach programs. YRMC proudly serves the healthcare needs of people of all ages and from all walks of life. We're pleased to meet those needs 24 hours a day, 365 days a year. YRMC's sole purpose is to provide high-quality healthcare for the communities we serve. There are no stockholders to whom we must pay dividends; we focus instead on the people we serve. The "dividends" they receive are healthier lives for themselves and those they love. Any money remaining after YRMC has paid its bills goes back into the organization to help expand programs and add new services for the people in our communities. YRMC's Vision is Creating a Total Healing Environment, in which the people associated with YRMC work in partnership with patients and their families who are seeking peace of mind and peace of heart as well as physical cure and comfort because we honor the indivisible relationship that exists between body, mind, and the human spirit. The spirit of caring is a higher calling that resonated throughout YRMC in 2010. During a time when our nation, state, and communities experienced tremendous hardship, YRMC's family, which is comprised of board members, community supporters, donors, employees, physicians and volunteers, did not waver from this spirit of caring. YRMC has two hospitals; one in Prescott, YRMC West, and one in Prescott Valley, YRMC East. YRMC is truly two great hospitals with one caring spirit. Consider that in 2010, YRMC embraced its not-for-profit mission by providing more than seven million dollars in community benefit to the people of western Yavapai County. This includes direct healthcare services as well as programs that improve health and prevent illness. In 2010, YRMC touched more than 162,000 area residents through our community benefit programs. The spirit of YRMC is one of treating each patient as a unique and valuable human being. The long-awaited tiny newborn taking her first breath at YRMC is one of those special people. The frail yet feisty 87-year-old-woman who tells stories of riding in an open cockpit plane as a small child with her mother piloting and who now struggles with congestive heart failure is one of those special people. The young mother of four small children who just heard the frightening diagnosis of cancer and is recovering from surgery is another one of those special people. YRMC provides peace of mind and peace of heart year in and year out to all our patients, each one of whom is a special person. YRMC also offers a patient assistance program to help people who have no insurance or who have limited insurance coverage. At no time has this kind of support been more important - or more welcomed - than now. YRMC works diligently with patients to allow them to worry less about paying for services and be able to focus more directly on recovering and getting back on their feet. 2010 was another year of providing personalized care to many thousands of people. For example, 1,053 babies entered the world in YRMC's obstetrics department. These little ones represent the love, dreams, and hopes of their parents and are also the promise of tomorrow for the world. Nearly 490 women received additional preparation for their new babies through YRMC's Childbirth Education program which was especially important for first-time moms. YRMC also opened a new Family Birthing Center (obstetrics) at YRMC East in May 2010. Increasingly discouraging economic conditions, along with the added challenges of new babies, can create stress that's unmanageable for many young families. Consequently, YRMC provides Family Resource Center services that include free parenting education, counseling services, and coordination with other community resources that can help support young families. This program has also provided much-needed necessities to new families such as baby formula and diapers. In 2010 thousands of area residents participated in this remarkable program. The Family Resource Center advised 2,132 parents on how to care for their newborns through the First Steps program. An additional 2,884 families received ongoing support and home visits through YRMC's Healthy Families Program. These programs have virtually eliminated child abuse and neglect among participating families. This is a remarkable achievement at a time when economic stressors have increased along with the national rate of child abuse and neglect. YRMC is also pleased to offer the Partners for Healthy Students program. This is a school-based health program for children who are uninsured or underinsured. The program is led by a pediatric nurse practitioner who works in conjunction with a local pediatrician. School-age children and their siblings are diagnosed and treated for a wide variety of health problems. A specially-equipped van is sent to local schools and children receive the care and treatment they need. Some children have previously undiagnosed chronic health problems like asthma, allergies, ear infections, and subsequent hearing loss, or vision problems. Many children have never seen a dentist and have painful tooth decay to the point that their teeth are literally rotted down to the gums. These children suffer unimaginable pain every day. The program helps ensure all these children are given the care and treatment they need but could not otherwise receive. Health problems can seriously impede children's ability to learn and to grow up healthy. More than 1,052 children in 27 school-based clinics benefited from services provided by the Partners for Healthy Students program last year. YRMC is proud to provide these services at no charge. There are also numerous beneficial programs provided for adults by YRMC. For example, in 2010 more than 191 people suffering with respiratory problems were helped to breathe easier through wellness classes offered by YRMC's Respiratory Wellness program. YRMC also offered smoking cessation classes for 75 people who wanted to give up tobacco in 2010. YRMC physicians, pharmacists, and physical therapists gave presentations to more than 175 community members at the Wellness Center Education Room about heart health. The James Family Heart Center at YRMC reached a milestone in 2010 with performing its 500th cardiovascular surgery early in the year. The center performs hundreds of cardiac and thoracic cases and has also perfected a blood conservation program which greatly benefits patients. In 2010, YRMC helped 1,213 individuals with diabetes better manage their health in order to prevent hospitalization. Many newly-diagnosed diabetics learned more about their condition and how to maintain and optimize their health. Many people who have lived with diabetes for years learned new information about how to live healthier lives. A vigorous community outreach program reached more than 90,000 residents throughout 2010 with complimentary, current health information. This includes free community newsletters and mailers, health fairs, and a speaker's bureau service. Local community and faith groups have enjoyed 82 presentations from YRMC health professionals about health-related topics. Many speakers also distribute additional free take-home information provided by YRMC for future reference, whether it be about fitness, nutrition, stress management, or whatever topic the group requests. YRMC's Physical Rehabilitation department also provides a free stroke support group for stroke patients and their caregivers. Everyone can benefit from the fall risk assessment program which helps determine an individual's risk of falling down. Falls can lead to debilitating injuries and even death, especially for those over the age of 65. This assessment program helps identify risk factors, and physical rehab can help assist people with specific strengthening exercises to help prevent falls. YRMC's healthcare team - nurses, physicians, and other medical professionals - cared for 11,019 inpatients in 2010. That same year, 67,697 people, approximately 1,300 a week, received care in YRMC's Emergency Departments. YRMC is extremely proud of the fact that it is one of the largest employers in Yavapai County and has an outstanding reputation for attracting top healthcare professionals. Another source of pride is YRMC's dedicated volunteer force of 906 people who collectively donated 100,412 hours, breaking the 100,000-hour mark for the third year in a row. This is yet another example of the community's strong support for YRMC and how YRMC is regarded as a treasured community asset by the entire region.
Reconciliation of Net Assets		CHANGE IN SPLIT INTEREST AGREEMENT (17,759) TIMING AND BOOK/TAX DIFFERENCES ON INVESTMENT IN EQUITY INVESTEES 90,424 UNREALIZED GAINS 117,800 TOTAL OTHER CHANGES TO NET ASSETS 190,465
Members of the organization	Part VI, Question 6	Each resident of the Central Yavapai Hospital District who is at least (18) years of age shall be a member of the Association (Hospital) at his will and shall be eligible to cast one vote in person upon any issue presented at an annual or special meeting. There shall be no proxy or cumulative voting.
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Timothy J Barnett TITLE:CEO HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Brian L Hoefle TITLE:CFO HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Roberta Nicol TITLE:Dir of Philanthropy HOURS:1

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Yavapai Community Hospital Association

Employer identification number

86-0098923

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) Yavapai Reg'l Med Ctr Physician Care LLC 1003 Willow Creek Road Prescott,AZ86301 26-3257358	Med Svcs	AZ	5,028,222	3,196,222	NA

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) Yavapai Regional Medical Center Fdn 1003 Willow Creek Road Prescott,AZ86301 86-1038463	Support Org	AZ	501(c)(3)	LN11 TypeII	NA

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) PRESCOTT MEDICAL IMAGING LLC 810 WHIPPLE PRESCOTT,AZ86301 77-0603441	MEDICAL IMAGING	AZ	NA	RELATED	20,747	389,378		No		Yes		50.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

Yes

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved
(1) Yavapai Regional Medical Center Fdn	b	297,902
(2) Yavapai Regional Medical Center Fdn	c	642,763
(3) Yavapai Regional Medical Center Fdn	d	100,000
(4)
(5)
(6)

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: To provide comprehensive, high-quality healthcare consistent with our communities' needs.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	8
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	8
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	2,016
6	Total number of volunteers (estimate if necessary) ....	6	906
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,694,682	2,327,962
9	Program service revenue (Part VIII, line 2g) .........	222,404,450	229,145,635
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	281,167	826,994
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,128,507	2,188,534
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	226,508,806	234,489,125
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	155,802	297,902
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	116,320,835	115,461,618
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	140,339	220,800
b	Total fundraising expenses (Part IX, column (D), line 25) 566,310
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	99,086,218	104,926,078
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	215,703,194	220,906,398
19	Revenue less expenses. Subtract line 18 from line 12......	10,805,612	13,582,727
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	283,654,240	291,965,997
21	Total liabilities (Part X, line 26)............	144,148,970	138,687,535
22	Net assets or fund balances. Subtract line 21 from line 20 .....	139,505,270	153,278,462

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 192,689,933 including grants of $ 297,902 ) (Revenue $ 229,141,402 )
	See Schedule O.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 192,689,933

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)				(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Brian L Hoefle CFO	39.0	X			269,640	0	44,729
(19) Mark Timm Dir of HR	40.0		X		158,609	0	28,782
(20) Roberta Nicol Dir of Philanthropy	39.0		X		172,093	0	35,707
(21) Robert Stomel Cardiologist	40.0			X	347,574	0	15,947
(22) Sergio Soto Cardiologist	40.0			X	320,073	0	14,453
(23) Allen Gardner Physician - Internal Medicine	40.0			X	234,238	0	17,114
(24) Baldwin Stutts Cardiologist	40.0			X	529,939	0	17,179
(25) Jerome Robinson Cardiologist	40.0			X	247,329	0	21,855

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,806,073	0	582,183

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		642,763
e	Government grants (contributions)1e		520,216

f	All other contributions, gifts, grants, and similar amounts not included above1f		1,164,983
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			2,327,962
			Business Code
2a	PATIENT SERVICE REVENUE		900,099	228,925,900	228,925,900
b	INCOME FROM EQUITY INVESTEE		900,099	43,856	43,856
c	MISCELLANEOUS		900,099	175,879	171,646		4,233
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			229,145,635
3	Investment income (including dividends, interest
	and other similar amounts).....			203,558			203,558
4	Income from investment of tax-exempt bond proceeds..			404,586			404,586
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross Rents	1,002,681
b	Less: rental expenses
c	Rental income or (loss)	1,002,681
d	Net rental income or (loss).......			1,002,681			1,002,681
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	23,712,280	421,800
b	Less: cost or other basis and sales expenses	23,798,448	116,782
c	Gain or (loss)	-86,168	305,018
d	Net gain or (loss)..........			218,850			218,850
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a		33,864
b	Less: direct expenses ...b		57,524
c	Net income or (loss) from fundraising events..			-23,660			-23,660
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a		232,146
b	Less: cost of goods sold ..b		143,789
c	Net income or (loss) from sales of inventory..			88,357			88,357
Miscellaneous Revenue			Business Code
11a	CAFETERIA		722,210	1,071,569			1,071,569
b	VENDING/SNACK CART		900,099	45,296			45,296
c	COPY MACHINE		900,099	4,291			4,291
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,121,156
12	Total revenue. See Instructions....			234,489,125	229,141,402		3,019,761


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			36,427,267	1	52,002,666
2	Savings and temporary cash investments .......			44,267,122	2	37,765,541
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			35,883,947	4	31,511,810
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			446,290	5	432,419
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............			1,085,114	7	1,639,398
8	Inventories for sale or use ..............			4,375,242	8	4,346,513
9	Prepaid expenses and deferred charges ............			2,594,331	9	2,237,323
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	228,727,707
b	Less: accumulated depreciation. .....	10b	86,506,380	137,243,218	10c	142,221,327
11	Investments—publicly traded securities ..........			9,908,774	11	5,532,406
12	Investments—other securities. See Part IV, line 11 ......			3,558,177	12	3,508,176
13	Investments—program-related. See Part IV, line 11 ..			3,411,754	13	6,193,846
14	Intangible assets .........			0	14	371,743
15	Other assets. See Part IV, line 11 ...........			4,453,004	15	4,202,829
16	Total assets. Add lines 1 through 15 (must equal line 34)...			283,654,240	16	291,965,997
17	Accounts payable and accrued expenses .			18,056,171	17	15,418,289
18	Grants payable ..........				18
19	Deferred revenue ..........			1,863,911	19	1,929,735
20	Tax-exempt bond liabilities ..........			119,045,000	20	116,300,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			3,358,067	23	3,141,737
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities. Complete Part X of Schedule D.....			1,825,821	25	1,897,774
26	Total liabilities. Add lines 17 through 25.....			144,148,970	26	138,687,535
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			139,339,321	27	153,247,713
28	Temporarily restricted net assets .....			165,949	28	30,749
29	Permanently restricted net assets .....				29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			139,505,270	33	153,278,462
34	Total liabilities and net assets/fund balances .....			283,654,240	34	291,965,997