TY 2012 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Doug Wright........................................................................ Chf Med Staff	4.00 .......................0.00	X				15,683	0
(2) Becky Thompson........................................................................ Board Member	4.00 .......................0.00	X				14,400	0
(3) Thomas Paxman DO........................................................................ Board Member	4.00 .......................0.00	X				16,400	0
(4) Steven Garrett........................................................................ Board Member	4.00 .......................0.00	X				14,400	0
(5) John Corder........................................................................ Board Member	4.00 .......................0.00	X				14,400	0
(6) Paul Watson........................................................................ Vice Chairman	4.00 .......................0.00	X				14,400	0
(7) Neal Thompson........................................................................ Chairman	4.00 .......................0.00	X				14,400	0
(8) Kurt Loveless........................................................................ CFO	40.00 .......................0.00		X			232,225	9,355
(9) Ron McArthur........................................................................ CEO	40.00 .......................0.00		X			387,747	10,700
(10) Kenneth Allen........................................................................ Chief Compliance Officer	40.00 .......................0.00			X		163,885	6,163
(11) William McQuillan........................................................................ Chief Info Sys Officer	40.00 .......................0.00			X		182,328	7,494
(12) Jeffrey Northup DO........................................................................ Chief Medical Officer	40.00 .......................0.00			X		290,537	10,000
(13) Doug Gilchrist........................................................................ VP of Operations	40.00 .......................0.00			X		177,779	7,893
(14) Cynthia Ebert-Loomis........................................................................ Chief Nursing Officer	40.00 .......................0.00			X		169,279	7,243
(15) Abdul O Memon MD........................................................................ Cardiologist	40.00 .......................0.00				X	649,119	11,200
(16) Brian C Fuller MD........................................................................ Cardiologist	40.00 .......................0.00				X	610,929	11,100
(17) Snehal G Thakkar MD........................................................................ Oncologist	40.00 .......................0.00				X	561,200	15,250

(A) Name and business address	(B) Description of services	(C) Compensation
Wht Mtn Emergency PhysiciansPO Box 1389PinetopAZ85935	ER Physician Group	365,976
Pridestaff Inc7535 N Palm Ave Ste 101FresnoCA93711	Contract Lbr-Pharmac	267,521
Medicus Hospitalists West LLC22 Roulston RdWindhamNH03087	Hospitalists	2,546,324
Dependable Staffing ServicesPO Box 2999PhoenixAZ85062	Contract Lbr-Pharmac	329,302
Clin-Path Associates PCPO Box 42210PhoenixAZ85080	Pathology Services	625,477
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 27

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 United States. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. 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 ....	1,860,948		1,860,948
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	49,710,538	20,878,426	28,832,112
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	874,045	297,403	576,642
9	Other employee benefits .......	8,126,013	3,224,554	4,901,459
10	Payroll taxes ...........	3,373,980	1,225,466	2,148,514
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	241,936		241,936
c	Accounting ...........	48,000		48,000
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	102,849		102,849
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	4,998,739	79,165	4,919,574
12	Advertising and promotion ....	914,265		914,265
13	Office expenses .......	0
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	2,693,199		2,693,199
17	Travel ............	150,002		150,002
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	464,225		464,225
20	Interest ...........	1,497,599		1,497,599
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	7,492,021	3,296,489	4,195,532
23	Insurance ..............	2,130,208		2,130,208
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Physician Recruitment	839,987	671,990	167,997
b	Equipment Rent & Maintenance	5,088,170	2,137,031	2,951,139
c	Physician Fees & Contract Lbr	6,169,682	1,332,853	4,836,829
d	Supplies	23,796,672	20,183,229	3,613,443
e	All other expenses	1,382,491		1,382,491
25	Total functional expenses. Add lines 1 through 24e	121,955,569	53,326,606	68,628,963	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	181,753	1	182,325
2	Savings and temporary cash investments .........	15,641,699	2	29,566,894
3	Pledges and grants receivable, net ...........		3	0
4	Accounts receivable, net .............	16,230,163	4	25,887,131
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6	0
7	Notes and loans receivable, net .............	169,777	7	275,776
8	Inventories for sale or use ..............	3,236,654	8	3,714,744
9	Prepaid expenses and deferred charges ..........	1,009,198	9	2,081,487
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	143,095,463
b	Less: accumulated depreciation .....	10b	53,228,663	78,668,367	10c	89,866,800
11	Investments—publicly traded securities ..........	37,026,671	11	29,507,197
12	Investments—other securities. See Part IV, line 11 .....		12	0
13	Investments—program-related. See Part IV, line 11 .....		13	0
14	Intangible assets ...............		14	0
15	Other assets. See Part IV, line 11 ...........	3,706,167	15	2,993,563
16	Total assets. Add lines 1 through 15 (must equal line 34)......	155,870,449	16	184,075,917
	17	Accounts payable and accrued expenses .........	11,748,255	17	12,394,226
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	25,543,761	20	25,521,026
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other 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 ..	9,494,714	23	33,799,431
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	1,330,490	25	2,133,151
26	Total liabilities. Add lines 17 through 25.........	48,117,220	26	73,847,834
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	107,128,841	27	109,379,376
28	Temporarily restricted net assets ...........	624,388	28	848,707
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........	107,753,229	33	110,228,083
34	Total liabilities and net assets/fund balances ........	155,870,449	34	184,075,917

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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

2012

Open to Public
Inspection

Name of the organization

Summit Healthcare Association
FKA Navapache Health Care Assoc Inc

Employer identification number

86-0320447

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 described in 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. See section 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 - Non-functionally integrated

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 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 monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. 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—2011. If the organization did not check a 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—2012. 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—2011. 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) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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.)..

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 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2012. 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—2011. 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) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

Additional Data

Software ID:	12000229
Software Version:	2012v2.0

- 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

2012

Name of the organization

Summit Healthcare Association
FKA Navapache Health Care Assoc Inc

Employer identification number

86-0320447

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, total 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 total 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 on line H of its
Form 990-EZ or on Part I, 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 2

Name of organization Summit Healthcare Association FKA Navapache Health Care Assoc Inc

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total 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) Total 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) Total 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) Total 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) Total 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) Total 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 3

Name of organization Summit Healthcare Association FKA Navapache Health Care Assoc Inc

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 4

Name of organization
Summit Healthcare Association
FKA Navapache Health Care Assoc Inc

Employer identification number

86-0320447

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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

$
Use duplicate copies of Part III if additional space is needed.

(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) (2012)

Additional Data

Software ID:	12000229
Software Version:	2012v2.0

- 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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

Summit Healthcare Association
FKA Navapache Health Care Assoc Inc

Employer identification number

86-0320447

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 .........	3	2
2	Aggregate contributions to (during year) ...	224,319	30,981
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........	848,707	305,129

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 can 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 education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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 section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, 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 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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 (ASC 958) 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

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

Using the organization’s acquisition, 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 XIII.

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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........

Part V

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

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

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 XIII the intended uses of the organization's endowment funds.

Part VI

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

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	1,365,233		1,365,233
b	Buildings ................	78,240,352	26,362,631	51,877,721
c	Leasehold improvements ............
d	Equipment ................	48,801,991	26,866,032	21,935,959
e	Other .................	14,687,887		14,687,887
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				89,866,800

Schedule D (Form 990) 2012

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) must 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) must 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) must 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) Book value
Federal income taxes
Third Party Settlements		2,061,490
Physician Liability		71,661







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		2,133,151
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	124,503,460
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	73,037
e	Add lines 2a through 2d .....................			2e	73,037
3	Subtract line 2e from line 1.....................			3	124,430,423
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 XIII.) ...........	4b
c	Add lines 4a and 4b.......................			4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	124,430,423

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements ...........			1	122,028,606
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 XIII.) ............	2d	73,037
e	Add lines 2a through 2d......................			2e	73,037
3	Subtract line 2e from line 1.....................			3	121,955,569
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 XIII.) ............	4b
c	Add lines 4a and 4b.......................			4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	121,955,569

Part XIII

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
Part XII, Line 2d	Part XII, Line 2d: Other expenses and losses per audited F/S	Special Events reclassifications $73037
Part XI, Line 2d	Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990	Special Events reclassifications $73037

Schedule D (Form 990) 2012

Additional Data

Software ID:	12000229
Software Version:	2012v2.0

- 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. Form 990-EZ filers are not required to complete this part. right arrow

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

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization
Summit Healthcare Association
FKA Navapache Health Care Assoc Inc

Employer identification number

86-0320447

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 email 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.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2012

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 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 GALA (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . .	143,440	143,440
2	Less: Contributions . .	143,440	143,440
3	Gross income (line 1 minus line 2) . . .
4	Cash prizes . . .
5	Noncash prizes . .
6	Rent/facility costs . .	13,705	13,705
7	Food and beverages .
8	Entertainment . . .	7,500	7,500
9	Other direct expenses .	51,832	51,832
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........		73,037
11	Net income summary. Combine line 3, column (d), and line 10. ..........		-73,037

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:

Schedule G (Form 990 or 990-EZ) 2012

Page 3

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

Indicate the percentage of gaming activity operated in:

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

13a

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

13b

Enter 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 of the third party:

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

Supplemental Information. Complete this part to provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Identifier	Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000229
Software Version:	2012v2.0

- 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

2012

Open to Public Inspection

Name of the organization

Summit Healthcare Association
FKA Navapache Health Care Assoc Inc

Employer identification number

86-0320447

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

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

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance 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 discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did 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.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	1,499,429		1,499,429	1.230 %
b	Medicaid (from Worksheet 3, column a) ....	24,795,846	17,384,345	7,411,501	6.080 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	26,295,275	17,384,345	8,910,930	7.310 %
Other Benefits		606,706	284,928	321,778	0.260 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	606,706	284,928	321,778	0.260 %
f	Health professions education (from Worksheet 5) ..
g	Subsidized health services (from Worksheet 6) ..	59,920,492	37,251,516	22,668,976	18.590 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)
j	Total. Other Benefits ..	60,527,198	37,536,444	22,990,754	18.850 %
k	Total. Add lines 7d and 7j .	86,822,473	54,920,789	31,901,684	26.160 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012

Schedule H (Form 990) 2012

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

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

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

4,891,717

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

44,775,514

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

57,398,157

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

-12,622,643

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

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(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 %
1White Mountain Imaging	Open MRI	51.000 %	3.000 %	2.000 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2012

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, and primary website address
1	Summit Healthcare Association 2200 E Show Low Lake Road Show Low,AZ85901	X	X	X

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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


Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 ....................

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 150.0000% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.0000% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	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)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14		No
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17	Yes
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

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?..........

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?17
Name and address		Type of Facility (describe)
1	Summit Healthy Steps 300 W White Mountain Blvd Ste D Lakeside,AZ85929	Outpatient Center, Child Development
2	Summit Healthcare Holbrook Specialty Clinic 1401 W Florida Holbrook,AZ86025	Outpatient Center, Specialty Clinic
3	Summit Healthcare Rehabilitation 300 W White Mountain Blvd Pinetop,AZ85935	Outpatient Centers, Rehabilitation
4	Summit Healthcare Rehabilitation 5171 Cub Lake Rd Ste 360 Show Low,AZ85901	Outpatient Centers, Rehabilitation
5	Summit Internal Medicine Dr Ahmed 2450 E Show Low Lake Rd Bldg 1 Show Low,AZ85901	Physician Offices, Medical Clinic
6	Summit Pain Clinic Dr Mitchell Majors 2051 E Evergreen Lane B Show Low,AZ85901	Physician Offices, Pain Clinic
7	Summit OBGYN Dr Kyrimis 5448 S White Mountain Blvd Lakeside,AZ85929	Physician Offices, OB/GYN
8	Summit Plastic Surgery Dr Olack 2450 E Show Low Lake Rd Bldg 2 Show Low,AZ85901	Physician Offices, Plastic Surgery Clinic
9	Heber-Overgaard Community Clinic 2931 South Highway 260 Overgaard,AZ85933	Outpatient Center, Community Clinic
10	Summit Urology Dr Waller 5171 Cub Lake Rd Ste 280B Show Low,AZ85901	Pysician Offices, Urology Clinic
11	Cub Lake Outpatient Clinic 5171 Cub Lake Rd Ste 330 Show Low,AZ85901	Outpatient Center, Clinic
12	Summit Practice MgmtHome Health 3401 S White Mountain Blvd Show Low,AZ85901	Outpatient Centers, Home Health
13	Snowflake Imaging Center 1121 S Main St Snowflake,AZ85937	Outpatient Center, Imaging
14	Summit Pediatrics Dr Bennett 5171 Cub Lake Rd Ste 350C Show Low,AZ85901	Physician Offices, Pediatrics
15	Summit Cardiology Dr Memon & Fuller 5171 Cub Lake Rd Ste 220B Show Low,AZ85901	Physician Offices, Cardiology
16	Snowflake Medical Center 590 S Main Street Snowflake,AZ85937	Physician Offices
17	Summit Healthcare-East Campus Oncology 2500 E Hunt Drive Show Low,AZ85901	East Campus, Cancer Center

Schedule H (Form 990) 2012

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

Identifier	ReturnReference	Explanation
	Part VI - Additional Information	On Schedule H, Part V, Section C, Facility Information, Other Facilities, under the heading Name and Address there appears a random number next to each facility name. This is due to a software limitation and has no meaning, and may be disregarded.
	Part V - Explanation of Number of Facility Type	Besides the main Hospital, there is an Oncology Center, 8 Physician Offices, and 7 Outpatient Centers, offering specialties such as: Imaging; Pediatrics; Cardiology; Home Health; Urology; Plastic Surgery; OB/GYN; Internal Medicine; Healthcare Rehabilitation; Child Development; a Pain clinic; and a Specialty Clinic.
	Part VI - Affilated Health Care System Roles and Promotion	N/A
	Part VI - Explanation Of How Organization Furthers Its Exempt Purpose	For over 40 years, Summit Healthcare Regional Medical Center has been deeply committed to providing healthcare as an essential community service for White Mountain communities. As a non-profit hospital, any net income is reinvested into facilities, technology, and healthcare services to ensure our facilities are up-to-date and our equipment is state-of-the-art. This is an investment in the health of our community. Summit Healthcare has a total of 89 licensed inpatient beds with 42 private Medical/Surgical Beds, a 10 Bed Obstetrical/Womens Health Unit, 20 Postpartum/Couplet Care beds, a Level II Nursery, 2 in-unit ORs for Caesarean deliveries, 12 Intensive Care Unit Beds, 31 Emergency Beds, a designated Level IV Trauma Center, modern state-of-the-art operating suites and two endoscopy suites, a Cardiac Cath and Vascular Lab, Cardiac Rehab, Cardiopulmonary, Respiratory, two state-of-the-art sleep rooms, a Wound Care/HBO center, a dedicated womens center offering mammography, DEXA scanning, biopsy, breast MRI, a state-of-the-art Cancer Center complete with radiation and medical oncology, a Therapy Services department that includes Physical Therapy, Speech Therapy, and Occupational Therapy, Surgical Services, Telestroke, Teleneurology and Teleconcussion, Home Health, outpatient clinics in Show Low, Snowflake, Heber and Holbrook, a Mobile Health Van, and more.Summit Healthcare has almost 1,000 employees and over 100 active, affiliate and consulting medical staff representing 25 different specialties. Summit Healthcare now has 23 employed physicians.Summit Healthcare has training programs for students from every discipline. Summit rotates nursing students from NPC and NAU, medical students from the University of Arizona, Midwestern and AT Still, and pharmacy, podiatry, CRNA and PA students.To date, approximately 40 infant car seats have been distributed to parents of infants who can't afford a car seat. The parents have to receive instruction, watch a video, and perform a return demonstration on the proper installation of each car seat. The hospital also paid for three more car seat technicians (from OB) to make sure that new parents are able to install their car seats properly.In 2011, we created a new committee, called the White Mountain Fire and Life Safety Educators Group for the purpose of tracking local education from fire and EMS agencies and the hospital. This organization has now applied to be a 501(c)3 non-profit organization in order to apply for grants and scholarships to pay for educational materials. Because of major budget cuts to the local fire departments, this organization will be able to use grant money and donations to help supplement these agencies with materials they use to educate our area's children and adults. This organization includes Summit Healthcare, Pinetop, Lakeside, Show Low, Taylor, Snowflake, Linden, and Heber/Overgaard fire departments. It also includes the Pinetop-Lakeside and Show Low police departments; it also includes Navajo County injury prevention, medical examiner's office, and county attorney and NACOG (Northern Arizona Council of Governments) Area Agency on Aging. In 2012, we participated once again in the White Mountain Bike Safety Rodeo and Car Seat Check and distributed approximately 500 helmets. We co-sponsored our second annual EMS "Trauma in the White Mountains" Conference. We had well over 100 participants made up of EMTs, Paramedics, RNs, ER techs, PAs, and Physicians. Our Health and Safety Fair in June was a success - the ER had two booths; a "Teddy Bear Clinic" and a "Casting clinic". Cost for these was approximately $ 300.We are now providing high quality education to our pre-hospital personnel to help them be the most qualified, competent providers available. Eighteen agencies have contracts with Summit Healthcare, and medical direction is provided to 240+ EMTs and Paramedics.Many of these agencies do not have the funding for additional education and Summit Healthcare has stepped up to provide them with higher learning. We provide opportunities for them to take ACLS, PALS, and BLS (all required of paramedics), plus our monthly run review. We now provide them with remote access to the run reviews, with a "teleconference" system that allows them to listen in at their stations and follow along with a Power Point. Our annual Trauma Conference helps train our pre-hospital personnel with education to deal with all types of trauma. All of this helps to provide a higher quality of service to even the smallest of Fire/EMS agencies and their communities.When it comes to the health of our community, Summit Healthcare continually reaches out to provide support, education, improvement, and cooperation. Wherever we see opportunities to improve our services and help other healthcare providers, we form relationships and establish alliances with the goal of improving the health of the community. We participate in community events and activities that support our mission, including health fairs in Holbrook, Heber, Whiteriver and Show Low. Our Mobile Health Van visited: 87 children on the the Navajo Reservation; 6 people at the Concho Food Bank; 17 at the Pinetop Food Bank; 16 during "First Fridays" in Show Low; 56 at the Heber Health Fair; 34 at the Women's Health Fair in Holbrook; and 102 people at the 2012 Show Low Days in conjunction with Healthy Steps. In addition, the Healthy Steps program treated 1700 children.One of the many events and activities we are involved with is our Annual Community Health Fair. We offer this service free of charge to the public, providing patient and health education and information. The booths provide information on topics such as wellness and prevention, disease and general health-related issues, as well as offering many free health screenings, including a free PSA clinic for men. We also hold an annual Womens Health Conference, which provides women with a day of fun, friendship, laughter and health education. Summit Healthcare also hosts regular blood drives, numerous support groups and educational classes. In 2012, we provided community benefit sponsorships and donations supporting the Ameri-can Cancer Societys Relay for Life, Pinetop-Lakeside Advocate Against Drugs, Blue Ridge and Show Low High Schools Grad Lock-in Nights, Navajo County Family Advocacy Program, the City of Show Lows Knock the Blues Out of Hunger, Friends of Navajo County Drug Coalition, the Living Hope Womens Center, the Arizona Perinatal Trust, Friends of Navajo County Junior Academy, Salvation Army of the White Mountains, Show Low Shriners, White Mountain Clothe-a-Child, the SAFE House, Show Low Days, Tri in the Pines, the Salvation Army, The Young Marines, and more.Physician specialists in urology, pulmonary medicine, nephrology, oncology, vascular surgery and interventional cardiology now provide the specialty coverage to our communities, allowing our patients to stay on the mountain. Since 2011, Summit Healthcare has welcomed eighteen new physicians to our community and medical center. We are currently actively recruiting for several specialties including Neurology, Orthopedic Surgery, Pain Management, Otolaryngology, and Family Medicine.
	Part VI - Community Building Activities	N/A
	Part VI - Community Information	Summit Healthcare Association (the Hospital) operates Summit Healthcare, a 89-bed acute care hospital facility, formerly known as Navapache Health Care Association. The Hospital provides inpatient and outpatient, home health, imaging and other health care related services to the residents of Show Low, Arizona and the surrounding White Mountain communities.
	Part VI - Patient Education of Eligibility for Assistance	Hospital admitting staff members advise and assist all self-pay patients of the options for available assistance.
	Part VI - Needs Assessment	Summit Healthcare Association delivers community benefits based on the unique health needs of their respective service areas, regardless of source or availability of payment. These programs and services are intended to improve access to healthcare, health status and the use of healthcare resources. Summit Healthcare provided charity care and community benefits to members of our community as part of its vision; "...to be a model of success as a rural healthcare provider bydelivering exceptional health care and promoting wellness for the individual, the family, and the community"...
Number of Hospital Faciltiy - 1	Part V, Line 20d - Other Billing Determination of Individuals Without Insurance	Charge structure is the same for all. Discount policies are in place to address private payers.
Number of Hospital Faciltiy - 1	Part V, Line 18e - Other Actions Took Before Any Collection Actions	Patients are notified when need is identified
Number of Hospital Faciltiy - 1	Part V, Line 12h - Other Factors Used in Determing Amounts Charged Patients	Number of dependents, family size
	Part III, Line 9b - Provisions On Collection Practices For Qualified Patients	Procedure: Charity Care is defined as an inability to pay. The patients indigence must be determined by the facility, not by the patient. This determination may occur at any time prior to the patients account achieving zero balance; prior to admission, at admission, after discharge or during the billing and collection process.The charity determination is to be made based on the patient/responsible partys net worth, net income and the number of members in the household. Summit Healthcare Association bases their charity care on the Federal Poverty Income Guidelines. The facility must determine that no source other than the patient/responsible party would be legally responsible for the patients medical bill. This includes federal, state or local financial programs and/or legal guardians.The patients business office file will contain documentation of the method by which indigence was determined along with all supporting documentation to substantiate the decision. The final determination will be made by the CFO, with the recommendation of the Patient Account Supervisor.
	Part III, Line 8 - Explanation Of Shortfall As Community Benefit	The entire shortfall is attributed to community benefit.
	Part III, Line 4 - Bad Debt Expense	Description of Bad Debt Expense:Charges to the financial assistance program are not applied to bad debt. Therefore, none of the organization's bad debt expense is attributable to the charity care policy.Financial Statement Footnote:The Hospital does not have a financial statement footnote specific to bad debt expense, but does include two financial footnotes related to Charity Care. The financial statements compute charity care by aggregating gross charges and all deductions from revenue, while the Schedule H computations in Parts I and III are calculated using a cost to charge approach. The financial statement footnote follows:Charity Care: The Hospital accepts all patients regardless of their ability to pay. A patient is classified as a charity patient by reference to certain established policies of the Hospital. Essentially, these policies define charity services as those services for which no payment is anticipated. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as net patient service revenues. Services provided are recorded as gross patient service revenues and then written off entirely as an adjustment to net patient service revenues.NOTE L - CHARITY CARE AND COMMUNITY BENEFIT The Hospital maintains records to identify and monitor the level of charity care and community service it provides. These records include: the amount of charges foregone, (based on established rates), for services and supplies furnished under its charity care and community service policies; the estimated cost of those services and supplies; and statistics quantifying the level of charity care as a percentage of expenses of the Hospital as a whole. The following is a summary of the Hospital's charity care and community benefit expense for the years ended December 31, 2012 and 2011, in terms of services to the poor and benefits to the broader community:Benefits for the poor: Total benefits for the poor - $50,448,904 (2012), and $55,514,166 (2011).Benefits for the broader community: Unpaid Medicare Program Charges - $112,333,973 (2012), and $95,088,174 (2011).
	Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense	Cost to Charge Ratio
	Part I, Line 7g - Costs Associated With Physicans Clinics	Subsidized health services are clinical services provided to patients despite a financial loss to the organization. The difference between the costs the hospital incurs to provide a specific service and the amount the hospital receives as payment for that service, define subsidized health services. Furthermore, they are those clinical services that: if the hospital were unable to provide, would result in not meeting community needs. This would mean that patients would be required to go elsewhere for services which would then become the responsibility of government or of other tax-exempt organizations.
	Part I, Line 7, Column F - Explanation of Bad Debt Expense	Please refer to the explanation of bad debt expense provided for Part III, line 4.
	Part I, Line 7 - Explanation of Costing Methodology	Cost to charge ratio

Schedule H (Form 990) 2012

Additional Data

Software ID:	12000229
Software Version:	2012v2.0

- 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

2012

Open to Public Inspection

Name of the organization

Summit Healthcare Association
FKA Navapache Health Care Assoc Inc

Employer identification number

86-0320447

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 or provision of all of the expenses described above? If "No," complete Part III to explain....

Yes

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? .......

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

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? ................

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

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 ............

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

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(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 as deferred in prior Form 990
(A) Name and Title		(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)	(F) Compensation reported as deferred in prior Form 990
(1)William McQuillanChief Info Sys Officer	(i) (ii)	167,881	14,447		6,794	700	189,822
(2)Snehal G Thakkar MDOncologist	(i) (ii)	536,450	10,000	14,750	10,000	5,250	576,450
(3)Ron McArthurCEO	(i) (ii)	351,247	33,000	3,500	10,000	700	398,447
(4)Kurt LovelessCFO	(i) (ii)	211,986	20,239		8,713	642	241,580
(5)Kenneth AllenChief Compliance Officer	(i) (ii)	150,933	12,952		6,163		170,048
(6)Jeffrey Northup DOChief Medical Officer	(i) (ii)	267,677	22,860		10,000		300,537
(7)James B Olack MDPlastic Surgeon	(i) (ii)	431,617	39,025			1,200	471,842
(8)Douglas D Lee MDAnesthesiologist	(i) (ii)	430,592	42,500	15,003	10,000	1,200	499,295
(9)Doug GilchristVP of Operations	(i) (ii)	161,819	15,960		6,583	1,310	185,672
(10)Cynthia Ebert-LoomisChief Nursing Officer	(i) (ii)	156,995	12,284		6,535	708	176,522
(11)Brian C Fuller MDCardiologist	(i) (ii)	554,629	27,500	28,800	10,000	1,100	622,029
(12)Abdul O Memon MDCardiologist	(i) (ii)	587,556	21,563	40,000	10,000	1,200	660,319

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Identifier	Return Reference	Explanation
Sch J, Part III, Additional Information	Part III, Additional Information	Compensation agreement with Physicians allows for a bonus based on the productivity of their specialized practice.
Sch J, Part I, Line 1a	Part I, Line 1a: Relevant information in regards to selections on 1a.	Payment made in accordance to employment agreement and board approval.

Schedule J (Form 990) 2012

Additional Data

Software ID:	12000229
Software Version:	2012v2.0

- 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 Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
Summit Healthcare Association
FKA Navapache Health Care Assoc Inc

Employer identification number
86-0320447

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	Industrial Development Authority of the City of Show Low AZ		825375AH1	12-01-2005	25,000,000	Facility Expansion: 5-Story Tower & Cafeteria		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	25,682,071
4 Gross proceeds in reserve funds . . . . . . . . . . . .	2,138,000
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	1,221,159
8 Credit enhancement from proceeds . . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	22,322,912
11 Other spent proceeds . . . . . . . . . . . . . .
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X

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

Cat. No. 50193E

Schedule K (Form 990) 2012

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 of bond-financed property? . . . . . . . . . . . .		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .
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 . .	%		%		%		%
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 . . . . . . .	%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	%		%		%		%
7 Does the bond issue meet the private security or payment test? . . . . .
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	%		%		%		%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .	X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .
b Exception to rebate? . . . . . . . .
c No rebate due? . . . . . . . . . .
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .
e Was a hedge terminated? . . . . . . .

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		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? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?

Part VI

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) 2012

Additional Data

Software ID:	12000229
Software Version:	2012v2.0

- 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, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

Summit Healthcare Association
FKA Navapache Health Care Assoc Inc

Employer identification number

86-0320447

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

Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

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 assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2012

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	(b) Relationship between interested person and the organization	(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
(1) Doug Wright	Board Member	365,976	Interest in Vendor		No
(2) Becky Thompson	Board Member	317,098	Family Mbr Compensat		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
		Becky Thompson is related to a physcian that Summit Healthcare employs. Dr. Mulder is her cousin-in-law, and was paid $317,098 during the year 2012.Doug Wright-is employed by White Mountain ER Physicians and is a 20% partner. This organization is one of Summit's highest paid Independent Contractors.

Schedule L (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000229
Software Version:	2012v2.0

- 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

2012

Open to Public
Inspection

Name of the organization

Summit Healthcare Association
FKA Navapache Health Care Assoc Inc

Employer identification number

86-0320447

Identifier	Return Reference	Explanation
	Schedule H, Part V, Facility Info, pages 4-6	The IRS instructions for Part V, state that the questions regarding community health needs assessments (lines 1-8) are optional for tax year 2012. Summit Healthcare Association (SHA) qualified for this optional reporting, and did not choose to respond to lines 1-8. However, the tax software program that was utilized in preparing the Form 990 automatically generated responses to question 1. This response was the result of a software malfunction and was unable to be removed before the filing deadline. Please disregard this response, and note that SHA did not complete these questions due to the fact they were OPTIONAL. All lines 1-8, in part V Section B, should be blank.
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	These documents are made available upon request.
Form 990, Part VI, Line 15b	Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	Independent consulting firms are hired to review the compensation of directors, officers, and key employees.
Form 990, Part VI, Line 15a	Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management	Independent consulting firms are hired to review the compensation of directors, officers, and key employees. Final approval of top management compensation is the responsibility of the Board of Directors.
Form 990, Part VI, Line 12c	Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	Director of Medical Staff/Board Services is responsible for monitoring and ensuring records are updated in a timely manner.
Form 990, Part VI, Line 11b	Form 990, Part VI, Line 11b: Form 990 Review Process	The 990 is reviewed in the scheduled Governing Board meeting following its completion.
Form 990, Part VI, Line 2	Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et	All of the hospital's governing board members received stipends for board of director services provided. Three were compensated for other servics: Doug Wright was compensated as the Medical Director of Wound Care (Stipend $14,069 and Med Director $1,614), Becky Thompson was compensated as a board member and her company was paid for rental of office space (Stipend $14,400 and Rent $43,500), and Thomas Paxman was compensated for Pinetop Clinic office space usage and overhead (Stipend $16,400 and Office Space $96,739). After consideration of the circumstances of each of the following business situations described involving board members: Thomas Paxman, Becky Thompson and Doug Wright were deemed to have compromised independence as voting members. Board member Thomas Paxman is a 3% physician investor in White Mountain Imaging, the same company that hospital Holds 51% interest in. Both Paxman and Summit would have to have an interest in the joint venture of greater than 10% in order for it to be reportable on Schedule L. In addition, Thomas Paxman is paid by Summit via his company Pinetop Medical for use of office space and overhead at the Pinetop Clinic in the amount of $96,739 for 2012. This transaction was under the $100K threshold for reporting on Schedule L. Doug Wright is employed by White Mountain ER Physicians, and is a 20% partner. This organization is one of Summit's highest paid Independent Contractors. The transactions between ER Physician Group and the hospital were valued in excess of $100,000, and were reported on Schedule L.Doug Wright is also compensated from Summit as the Medical Director of Wound Care. Compensation for 2012 was $1,614. Medical Director compensation was under the reporting threshold for Schedule L. Becky Thompson has a controlling ownership interest in Old Bear Properties. Summit rented office space on this property and paid this organization $43,500 in 2012 - under the threshold for reporting on Schedule L, but did compromise her independence as a voting Board member. Becky Thompson is also related to a physcian that Summit Healthcare employs. Dr. Mulder is her cousin-in-law, and was paid $317,098 during the year 2012. This transaction was reported on Schedule L. Becky Thompson, Thomas Paxman, and an employed physician have a joint business interest in a Call Group. Paxman and Thompson are Board Members, and Smithson is an employed physician. No money has been reported to have been exchanged in this arrangement. John Corder is a Governing Board Member who owns a 33% share of an outside company that provides limited security services to Summit Healthcare. Total compensation paid by the hospital to that company was $7,340. Since it was less than $10,000, it was not deemed reportable on schedule L. Paul Watson is the Town Manager of Snowflake, AZ. This is a community primarily serviced by Summit Healthcare. Summit currently has an outpatient imaging center and physcian group practice in Snowflake. Paul Watson and Neal Thompson (both Board Members of Summit) have several business interests together that are not necessarily related to Summit. Business interests are generally related to real estate dealings. None were deemed reportable on Schedule L, nor compromised their independence.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000229
Software Version:	2012v2.0

- 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

2012

Open to Public Inspection

Name of the organization

Summit Healthcare Association
FKA Navapache Health Care Assoc Inc

Employer identification number

86-0320447

Part I

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

(a) Name, address, and EIN (if applicable) 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

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to 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 entity?
(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

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

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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) White Mountain Imaging LLC 5448 S Highway 260 110 Lakeside,AZ85929 76-0767410	OPEN MRI	AZ	NA	Related	109,817	473,529		No		Yes		51.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No

Schedule R (Form 990) 2012

Page 3

Part V

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

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

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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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

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

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

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

Yes

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-s)	(c) Amount involved	(d) Method of determining amount involved
(1) White Mountain Imaging LLC	s	105,287	Schedule K-1
(2) White Mountain Imaging LLC	a	4,530	Schedule K-1

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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)	(e) Are all partners section 501(c)(3) organizations?		(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(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

Schedule R (Form 990) 2012

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:	12000229
Software Version:	2012v2.0

1	Briefly describe the organization’s mission or most significant activities: Acute Care Hospital
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	7
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	4
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	1,087
6	Total number of volunteers (estimate if necessary) .............	6	170
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

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	85,949	451,267
9	Program service revenue (Part VIII, line 2g) .........	107,690,065	119,886,067
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-44,376	2,468,998
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,352,246	1,624,091
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	109,083,884	124,430,423
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	51,650,592	63,945,524
16a	Professional fundraising fees (Part IX, column (A), line 11e).....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	46,396,741	58,010,045
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	98,047,333	121,955,569
19	Revenue less expenses. Subtract line 18 from line 12.......	11,036,551	2,474,854
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	155,870,449	184,075,917
21	Total liabilities (Part X, line 26).............	48,117,220	73,847,834
22	Net assets or fund balances. Subtract line 21 from line 20.....	107,753,229	110,228,083

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 53,326,606 including grants of $ ) (Revenue $ 119,886,067 )
	Summit Healthcares (formerly known as Navapache Health Care Association) overall mission is to deliver exceptional, compassionate care close to home. The organization is committed to improving the overall health and wellness of the members of our communities through partnerships within our region by delivering the highest quality healthcare, state of the art services, and exceptional patient experiences. In addition to operating an 89-bed acute care hospital facility, the organization also operates a number of outpatient clinics in the various outlying communities of the White Mountains. The hospital porvides inpatient and outpatient, home health, imaging, and other health care related services to the residents of Show Low, Arizona and the surrounding White Mountain communities. Summit Healthcare Association also employs 26 physicians with various specialties to be able to provide services to community members in the White Mountains.The Hospital provides inpatient and outpatient, home health, imaging, and other health care related services to the residents of Show Low, Arizona and the surrounding White Mountain communities. Admitting physicians are primarily practitioners in the local area. Total adult patient days were 11,639. Newborn patient days were 2,103. ER visits were 24,421, and outpatient visits were 51,288.-24 Hour Emergency Services and In-House Physician Coverage-Radiology Department with Diagnostic Imaging Services which include mammography, CT scan, MRI, Nuclear Medicine, X-Ray, Cardiac Ultrasound, and Ultrasound. The Diagnostic Imaging Departments utilizes the most up-to-date technology. -A level IV Emergency Department; the department is staffed around the clock by Board Certified Emergency Medicine Physicians and features fully equipped major truama/cardiac suites.-An Obstetrical Department with: both LDR and OB/GYN beds and a level I newborn intensive care unit. In addition, Summit Healthcare provides peri-natal classes. -A fully monitored intensive care unit, providing Medical/Surgical/Cardiac intermediate and intensive care. -A surgical service department: Capabilities include general, orthopedic, opthamology, ent, gyn, urology, and more. In addition, Summit Healthcare offers service for pain management.-Summit Healthcare offers radiation and medical oncology services.-November 2012 opened new Wound Care Department-Received a matching grant from First Things First to provide child development services for children ages 0-5 years, which is called Healthy Steps

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 expenses53,326,606

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	4,487,848	108,798

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(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) Douglas D Lee MD........................................................................ Anesthesiologist	40.00 .......................0.00	X	488,095	0	11,200
(19) James B Olack MD........................................................................ Plastic Surgeon	40.00 .......................0.00	X	470,642	0	1,200

				(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		143,440
d	Related organizations...1d
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		307,827

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			451,267
			Business Code
2a	Net Patient Revenue			119,886,067	119,886,067
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			119,886,067
3	Investment income (including dividends, interest, and other similar amounts).......			2,467,725			2,467,725
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	97,983
b	Less: rental expenses
c	Rental income or (loss)	97,983
d	Net rental income or (loss).......			97,983			97,983
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		239,398
b	Less: cost or other basis and sales expenses		238,125
c	Gain or (loss)		1,273
d	Net gain or (loss)..........			1,273			1,273
8a	Gross income from fundraising events (not including $ 143,440 of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b		73,037
c	Net income or (loss) from fundraising events..			-73,037			-73,037
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
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	Rebates related med supp			160,312			160,312
b	Other Miscellaneous			718,282			718,282
c	Cafeteria			565,709			565,709
d	All other revenue ....			154,842			154,842
e	Total. Add lines 11a–11d ......			1,599,145
12	Total revenue. See Instructions......			124,430,423	119,886,067		4,093,089


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			181,753	1	182,325
2	Savings and temporary cash investments .........			15,641,699	2	29,566,894
3	Pledges and grants receivable, net ...........				3	0
4	Accounts receivable, net .............			16,230,163	4	25,887,131
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6	0
7	Notes and loans receivable, net .............			169,777	7	275,776
8	Inventories for sale or use ..............			3,236,654	8	3,714,744
9	Prepaid expenses and deferred charges ..........			1,009,198	9	2,081,487
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	143,095,463
b	Less: accumulated depreciation .....	10b	53,228,663	78,668,367	10c	89,866,800
11	Investments—publicly traded securities ..........			37,026,671	11	29,507,197
12	Investments—other securities. See Part IV, line 11 .....				12	0
13	Investments—program-related. See Part IV, line 11 .....				13	0
14	Intangible assets ...............				14	0
15	Other assets. See Part IV, line 11 ...........			3,706,167	15	2,993,563
16	Total assets. Add lines 1 through 15 (must equal line 34)......			155,870,449	16	184,075,917
17	Accounts payable and accrued expenses .........			11,748,255	17	12,394,226
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			25,543,761	20	25,521,026
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other 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 ..			9,494,714	23	33,799,431
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			1,330,490	25	2,133,151
26	Total liabilities. Add lines 17 through 25.........			48,117,220	26	73,847,834
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			107,128,841	27	109,379,376
28	Temporarily restricted net assets ...........			624,388	28	848,707
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........			107,753,229	33	110,228,083
34	Total liabilities and net assets/fund balances ........			155,870,449	34	184,075,917