Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 01-01-2012 , 2012, and ending 12-31-2012
BCheck if applicable:
CName of organization
JOHN C LINCOLN HEALTH NETWORK
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
2500 W UTOPIA ROAD
Suite 100
Room/suite
City or town, state or country, and ZIP + 4
PHOENIX, AZ85027
D Employer identification number

86-0117301
E Telephone number

G Gross receipts $ 609,535,730
F Name and address of principal officer:
RHONDA FORSYTH
2500 W UTOPIA ROAD STE 100
PHOENIX,AZ85027
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.JCL.COM
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1954
M State of legal domicile: AZ
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: OUR MISSION IS TO ASSIST EACH PERSON ENTRUSTED TO OUR CARE TO ENJOY THE HIGHEST QUALITY HEALTH CARE POSSIBLE AND TO WORK WITH OTHERS TO BUILD HEALTHY COMMUNITIES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 22
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 17
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 4,645
6 Total number of volunteers (estimate if necessary) ............. 6 1,471
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,210,830 5,508,323
9 Program service revenue (Part VIII, line 2g) ......... 472,982,500 507,109,106
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 6,755,629 2,903,627
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 -255,411
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 480,948,959 515,265,645
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 24,448 24,448
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 260,659,046 262,444,788
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 199,333,453 223,685,143
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 460,016,947 486,154,379
19 Revenue less expenses. Subtract line 18 from line 12....... 20,932,012 29,111,266
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 575,899,029 608,555,113
21 Total liabilities (Part X, line 26)............. 315,077,058 318,204,941
22 Net assets or fund balances. Subtract line 21 from line 20..... 260,821,971 290,350,172
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 413,215,382 including grants of $ 24,448 ) (Revenue $ 507,109,106 )
PROVISION OF HEALTHCARE AND OTHER COMMUNITY SERVICES TO THE NORTH PHOENIX AREA. SEE SCHEDULE O FOR MORE DETAIL.
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 expensesMediumBullet413,215,382
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H.... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................ Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
443
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
4,645
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI ...............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
22
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
17
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
AZ
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletTHE ORGANIZATION2500 W UTOPIA ROAD STE 100PHOENIXAZ85027 (623) 434-6200
Form 990 (2012)
Form 990 (2012)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII ...............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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) 		(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) FRANK PUGH........................................................................
CHAIRMAN
 1.0
.......................1.0 		X   X       0 0 0
(2) KATHLEEN WADE........................................................................
VICE CHAIRMAN
 1.0
.......................0.0 		X   X       0 0 0
(3) JOEL KRAMER........................................................................
SECRETARY/TREASURER
 1.0
.......................0.0 		X   X       0 0 0
(4) RHONDA FORSYTH........................................................................
PRESIDENT & CEO
 37.0
.......................3.0 		X   X       1,881,552 0 99,480
(5) ARNOLD ALPERT........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(6) RICHARD A FRIEDLANDER........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(7) DANA M GEORGE........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(8) SCOTT GOLDEN........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(9) BRADLEY J HANSEN........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(10) PETER HATHAWAY........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(11) CLIFF KLIMA........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(12) KATHRYN JO LINCOLN........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(13) SUE ROE DPA RN........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(14) MICHAEL STANLEY........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(15) MARGIE TRAYLOR........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(16) KENNETH ASHTON MD........................................................................
EX-OFFICIO MEMBER(EFF 10/1/12)
 1.0
.......................0.0 		X           0 0 0
(17) DAN HELLER MD........................................................................
EX-OFFICIO MEMBER
 1.0
.......................0.0 		X           39,923 0 0
Form 990 (2012)
Form 990 (2012)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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) 		(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) ROBIN KREUTZBERG........................................................................
EX-OFFICIO MEMBER
 1.0
.......................2.0 		X           0 0 0
(19) LARRY SEAY........................................................................
EX-OFFICIO MEMBER
 1.0
.......................1.0 		X           0 0 0
(20) MARIA SORIANO MD........................................................................
EX-OFFICIO MEMBER
 1.0
.......................0.0 		X           17,496 0 0
(21) KEVIN VEALE DO........................................................................
EX-OFFICIO MEMBER
 1.0
.......................1.0 		X           14,483 0 0
(22) LAWRENCE GASSNER MD........................................................................
VICE CHAIRMAN
 1.0
.......................0.0 		X   X       0 0 0
(23) THOMAS BATSON........................................................................
EX-OFFICIO MEMBER(THRU 2/9/12)
 1.0
.......................1.0 		X           0 0 0
(24) DAVID LAMPARTER........................................................................
ASSISTANT TREASURER & CFO
 37.0
.......................3.0 		    X       1,812,532 0 68,708
(25) CYNTHIA A HOPKINS........................................................................
ASSISTANT SECRETARY
 40.0
.......................0.0 		    X       98,029 0 0
(26) BRUCE PEARSON........................................................................
EXECUTIVE VICE PRESIDENT
 40.0
.......................0.0 		      X     809,937 0 72,532
(27) NATHAN ANSPACH........................................................................
SENIOR VICE PRESIDENT
 40.0
.......................0.0 		      X     518,776 0 60,930
(28) SHEILA GERRY........................................................................
SENIOR VICE PRESIDENT
 39.0
.......................1.0 		      X     598,159 0 48,557
(29) ALAINA CHABRIER........................................................................
VICE PRESIDENT
 40.0
.......................0.0 		      X     416,192 0 57,086
(30) FRANK CUMMINS........................................................................
VICE PRESIDENT
 40.0
.......................0.0 		      X     419,055 0 24,501
(31) MAGGIE GRIFFIN........................................................................
VICE PRESIDENT
 40.0
.......................0.0 		      X     425,123 0 26,233
(32) CINDY HALLMAN........................................................................
VICE PRESIDENT
 4.0
.......................36.0 		      X     258,277 0 35,966
(33) SUSAN MELKER........................................................................
VICE PRESIDENT
 40.0
.......................0.0 		      X     492,751 0 22,676
(34) MARCIA MINTZ........................................................................
VICE PRESIDENT/CEO, JCLHF
 39.0
.......................1.0 		      X     370,669 0 48,910
(35) MICHAEL SKEHAN........................................................................
VICE PRESIDENT (THRU 4/7/12)
 40.0
.......................0.0 		      X     159,523 0 2,311
(36) ROBERT SLEPIN........................................................................
VICE PRESIDENT
 40.0
.......................0.0 		      X     399,803 0 55,554
(37) BRIAN SMIT........................................................................
VICE PRESIDENT
 40.0
.......................0.0 		      X     336,858 0 55,507
(38) JOHN HARRINGTON JR........................................................................
VICE PRESIDENT (EFF 5/14/12)
 40.0
.......................0.0 		      X     232,317 0 32,649
(39) WAYNE GILLIS........................................................................
VICE PRESIDENT (EFF 9/4/12)
 40.0
.......................0.0 		      X     83,875 0 16,239
(40) DAVID PRICE........................................................................
VICE PRESIDENT
 40.0
.......................0.0 		      X     295,544 0 45,635
(41) PATRICIA REHN........................................................................
VICE PRESIDENT (THRU 3/10/12)
 40.0
.......................0.0 		      X     223,646 0 3,762
(42) JOSEPH B FARES MD........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   934,916 0 8,034
(43) JUAN CARLOS TERAN MD........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   849,636 0 24,897
(44) DARYL PHILLIP BEABEAU MD........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   679,022 0 16,366
(45) PETER M STEINBERG MD........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   672,823 0 18,289
(46) PHILLIP MOESER MD........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   634,232 0 26,516
(47) DAN COLEMAN........................................................................
FORMER OFFICER
 0.0
.......................0.0 		          X 2,108,387 0 0
(48) COLLEEN SHARNECK........................................................................
FORMER KEY EMPLOYEE
 0.0
.......................0.0 		          X 675,084 0 0
(49) CATHERINE LINDSTROM........................................................................
FORMER KEY EMPLOYEE
 0.0
.......................0.0 		          X 553,172 0 0
(50) DALE SPARTZ........................................................................
FORMER KEY EMPLOYEE
 0.0
.......................0.0 		          X 282,949 0 0
(51) GARY GROVER........................................................................
FORMER KEY EMPLOYEE
 0.0
.......................0.0 		          X 566,379 0 0
(52) TIMOTHY TRACY........................................................................
FORMER KEY EMPLOYEE
 0.0
.......................0.0 		          X 308,124 0 0
(53) SUSAN KELLEY........................................................................
FORMER KEY EMPLOYEE
 0.0
.......................0.0 		          X 295,450 0 0
(54) ROBERT ISRAEL........................................................................
FORMER KEY EMPLOYEE
 0.0
.......................0.0 		          X 245,022 0 0
(55) POLLY BAUGHMAN........................................................................
FORMER KEY EMPLOYEE
 0.0
.......................0.0 		          X 244,961 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 18,954,677 0 871,338
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet374
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
GILBANE BUILDING COMPANY, 7 JACKSON WALKWAYPROVIDENCERI02940 CONSTRUCTION SVCS 12,232,969
EPIC, 1979 MILKY WAYVERONAWI53593 COMPUTER SOFTWARE 7,395,180
DPR CONSTRUCTION, 222 NORTH 44TH STREETPHOENIXAZ85034 CONSTRUCTION SVCS 3,930,212
ASPEN ADVISORS LLC, 22337 MEADOW VIEW ROADMORRISONCO80465 CONSULTING SERVICES 2,589,101
ANGELICA TEXTILE SERVICE, 4410 WEST MOHAVE STREETPHOENIXAZ85043 LAUNDRY SERVICES 2,298,948
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet135
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 5,387,491
e Government grants (contributions)1e 120,832
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 5,508,323
Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 621400 495,408,132 495,408,132    
b OTHER OPERATING REVENUE 900099 6,879,401 6,879,401    
c EXCLUDED RENTAL 531120 1,560,660     1,560,660
d FOOD SERVICE REVENUE 900099 3,161,160     3,161,160
e PARKING 900099 99,753     99,753
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 507,109,106
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 4,138,015     4,138,015
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 429,337  
b Less: rental expenses 429,337  
c Rental income or (loss) 0 0
d Net rental income or (loss).......MediumBullet 0      
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 92,500,282 106,078
b Less: cost or other basis and sales expenses 93,793,506 47,242
c Gain or (loss) -1,293,224 58,836
d Net gain or (loss)..........MediumBullet -1,234,388     -1,234,388
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
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...MediumBullet 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..MediumBullet 0      
Miscellaneous Revenue Business Code
11a OTHER MISCELLANEOUS LOSSES 900099 -255,411     -255,411
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet -255,411
12 Total revenue. See Instructions......MediumBullet 515,265,645 502,287,533   7,469,789
Form 990 (2012)
Form 990 (2012)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............
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 24,448 24,448
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 .... 9,904,518 8,486,149 1,418,369  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 2,696,805 2,310,611 386,194  
7 Other salaries and wages 210,785,600 180,600,209 30,185,391  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 4,254,014 3,640,418 613,596  
9 Other employee benefits ....... 19,544,587 16,565,396 2,979,191  
10 Payroll taxes ........... 15,259,264 13,583,062 1,676,202  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 1,150,217   1,150,217  
c Accounting ........... 0      
d Lobbying ........... 53,021   53,021  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 775,868 740,887 34,981  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 41,600,979 35,319,783 6,281,196  
12 Advertising and promotion .... 1,546,760 236,645 1,310,115  
13 Office expenses ....... 5,649,299 3,656,687 1,992,612  
14 Information technology ...... 17,140,059 600,752 16,539,307  
15 Royalties .. 0      
16 Occupancy ........... 12,725,676 10,790,994 1,934,682  
17 Travel ............ 456,315 220,878 235,437  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 305,670 228,245 77,425  
20 Interest ........... 9,495,127 9,147,728 347,399  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 24,857,433 20,627,295 4,230,138  
23 Insurance .............. 3,290,038 3,288,573 1,465  
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 EQUIPMENT RENTAL/REPAIR 5,963,610 5,893,302 70,308  
b FOOD SERVICE 3,818,668 3,719,089 99,579  
c MAINTENANCE CONTRACTS 4,847,698 4,819,038 28,660  
d MEDICAL SUPPLIES 87,767,679 87,738,987 28,692  
e All other expenses 2,241,026 976,206 1,264,820  
25 Total functional expenses. Add lines 1 through 24e 486,154,379 413,215,382 72,938,997 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 16,897 1 19,317
2 Savings and temporary cash investments ......... 88,727,925 2 30,211,288
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 68,558,372 4 76,369,184
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 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
0 6 0
7 Notes and loans receivable, net ............. 6,579,587 7 5,322,070
8 Inventories for sale or use .............. 11,007,905 8 11,747,013
9 Prepaid expenses and deferred charges .......... 7,334,352 9 6,512,544
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 483,924,855
b Less: accumulated depreciation ..... 10b 176,602,441 256,860,246 10c 307,322,414
11 Investments—publicly traded securities .......... 115,053,577 11 144,903,295
12 Investments—other securities. See Part IV, line 11 ..... 4,641,610 12 10,483,775
13 Investments—program-related. See Part IV, line 11 ..... 11,636,181 13 8,675,084
14 Intangible assets ............... 510,000 14 510,000
15 Other assets. See Part IV, line 11 ........... 4,972,377 15 6,479,129
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 575,899,029 16 608,555,113
Liabilities 17 Accounts payable and accrued expenses ......... 90,848,663 17 68,012,455
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 196,023,986 20 192,652,461
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
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.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 25,564,409 23 54,900,025
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
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.................... 2,640,000 25 2,640,000
26 Total liabilities. Add lines 17 through 25......... 315,077,058 26 318,204,941
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 251,988,287 27 284,715,281
28 Temporarily restricted net assets ........... 5,428,963 28 2,230,070
29 Permanently restricted net assets ........... 3,404,721 29 3,404,821
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet 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 ........... 260,821,971 33 290,350,172
34 Total liabilities and net assets/fund balances ........ 575,899,029 34 608,555,113
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
515,265,645
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
486,154,379
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
29,111,266
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
260,821,971
5
Net unrealized gains (losses) on investments ...............
5
3,566,844
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-3,149,909
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
290,350,172
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
Yes
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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.
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
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number

86-0117301
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.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
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)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (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
Yes No Yes No Yes No
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
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) right arrow (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) right arrow (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).            
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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
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) right arrow (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) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
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:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2012
Name of the organization
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number

86-0117301
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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
Special Rules
......................... 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
JOHN C LINCOLN HEALTH NETWORK
  		Employer identification number

86-0117301
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


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(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
JOHN C LINCOLN HEALTH NETWORK
  		Employer identification number

86-0117301
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
JOHN C LINCOLN HEALTH NETWORK
  		Employer identification number

86-0117301
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 (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number

86-0117301
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2012

Schedule C (Form 990 or 990-EZ) 2012
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) Total
             
2a Lobbying nontaxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2012


Schedule C (Form 990 or 990-EZ) 2012
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
53,021
j
Total. Add lines 1c through 1i ...............................
53,021
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Identifier Return Reference Explanation
LOBBYING EXPENSE SCHEDULE C, PART II-B, LINE 1G JOHN C. LINCOLN HEALTH NETWORK PAYS DUES TO AHA AND AZHHA IN WHICH A PORTION OF THE DUES IS ATTRIBUTABLE TO LOBBYING. THE AMOUNT SHOWN ON THIS LINE IS THAT PERCENTAGE.
Schedule C (Form 990 or 990EZ) 2012

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number

86-0117301
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .......................................
9
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.
1a
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.
b
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 $  
2
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:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?........
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
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 .... 5,370,303 5,854,813 5,254,651 4,325,429 4,664,970
b Contributions ........ 350 2,285 15,000 274,844 882,571
c Net investment earnings, gains, and losses 342,048 -237,069 634,552 722,660 -1,073,766
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		380,070 236,868 32,158 68,282 148,346
f Administrative expenses .... 11,095 12,858 17,232    
g End of year balance ...... 5,321,536 5,370,303 5,854,813 5,254,651 4,325,429
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet29.360 %
b
Permanent endowment SchDMd Bullet63.980 %
c
Temporarily restricted endowment SchDMd Bullet6.660 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   33,386,608 33,386,608
b Buildings ................   271,848,198 102,456,312 169,391,886
c Leasehold improvements ............   10,927,588 3,495,991 7,431,597
d Equipment ................   154,696,738 70,650,138 84,046,600
e Other .................   13,065,723 0 13,065,723
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 307,322,414
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other 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.)Small Bullet  
Part VIII
Investments—Program 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.)Small Bullet  
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.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
NOTE PAYABLE, RELATED PARTY 2,640,000








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 2,640,000
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

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 ....... 1 516,111,917
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a 3,566,844
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d -3,149,909
e Add lines 2a through 2d ..................... 2e 416,935
3 Subtract line 2e from line 1..................... 3 515,694,982
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 -429,337
c Add lines 4a and 4b....................... 4c -429,337
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 515,265,645
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ........... 1 486,583,716
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  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3 486,583,716
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 -429,337
c Add lines 4a and 4b....................... 4c -429,337
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 486,154,379
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
INTENDED USE OF ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 THE ENDOWMENT FUNDS CONSIST OF EIGHT INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES RELATED TO THE EXEMPT PURPOSE OF THE ORGANIZATION. THE FUNDS ARE TO BE USED TO SUPPORT THE ACTIVITIES WITHIN DEER VALLEY HOSPITAL, NORTH MOUNTAIN HOSPITAL AND ADMINISTRATION. THE TERM ENDOWMENTS HAVE BEEN RESTRICTED BY THE DONOR FOR A SPECIFIC TIME PERIOD OR PURPOSE.
ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
OTHER REVENUE ON BOOKS NOT ON RETURN SCHEDULE D, PART XI, LINE 2D CHANGE IN INTEREST IN FOUNDATION $(2,975,809) LOSS ON IMPAIRMENT (174,100) ----------- TOTAL $(3,149,909) ===========
OTHER REVENUE ON RETURN NOT ON BOOKS SCHEDULE D, PART XI, LINE 4B RENTAL EXPENSES $(429,337)
OTHER EXPENSES ON RETURN NOT ON BOOKS SCHEDULE D, PART XII, LINE 4B RENTAL EXPENSES $(429,337)
Schedule D (Form 990) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number

86-0117301
Part I
General Information on Activities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside
the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
Central America and the Caribbean     Investments   4,804,534
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     4,804,534
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     4,804,534
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If “Yes,”the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If “Yes,” the organizationmay be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 5
Part V
Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
Identifier ReturnReference Explanation
ACCOUNTING METHOD FOR INVESTMENTS PART I, LINE 3, COLUMN (F) THE AMOUNT REPORTED IN COLUMN (F) IS DETERMINED BASED ON THE ACCRUAL METHOD OF ACCOUNTING.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2012
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number

86-0117301
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: .........
3b
Yes
 
c
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.
4
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"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
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? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
 
No
b
If "Yes," did the organization make it available to the public? ..............
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (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) .. 		    21,729,298 0 21,729,298 4.470 %
b Medicaid (from Worksheet 3,
column a) .... 		    74,340,147 56,280,950 18,059,197 3.710 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    96,069,445 56,280,950 39,788,495 8.180 %
Other Benefits
     1,135,729 657,679 478,050 0.100 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		           
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    1,113,000 0 1,113,000 0.230 %
j Total. Other Benefits ..     2,248,729 657,679 1,591,050 0.330 %
k Total. Add lines 7d and 7j .     98,318,174 56,938,629 41,379,545 8.510 %
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
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
16,336,000
3
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. ......
3
9,802,000
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
79,369,530
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
84,542,347
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-5,172,817
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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.......................

9b

 

No
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 %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2012
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?2
Name, address, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 JOHN C LINCOLN HOSPITAL - NORTH MTN
250 EAST DUNLAP AVENUE
PHOENIX,AZ85020
WWW.JCL.COM 		X X         X     A
2 JOHN C LINCOLN HOSPITAL - DEER VALLEY
19829 NORTH 27TH AVENUE
PHOENIX,AZ85027
WWW.JCL.COM 		X X         X     A
Schedule H (Form 990) 2012
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)
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 No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 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.................... 1    
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20  
3 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 .................... 3    
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4    
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5    
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 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 ........ 7    
8a 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)? ........................... 8a    
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c 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
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: 200.%
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: 425.%
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
b
c
d
e
f
g
h
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 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
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
b
c
d
e
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   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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.
a
b
c
d
21 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? ............................ 21   No
If “Yes,” explain in Part VI.
22 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? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
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?29
Name and address Type of Facility (describe)
1 SAGUARO FAMILY PRACTICE
18404 N TATUM BOULEVARD SUITE 101
PHOENIX,AZ85032 		PHYSICIAN CLINIC
2 DEER VALLEY FAMILY PRACTICE
19636 N 27TH AVENUE SUITE 308
PHOENIX,AZ85027 		PHYSICIAN CLINIC
3 NORTH VALLEY GASTROENTEROLOGY
19646 N 27TH AVENUE SUITE 201
PHOENIX,AZ85027 		PHYSICIAN CLINIC
4 ARCADIA FAMILY CLINIC
4131 N 24TH STREET SUITE B102
PHOENIX,AZ85016 		PHYSICIAN CLINIC
5 NORTH PHOENIX MEDICAL CLINIC
9100 N 2ND STREET SUITE 121
PHOENIX,AZ85020 		PHYSICIAN CLINIC
6 DEER VALLEY MEDICAL
6202 W BELL ROAD SUITE 5
GLENDALE,AZ85308 		PHYSICIAN CLINIC
7 DYNAMITE CREEK MEDICAL CENTER
4712 E DYNAMITE BOULEVARD
CAVE CREEK,AZ85331 		PHYSICIAN CLINIC
8 GAVILAN PEAK FAMILY PRACTICE
3648 W ANTHEM WAY BUILDING A-100
ANTHEM,AZ85086 		PHYSICIAN CLINIC
9 JOHN C LINCOLN CARE FOR WOMEN DEER VLY
19646 N 27TH AVENUE SUITE 301
PHOENIX,AZ85027 		PHYSICIAN CLINIC
10 JOHN C LINCOLN URGENT CARE AT ANTHEM
3648 W ANTHEM WAY BLDG A-100
ANTHEM,AZ85086 		PHYSICIAN CLINIC
11 NORTH VALLEY INTERNAL MEDICINE
18404 N TATUM BOULEVARD SUITE 102
PHOENIX,AZ85032 		PHYSICIAN CLINIC
12 HARBOR POINTE INTERNAL MEDICINE
5859 W TALAVI BOULEVARD SUITE 165
GLENDALE,AZ85306 		PHYSICIAN CLINIC
13 SUN VALLEY NEUROLOGY
2500 W UTOPIA RD SUITE 100
PHOENIX,AZ85027 		PHYSICIAN CLINIC
14 JOHN C LINCOLN DEARING FAMILY MEDICINE
19841 N 27TH AVENUE SUITE 101
PHOENIX,AZ85027 		PHYSICIAN CLINIC
15 NORTH VALLEY AUDIOLOGY
18404 N TATUM BOULEVARD SUITE 101
PHOENIX,AZ85032 		PHYSICIAN CLINIC
16 JOHN C LINCOLN YOUR FAMILY MEDICINE
6320 W UNION HILLS DR BLDG B STE
GLENDALE,AZ85308 		PHYSICIAN CLINIC
17 SQUAW PEAK FAMILY MEDICINE
9327 N 3RD STREET SUITE 100
PHOENIX,AZ85020 		PHYSICIAN CLINIC
18 DEL LAGO FAMILY MEDICINE
20470 N LAKE PLEASANT ROAD SUITE
PEORIA,AZ85382 		PHYSICIAN CLINIC
19 JOHN C LINCOLN AT THE BEATITUDES
1668 W GLENDALE AVENUE SUITE 128
PHOENIX,AZ85021 		PHYSICIAN CLINIC
20 SUN VALLEY FAMILY MEDICINE II
5040 N 15TH AVENUE SUITE 202
PHOENIX,AZ85015 		PHYSICIAN CLINIC
21 JOHN C LINCOLN CARE FOR WOMEN NORTH MTN
9225 N 3RD STREET SUITE 103
PHOENIX,AZ85020 		PHYSICIAN CLINIC
22 NEW RIVER MEDICAL OFFICE
46641 NORTH BLACK CANYON HWY SUITE
NEW RIVER,AZ85087 		PHYSICIAN CLINIC
23 CALAVAR FAMILY MEDICINE
3525 W CALAVAR ROAD
PHOENIX,AZ85053 		PHYSICIAN CLINIC
24 JOHN C LINCOLN YOUR FAMILY WELLNESS
6320 W UNION HILLS DR BLDG B STE
GLENDALE,AZ85308 		PHYSICIAN CLINIC
25 JOHN C LINCOLN LIFESTREAM AT THUNDERBIRD
13617 N 55TH AVENUE
GLENDALE,AZ85304 		PHYSICIAN CLINIC
26 JOHN C LINCOLN LIFESTREAM AT YOUNGTOWN
10800 N 115TH AVENUE SUITE 94
YOUNGTOWN,AZ85363 		PHYSICIAN CLINIC
27 NORTH PHOENIX PULMONOLOGY
9100 N 2ND STREET SUITE 121
PHOENIX,AZ85020 		PHYSICIAN CLINIC
28 TRAMONTO CROSSING FAMILY MEDICINE
34975 N NORTH VALLEY PARKWAY SUIT
PHOENIX,AZ85086 		PHYSICIAN CLINIC
29 ANTHEM RADIOLOGY
3648 W ANTHEM WAY BUILDING A-100
ANTHEM,AZ85086 		PHYSICIAN CLINIC
Schedule H (Form 990) 2012
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
COSTING METHODOLOGY SCHEDULE H, PART I, LINE 7 THE NETWORK USED A COST-TO-CHARGE RATIO TO COMPUTE LINE 7A. THE COST-TO-CHARGE RATIO FOR LINE 7A WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. LINE 7B AND 7G COSTS WERE DERIVED FROM THE NETWORK'S COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. COSTS FOR LINES 7E, 7F, AND 7I WERE DERIVED FROM INFORMATION WITHIN THE GENERAL LEDGER OR OTHER FINANCIAL INFORMATION RELATED TO THE SPECIFIC TYPES OF SERVICES PROVIDED TO THE COMMUNITY.
METHODOLOGY FOR CALCULATING BAD DEBT SCHEDULE H, PART III, LINE 2 THE NETWORK REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. THE NETWORK PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE NETWORK BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE ORDINARILY DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND ARE SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT OR ACCOUNT.
METHODOLOGY FOR ATTRIBUTING BAD DEBT TO PATIENTS UNDER THE FAP SCHEDULE H, PART III, LINE 3 THE COST OF BAD DEBT EXPENSE IS DETERMINED USING THE NETWORK'S CALCULATED COST TO CHARGE RATIO APPLIED TO REPORTED GROSS CHARGES WRITTEN OFF DURING THE YEAR. USING A SAMPLE OF ACCOUNTS WRITTEN OFF DURING THE YEAR, THE NETWORK HAS ESTIMATED THAT APPROXIMATELY 60% OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE NETWORK'S CHARITY CARE POLICY. A NUMBER OF PATIENTS ARE TRULY UNABLE TO PAY THEIR OUT-OF-POCKET LIABILITY, BUT DO NOT COMPLETE THE PROCESS REQUIRED TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY. THESE PATIENTS WOULD QUALIFY FOR CHARITY CARE IF THEY COMPLETED THE PAPERWORK, SO THE BAD DEBT EXPENSE ASSOCIATED WITH TREATING THEM SHOULD BE TREATED AS COMMUNITY BENEFIT.
AUDIT FOOTNOTE THAT DESCRIBES BAD DEBT SCHEDULE H, PART III, LINE 4 ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE NETWORK ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE NETWORK ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE NETWORK RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
MEDICARE COSTING METHODOLOGY SCHEDULE H, PART III, LINE 8 THE AMOUNT ON PART III, LINE 6 IS FROM THE MEDICARE COSTS REPORTS FILED BY THE ORGANIZATION. THE ENTIRE SHORTFALL REPORTED ON PART III, LINE 7 IS A COMMUNITY BENEFIT. THE RATIONALE FOR INCLUDING MEDICARE LOSSES AS COMMUNITY BENEFIT LIES IN THE NETWORK'S BELIEF THAT, BASED ON IRS REVENUE RULING 69-545, SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS SUCH AS MEDICARE IS AN INDICATOR THAT THE NETWORK'S HOSPITALS OPERATE TO PROMOTE THE HEALTH OF THE COMMUNITY AND THEREFORE PROVIDES A COMMUNITY BENEFIT. THE NETWORK ALSO BELIEVES THAT TAX-EXEMPT HOSPITALS PLAY A VITAL ROLE IN PROVIDING THE ELDERLY WITH ACCESS TO HEALTHCARE SERVICES THEY MIGHT OTHERWISE BE DENIED BY FOR-PROFIT AND SPECIALTY HOSPITALS THAT FOCUS ON HIGH-MARGIN SERVICES OR THAT WOULD HAVE TO BE PROVIDED DIRECTLY BY THE FEDERAL GOVERNMENT.
NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 JOHN C. LINCOLN HEALTH NETWORK PERIODICALLY CONDUCTS COMMUNITY NEEDS ASSESSMENTS WITH THE ASSISTANCE OF EXTERNAL CONSULTANTS.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 THE CONDITIONS OF ADMISSION ADVISES PATIENTS OF THE ORGANIZATION'S PAYMENT EXPECTATIONS AND ALSO ADVISES THEM TO NOTIFY US IMMEDIATELY SO WE CAN EVALUATE THEIR SITUATION AND HELP THEM OBTAIN BENEFITS OR ASSISTANCE. ADDITIONALLY, WE INCLUDE SIMILAR VERBIAGE ON OUR STATEMENTS, COLLECTION LETTERS, AND ON OUR WEBSITE SO THEY CAN APPLY FOR ASSISTANCE. IN-HOUSE FINANCIAL COUNSELORS TALK WITH PATIENTS AND ADVISE THEM OF THEIR OPTIONS. WE ALSO RETAIN OUTSIDE VENDORS TO FOLLOW UP WITH PATIENTS TO OBTAIN MEDICAID COVERAGE FOR TREAT AND RELEASE CASES.
COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 JOHN C. LINCOLN HEALTH NETWORK HAS ALWAYS BEEN A LOCALLY BASED, LOCALLY OWNED NOT-FOR-PROFIT HEALTH CARE ORGANIZATION SERVING THE PEOPLE IN NORTH CENTRAL PHOENIX AND NOW ALSO SERVES THE NORTH VALLEY ALONG THE I-17 CORRIDOR THROUGH MARICOPA AND SOUTHERN YAVAPAI COUNTIES. WE PROVIDE THE HIGHEST QUALITY EMERGENCY MEDICAL CARE THROUGH OUR LEVEL I AND LEVEL III TRAUMA CENTERS; OUR VIRGINIA G. PIPER PEDIATRIC CENTER OF EXCELLENCE, WHICH INCLUDES OUR CHILDREN'S EMERGENCY CENTER, MENDY'S PLACE, AND KIDSZONE INPATIENT PEDIATRIC UNIT; AND A COMPLETE RANGE OF PERSONALIZED INPATIENT AND OUTPATIENT CARE. AT JOHN C. LINCOLN NORTH MOUNTAIN HOSPITAL, THE QUALITY OF PATIENT CARE WAS FIRST IN THE VALLEY TO EARN AND RETAIN MAGNET RECOGNITION FROM THE AMERICAN NURSES ASSOCIATION. OUR BREAST HEALTH AND RESEARCH CENTER IS A MODEL FOR THE INDUSTRY, PROVIDING A COMPLETE RANGE OF BREAST DISEASE DIAGNOSTIC CARE AND COORDINATED REFERRAL FOR FOLLOW-UP CARE. WE PROVIDE OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR COMMUNITY THROUGH JOHN C. LINCOLN'S DESERT MISSION FOOD BANK, CHILDREN'S DENTAL CLINIC, COMMUNITY HEALTH CENTER, MARLEY HOUSE BEHAVIORAL HEALTH CENTER AND NEIGHBORHOOD RENEWAL. IN 2012, DESERT MISSION SERVED 39,805 CLIENTS - AN INCREASE OF NEARLY 5,000 INDIVIDUALS REPRESENTING A 15 PERCENT INCREASE FROM 2011. ONE HUNDRED PERCENT OF THOSE ACCESSING DESERT MISSION'S MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES WERE UNINSURED OR MEDICAID ELIGIBLE. ABOUT 44 PERCENT OF THOSE SERVED BY DESERT MISSION ARE CHILDREN AND THE ELDERLY (UNDER AGE 18 OR OVER AGE 64). JUST OVER 39 PERCENT WERE UNINSURED, AND ALMOST 59 PERCENT WERE MINORITIES. EIGHTY PERCENT OF OUR CLIENTS LIVE IN HOUSEHOLDS WHERE INCOME WAS AT OR BELOW 100 PERCENT OF FEDERAL POVERTY LEVEL. (CURRENTLY, 100 PERCENT OF FEDERAL POVERTY LEVEL FOR A FAMILY OF FOUR IS $23,050.) OF THE 19,680 ADULT CLIENTS SEEN FOR EMERGENCY FOOD ASSISTANCE IN 2012, 70 PERCENT WERE UNEMPLOYED. INDIVIDUALS AND FAMILIES ARE REFERRED TO THE DESERT MISSION BY OTHER COMMUNITY AGENCIES, FAITH-BASED COMMUNITIES, SCHOOLS AND THEIR NEIGHBORS. EIGHTEEN PERCENT OF DESERT MISSION'S CLIENTS ACCESSED MORE THAN ONE TYPE OF ITS SAFETY-NET SERVICES DURING THE YEAR - FOR EXAMPLE, EMERGENCY FOOD AND DENTAL CARE.
PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 JOHN C. LINCOLN PROMOTES COMMUNITY HEALTH THOUGH AN ONGOING SERIES OF FREE MEDICAL SEMINARS ON TOPICS SUCH AS UTERINE FIBROID EMBOLIZATION, INFLAMMATORY BREAST CANCER, JOINT PAIN, LYMPHEDEMA, VARICOSE VEINS, INTEGRATIVE MEDICINE, COLORECTAL CANCER, DIABETES SELF-MANAGEMENT, AND SCREENINGS FOR CONDITIONS INCLUDING STROKE, HEARING, AND GENERAL HEALTH. FREE SUPPORT GROUPS THAT MEET MONTHLY IN JOHN C. LINCOLN'S FACILITIES SERVE CAREGIVERS, INTERSTITIAL CYSTITIS, DIABETES AND SIX SEPARATE BREAST CANCER GROUPS. JOHN C. LINCOLN ALSO PARTNERS WITH OTHER COMMUNITY ORGANIZATIONS TO PROMOTE SAFETY, DISEASE PREVENTION AND HEALTH EDUCATION. OUR TRAUMA SERVICES PROGRAM PROVIDES SAFETY EDUCATION FOR TEENAGERS AND CONTINUING MEDICAL EDUCATION FOR PHYSICIANS AND FIRST RESPONDERS. ADDITIONALLY, OUR DESERT MISSION PROGRAMS SINCE THE LATE 1920S HAVE PROVIDED OUTREACH SERVICES TO ADDRESS THE PHYSICAL AND SOCIAL NEEDS OF FAMILIES IN THE NORTH PHOENIX DESERT.. TODAY, HEALTH NEEDS ARE SERVED THROUGH DESERT MISSION FOOD BANK, CHILDREN'S DENTAL CLINIC (WHICH ADDITIONALLY SENDS STAFF TO EDUCATE AND SCREEN SCHOOL CHILDREN), AND COMMUNITY HEALTH CENTER FOR FAMILIES.
AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 6 THE JOHN C. LINCOLN HEALTH NETWORK IS THE PARENT ORGANIZATION OF SEVERAL NONPROFIT CORPORATIONS SERVING THE NORTH PHOENIX COMMUNITY. DESERT MISSION, INC., ROUNDS OUT THE HOSPITAL'S CORE HEALTH CARE BUSINESS BY ADDRESSING THE COMMUNITY'S BROADER HEALTH NEEDS. IN RETURN, THE NETWORK PROVIDES IN-KIND ADMINISTRATIVE SUPPORT FOR SERVICES SUCH AS INFORMATION TECHNOLOGY, HUMAN RESOURCES, FUNDRAISING, AND ACCOUNTING. THOSE COSTS TOTALING $1,113,000 ARE REPORTED AS COMMUNITY BENEFIT ON SCHEDULE H, PART I, LINE 7I. -COMMUNITY HEALTH CENTER PROVIDES HEALTH CARE SERVICES SUCH AS WELLNESS CHECKUPS, IMMUNIZATIONS, AND OTHER PRIMARY CARE SERVICES AT A DISCOUNTED FEE BASED ON A FAMILY'S INCOME OR ABILITY TO PAY. IN 2012, OUR COMMUNITY HEALTH CENTER HAD 4,347 PATIENT VISITS AND 97 PERCENT OF CHILDREN AGED 11 THROUGH 15 HAD COMPLETE IMMUNIZATIONS. THE HEALTH CENTER IS CONTRACTED WITH AHCCCS. -CHILDREN'S DENTAL CLINIC PROVIDES LOW-COST AND FREE DENTAL CARE FOR UNINSURED CHILDREN THROUGH A STAFF THAT INCLUDES MORE THAN 50 VOLUNTEER DENTISTS AND HYGIENISTS. IN 2012, OUR CHILDREN'S DENTAL CLINIC FURNISHED 3,420 DENTAL VISITS, AND PERFORMED 14,655 DENTAL PROCEDURES. THERE WERE 8,550 STUDENTS IN 16 LOCAL SCHOOLS WHO WERE SCREENED FOR DENTAL DISEASE AND GIVEN A TOOTHBRUSH, TOOTHPASTE AND DENTAL FLOSS. THE DENTAL CLINIC ACCEPTS AHCCCS. -DESERT MISSION FOOD BANK PROVIDES EMERGENCY FOOD AND FOOD SECURITY PROGRAMS TO 35,000 FAMILIES WITH CHILDREN. IN 2012, THE FOOD BANK SERVED MORE THAN 2,000 INDIVIDUALS PER MONTH AND DISTRIBUTED 2.2 MILLION POUNDS OF DONATED FOOD TO THE COMMUNITY, INCLUDING 40,752 EMERGENCY FOOD BOXES. AREA SCHOOL CHILDREN RECEIVED 40,352 SNACK PACS. MARLEY HOUSE IS LICENSED BY THE STATE OF ARIZONA AS AN OUTPATIENT BEHAVIORAL HEALTH CLINIC. MARLEY HOUSE IS CONTRACTED BY THE STATE RHBA TO PROVIDE BEHAVIORAL HEALTH SERVICES FOR FAMILIES, CHILDREN AND INDIVIDUALS WITH GENERAL MENTAL HEALTH, SUBSTANCE ABUSE, AND SERIOUS MENTAL HEALTH CONDITIONS. IN 2012, VISITS TO MARLEY HOUSE INCREASED 9 PERCENT. THE BEHAVIORAL HEALTH CLINIC PROVIDED 1,866 COUNSELING SESSIONS TO 310 FAMILIES. -LINCOLN LEARNING CENTER OFFERS QUALITY CHILDCARE FOR CHILDREN AGES 6 WEEKS TO 12 YEARS. LINCOLN LEARNING CENTER IS ACCREDITED BY THE NATIONAL ACADEMY OF EARLY CHILDHOOD PROGRAMS (NAEYC). IN 2012, LINCOLN LEARNING CENTER HAD 447 CHILDREN ENROLLED; 76 OF THESE RECEIVED FINANCIAL ASSISTANCE. -DESERT MISSION NEIGHBORHOOD RENEWAL (DMNR) IS COMMITTED TO FACILITATING THE DEVELOPMENT OF COMMUNITY, HOUSING AND BUSINESS IN THE NORTH VALLEY OF PHOENIX, ARIZONA. DMNR PRIMARILY FOCUSES ON NEIGHBORHOOD REVITALIZATION THROUGH AFFORDABLE HOUSING DEVELOPMENT, BLIGHT ELIMINATION AND OWNER-OCCUPIED HOME REHABILITATION. DMNR ALSO PROVIDES LEADERSHIP AND SUPPORT IN DEVELOPING THE BUSINESS CORRIDOR AROUND THE JOHN C. LINCOLN NORTH MOUNTAIN HOSPITAL CAMPUS. NEIGHBORHOOD RENEWAL COUNSELED 326 FAMILIES ON HOUSING, AND HELPED 121 HOMEBUYERS LEVERAGE MORE THAN $13.8 MILLION IN FIRST MORTGAGES. THE NETWORK PROVIDED APPROXIMATELY $51,600 OF ADMINISTRATIVE SUPPORT TO DMNR IN 2012. -JOHN C. LINCOLN HEALTH FOUNDATION SUPPORTS THE NETWORK AND ITS AFFILIATES WITH FUNDRAISING SERVICES. IN ADDITION TO RAISING AND ADMINISTERING FUNDS TO SUPPORT NETWORK PROGRAMS, IN 2012 THE FOUNDATION DISTRIBUTED APPROXIMATELY $326,689 TO LOCAL NONPROFIT ORGANIZATIONS THROUGH COMMUNITY GRANTS.
FACILITY REPORTING GROUP SCHEDULE H, PART VI, LINE 8 A SINGLE SCHEDULE H, PART V, SECTION B WAS COMPLETED FOR FACILITY REPORTING GROUP A. THE FOLLOWING HOSPITAL FACILITIES ARE INCLUDED IN FACILITY REPORTING GROUP A: (1) JOHN C LINCOLN HOSPITAL - NORTH MOUNTAIN (2) JOHN C LINCOLN HOSPITAL - DEER VALLEY THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 12(H) APPLIES TO ALL HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A: THE NETWORK WILL ALSO CONSIDER PERSONAL APPEALS RELATED TO THE FACTS AND CIRCUMSTANCES OF A PATIENT'S SITUATION IN DETERMINING AMOUNTS CHARGED TO THOSE PATIENTS. THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 14(G) APPLIES TO ALL HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A: THE NETWORK ALSO ENCOURAGES PATIENTS ON ITS CONDITIONS OF ADMISSION STATEMENT AND BILLING STATEMENTS TO CONTACT OUR FINANCIAL PROFESSIONALS FOR HELP IN APPLYING FOR FEDERAL, STATE AND NETWORK FINANCIAL ASSISTANCE. THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 20(D) APPLIES TO ALL HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A: THE NETWORK USES A TIERED FINANCIAL ASSISTANCE POLICY TO DETERMINE THE AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. BASIC FINANCIAL ASSISTANCE AVAILABLE TO ALL INDIVIDUALS ATTESTING TO INCOME LESS THAN 500% OF FEDERAL POVERTY LEVEL (FPL) IS A 75% DISCOUNT. IN ADDITION TO THIS DISCOUNT, A SLIDING SCALE FROM 10%-100% DISCOUNT IS THEN AVAILABLE TO THOSE PROVIDING DOCUMENTATION OF INCOME BETWEEN 200%-425% OF FPL. OUR POLICY ALSO ALLOWS OUR MANAGEMENT TO EXTEND ASSISTANCE IN INDIVIDUAL CASES BASED ON FACTS AND CIRCUMSTANCES.
Schedule H (Form 990) 2012
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number
86-0117301
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) DESERT MISSION INC
9201 N 5TH STREET
PHOENIX,AZ85020 		86-0096941 501(C)(3) 24,448       SUPPORT THE






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012

Schedule I (Form 990) 2012
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance












Part IV
Supplemental Information.
Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS SCHEDULE I, PART I, LINE 2 THE ORGANIZATION ONLY MAKES CONTRIBUTIONS TO RELATED TAX-EXEMPT ORGANIZATIONS FOR SPECIFIC PURPOSES.
Schedule I (Form 990) 2012


Additional Data


Software ID:  
Software Version:  


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
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number

86-0117301
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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....
1b
 
 
2
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? .......
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
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:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)RHONDA FORSYTHPRESIDENT & CEO (i)
(ii)		 686,366
0 		265,991
0 		929,195
0 		81,026
0 		18,454
0 		1,981,032
0 		0
0
(2)DAVID LAMPARTERASSISTANT TREASURER & CFO (i)
(ii)		 366,223
0 		133,397
0 		1,312,912
0 		50,198
0 		18,510
0 		1,881,240
0 		0
0
(3)BRUCE PEARSONEXECUTIVE VICE PRESIDENT (i)
(ii)		 383,137
0 		166,512
0 		260,288
0 		51,884
0 		20,648
0 		882,469
0 		0
0
(4)NATHAN ANSPACHSENIOR VICE PRESIDENT (i)
(ii)		 323,672
0 		106,013
0 		89,091
0 		37,142
0 		23,788
0 		579,706
0 		0
0
(5)SHEILA GERRYSENIOR VICE PRESIDENT (i)
(ii)		 208,972
0 		86,518
0 		302,669
0 		32,223
0 		16,334
0 		646,716
0 		0
0
(6)ALAINA CHABRIERVICE PRESIDENT (i)
(ii)		 200,684
0 		68,152
0 		147,356
0 		30,757
0 		26,329
0 		473,278
0 		0
0
(7)FRANK CUMMINSVICE PRESIDENT (i)
(ii)		 244,496
0 		70,747
0 		103,812
0 		9,772
0 		14,729
0 		443,556
0 		0
0
(8)MAGGIE GRIFFINVICE PRESIDENT (i)
(ii)		 244,869
0 		80,440
0 		99,814
0 		10,000
0 		16,233
0 		451,356
0 		0
0
(9)CINDY HALLMANVICE PRESIDENT (i)
(ii)		 140,333
0 		33,158
0 		84,786
0 		21,931
0 		14,035
0 		294,243
0 		0
0
(10)SUSAN MELKERVICE PRESIDENT (i)
(ii)		 167,943
0 		55,539
0 		269,269
0 		6,158
0 		16,518
0 		515,427
0 		0
0
(11)MARCIA MINTZVICE PRESIDENT/CEO, JCLHF (i)
(ii)		 224,177
0 		72,334
0 		74,158
0 		24,355
0 		24,555
0 		419,579
0 		0
0
(12)MICHAEL SKEHANVICE PRESIDENT (THRU 4/7/12) (i)
(ii)		 65,178
0 		59,540
0 		34,805
0 		0
0 		2,311
0 		161,834
0 		0
0
(13)ROBERT SLEPINVICE PRESIDENT (i)
(ii)		 280,186
0 		65,868
0 		53,749
0 		39,032
0 		16,522
0 		455,357
0 		0
0
(14)BRIAN SMITVICE PRESIDENT (i)
(ii)		 211,833
0 		64,215
0 		60,810
0 		31,192
0 		24,315
0 		392,365
0 		0
0
(15)JOHN HARRINGTON JRVICE PRESIDENT (EFF 5/14/12) (i)
(ii)		 227,539
0 		0
0 		4,778
0 		31,980
0 		669
0 		264,966
0 		0
0
(16)DAVID PRICEVICE PRESIDENT (i)
(ii)		 231,843
0 		32,651
0 		31,050
0 		23,981
0 		21,654
0 		341,179
0 		0
0
(17)PATRICIA REHNVICE PRESIDENT (THRU 3/10/12) (i)
(ii)		 138,932
0 		47,780
0 		36,934
0 		0
0 		3,762
0 		227,408
0 		0
0
(18)JOSEPH B FARES MDPHYSICIAN (i)
(ii)		 918,805
0 		998
0 		15,113
0 		0
0 		8,034
0 		942,950
0 		0
0
(19)JUAN CARLOS TERAN MDPHYSICIAN (i)
(ii)		 848,391
0 		945
0 		300
0 		0
0 		24,897
0 		874,533
0 		0
0
(20)DARYL PHILLIP BEABEAU MDPHYSICIAN (i)
(ii)		 498,236
0 		150,107
0 		30,679
0 		0
0 		16,366
0 		695,388
0 		0
0
(21)PETER M STEINBERG MDPHYSICIAN (i)
(ii)		 495,866
0 		150,105
0 		26,852
0 		0
0 		18,289
0 		691,112
0 		0
0
(22)PHILLIP MOESER MDPHYSICIAN (i)
(ii)		 523,021
0 		100,106
0 		11,105
0 		0
0 		26,516
0 		660,748
0 		0
0
(23)COLLEEN SHARNECKFORMER KEY EMPLOYEE (i)
(ii)		 3,227
0 		30,420
0 		641,437
0 		0
0 		0
0 		675,084
0 		0
0
(24)CATHERINE LINDSTROMFORMER KEY EMPLOYEE (i)
(ii)		 2,104
0 		50,280
0 		500,788
0 		0
0 		0
0 		553,172
0 		0
0
(25)DALE SPARTZFORMER KEY EMPLOYEE (i)
(ii)		 0
0 		0
0 		282,949
0 		0
0 		0
0 		282,949
0 		0
0
(26)GARY GROVERFORMER KEY EMPLOYEE (i)
(ii)		 0
0 		0
0 		566,379
0 		0
0 		0
0 		566,379
0 		0
0
(27)TIMOTHY TRACYFORMER KEY EMPLOYEE (i)
(ii)		 0
0 		0
0 		308,124
0 		0
0 		0
0 		308,124
0 		0
0
(28)SUSAN KELLEYFORMER KEY EMPLOYEE (i)
(ii)		 0
0 		0
0 		295,450
0 		0
0 		0
0 		295,450
0 		0
0
(29)ROBERT ISRAELFORMER KEY EMPLOYEE (i)
(ii)		 0
0 		0
0 		245,022
0 		0
0 		0
0 		245,022
0 		0
0
(30)DAN COLEMANFORMER OFFICER (i)
(ii)		 0
0 		0
0 		2,108,387
0 		0
0 		0
0 		2,108,387
0 		0
0
(31)POLLY BAUGHMANFORMER KEY EMPLOYEE (i)
(ii)		 0
0 		0
0 		244,961
0 		0
0 		0
0 		244,961
0 		0
0
Schedule J (Form 990) 2012

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
SEVERANCE PAYMENTS SCHEDULE J, PART I, LINE 4A CATHY LINDSTROM RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $99,195. COLLEEN SCHARNECK RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF 106,781. PATRICIA REHN RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $96,179.
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B THE FOLLOWING INDIVIDUALS HAD AMOUNTS INCLUDIBLE IN OTHER REPORTABLE COMPENSATION, SCHEDULE J, PART II, COLUMN (B)(III), RELATED TO PAYMENTS RECEIVED FROM A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN THAT WAS TERMINATED IN 2011: RHONDA FORSYTH: $911,711 DAVID LAMPARTER: $1,269,015 BRUCE PEARSON: $215,276 NATHAN ANSPACH: $82,977 SHEILA GERRY: $275,609 ALAINA CHABRIER: $128,379 FRANK CUMMINS: $96,803 MAGGIE GRIFFIN: $92,749 CINDY HALLMAN: $83,330 SUSAN MELKER: $239,914 MARCIA MINTZ: $67,637 MICHAEL SKEHAN: $31,200 ROBERT SLEPIN: $39,752 BRIAN SMIT: $59,480 DAVID PRICE: $29,999 PATRICIA REHN: $28,854 COLLEEN SHARNECK: $534,657 CATHERINE LINDSTROM: $401,593 DALE SPARTZ: $282,949 GARY GROVER: $566,379 TIMOTHY TRACY: $308,124 SUSAN KELLEY: $295,450 ROBERT ISRAEL: $245,022 DAN COLEMAN: $2,108,387 POLLY BAUGHMAN: $244,961 EFFECTIVE JANUARY 1, 2012, THE ORGANIZATION OFFERS A NONQUALIFIED DEFERRED COMPENSATION PLAN ORGANIZED UNDER SECTION 457(F) FOR CERTAIN EXECUTIVES OF THE ORGANIZATION. THE ORGANIZATION MAKES CONTRIBUTIONS ON BEHALF OF THE EMPLOYEES AS DETERMINED BY THE BOARD.
NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 THE LINCOLN PERFORMANCE INCENTIVE PLAN (LPIP) PROVIDES A FORMAL METHOD OF REWARDING JOHN C. LINCOLN HEALTH NETWORK (JCLHN) LEADERSHIP FOR MEETING AND/OR EXCEEDING THE ORGANIZATIONAL GOALS ESTABLISHED BY THE NETWORK BOARD OF DIRECTORS. LPIP IS PAY AT RISK AND IS OFFERED TO ENSURE OUR TOTAL COMPENSATION PACKAGE IS COMPETITIVE IN THE MARKET.
Schedule J (Form 990) 2012

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet 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
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number
86-0117301
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
Yes No Yes No Yes No
A INDUSTRIAL DEV AUTHORITY OF CITY OF GLENDALE AZ
  		86-0447234 378282BLO 06-08-2005 47,305,136 SEE PART VI   X   X   X
B INDUSTRIAL DEV AUTHORITY OF CITY OF GLENDALE AZ
  		86-0447234 378282CPO 12-02-2005 60,851,680 SEE PART VI   X   X   X
C ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   12-22-2006 28,225,895 LEASE PURCHASE AGREEMENT   X   X   X
D INDUSTRIAL DEV AUTHORITY OF CITY OF GLENDALE AZ
  		86-0447234 378282DR5 04-25-2007 77,615,738 SEE PART VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   12-17-2010 11,000,000 LEASE PURCHASE AGREEMENT   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   05-12-2011 20,050,000 LEASE PURCHASE AGREEMENT   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   05-31-2011 5,000,000 LEASE PURCHASE AGREEMENT   X   X   X
INDUSTRIAL DEV AUTHORITY OF TOWN OF GILBERT AZ
  		46-0914696   09-11-2012 31,165,000 SEE PART VI   X   X   X
INDUSTRIAL DEV AUTHORITY OF TOWN OF GILBERT AZ
  		46-0914696   09-11-2012 49,435,000 SEE PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 3,280,000 1,000,000 0 8,545,000
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 47,305,136 60,851,680 28,225,895 77,615,738
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 429,564
6 Proceeds in refunding escrows . . . . . . . . . . . . 6,177,663 47,159,449 0 40,885,685
7 Issuance costs from proceeds . . . . . . . . . . . . 554,132 611,558 0 0
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 0 690,323
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 28,225,895 0
10 Capital expenditures from proceeds . . . . . . . . . . . 37,333,577 13,080,673 0 35,570,436
11 Other spent proceeds . . . . . . . . . . . . . . 0 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2008 2007 2007 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X X     X X  
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2012
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   X   X   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   X   X   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 . . SchKMediumBullet 0% 0% 0% 0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet   %   %   %   %
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .   %   %   %   %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
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?. . . . . . . . . . . . . . . . .   X   X   X   X
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? . . . . . . . . . . . . .   X   X   X   X
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   X   X   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   X   X   X  
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . . X   X   X   X  
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? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . . . .                
e Was a hedge terminated? . . . . . . .                
Schedule K (Form 990) 2012
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     X   X X  
b Name of provider . . . . . . . . . ROYAL BANK OF CANADA
  		0
  		0
  		RABOBANK
 
c Term of GIC . . . . . . . . . . 1.67     2.75
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X           X  
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   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? X   X   X   X  
Part VI
Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
DESCRIPTION OF PURPOSE 0 SCHEDULE K (1), PART I, LINE A, COLUMN (F) REFUND THE REMAINING SERIES 1994 BONDS, PROVIDE CAPITAL AND PROJECT FUNDING FOR REMODELING AND EXPANSION OF NORTH MOUNTAIN HOSPITAL AND PAY COSTS INCIDENTAL TO THEIR ISSUANCE. DESCRIPTION OF PURPOSE SCHEDULE K (1), PART I, LINE B, COLUMN (F) REFUND THE REMAINING SERIES 2000 AND 2002 BONDS, PROVIDE CAPITAL AND PROJECT FUNDING FOR REMODELING AND EXPANSION OF NORTH MOUNTAIN HOSPITAL AND DEER VALLEY HOSPITAL AND PAY COSTS INCIDENTAL TO THEIR ISSUANCE. DESCRIPTION OF PURPOSE SCHEDULE K (1), PART I, LINE D, COLUMN (F) REFUND THE SERIES 1997B BONDS AND PARTIALLY REFUND A PORTION OF SERIES 2002 BONDS, PROVIDE CAPITAL AND PROJECT FUNDING FOR REMODELING AND EXPANSION OF NORTH MOUNTAIN HOSPITAL AND DEER VALLEY HOSPITAL AND PAY COSTS INCIDENTAL TO THEIR ISSUANCE. DESCRIPTION OF PURPOSE SCHEDULE K (2), PART I, LINE D, COLUMN (F) AND SCHEDULE K (3), PART I, LINE A, COLUMN (F) THE SERIES 2012 BONDS WERE ISSUED FOR THE PURPOSE OF (I) REIMBURSING IMPROVEMENTS, EXPANSIONS AND EQUIPPING AT JOHN C. LINCOLN NORTH MOUNTAIN HOSPITAL AND JOHN C. LINCOLN DEER VALLEY HOSPITAL (COLLECTIVELY, THE "PROJECT"), (II) REFUNDING ALL OF THE OUTSTANDING SERIES 1997 BONDS, SERIES 2000 BONDS AND SERIES 2002 BONDS WITHIN 90 DAYS OF THE DATED DATE, AND (III) PAYING ISSUANCE EXPENSES.
Schedule K (Form 990) 2012

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet 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
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number
86-0117301
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
Yes No Yes No Yes No
A INDUSTRIAL DEV AUTHORITY OF CITY OF GLENDALE AZ
  		86-0447234 378282BLO 06-08-2005 47,305,136 SEE PART VI   X   X   X
B INDUSTRIAL DEV AUTHORITY OF CITY OF GLENDALE AZ
  		86-0447234 378282CPO 12-02-2005 60,851,680 SEE PART VI   X   X   X
C ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   12-22-2006 28,225,895 LEASE PURCHASE AGREEMENT   X   X   X
D INDUSTRIAL DEV AUTHORITY OF CITY OF GLENDALE AZ
  		86-0447234 378282DR5 04-25-2007 77,615,738 SEE PART VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   12-17-2010 11,000,000 LEASE PURCHASE AGREEMENT   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   05-12-2011 20,050,000 LEASE PURCHASE AGREEMENT   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   05-31-2011 5,000,000 LEASE PURCHASE AGREEMENT   X   X   X
INDUSTRIAL DEV AUTHORITY OF TOWN OF GILBERT AZ
  		46-0914696   09-11-2012 31,165,000 SEE PART VI   X   X   X
INDUSTRIAL DEV AUTHORITY OF TOWN OF GILBERT AZ
  		46-0914696   09-11-2012 49,435,000 SEE PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 3,280,000 1,000,000 0 8,545,000
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 47,305,136 60,851,680 28,225,895 77,615,738
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 429,564
6 Proceeds in refunding escrows . . . . . . . . . . . . 6,177,663 47,159,449 0 40,885,685
7 Issuance costs from proceeds . . . . . . . . . . . . 554,132 611,558 0 0
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 0 690,323
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 28,225,895 0
10 Capital expenditures from proceeds . . . . . . . . . . . 37,333,577 13,080,673 0 35,570,436
11 Other spent proceeds . . . . . . . . . . . . . . 0 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2008 2007 2007 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X X     X X  
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2012
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   X   X   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   X   X   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 . . SchKMediumBullet 0% 0% 0% 0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet   %   %   %   %
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .   %   %   %   %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
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?. . . . . . . . . . . . . . . . .   X   X   X   X
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? . . . . . . . . . . . . .   X   X   X   X
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   X   X   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   X   X   X  
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . . X   X   X   X  
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? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . . . .                
e Was a hedge terminated? . . . . . . .                
Schedule K (Form 990) 2012
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     X   X X  
b Name of provider . . . . . . . . . ROYAL BANK OF CANADA
  		0
  		0
  		RABOBANK
 
c Term of GIC . . . . . . . . . . 1.67     2.75
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X           X  
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   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? X   X   X   X  
Part VI
Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
DESCRIPTION OF PURPOSE 0 SCHEDULE K (1), PART I, LINE A, COLUMN (F) REFUND THE REMAINING SERIES 1994 BONDS, PROVIDE CAPITAL AND PROJECT FUNDING FOR REMODELING AND EXPANSION OF NORTH MOUNTAIN HOSPITAL AND PAY COSTS INCIDENTAL TO THEIR ISSUANCE. DESCRIPTION OF PURPOSE SCHEDULE K (1), PART I, LINE B, COLUMN (F) REFUND THE REMAINING SERIES 2000 AND 2002 BONDS, PROVIDE CAPITAL AND PROJECT FUNDING FOR REMODELING AND EXPANSION OF NORTH MOUNTAIN HOSPITAL AND DEER VALLEY HOSPITAL AND PAY COSTS INCIDENTAL TO THEIR ISSUANCE. DESCRIPTION OF PURPOSE SCHEDULE K (1), PART I, LINE D, COLUMN (F) REFUND THE SERIES 1997B BONDS AND PARTIALLY REFUND A PORTION OF SERIES 2002 BONDS, PROVIDE CAPITAL AND PROJECT FUNDING FOR REMODELING AND EXPANSION OF NORTH MOUNTAIN HOSPITAL AND DEER VALLEY HOSPITAL AND PAY COSTS INCIDENTAL TO THEIR ISSUANCE. DESCRIPTION OF PURPOSE SCHEDULE K (2), PART I, LINE D, COLUMN (F) AND SCHEDULE K (3), PART I, LINE A, COLUMN (F) THE SERIES 2012 BONDS WERE ISSUED FOR THE PURPOSE OF (I) REIMBURSING IMPROVEMENTS, EXPANSIONS AND EQUIPPING AT JOHN C. LINCOLN NORTH MOUNTAIN HOSPITAL AND JOHN C. LINCOLN DEER VALLEY HOSPITAL (COLLECTIVELY, THE "PROJECT"), (II) REFUNDING ALL OF THE OUTSTANDING SERIES 1997 BONDS, SERIES 2000 BONDS AND SERIES 2002 BONDS WITHIN 90 DAYS OF THE DATED DATE, AND (III) PAYING ISSUANCE EXPENSES.
Schedule K (Form 990) 2012

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet 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
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number
86-0117301
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
Yes No Yes No Yes No
A INDUSTRIAL DEV AUTHORITY OF CITY OF GLENDALE AZ
  		86-0447234 378282BLO 06-08-2005 47,305,136 SEE PART VI   X   X   X
B INDUSTRIAL DEV AUTHORITY OF CITY OF GLENDALE AZ
  		86-0447234 378282CPO 12-02-2005 60,851,680 SEE PART VI   X   X   X
C ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   12-22-2006 28,225,895 LEASE PURCHASE AGREEMENT   X   X   X
D INDUSTRIAL DEV AUTHORITY OF CITY OF GLENDALE AZ
  		86-0447234 378282DR5 04-25-2007 77,615,738 SEE PART VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   12-17-2010 11,000,000 LEASE PURCHASE AGREEMENT   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   05-12-2011 20,050,000 LEASE PURCHASE AGREEMENT   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292   05-31-2011 5,000,000 LEASE PURCHASE AGREEMENT   X   X   X
INDUSTRIAL DEV AUTHORITY OF TOWN OF GILBERT AZ
  		46-0914696   09-11-2012 31,165,000 SEE PART VI   X   X   X
INDUSTRIAL DEV AUTHORITY OF TOWN OF GILBERT AZ
  		46-0914696   09-11-2012 49,435,000 SEE PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 3,280,000 1,000,000 0 8,545,000
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 47,305,136 60,851,680 28,225,895 77,615,738
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 429,564
6 Proceeds in refunding escrows . . . . . . . . . . . . 6,177,663 47,159,449 0 40,885,685
7 Issuance costs from proceeds . . . . . . . . . . . . 554,132 611,558 0 0
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 0 690,323
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 28,225,895 0
10 Capital expenditures from proceeds . . . . . . . . . . . 37,333,577 13,080,673 0 35,570,436
11 Other spent proceeds . . . . . . . . . . . . . . 0 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2008 2007 2007 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X X     X X  
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2012
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   X   X   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   X   X   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 . . SchKMediumBullet 0% 0% 0% 0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet   %   %   %   %
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .   %   %   %   %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
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?. . . . . . . . . . . . . . . . .   X   X   X   X
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? . . . . . . . . . . . . .   X   X   X   X
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   X   X   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   X   X   X  
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . . X   X   X   X  
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? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . . . .                
e Was a hedge terminated? . . . . . . .                
Schedule K (Form 990) 2012
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     X   X X  
b Name of provider . . . . . . . . . ROYAL BANK OF CANADA
  		0
  		0
  		RABOBANK
 
c Term of GIC . . . . . . . . . . 1.67     2.75
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X           X  
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   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? X   X   X   X  
Part VI
Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
DESCRIPTION OF PURPOSE 0 SCHEDULE K (1), PART I, LINE A, COLUMN (F) REFUND THE REMAINING SERIES 1994 BONDS, PROVIDE CAPITAL AND PROJECT FUNDING FOR REMODELING AND EXPANSION OF NORTH MOUNTAIN HOSPITAL AND PAY COSTS INCIDENTAL TO THEIR ISSUANCE. DESCRIPTION OF PURPOSE SCHEDULE K (1), PART I, LINE B, COLUMN (F) REFUND THE REMAINING SERIES 2000 AND 2002 BONDS, PROVIDE CAPITAL AND PROJECT FUNDING FOR REMODELING AND EXPANSION OF NORTH MOUNTAIN HOSPITAL AND DEER VALLEY HOSPITAL AND PAY COSTS INCIDENTAL TO THEIR ISSUANCE. DESCRIPTION OF PURPOSE SCHEDULE K (1), PART I, LINE D, COLUMN (F) REFUND THE SERIES 1997B BONDS AND PARTIALLY REFUND A PORTION OF SERIES 2002 BONDS, PROVIDE CAPITAL AND PROJECT FUNDING FOR REMODELING AND EXPANSION OF NORTH MOUNTAIN HOSPITAL AND DEER VALLEY HOSPITAL AND PAY COSTS INCIDENTAL TO THEIR ISSUANCE. DESCRIPTION OF PURPOSE SCHEDULE K (2), PART I, LINE D, COLUMN (F) AND SCHEDULE K (3), PART I, LINE A, COLUMN (F) THE SERIES 2012 BONDS WERE ISSUED FOR THE PURPOSE OF (I) REIMBURSING IMPROVEMENTS, EXPANSIONS AND EQUIPPING AT JOHN C. LINCOLN NORTH MOUNTAIN HOSPITAL AND JOHN C. LINCOLN DEER VALLEY HOSPITAL (COLLECTIVELY, THE "PROJECT"), (II) REFUNDING ALL OF THE OUTSTANDING SERIES 1997 BONDS, SERIES 2000 BONDS AND SERIES 2002 BONDS WITHIN 90 DAYS OF THE DATED DATE, AND (III) PAYING ISSUANCE EXPENSES.
Schedule K (Form 990) 2012

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet 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
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number

86-0117301
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
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?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
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
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?
Yes No
(1) DICKENSON WRIGHT PLCC SEE PART V 100,678 INDEPENDENT CONTR. ARRANGEMENT   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
RELATIONSHIP BETWEEN INTEREST PERSON AND ORGANIZATION SCHEDULE L, PART IV, LINE 3, COLUMN (B) DICKENSON WRIGHT PLCC (FORMERLY MARISCAL, WEEKS, MCINTYRE & FRIEDLANDER) IS AN ENTITY WHICH IS MORE THAN 5% OWNED BY A BOARD MEMBER.
Schedule L (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  




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
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number

86-0117301
Identifier Return Reference Explanation
VOLUNTEERS FORM 990, PART I, LINE 6 THE TOTAL NUMBER OF VOLUNTEER HOURS FOR THE JOHN C. LINCOLN HEALTH NETWORK: JOHN C LINCOLN HOSPITAL - DEER VALLEY: 69,556 HOURS JOHN C LINCOLN HOSPITAL - NORTH MOUNTAIN: 75,214 HOURS DESERT MISSION: 43,664 HOURS
ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 JOHN C. LINCOLN HEALTH NETWORK IS A LOCAL NOT-FOR-PROFIT HEALTH AND HUMAN SERVICES ORGANIZATION SERVING THE NORTH VALLEY OF PHOENIX, ARIZONA. IN 2012, THE ORGANIZATION CELEBRATED A MAJOR MILESTONE: 85 YEARS OF CARING FOR ITS COMMUNITY. IN ITS MORE THAN 85 YEARS OF GROWTH, THE HEALTH NETWORK HAS EXPANDED ITS SERVICE TERRITORY AND HAS BECOME A WELL-REGARDED ORGANIZATION THAT HAS BEEN HONORED BY INDEPENDENT EXPERTS FOR EXCELLENCE IN: HOSPITAL PERFORMANCE, NURSING CARE, COMMUNITY SERVICE, BUSINESS ETHICS, AND WORK ENVIRONMENT. SUCH HONORS HAVE BEEN BESTOWED ON THE NETWORK BY PRESTIGIOUS ORGANIZATIONS SUCH AS THE AMERICAN HOSPITAL ASSOCIATION, THE AMERICAN NURSES ASSOCIATION, THE NATIONAL CRITICAL-CARE NURSES ASSOCIATION, THE U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES, THE ARIZONA STATE QUALITY ALLIANCE, THE BETTER BUSINESS BUREAU OF CENTRAL AND NORTHERN ARIZONA, AND THE GREAT PLACES TO WORK INSTITUTE. ORGANIZATION'S MISSION: OUR MISSION IS TO ASSIST EACH PERSON ENTRUSTED TO OUR CARE TO ENJOY THE HIGHEST QUALITY HEALTH CARE POSSIBLE AND TO WORK WITH OTHERS TO BUILD HEALTHY COMMUNITIES.
PROGRAM SERVICE ACTIVITIES FORM 990, PART III, LINE 4A THE NOT-FOR-PROFIT JOHN C. LINCOLN HEALTH NETWORK IS COMPOSED OF MORE THAN 3,800 EMPLOYEES WITH A MEDICAL STAFF OF MORE THAN 1,100 PHYSICIANS. IT INCLUDES: JOHN C. LINCOLN DEER VALLEY HOSPITAL - JOHN C. LINCOLN DEER VALLEY HOSPITAL IS A 204-BED COMMUNITY HOSPITAL THAT WAS HONORED FOR ITS EXCELLENCE BY THE ARIZONA STATE QUALITY ALLIANCE WITH ITS PRESTIGIOUS ARIZONA PIONEER AWARD FOR QUALITY. THE DEER VALLEY HOSPITAL WAS RECOGNIZED AS A QUEST 2011 TOP PERFORMING HOSPITAL AND WAS NAMED A BLUE DISTINCTION CENTER FOR KNEE AND HIP REPLACEMENT; THE HOSPITAL SERVES THE RAPIDLY EXPANDING NORTHERN PHOENIX METROPOLITAN AREA AS WELL AS COMMUNITIES TO THE NORTH ALONG INTERSTATE 17, INCLUDING NEW RIVER, BLACK CANYON CITY AND ANTHEM. THE HOSPITAL HAS A MEDICAL STAFF OF MORE THAN 700 PHYSICIANS REPRESENTING ALL MAJOR MEDICAL SPECIALTIES AND A CLINICAL STAFF OF MORE THAN 1,300 HEALTH CARE PROFESSIONALS OFFERING A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES INCLUDING: A 24-HOUR, 35-BED EMERGENCY DEPARTMENT AND LEVEL III TRAUMA CENTER DESIGNED TO SERVE UP TO 60,000 PATIENTS PER YEAR WITH AN EXPEDITED CARE PROGRAM FOR TRAUMA PATIENTS 60 AND OLDER; RADIATION ONCOLOGY AND MRI IN A MEDICAL IMAGING AND ONCOLOGY UNIT; THE VIRGINIA G. PIPER PEDIATRIC CENTER OF EXCELLENCE WHICH INCLUDES OUR CHILDREN'S EMERGENCY CENTER, MENDY'S PLACE, AND KIDSZONE INPATIENT PEDIATRIC UNIT, AND A COMPLETE RANGE OF PERSONALIZED INPATIENT AND OUTPATIENT CARE; A 32-BED CRITICAL CARE UNIT; A 30-BED PROGRESSIVE CARDIAC CARE UNIT WITH OUTPATIENT CARDIAC REHABILITATION; AND A 30-BED ORTHOPEDIC UNIT FOR PATIENTS UNDERGOING JOINT REPLACEMENTS, INPATIENT AND OUTPATIENT ARTHROSCOPIC AND OTHER ORTHOPEDIC PROCEDURES. CARDIAC CARE INCLUDING TRADITIONAL OPEN-HEART AND "BEATING HEART" SURGERY; A MODERN DIAGNOSTIC AND INTERVENTIONAL CARDIAC CATHETERIZATION LAB AND ELECTROPHYSIOLOGY STUDIES, HAS RECEIVED FULL ACCREDITATION AS A HEART FAILURE CENTER, A CARDIAC ARREST CENTER AND AS A CHEST PAIN CENTER. INPATIENT CARE UNITS IN PAVILION 2 WERE DESIGNED WITH NURSES' WORK STATIONS LOCATED OUTSIDE PATIENT ROOMS, ENABLING NURSES TO STAY CLOSE TO THEIR PATIENTS. INPATIENT AND OUTPATIENT CARE INCLUDES GENERAL AND LAPAROSCOPIC SURGERY FEATURING STATE-OF-THE-ART EQUIPMENT AND MINIMALLY INVASIVE PROCEDURES; DIGITAL NUCLEAR, COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE MEDICAL IMAGING; PHARMACY, RESPIRATORY, LABORATORY, ENDOSCOPY, SOCIAL SERVICES AND NUTRITIONAL SERVICES. THE BREAST HEALTH AND RESEARCH CENTER, WITH ADVANCED DIAGNOSTIC AND THERAPEUTIC TECHNOLOGY INCLUDING 3D AND 2D DIGITAL MAMMOGRAPHY, ULTRASOUND, NEEDLE BIOPSIES, BREAST AND SPINE MRI AND PATIENT EDUCATION FOR DETECTION AND TREATMENT OF BREAST CANCER. DIAGNOSIS OF OSTEOPOROSIS AND BODY MASS ANALYSIS IS ALSO OFFERED. BREAST CANCER CARE IS ENHANCED WITH GUIDANCE, ASSISTANCE AND EDUCATION FROM A PATIENT CARE COORDINATOR AND AN OUTREACH AND PATIENT RESOURCE COORDINATOR. THE BREAST HEALTH AND RESEARCH CENTER WAS NAMED BY THE AMERICAN COLLEGE OF RADIOLOGY AS A BREAST IMAGING CENTER OF EXCELLENCE AND IS ONE OF SEVEN ORGANIZATIONS NATIONWIDE TO PARTNER WITH THE CDC TO BRING EDUCATION AND SUPPORT SERVICES TO YOUNG (<45) CANCER SURVIVORS AND THEIR FAMILIES TO REDUCE MORTALITY. JOHN C. LINCOLN NORTH MOUNTAIN HOSPITAL - JOHN C. LINCOLN NORTH MOUNTAIN HOSPITAL IS A 262-BED COMMUNITY HOSPITAL, PROVIDING A COMPREHENSIVE RANGE OF SERVICES TO MEET THE NEEDS OF PATIENTS IN NORTH CENTRAL PHOENIX IN WAYS FEW OTHER COMMUNITY HOSPITALS CAN MATCH. THE QUALITY OF ITS PATIENT CARE ENABLED NORTH MOUNTAIN TO BECOME THE FIRST HOSPITAL IN THE VALLEY DESIGNATED AND REDESIGNATED "MAGNET" BY THE AMERICAN NURSES ASSOCIATION. IT WAS THE FIRST HOSPITAL IN ARIZONA WHOSE INTENSIVE CARE UNIT EARNED THE BEACON AWARD FROM THE AMERICAN CRITICAL-CARE NURSES ASSOCIATION (ACCN), AND THE ONLY ONE WHOSE CARDIOVASCULAR INTENSIVE CARE UNIT ALSO EARNED THE ACCN'S BEACON AWARD. THE NORTH MOUNTAIN HOSPITAL HAS ACCREDITATION AS BOTH A CARDIAC ARREST CENTER AND AS A CHEST PAIN CENTER WITH PCI, HAS RECEIVED FULL ACCREDITATION AS A HEART FAILURE CENTER AND AS A PRIMARY STROKE CENTER; AND WAS NAMED IN THE US NEWS & WORLD REPORT BEST HOSPITALS. SOME 740 PHYSICIANS AND MORE THAN 1,700 DEDICATED HEALTH CARE PROFESSIONALS PROVIDE THE FOLLOWING SERVICES: THE LEVEL I TRAUMA CENTER WITH FOUR TRAUMA BAYS AND FOUR MAJOR MEDICAL ROOMS IS ONE OF SIX 24/7 TRAUMA CENTERS IN THE METROPOLITAN PHOENIX AREA AND THE CLOSEST ONE SERVING THE MOST SEVERELY INJURED IN THE NORTH VALLEY, NORTHERN ARIZONA AND PARTS OF SOUTHEAST CALIFORNIA, SOUTHERN NEVADA, UTAH AND NORTHWEST NEW MEXICO; AN EMERGENCY DEPARTMENT WITH 30 PRIVATE ROOMS THAT PROVIDE 24/7 CARE FOR A WIDE VARIETY OF INJURED AND ILL PEOPLE, AN EXPEDITED CARE PROGRAM FOR TRAUMA PATIENTS 60 AND OLDER AND A SEVEN-BED FAST TRACK UNIT FOR LESS SEVERELY ILL OR INJURED PATIENTS; CARDIAC CARE INCLUDING TRADITIONAL OPEN-HEART AND "BEATING HEART" SURGERY, A MODERN DIAGNOSTIC AND INTERVENTIONAL CARDIAC CATHETERIZATION LAB, ELECTROPHYSIOLOGY STUDIES; TRAUMA SURGERY, NEUROSURGERY AND RECONSTRUCTIVE SURGERY, AS WELL AS GENERAL AND LAPAROSCOPIC SURGERY; GENERAL, UROLOGICAL AND GYNECOLOGICAL ROBOTIC SURGERY WITH THE DA VINCI SURGICAL SYSTEM; INPATIENT MED/SURG CARE, INTENSIVE CARE, CARDIOVASCULAR INTENSIVE CARE AND PROGRESSIVE CARDIOVASCULAR CARE; ORTHOPEDIC CARE FOR PATIENTS UNDERGOING JOINT REPLACEMENTS; INPATIENT AND OUTPATIENT ARTHROSCOPIC AND OTHER ORTHOPEDIC PROCEDURES; DIGITAL NUCLEAR, COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE MEDICAL IMAGING; PHARMACY; PULMONARY AND RESPIRATORY; LABORATORY; ENDOSCOPY; AND SOCIAL SERVICES AND NUTRITIONAL SERVICES. PRIMARY CARE CENTERS: JOHN C. LINCOLN HEALTH CENTER AT ANTHEM JOHN C. LINCOLN HEALTH CENTER ON TATUM BOULEVARD URGENT CARE AT JOHN C. LINCOLN HEALTH CENTER AT ANTHEM IMMEDIATE CARE AT SAGUARO FAMILY PRACTICE AND DEER VALLEY MEDICAL PHYSICIAN NETWORK - JOHN C. LINCOLN'S PHYSICIAN AND ALLIED HEALTH CARE PARTNERS IN 38 PRIMARY AND SPECIALTY CARE PRACTICES THAT ARE PART OF THE HEALTH NETWORK. THESE INCLUDE: FAMILY PRACTICES: ARCADIA FAMILY CLINIC, BEATITUDES CAMPUS, CACTUS FAMILY MEDICINE, CALAVAR FAMILY MEDICINE, CAVE CREEK FAMILY MEDICINE, CARE FOR WOMEN DEER VALLEY, CARE FOR WOMEN NORTH MOUNTAIN, DEARING FAMILY MEDICINE, DEER VALLEY FAMILY PRACTICE, DEER VALLEY MEDICAL, DEL LAGO FAMILY MEDICINE, DYNAMITE CREEK MEDICAL CENTER, GAVILAN PEAK FAMILY PRACTICE, GLENDALE FAMILY MEDICINE, LIFE STREAM AT THUNDERBIRD AND YOUNGTOWN, NEW RIVER MEDICAL OFFICE, NORTH PEORIA FAMILY MEDICINE, SAGUARO FAMILY PRACTICE, SQUAW PEAK FAMILY MEDICINE, TRAMONTO CROSSING FAMILY MEDICINE, YOUR FAMILY MEDICINE AND YOUR FAMILY WELLNESS. INTERNAL MEDICINE PRACTICES: HARBOR POINTE INTERNAL MEDICINE, NORTH PHOENIX MEDICAL CLINIC, AND NORTH VALLEY INTERNAL MEDICINE. SPECIALTY PRACTICES: BREAST HEALTH AND RESEARCH CENTER, HEART INSTITUTE AT NORTH MOUNTAIN, ARROWHEAD, ESTRELLA AND TATUM, URGENT CARE AT ANTHEM, IMMEDIATE CARE AT SAGUARO FAMILY PRACTICE AND DEER VALLEY MEDICAL, NORTH MOUNTAIN RADIOLOGY GROUP, NORTH PHOENIX PULMONOLOGY, NORTH VALLEY AUDIOLOGY, AND NORTH VALLEY GASTROENTEROLOGY. ACCOUNTABLE CARE ORGANIZATION - AN ORGANIZATION THAT INCLUDES A GROUP OF HEALTH CARE PROVIDERS WHO COLLABORATE AND AGREE TO SHARE RESPONSIBILITY FOR THE TOTAL COST AND QUALITY OF CARE FOR A DESIGNATED GROUP OF PATIENTS OVER A PERIOD OF TIME. DESERT MISSION - AN ORGANIZATION THAT PROVIDES COMMUNITY SERVICES, INCLUDING THE ONLY HOSPITAL-BASED FOOD BANK IN ARIZONA, THE COMMUNITY HEALTH CENTER, MARLEY HOUSE FOR BEHAVIORAL HEALTH AND FAMILY ASSISTANCE, LINCOLN LEARNING CENTER, ADULT DAY HEALTH AND CHILDREN'S DENTAL CLINIC. JOHN C. LINCOLN HEALTH FOUNDATION - THE PHILANTHROPIC AND FUNDRAISING BRANCH OF THE NETWORK THAT SUPPORTS THE ORGANIZATION'S CHARITABLE AND MEDICAL MISSION. DESERT MISSION NEIGHBORHOOD RENEWAL - AN ORGANIZATION THAT PROVIDES LOW-INCOME FAMILIES WITH AFFORDABLE HOUSING ALTERNATIVES AND WORKS WITH OTHER COMMUNITY ORGANIZATIONS TO IMPROVE THE QUALITY OF LIFE IN JOHN C. LINCOLN'S COMMUNITY.
EXECUTIVE COMMITTEE FORM 990, PART VI, LINE 1A PURSUANT TO THE BYLAWS, THE EXECUTIVE COMMITTEE HAS THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE ORGANIZATION AND SUCH OTHER MATTERS AS MAY BE DELEGATED TO IT IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OR BY STATUTE. MATTERS OF MAJOR IMPORTANCE BROUGHT BEFORE THE EXECUTIVE COMMITTEE SHALL BE REFERRED TO THE BOARD AND ALL ACTIONS OF THE EXECUTIVE COMMITTEE SHALL BE REPORTED AT THE NEXT REGULAR MEETING OF THE BOARD. SPECIFIC DUTIES OF THIS COMMITTEE SHALL INCLUDE THE FOLLOWING: (A) ANNUALLY REVIEW AND EVALUATE THE PRESIDENT'S PERFORMANCE BASED ON CRITERIA OUTLINED IN THE PRESIDENT'S JOB DESCRIPTION. THIS EVALUATION IS TO BE DONE IN CONCERT WITH THE EXECUTIVE COMPENSATION COMMITTEE; (B) REVIEW AND EVALUATE THE CORPORATE COMPLIANCE PROGRAM; (C) DEVELOP AND RECOMMEND LAND AND FACILITY PLANS APPLICABLE TO THE CORPORATION AND ITS AFFILIATES; (D) REVIEW AND MONITOR ALL MAJOR BUILDING AND REMODELING PLANS AND PROJECTS FOR THE CORPORATION AND ALL ITS AFFILIATES; (E) REVIEW AND RECOMMEND TO THE APPROPRIATE BOARD PROPERTY ACQUISITION, DISPOSITION AND DEVELOPMENT PROPOSALS; AND (F) OVERSEE THE STRATEGIC PLANNING OF THE CORPORATION AND MAKE RECOMMENDATIONS FOR ACTION TO THE BOARD. THE EXECUTIVE COMMITTEE CONSISTS OF NO MORE THAN 9 MEMBERS AND SHALL INCLUDE THE CHAIRMAN, THE VICE CHAIRMAN, THE SECRETARY/TREASURER, THE CHAIRMAN OF THE FINANCE COMMITTEE, THE CHAIRMAN OF THE QUALITY AND SAFETY COMMITTEE, AND THE PRESIDENT.
PROCESS TO REVIEW THE FORM 990 FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED BY A THIRD PARTY. THE FORM 990 GOES THROUGH A DETAILED REVIEW INTERNALLY BY THE CONTROLLER AND ASSISTANT CONTROLLER. ONCE THIS PROCESS IS COMPLETE THE RETURN IS REVIEWED BY THE CFO AND THE AUDIT COMMITTEE. ONCE THE RETURN HAS GONE THROUGH THIS REVIEW, THE FINAL FORM 990 WILL BE DISTRIBUTED VIA EMAIL TO EACH MEMBER OF THE BOARD OF DIRECTORS WITH A RECOMMENDATION TO FILE THE RETURN WITH THE IRS.
PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C THE CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM IS SENT TO EVERY BOARD MEMBER, CORPORATE OFFICER, EXECUTIVE AND KEY EMPLOYEE ON AN ANNUAL BASIS. THE INFORMATION FROM COMPLETED DISCLOSURE FORMS IS REVIEWED BY THE NETWORK AUDIT COMMITTEE FOR THE PURPOSES OF DETERMINING INDEPENDENCE. ADDITIONALLY, THE NETWORK'S COMPLIANCE COMMITTEE REVIEWS ALL EMPLOYEE DISCLOSURES. A SUMMARY REPORT OF THE DISCLOSURES AND THE AUDIT COMMITTEE'S RECOMMENDATIONS RELATED TO INDEPENDENCE ARE SUBMITTED TO THE NETWORK BOARD FOR APPROVAL. THE CONFLICT OF INTEREST POLICY REQUIRES VOLUNTEERS AND STAFF TO SELF-REPORT CONFLICTS AT THE TIME THEY ARISE AND COMPLETE AN UPDATED DISCLOSURE FORM. DURING THE COURSE OF COMMITTEE OR BOARD MEETINGS, BOARD MEMBERS DISCLOSE ANY CONFLICTS RELATED TO THE AGENDA ITEM/DISCUSSION AND ABSTAIN FROM VOTING. WHENEVER APPROPRIATE, THE BOARD MEMBER WOULD BE EXCUSED FROM THE ROOM DURING DISCUSSION AND VOTING. IF A BOARD MEMBER IS INTERESTED IN CONDUCTING BUSINESS WITH JCLHN, THE CONFLICT OF INTEREST POLICY REQUIRES HIM OR HER TO INITIATE THAT PROCESS THROUGH THE NETWORK CEO AND NOT ANY OTHER EXECUTIVE OR EMPLOYEE.
PROCESS FOR COMPENSATION OF CEO, OTHER OFFICERS AND KEY EMPLOYEES FORM 990, PART VI, LINE 15A AND 15B JOHN C. LINCOLN HEALTH NETWORK USES A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT DIRECTORS THAT OVERSEES ALL ASPECTS OF COMPENSATION PAID TO THE CEO AND OTHER EXECUTIVES. ANNUALLY, THE COMMITTEE ASSESSES THE PERFORMANCE OF THE CEO AND RECOMMENDS TO THE BOARD THE CEO'S COMPENSATION. ADDITIONALLY, THE COMMITTEE EVALUATES THE ORGANIZATION'S COMPENSATION PHILOSOPHY AND ESTABLISHES PERMISSIBLE RANGES OF COMPENSATION FOR ALL EXECUTIVES. THE COMMITTEE ENGAGES A NATIONALLY RECOGNIZED INDEPENDENT CONSULTANT WHO PROVIDES ADVICE BASED ON COMPENSATION SURVEYS OF ORGANIZATIONS WITH A SIMILAR SIZE AND SCOPE OF SERVICES TO JOHN C. LINCOLN HEALTH NETWORK. THE CONSULTANT PROVIDES A WRITTEN ATTESTATION OF INDEPENDENCE AND REPORTS ONLY TO THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE CEO IS NOT A MEMBER OF THIS COMMITTEE, BUT WILL BE CALLED ON TO ASSESS AND REPORT ON SENIOR EXECUTIVE PERFORMANCE.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 THE ORGANIZATION CONSIDERS REQUESTS FOR FINANCIAL STATEMENTS, GOVERNING DOCUMENTS OR THE CONFLICT OF INTEREST POLICY ON A CASE BY CASE BASIS.
OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 CHANGE IN INTEREST IN FOUNDATION $(2,975,809) LOSS ON IMPAIRMENT (174,100) ----------- TOTAL $(3,149,909) ===========
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


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
JOHN C LINCOLN HEALTH NETWORK
 
Employer identification number

86-0117301
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
(1) JOHN C LINCOLN LLC
2500 W UTOPIA RD SUITE 100
PHOENIX,AZ85027
86-0828589 		PHYS PRACTICE AZ 32,933,552 6,610,578 JCLHN
 
(2) JOHN C LINCOLN ACO
2500 W UTOPIA RD SUITE 100
PHOENIX,AZ85027
35-2437265 		ACO AZ 0 142 JCLHN
 








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?
Yes No
(1) JOHN C LINCOLN HEALTH FOUNDATION

2500 W UTOPIA ROAD SUITE 100

PHOENIX,AZ85027
95-3320185 		FUNDRAISING AZ 501(C)(3) 7 JCLHN
 
Yes
 
(2) DESERT MISSION INC

2500 W UTOPIA ROAD SUITE 100

PHOENIX,AZ85027
86-0096941 		COMMUNITY SVC AZ 501(C)(3) 7 JCLHN
 
Yes
 
(3) DESERT MISSION NEIGHBORHOOD RENEWAL

2500 W UTOPIA ROAD SUITE 100

PHOENIX,AZ85027
86-0746598 		HOUSING/REHAB AZ 501(C)(3) 7 JCLHN
 
Yes
 








For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
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 V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












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
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No












Schedule R (Form 990) 2012
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
No
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 . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
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) JOHN C LINCOLN HEALTH FOUNDATION

 C 5,387,491 CASH
(2) DESERT MISSION INC

 E 2,640,000 BOOK BALANCE
(3) DESERT MISSION NEIGHBORHOOD RENEWAL

 D 688,418 BOOK BALANCE



Schedule R (Form 990) 2012
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) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(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 V—UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
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


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