TY 2011 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) MARI PETERSON TRUSTEE	4.0	X			0	0
(2) RONALD WAGNER TRUSTEE	4.0	X			0	0
(3) ANDREA DUNLAP TRUSTEE	4.0	X			0	0
(4) JOHN HAUN MD TRUSTEE	4.0	X			0	0
(5) DAVID KNAPP MD TRUSTEE	4.0	X			77,772	0
(6) SUSAN A WARNE TRUSTEE	4.0	X			0	0
(7) WILLIAM MILLER TRUSTEE	4.0	X			0	0
(8) ALAN OSUMI MD TRUSTEE	4.0	X			45,335	0
(9) RONALD L SCOTT TRUSTEE	4.0	X			0	0
(10) LANNY KOPE TRUSTEE/CHAIR	4.0	X	X		2,400	0
(11) BRUCE DOCKTER TRUSTEE/VICE CHAIR	4.0	X	X		0	0
(12) JOANNA MICHELICH PHD TRUSTEE/SECRETARY	4.0	X	X		0	0
(13) JAYAY MADDUR MD MED CHIEF OF STAFF/EX OFFICIO	40.0		X		38,058	0
(14) MARGARET HEPBURN - SVRH CEO - SEE SCH J	40.0		X		436,666	48,472
(15) MARGARET HEPBURN - CHN CEO - SEE SCH J	0.0		X		130,214	0
(16) BRUCE NORTON SR VICE PRES., FINANCE	40.0		X		295,039	52,969
(17) MARIE WURTH VICE PRESIDENT	40.0			X	208,808	20,722

(A) Name and business address	(B) Description of services	(C) Compensation
ARAMARK CORPORATION 24863 NETWORK PLACE CHICAGO,IL60673	BIO MED/MGT CONTRACT	3,635,087
COMPREHENSIVE PHARMACY PO BOX 1000 DEPT 176 MEMPHIS,TN38148	PHARMACY MANAGEMENT	2,150,724
CERNER CORPORATION PO BOX 412702 KANSAS CITY,MO64141	SOFTWARE MAINTENANCE	2,718,921
MIDWESTERN UNIVERSITY 19555 NORTH 59TH AVE GLENDALE,AZ85308	RESIDENTS	1,263,651
WE O'NEIL CONSTRUCTION CO 710 S CAMPBELL AVE TUCSON,AZ85719	CONSTRUCTION	1,523,948
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 35

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	1,418,429	0	1,418,429
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	34,729,111	26,430,617	8,298,494
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	767,839	443,735	324,104
9	Other employee benefits .......	5,303,195	3,394,462	1,908,733
10	Payroll taxes ...........	2,545,050	1,898,264	646,786
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	314,431	0	314,431
c	Accounting ...........	287,625	0	287,625
d	Lobbying ...........	0
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	0
g	Other ..........	13,425,574	8,853,207	4,572,367
12	Advertising and promotion ....	448,906	0	448,906
13	Office expenses .......	14,437,741	12,783,912	1,653,829
14	Information technology ......	3,249,976	2,107,531	1,142,445
15	Royalties ..	0
16	Occupancy ...........	1,391,227	958,787	432,440
17	Travel ............	117,780	35,869	81,911
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	422,697	44,838	377,859
20	Interest ...........	1,753,009	1,402,407	350,602
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	5,415,621	3,192,718	2,222,903
23	Insurance ..............	-275,131	0	-275,131
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a	PROVISION FOR NOTE RECEIVABLE	1,182,056	1,182,056	0
b	EQUIPMENT REPAIRS & MAINT	2,504,135	2,483,360	20,775
c	MINOR EQUIPMENT & INSTRUMENTS	246,293	157,266	89,027
d	BLDG REPAIRS & MAINT	184,372	110,624	73,748
e
f	All other expenses	491,494	65,924	425,570
25	Total functional expenses. Add lines 1 through 24f	90,361,430	65,545,577	24,815,853	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	14,883,870	1	14,891,010
2	Savings and temporary cash investments .......	0	2	0
3	Pledges and grants receivable, net .........	0	3	0
4	Accounts receivable, net .........	8,593,614	4	8,783,078
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	0	5	0
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........	0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	2,390,380	8	1,991,099
9	Prepaid expenses and deferred charges ............	2,759,565	9	4,218,753
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	93,129,283
b	Less: accumulated depreciation. .....	10b	55,986,949	34,802,744	10c	37,142,334
11	Investments—publicly traded securities ..........	48,915,289	11	46,207,199
12	Investments—other securities. See Part IV, line 11 ......	0	12	0
13	Investments—program-related. See Part IV, line 11 ..	82,535	13	0
14	Intangible assets .........	0	14	0
15	Other assets. See Part IV, line 11 ...........	1,711,850	15	2,102,423
16	Total assets. Add lines 1 through 15 (must equal line 34)...	114,139,847	16	115,335,896
	17	Accounts payable and accrued expenses .	4,205,335	17	4,666,366
18	Grants payable ..........	0	18	0
19	Deferred revenue ..........	0	19	0
20	Tax-exempt bond liabilities ..........	25,552,129	20	24,322,261
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	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 ..	264,220	23	119,597
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.....	9,968,759	25	8,323,252
26	Total liabilities. Add lines 17 through 25.....	39,990,443	26	37,431,476
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	74,101,315	27	77,860,577
28	Temporarily restricted net assets .....	48,089	28	43,843
29	Permanently restricted net assets .....	0	29	0
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	74,149,404	33	77,904,420
34	Total liabilities and net assets/fund balances .....	114,139,847	34	115,335,896

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

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

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

SIERRA VISTA REGIONAL HEALTH CENTER INC

Employer identification number

86-0186064

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Type I

Type II

Type III - Functionally integrated

Type III - Other

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

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

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

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

Yes

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

11g(i)

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

11g(ii)

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

11g(iii)

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2011

Page 2

Part II

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

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

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

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

Section C. Computation of Public Support Percentage

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

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

16a

33 1/3% support test—2011. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2010. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

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

Schedule A (Form 990 or 990-EZ) 2011

Page 3

Part III

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

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2011

Page 4

Part IV

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

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

OMB No. 1545-0047

2011

Name of organization

SIERRA VISTA REGIONAL HEALTH CENTER INC

Employer identification number

86-0186064

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2

Name of organization SIERRA VISTA REGIONAL HEALTH CENTER INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

Name of organization SIERRA VISTA REGIONAL HEALTH CENTER INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
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) (2011)

Page 4

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization
SIERRA VISTA REGIONAL HEALTH CENTER INC

Employer identification number

86-0186064

Part III

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

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below.
SchCMd Bullet

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

See separate instructions.

OMB No. 1545-0047

2011

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, line 35c (Proxy Tax), then
Round Bullet

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

Name of the organization

SIERRA VISTA REGIONAL HEALTH CENTER INC

Employer identification number

86-0186064

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2011

Page 2

Part II-A

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

A Check if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check if the filing organization checked box A and "limited control" provisions apply.

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) Total

2a	Lobbying non-taxable 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) 2011

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)

Yes

(b)

Amount

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

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

Yes

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

Yes

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

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

Yes

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

Yes

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

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

Yes

1,523

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

Other activities? ..........................

Yes

10,576

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

12,099

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Identifier	Return Reference	Explanation
LOBBYING ACTIVITIES	SCHEDULE C, PART II-B	LINE 1G - ACTIVITY CONSISTED OF DINNER IN PHOENIX AZ WITH STATE REPRESENTATIVES AND MEMBERS OF THE HOSPITAL STAFF AND TRUSTEES. THE PURPOSE OF THE MEETING WAS TO DISCUSS THE IMPACT OF STATE LEGISLATION UPON THE HOSPITAL. LINE 1I - THIS AMOUNT REPRESENTS THE PORTION OF AMERICAN HOSPITAL ASSOCIATION DUES THAT HAVE BEEN ALLOCATED TO LOBBYING ACTIVITIES.

Schedule C (Form 990 or 990EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

SIERRA VISTA REGIONAL HEALTH CENTER INC

Employer identification number

86-0186064

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under SFAS 116 (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 XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

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

(ii)

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

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2011

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No

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


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

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

Yes No

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

Part V

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

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

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	1,824,928		1,824,928
b	Buildings ................	39,793,189	19,429,238	20,363,951
c	Leasehold improvements ............	0	0	0
d	Equipment ................	45,362,203	34,119,476	11,242,727
e	Other .................	6,148,963	2,438,235	3,710,728
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				37,142,334

Schedule D (Form 990) 2011

Page 3

Part VII

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

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








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

Part VIII

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

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









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

Part IX

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

(a) Description				(b) Book value









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

Part X

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

1.(a) Description of Liability		(b) Book value
Federal Income Taxes		0
ACCRUED COMPENSATION		3,872,080
ESTIMATED THIRD PARTY LIAB.		2,644,856
OTHER LIABILITIES		1,806,316






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		8,323,252
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2011

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3
4	Net unrealized gains (losses) on investments ..........................	4
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV.) .................................	8
9	Total adjustments (net). Add lines 4 through 8 .........................	9
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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

Part XIV

Supplemental Information

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

Identifier	Return Reference	Explanation
PART X, LINE 1	ASC 740 FOOTNOTE	THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2012 DO NOT CONTAIN AN ASC 740 FOOTNOTE. MANAGEMENT HAS DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS THAT REQUIRE ACCRUAL OR DISCLOSURE.

Schedule D (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

SIERRA VISTA REGIONAL HEALTH CENTER INC

Employer identification number

86-0186064

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other

Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the

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

Yes

200% 250% 300% 350% 400% Other 800 %

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

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

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Financial Assistance at cost (from Worksheet 1) ..	1,419,437	0	1,419,437	1.570 %
b Medicaid (from Worksheet 3, column a) .....	14,099,265	11,479,681	2,619,584	2.900 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .	2,973	2,241	732	0 %
dTotal Financial Assistance and Means-Tested Government Programs .....	15,521,675	11,481,922	4,039,753	4.470 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	199,013	0	199,013	0.220 %
f Health professions education (from Worksheet 5) ..	1,776,886	797,085	979,801	1.080 %
g Subsidized health services (from Worksheet 6) ..	0	0	0	0 %
h Research (from Worksheet 7)	0	0	0	0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....	70,285	2,175	68,110	0.080 %
jTotal Other Benefits ...	2,046,184	799,260	1,246,924	1.380 %
kTotal. Add lines 7d and 7j. ..	17,567,859	12,281,182	5,286,677	5.850 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011

Schedule H (Form 990) 2011

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.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	20,592	20,592	0.020 %
4	Environmental improvements
5	Leadership development and training for community members	22,500	22,500	0.020 %
6	Coalition building
7	Community health improvement advocacy	49,076	49,076	0.050 %
8	Workforce development	84,246	84,246	0.090 %
9	Other
10	Total	176,414	176,414	0.180 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Enter the amount of the organization's bad debt expense........

1,553,047

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....

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

Section B. Medicare

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

22,566,775

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

25,950,809

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

-3,384,034

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

Management Companies and Joint Ventures

(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) 2011

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	SIERRA VISTA REGIONAL HLTH CNTR 300 EL CAMINO REAL SIERRA VISTA,AZ85635	X	X	X	X

Schedule H (Form 990) 2011

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Part VFacility Information (continued)

Section B. Facility Policies and Practices.

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

SIERRA VISTA REGIONAL HLTH CNTR

Name of Hospital Facility:

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

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet the community health needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. ....		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9	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.

Schedule H (Form 990) 2011

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Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 800.% If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	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?..........		16	Yes
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

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Part VFacility Information (continued)

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

Schedule H (Form 990) 2011

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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?4
Name and address		Type of Facility (describe)
1	MOORMAN AVE OUTPATIENT SVCS 185 S MOORMAN AVE SIERRA VISTA,AZ85635	LAB/INFUSION/HOSPICE
2	SIERRA VISTA REGIONAL HEALTH CENTER 151 COLONIA DE SALUD SIERRA VISTA,AZ85635	OUT PATIENT SURGERY CENTER
3	SIERRA VISTA REGIONAL HEALTH CENTER 151 COLONIA DE SALUD SIERRA VISTA,AZ85635	IMAGING CENTER
4	SIERRA VISTA REGIONAL HEALTH CENTER 2151 S HWY 92 SIERRA VISTA,AZ85635	REHABILITATION SERVICES
5
6
7
8
9
10

Schedule H (Form 990) 2011

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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; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
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.

Identifier	ReturnReference	Explanation
PART I LINE 3C		1. PHILOSOPHY: IN KEEPING WITH SIERRA VISTA REGIONAL HEALTH CENTERS VISION TO BE A LEADER IN IMPROVING THE COMMUNITY'S HEALTH CARE STATUS, IT IS CONSIDERED NOT ONLY NECESSARY BUT ALSO APPROPRIATE TO MAKE ADJUSTMENT TO PATIENT CARE CHARGES UNDER CERTAIN CIRCUMSTANCES. IT IS NOT THE INTENT OF THIS POLICY TO RESTRICT THIS PRACTICE, BUT TO ESTABLISH CLEAR GUIDELINES BY WHICH TO ACCOMPLISH THE TASK. 2. DEFINITIONS: BECAUSE ADJUSTMENTS CAN OCCUR FOR SEVERAL REASONS, IT IS NECESSARY TO DEFINE CERTAIN TYPES OF ADJUSTMENTS. A. UNCOMPENSATED CARE: UNCOMPENSATED CARE/CHARITY CARE IS DEFINED AS SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE TO PAY BASED ON INCOME LEVEL, FINANCIAL ANALYSIS, DEMOGRAPHIC INDICATORS AND/OR FURTHER HEALTHCARE NEEDS BASED ON DIAGNOSIS OR CATASTROPHIC CIRCUMSTANCES. B. SELF - PAY DISCOUNT: A PAYMENT ADJUSTMENT MAY OCCUR WHEN THE PATIENT AGREES TO MAKE IMMEDIATE OR PROMPT PAYMENT IN RETURN FOR A REDUCTION IN THE AMOUNT DUE. C. PROCESS: ALL ADJUSTMENTS OF PATIENT CARE CHARGES REQUESTED SHALL BE APPROVED BY PERSONS DESIGNATED AS FOLLOWS: - $25,000 + CFO - $5,000 TO $24,999 DIRECTOR OF REVENUE MANAGEMENT - $101 TO $4,999 ASSISTANT MANAGER OF A/R - $1.00 TO $100 A/R STAFF - SELF PAY DISCOUNTS: A SELF PAY DISCOUNT OF 50% WILL BE APPLIED AT THE TIME OF BILLING. - SELF PAY PACKAGE PRICING: SELF PAY PACKAGE PRICING IS NOT ELIGIBLE FOR THE 50% DISCOUNT AS THESE CHARGES ARE ALREADY DISCOUNTED IN THE PACKAGE PRICING METHODOLOGY. D. PLEASE NOTE ON SELF PAY AFTER INSURANCE, THERE IS NO DISCOUNT ON DEDUCTIBLES OR CO-PAYS AS THIS IS PART OF THE CONTRACTUAL RELATIONSHIP BETWEEN THE PAYER AND THE SUBSCRIBER. ONLY COINSURANCE BALANCES ARE ELIGIBLE FOR DISCOUNTS. E. A COINSURANCE DISCOUNT OF 30% WILL BE APPLIED AT THE TIME OF BILLING. F. UNCOMPENSATED CARE - CHARITY CARE POLICY REQUEST FOR CHARITY CARE (FINANCIAL ASSISTANCE): FINANCIAL ASSISTANCE REQUEST MAY BE MADE BY THE PATIENT, OUTSIDE HEALTH CARE PROVIDERS, COMMUNITY OR RELIGIOUS GROUPS, SOCIAL SERVICES, FAMILY MEMBERS, AND SVRHC PERSONNEL. THE FINANCIAL COUNSELOR WILL KEEP ON FILE (AND FOR REFERENCE) AN ANNUAL "POVERTY GUIDELINES" AS PUBLISHED BY THE FEDERAL REGISTRY. 1. ELIGIBILITY CONSIDERATIONS FOR FINANCIAL ASSISTANCE: - FINANCIAL ASSISTANCE IS SECONDARY TO ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT INCLUDING INSURANCE, GOVERNMENT PROGRAMS, THIRD PARTY LIABILITY, AND PERSONAL ASSISTS. - FULL FINANCIAL ASSISTANCE WILL BE PROVIDED TO A PATIENT/GUARANTOR WITH A GROSS FAMILY INCOME 100% OF THE FEDERAL POVERTY GUIDELINES. DEPENDENT UPON THE ELIGIBILITY CRITERIA FOR THE AHCCCS PROGRAMS - MOST PROGRAMS AHCCCS ELIGIBILITY 100% FPL (FEDERAL POVERTY LEVEL) - A PATIENT/GUARANTOR WILL BE GIVEN PARTIAL FINANCIAL ASSISTANCE BASED ON HIS OR HER INCOME LEVEL UP TO 800% OF THE POVERTY GUIDELINES. - COSMETIC AND OTHER SERVICES THAT ARE NOT MEDICALLY NECESSARY ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE - OTHER CATASTROPHIC CIRCUMSTANCES MAY BE CONSIDERED IN THE CHARITY DECISION. - AHCCCS ELIGIBILITY WITHIN 60 DAYS OF SERVICE WILL BE PROOF OF INDIGENCE - MEDICAL INDIGENCE -EVALUATE ADDITIONAL CIRCUMSTANCE - MEDICAL BILLS (COMBINED) GREATER THAN 1 YEAR TIMES ANNUAL INCOME - CATASTROPHIC EVENT/DIAGNOSIS - ASSET AVAILABILITY - PATIENTS/GUARANTORS WILL BE ASKED TO COMPLETE AN APPLICATION FOR ASSISTANCE AND PROVIDE PROOF OF INCOME SUCH AS EMPLOYER PAYMENTS STUBS, BANK STATEMENTS AND/OR TAX RETURN. 2. DETERMINATION: - PATIENTS/GUARANTORS WILL BE NOTIFIED OF FINANCIAL ASSISTANCE DETERMINATION BY PHONE OR IN WRITING. - PATIENTS/GUARANTORS MAY APPEAL A FINANCIAL ASSISTANCE DETERMINATION BY PROVIDING ADDITIONAL INFORMATION SUCH AS INCOME VERIFICATION OR AN EXPLANATION OF EXTENUATING CIRCUMSTANCES TO THE FINANCIAL COUNSELOR FOR REVIEW. - SVRHC'S DECISION TO PROVIDE FINANCIAL ASSISTANCE IN NO WAY AFFECTS THE PATIENTS/GUARANTOR FINANCIAL OBLIGATION TO THEIR PHYSICIAN OR OTHER HEALTH CARE PROVIDERS.
PART I LINE 6A		THE ORGANIZATION HAD A COMMUNITY BENEFIT REPORT PREPARED FOR THIS TAX YEAR IN APRIL OF 2012 BY HMS ASSOCIATES.
PART I LINE 7		COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE IS PRIMARILY THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H. OTHER COSTS COME FROM OUR FY2012 COST REPORT.
PART II		COMMUNITY BUILDING ACTIVITIES SIERRA VISTA REGIONAL HEALTH CENTER'S MISSION REFLECTS THE PHILOSOPHY THAT WE WILL PROVIDE HEALTHCARE EDUCATION, RESOURCES, AND PROGRAMS TO CITIZENS WITHIN THE COMMUNITY IN ADDITION TO THOSE WHO ARE UNDERINSURED AND UNINSURED. THIS TYPE OF COMMUNITY BENEFIT INCLUDES THE COST OF TRADITIONAL CHARITY CARE, UNPAID PORTIONS OF AHCCCS, AND SUPPLIES OR STAFF TIME VOLUNTEERED ON BEHALF OF THE COMMUNITY. THROUGH OUR WELLNESS DEPOT IN THE MALL AT SIERRA VISTA, OUR COMMUNITY BENEFIT COORDINATOR HAS IMPLEMENTED AND HOSTED APPROXIMATELY 142 DIFFERENT HEALTH AND WELLNESS RELATED PROGRAMS AND EVENTS FOR THE PUBLIC. THE OVERWHELMING RESPONSE TO THESE OFTEN FREE EDUCATIONAL SYMPOSIUMS HAS BEEN NOTHING BUT POSITIVE. IN SOME CASES, WE'VE EVEN SAVED LIVES BY RECOGNIZING HIGH BLOOD PRESSURE, SYMPTOMS OF HEART DISEASE, AND TEACHING THE POSITIVE EFFECTS OF A PLANT BASED DIET. WE KNOW THAT OUR WELLNESS DEPOT HAS A VERY POSITIVE IMPACT WITHIN THE COMMUNITY BECAUSE WE HEAR TIME AND AGAIN HOW THANKFUL THE COMMUNITY IS FOR PROVIDING OUTREACH TO THOSE WHO MAY NOT HAVE REGULAR ACCESS TO HEALTHCARE. THROUGH THE DEPOT, WE'VE TOUCHED ABOUT 37,000 LIVES WITHIN THE LAST THREE YEARS WHICH IS AN INCREDIBLE NUMBER OF PEOPLE WE ARE REACHING. SIERRA VISTA REGIONAL HEALTH CENTER ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE FINANCIALLY VIABLE. THE DEVELOPMENT AND VALUE OF THESE PROGRAMS IS BASED ON A COMMUNITY HEALTH CARE ASSESSMENT PERFORMED BY AN INDEPENDENT COMPANY. ONGOING COMMUNITY OUTREACH PROGRAMS: ADULT HEARING LOSS SUPPORT GROUP ADVANCED DIRECTIVES ALZHEIMER EDUCATIONAL CLASSES ANIMAL THERAPY ARTHRITIS PROGRAMS ARTHRITIS SELF-HELP CLASSES BETTER BREATHERS CLUB BLOOD PRESSURE CHECKS BODY MASS INDEX BREASTFEEDING SUPPORT CARDIAC & PULMONARY REHABILITATION CHAIR ZUMBA CHOLESTEROL EDUCATION: KNOW WHAT YOUR NUMBERS MEAN COMPRESSION ONLY CPR CONGESTIVE HEART FAILURE CLASSES DIABETES EDUCATION ESSENTIAL OILS EDUCATION FLU PRECAUTION PROGRAMS FLU VACCINE CLINICS FOOD DRIVES HEALTHY LIFESTYLE CHOICES HELP WITH MEDICARE HOSPICE BEREAVEMENT GROUP SCHOOL & KIDS SPORTS TEAMS 1ST AID KITS KIDNEY SMART KIGONG LIVING WILLS MALL WALKERS PROGRAM MATH & SCIENCE EXPERIENCE AT COCHISE COLLEGE MUSIC THERAPY NUTRITION CLASSES FOR CHILDREN OSTOMY GROUP PARISH NURSE PROGRAM PET AND MUSIC THERAPY FOR PATIENTS PERINATAL GRIEF SUPPORT POSTPARTUM DEPRESSION INFORMATION PRENATAL CLASSES PULMONARY REHABILITATION PULSE OXYGEN TESTS SHINGLES AWARENESS TAI CHI SENIOR NUTRITION CLASS SERIES SPEAKERS BUREAU STROKE/BRAIN INJURY SUPPORT GROUP SUN SAFETY TELECARE HOME BOUND VICAP SPACE AND SUPPLIES VIRTUAL TOUR KITS FOR ALL SCHOOLS WEIGHT MANAGEMENT PROGRAM WELLNESS DEPOT ZUMBA GOLD FOR SENIORS SPECIAL COMMUNITY OUTREACH PROGRAMS: A BUYERS GUIDE TO HOME HEALTHCARE A MATTER OF BALANCE ATRIAL FIBRILLATION BAT EDUCATION BRAIN INJURY BREAST CANCER AWARENESS CHRONIC DISEASE MANAGEMENT CHRONIC SINUSITIS SUFFERS COLORECTAL CANCER AWARENESS DIGITAL MAMMOGRAPHY EDUCATION DOMESTIC VIOLENCE INFORMATION BUCKETLIST: END OF LIFE DECISIONS EPILEPSY 101 FALL INTO STEP GLUTEN FREE DIET HEALTH FAIRS HEALTHY LIFESTYLE CHOICES HEART HEALTH HEART SAVING CT SCANNING EDUCATION HPV: WHAT EVERY WOMAN SHOULD KNOW IMMUNIZATION INFORMATION LIVING VEGAN/MEATLESS MONDAY MAMMOGRAPHY EDUCATION MEDICAL IDENTITY THEFT MEDITATION: MIND & BODY MEDITERRANEAN COOKING MENTAL HEALTH MRSA AWARENESS MRSA FOR PARENTS MULTIPLE SCLEROSIS EDUCATION OSTEOPOROSIS EDUCATIONS PEACEFUL DYING: HOSPICE MONTH PROPER FITTING FOOTWEAR FOR SUMMER PREVENTION, STABILIZATION & REVERSAL OF CAD THROUGH A PLANT BASED DIET RADICAL SELF CARE FOR THE MODERN WOMAN REVERSAL OF DIABETES STRENGTH TRAINING FOR THE OLDER ADULT STRESS ON YOUR HEART STRESS MANAGEMENT STRESS RELIEF FOR THE HOLIDAYS SUGAR BLUES SURVIVAL STRATEGIES FOR THE HOLIDAYS SURVIVING THE HOLIDAYS WITH HUMOR THE GLUTEN CONNECTION THE "GUT" CONNECTION VENOMOUS REPTILES EDUCATION WHITE POISONS WOMEN & HEART DISEASE WOMEN & A PLANT BASED DIET EDUCATION SIERRA VISTA REGIONAL HEALTH CENTER, THE LARGEST NONPROFIT MEDICAL CENTER IN SOUTHEASTERN ARIZONA, OFFERS EXTENSIVE GRADUATE MEDICAL EDUCATION AND A RESOURCE MENTOR PROGRAM FOR NURSES, PHYSICIANS, AND OTHER HEALTHCARE PROFESSIONALS. EDUCATIONAL OFFERINGS INCLUDE: - SVRHC IS HOME TO THE ONLY COUNTY-WIDE INTERNAL MEDICINE & FAMILY RESIDENCY PROGRAMS - SVRHC PROVIDES TRAINING AT THE HOSPITAL TO NURSES FROM COCHISE COLLEGE - SVRHC HOSTS NURSING, REHABILITATION, PHARMACY, LABORATORY, DIAGNOSTIC IMAGING STUDENTS - SVRHC PROVIDES HOUSING AND MEALS TO MEDICAL STUDENTS AND RESIDENTS - THE SUMMER VOLUNTEEN PROGRAM PROVIDES REAL WORLD JOB EXPERIENCE AND MENTORING FOR STUDENTS INTERESTED IN PURSUING HEALTHCARE CAREERS COMMUNITY EVENTS THE HOSPITAL SPONSORS ORGANIZATIONS AND EVENTS IN THE COMMUNITY WHICH PROMOTE HEALTHY LIFE STYLES AND/OR DISEASE PREVENTION/INFORMATION. SOME OF THESE INCLUDE: AMERICAN CANCER SOCIETY AMERICAN RED CROSS BLOOD DRIVE VISTABILITY FAIR FORGACH HOUSE (BATTERED WOMEN/CHILDREN) GOOD NEIGHBOR ALLIANCE (MEN'S SHELTER) UNITED WAY MARCH OF DIMES JUST KIDS, INC (CLOTHING PROGRAM)SIERRA VISTA OPEN HIGH SCHOOL SCHOLARSHIPS COLLEGE SCHOLARSHIPS SENIOR EXPO FT. HUACHUCA HEALTH DAY (2/YR) CHAMBER BACK TO SCHOOL EVENT CHAMBER BUSINESS EXPO CHAMBER HEALTH DAY SCHOOL CAREER DAYS MOUNTAIN EMPIRE ROTARY SACA AMERICAN RED CROSS FIREFIGHTER'S TOY DRIVE VICAP SIERRA VISTA AND TOMBSTONE - PROJECT GRADUATION (DRUG/ALCOHOL FREE EVENING FOR GRADUATING SENIORS) CARONDELET HEALTH FOUNDATION ARTHRITIS FOUNDATION COMFORT ZONE (FREE BLOOD PRESSURE CHECKS) MINISTRY FAIR (FREE BLOOD PRESSURE CHECKS) LOWE'S HEALTH & SAFETY FAIR FEEDBACK SIERRA VISTA REGIONAL HEALTH CENTER PROVIDES MANY OPPORTUNITIES FOR COMMUNITY MEMBERS TO PROVIDE US FEEDBACK ON THE PROGRAMS AND SERVICES DELIVERED BY THE HOSPITAL. THESE PROGRAMS INCLUDE: SVRHC AUXILIARY SVRHC FOUNDATION FACILITY TOURS FOCUS GROUPS VOLUNTEER SERVICES COMMUNITY BREAKFASTS PRESS GANEY SURVEYS SUGGESTION BOXES LOCAL PHYSICIAN OFFICES COMMUNITY ASSESSMENTS WEB SITE CLERGY BREAKFASTS ANNUAL REPORT PASTORAL BREAKFASTS FACEBOOK HEALTH BEAT COMMUNICATION STATISTICS 1. COMMUNITY SPEAKERS 3,542 2. ATTENDANCE AT SPEAKING ENGAGEMENTS 5,120 3. SUPPORT GROUPS/CLASSES 2,100 4. COMMUNITY FEEDBACK OVER 3,500 5. WEB SITE HITS 3.7 MILLION 6. WELLNESS DEPOT ANNUAL RENTAL SPACE $ 49,076 7. COMMUNITY BENEFIT STAFF AND BENEFIT COST $ 84,246 8. ANNUAL VISITORS TO DEPOT 13,000 10. DIRECT MAIL OF HEALTH BEAT 52,000 12 TIMES PER YEAR 11. AMBULANCE SUPPLIES $ 16,532 12. VICAP SPACE & UTILITIES $ 4,060 13. SCHOLARSHIP COST $ 22,500 HIGH SCHOOL AND COLLEGE
PART III LINE 4		THE BAD DEBT EXPENSE (AT COST) WAS CALCULATED USING THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H. THE BAD DEBT EXPENSE IS RECORDED ON THE FINANCIALS AT GROSS CHARGES. EVERY EFFORT IS MADE TO IDENTIFY CHARITY PATIENTS AT THE POINT OF SERVICE SO NONE OF THE PATIENTS WRITTEN OFF TO BAD DEBT SHOULD HAVE BEEN ELIGIBLE FOR CHARITY CARE. IT IS POSSIBLE THAT SOME PATIENTS REFUSED TO COMPLETE THE CHARITY APPLICATION SO THAT NEED COULD NOT BE DETERMINED.
PART III LINE 8		MEDICARE ALLOWABLE COSTS WERE CALCULATED USING THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H. EXPENSE FOR HEALTH PROFESSIONAL EDUCATION WAS THEN EXCLUDED FROM RESULTING COST. THE ENTIRE SHORTFALL CALCULATED SHOULD BE ATTRIBUTABLE TO COMMUNITY BENEFIT, SINCE THERE ARE NO OTHER HOSPITALS IN THE AREA THAT COULD PROVIDE CARE FOR THESE PATIENTS.
PART III LINE 9B	BAD DEBT REVIEW	- HEALTH CARE OUT SOURCING NETWORK (HON) WILL PROVIDE A LISTING WEEKLY OF ACCOUNTS FOR POSSIBLE APPROVAL FOR BAD DEBT PROCESSING. - ALL ACCOUNTS WILL HAVE BEEN IN SELF PAY COLLECTIONS FOR 120 DAYS PRIOR TO ASSIGNMENT. - ALL ACCOUNTS WILL BE SCREENED TO ENSURE THAT THE CO-PAY AND OR DEDUCTIBLE AMOUNT IS CORRECT. - ALL ACCOUNTS WILL BE SCREENED PRIOR TO BAD DEBT PLACEMENT FOR POSSIBLE PAYMENTS, OTHER THIRD PARTY INSURANCE. AND OR OTHER AGENCY. - A LISTING OF ANY ACCOUNTS TO BE PULLED FROM COLLECTIONS WILL BE PROVIDED BACK TO HON FOR FURTHER WORK UP.
PART V LINE 18D		PURPOSE THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA) IMPOSES REQUIREMENTS ON HOSPITALS THAT PARTICIPATE IN THE MEDICARE PROGRAM. THESE OBLIGATIONS INCLUDE A REQUIREMENT THAT A HOSPITAL WITH A DEDICATED EMERGENCY DEPARTMENT (DED) PROVIDE A MEDICAL SCREENING EXAMINATION TO PERSONS REQUESTING OR REQUIRING SUCH SERVICES, A REQUIREMENT THAT HOSPITALS PROVIDE STABILIZING TREATMENT OR APPROPRIATE TRANSFER TO PERSONS WITH EMERGENCY MEDICAL CONDITIONS, A REQUIREMENT THAT HOSPITALS WITH SPECIALIZED CAPABILITIES ACCEPT CERTAIN TRANSFERS, AND VARIOUS NOTICE, RECORDKEEPING, REPORTING, AND ON-CALL PHYSICIAN REQUIREMENTS. THE PURPOSE OF EMTALA IS TO PREVENT HOSPITALS FROM "DUMPING" PERSONS WHO ARE UNABLE TO PAY FOR THEIR TREATMENT, EITHER BY REFUSING TO PROVIDE EMERGENCY MEDICAL SERVICES OR BY INAPPROPRIATELY TRANSFERRING OR DISCHARGING THESE PERSONS FOR FINANCIAL REASONS. ALL HOSPITALS WITH A DED MUST COMPLY WITH ALL OF THE EMTALA REQUIREMENTS. POLICY A. MEDICAL SCREENING EXAMINATION (MSE) 1. SVRHC PROVIDES EMERGENCY SERVICES AND MUST PROVIDE A MEDICAL SCREENING EXAMINATION TO ANYONE WHO COMES TO SVRHC OR THE SVRHC'S DEDICATED EMERGENCY DEPARTMENT AND REQUESTS (OR ON WHOSE BEHALF A REQUEST IS MADE) SUCH AN EXAMINATION OR TREATMENT. THE REQUEST MAY BE EXPRESSED OR IMPLIED. THIS INCLUDES PATIENTS WHO PRESENT TO THE SVRHC'S DED OR A PERSON WHO MAY HAVE FAILED TO ACTUALLY ENTER THE DED BUT IS ON SVRHC CAMPUS. IN THE ABSENCE OF A REQUEST FOR EXAM OR TREATMENT, A REQUEST WILL BE CONSIDERED TO EXIST IF A PRUDENT LAYPERSON OBSERVER WOULD BELIEVE, BASED ON THE PERSON'S APPEARANCE OR BEHAVIOR, THAT THE PERSON NEEDS EMERGENCY TREATMENT OR EXAM. A. THE PURPOSE OF THE MEDICAL SCREENING EXAMINATION IS TO DETERMINE WHETHER OR NOT THE PERSON HAS AN EMERGENCY MEDICAL CONDITION. AN EMERGENCY MEDICAL CONDITION IS: (1) A MEDICAL CONDITION MANIFESTING ITSELF BY ACUTE SYMPTOMS OF SUFFICIENT SEVERITY (INCLUDING SEVERE PAIN, PSYCHIATRIC DISTURBANCES, AND/OR SYMPTOMS OF SUBSTANCE ABUSE) SUCH THAT THE ABSENCE OF IMMEDIATE MEDICAL ATTENTION COULD REASONABLY BE EXPECTED TO RESULT IN THE FOLLOWING: (A) PLACING THE HEALTH OF THE PERSON (OR, WITH RESPECT TO A PREGNANT WOMAN, THE HEALTH OF THE WOMAN OR HER UNBORN CHILD) IN SERIOUS JEOPARDY; (B) SERIOUS IMPAIRMENT TO BODILY FUNCTIONS; OR (C) SERIOUS DYSFUNCTION OF ANY BODILY ORGAN OR PART; OR WITH RESPECT TO A PREGNANT WOMAN WHO IS HAVING CONTRACTIONS: (D) THERE IS INADEQUATE TIME TO EFFECT A SAFE TRANSFER TO ANOTHER HOSPITAL BEFORE DELIVERY; OR (E) A TRANSFER POSING A THREAT TO THE HEALTH OR SAFETY OF THE WOMAN OR THE UNBORN CHILD. THE MEDICAL SCREENING EXAMINATION AND THE DETERMINATION OF WHETHER THE PERSON HAS AN EMERGENCY MEDICAL CONDITION MUST BE PROVIDED BY QUALIFIED MEDICAL PERSONNEL DESIGNATED BY SVRHC IN ITS BYLAWS, RULESAND REGULATIONS, OR OTHER POLICIES OR PROCEDURES APPROVED BY SVRHC'S GOVERNING BOARD. QUALIFIED MEDICAL PERSONNEL TYPICALLY INCLUDE PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, MIDWIVES, AND NURSES AND OTHER NON-PHYSICIAN PERSONNEL WITH SPECIALIZED COMPETENCIES CONSISTENT WITH THEIR SCOPE OF PRACTICE. B. SVRHC MAY NOT DELAY MSES OR STABILIZING TREATMENT TO INQUIRE ABOUT PATIENT'S INSURANCE STATUS. C. REFER TO EMTALA GUIDELINES FOR SPECIAL CONDITIONS REGARDING LAW ENFORCEMENT REQUESTS, PREGNANT WOMEN, AND BEHAVIORAL HEALTH PATIENTS. B. NECESSARY STABILIZING TREATMENT 1. IF SVRHC'S QUALIFIED MEDICAL PERSON HAS DETERMINED THAT THE PERSON HAS AN EMERGENCY MEDICAL CONDITION, SVRHC MUST PROVIDE FURTHER MEDICAL EXAMINATION AND TREATMENT NECESSARY TO STABILIZE THE EMERGENCY MEDICAL CONDITION, OR TRANSFER THE PERSON SUBJECT TO THE TRANSFER REQUIREMENTS. A. A PERSON WITH AN EMERGENCY MEDICAL CONDITION IS STABILIZED WHEN NO MEDICAL DETERIORATION OF THE CONDITION IS LIKELY, WITHIN REASONABLE MEDICAL PROBABILITY, TO RESULT FROM OR OCCUR DURING THE TRANSFER OF THE PERSON FROM A FACILITY OR, WITH RESPECT TO A WOMAN HAVING CONTRACTIONS WHO HAS AN EMERGENCY MEDICAL CONDITION, THE WOMAN HAS DELIVERED THE CHILD AND THE PLACENTA. TO BE CONSIDERED STABILIZED, CMS HAS STATED THAT THE EMERGENCY MEDICAL CONDITION MUST BE "RESOLVED," BUT THE UNDERLYING MEDICAL CONDITION MAY STILL PERSIST. C. TRANSFER 1. THE PERSON OR PERSON'S LEGAL REPRESENTATIVE MAKES A WRITTEN REQUEST FOR TRANSFER AFTER HAVING BEEN INFORMED OF SVRHC'S OBLIGATION TO PROVIDE AN EXAMINATION AND STABILIZING TREATMENT, AND HAS BEEN INFORMED OF THE RISKS OF TRANSFER (THE WRITTEN REQUEST FORM MUST STATE THE REASONS FOR THE PERSON'S REQUEST; OR A. PHYSICIAN CERTIFIES IN WRITING THAT THE BENEFITS REASONABLY EXPECTED FROM TREATMENT AT ANOTHER FACILITY OUTWEIGH THE INCREASED RISKS TO THE PERSON (OR A PREGNANT WOMAN'S UNBORN CHILD) FROM THE TRANSFER AND THE PERSON OR HIS OR HER REPRESENTATIVE CONSENTS IN WRITING TO THE TRANSFER. IF A PHYSICIAN IS NOT PRESENT IN THE EMERGENCY DEPARTMENT AT THE TIME OF THE TRANSFER, THE QUALIFIED MEDICAL PERSON MAY SIGN THE CERTIFICATION IF A PHYSICIAN CONSULTING WITH THE QUALIFIED MEDICAL PERSON HAS MADE THE DETERMINATION THAT THE BENEFITS OF THE TRANSFER OUTWEIGH THE RISKS, AND THE PHYSICIAN LATER COUNTERSIGNS THE CERTIFICATION. D. DUTY TO REPORT QUESTIONABLE TRANSFERS 1. SVRHC IS REQUIRED TO REPORT TO CMS OR THE STATE SURVEY AGENCY ANY TIME IT HAS REASON TO BELIEVE THAT IT MAY HAVE RECEIVED A TRANSFER FROM ANOTHER HOSPITAL IN VIOLATION OF EMTALA. REPORTS MAY BE VERBAL OR IN WRITING AND SHOULD INCLUDE THE FOLLOWING INFORMATION: A. PATIENT NAME; B. DATE AND TIME OF SERVICE; C. DESCRIPTION OF THE INCIDENT; AND D. NAMES OF ANY WITNESSES, IF APPLICABLE. E. EMTALA SIGNAGE 1. SVRHC MUST CONSPICUOUSLY POST SIGNS IN THEIR EMERGENCY DEPARTMENT(S) AND OTHER PLACES LIKELY TO BE NOTICED BY ALL PERSONS WAITING FOR EMERGENCY EXAMINATION AND TREATMENT (E.G., THE ENTRANCE, ADMITTING AREA, WAITING ROOMS, AND TREATMENT AREAS) THAT EXPLAINS THE RIGHTS OF PERSONS TO EMERGENCY EXAMINATION AND TREATMENT FOR EMERGENCY MEDICAL CONDITIONS UNDER EMTALA. F. CENTRAL LOG 1. SVRHC MUST MAINTAIN A CENTRAL LOG THAT LISTS EACH WHO COMES TO SVRHC'S EMERGENCY DEPARTMENT(S) SEEKING ASSISTANCE FOR A MEDICAL CONDITION. THE CENTRAL LOG MUST CONTAIN THE FOLLOWING INFORMATION: A. THE NAME OF THE PERSON WHO CAME TO THE DED SEEKING EXAMINATION OR TREATMENT FOR A MEDICAL CONDITION; AND B. THE PERSON'S DISPOSITION; SPECIFICALLY WHETHER: (1) THE PERSON REFUSED TREATMENT; (2) SVRHC REFUSED TO EXAMINE OR TREAT THE PERSON (WHICH WOULD LIKELY CONSTITUTE AND EMTALA VIOLATION; (3) THE PERSON WAS TRANSFERRED; (4) THE PERSON WAS ADMITTED AND TREATED; (5) THE PERSON WAS STABILIZED AND TRANSFERRED; OR (6) THE PERSON WAS DISCHARGED. G. ON-CALL PHYSICIAN LIST 1. SVRHC MUST MAINTAIN A LIST OF PHYSICIANS ON-CALL TO PROVIDE STABILIZING TREATMENT TO PERSONS WITH EMERGENCY MEDICAL CONDITIONS. THE EMTALA REGULATIONS REQUIRE SVRHC TO MAINTAIN ITS ON-CALL LIST IN ACCORDANCE WITH THE RESOURCES AVAILABLE TO SVRHC, INCLUDING THE AVAILABILITY OF ON-CALL PHYSICIANS. 2. ON-CALL PHYSICIAN REQUIREMENTS A. THE DESIGNATED ON-CALL PHYSICIAN MAY RESPOND TO THE CALL TELEPHONICALLY OR IN PERSON, DEPENDING ON THE NEEDS OF THE PATIENT AS DETERMINED BY THE PHYSICIAN OR QUALIFIED MEDICAL PERSON ATTENDING THE PATIENT. THE EMTALA INTERPRETIVE GUIDELINES STATE THAT THE PERSON WHO ATTENDS TO THE PATIENT DETERMINES WHETHER THE PRESENCE OF THE ON-CALL PHYSICIAN IF REQUIRED. IF THE PHYSICIAN OR QUALIFIED MEDICAL PERSON REQUIRES THE ON-CALL PHYSICIAN'S PRESENCE, THEN THE ON-CALL PHYSICIAN MUST COME TO THE HOSPITAL. B. IF THE ON-CALL PHYSICIAN IS UNABLE IS UNABLE TO RESPOND TO THE CALL DUE TO CIRCUMSTANCES BEYOND HIS OR HER CONTROL (E.G., IN SURGERY AT ANOTHER HOSPITAL), THE ON-CALL PHYSICIAN SHOULD NOTIFY THE PERSON ATTENDING TO THE PATIENT THAT THE PHYSICIAN IS UNABLE TO RESPOND AND THE REASONS WHY. THE PHYSICIAN SHOULD EITHER PERSONALLY DOCUMENT, OR ENSURE THAT THE ATTENDING PHYSICIAN OR QUALIFIED MEDICAL PERSON DOCUMENTS, THE REASONS THAT THE PHYSICIAN COULD NOT RESPOND TO CALL IN THE MEDICAL RECORD. CMS DOES NOT VIEW "A FULL OFFICE" AS A VALID REASON FOR REFUSING TO RESPOND TO CALL. C. IF THE ON-CALL PHYSICIAN CONTENDS THAT HE OR SHE IS NOT QUALIFIED TO TREAT A PATIENT, THEN THE EMERGENCY DEPARTMENT PHYSICIAN OR QUALIFIED MEDICAL PERSON MAY STILL REQUEST THE PHYSICIAN'S PRESENCE IN THE EMERGENCY DEPARTMENT, EVEN IF THE ON-CALL PHYSICIAN WILL ONLY BE ABLE TO HELP MANAGE THE PATIENT'S TRANSFER. D. THE ON-CALL PHYSICIAN MAY DELEGATE HIS OR HER EVALUATION AND STABILIZATION DUTIES TO A NURSE PRACTITIONER OR PHYSICIAN ASSISTANT UNDER THE PHYSICIAN'S SUPERVISION, BUT ONLY IF: (1) THE ON-CALL PHYSICIAN MAKES A DETERMINATION ON A CASE-BY-CASE BASIS THAT THE NON-PHYSICIAN PRACTITIONER IS CAPABLE OF PROVIDING THE NECESSARY CARE, CONSISTENT WITH THE PATIENT'S NEEDS; (2) THE PATIENT'S CARE NEEDS ARE WITHIN THE SCOPE OF THE NON-PHYSICIAN PRACTITIONER'S PRACTICE, IN ACCORDANCE WITH STATE LAW; AND (3) SVRHC'S POLICIES AND PROCEDURES PERMIT THIS PRACTICE. IF THE TREATING PHYSICIAN DISAGREES WITH THE ON-CALL PHYSICIAN
PART V LINE 19D	DETERMINATION OF MAXIMUM CHARGES FOR FAP-ELIGIBLE INDIVIDUAL	SELF-PAY PATIENTS ARE TYPICALLY DISCOUNTED 50%. THEY CAN QUALIFY FOR ADDITIONAL DISCOUNTS BASED ON THEIR INCOME. THIS IS DONE ON A CASE BY CASE BASIS.
PART VI, LINE 2	NEEDS ASSESSMENT	A COMMUNITY HEALTH ASSESSMENT WAS PERFORMED BY HMS ASSOCIATES, A NATIONAL COMPANY FOR SIERRA VISTA REGIONAL HEALTH CENTER IN JULY, 2007. THE COMPANY CONDUCTED THE SURVEY UTILIZING THREE TYPES OF INFORMATION: A. STATISTICS ON DEATHS, BIRTHS, SERVICE USE B. COMMUNITY SURVEYS C. OPINIONS OF KEY ORGANIZATIONS THE ASSESSMENT COVERED ALL OF THE HOSPITAL'S SERVICE AREAS WITHIN THE COUNTY AND KEY EFFORTS INCLUDED DURING THE ANALYSIS WERE: GATHERING DATA, ASSIGNING DATA TO HEALTHY PEOPLE PROGRAM CATEGORIES, COMPARING DATA TO BENCHMARKS, ANALYZING DATA AND SELECTING PRIORITIES, AND SUMMARIZING FINDINGS. THE ASSESSMENT WAS THE FOUNDATION FOR SVRHC'S COMMUNITY BENEFIT PLAN WHICH INCLUDES ACTIVITIES AND PROGRAMS TO IMPROVE THE COMMUNITY HEALTH OF OUR CITIZENS.
PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	SIERRA VISTA REGIONAL HEALTH CENTER INFORMS AND EDUCATES OUR PATIENTS AND COMMUNITY MEMBERS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS AND UNDER THE HOSPITAL'S CHARITY CARE POLICY IN THE FOLLOWING WAYS: A. INFORMATION ON ELIGIBILITY ASSISTANCE IS PROVIDED ON THE WEBSITE, AT THE HOSPITAL'S WELLNESS DEPOT, AND IN PAMPHLETS. B. EACH PATIENT IS VISITED BY AN ELIGIBILITY SPECIALIST TO DISCUSS ONE-ON-ONE ELIGIBILITY ASSISTANCE. C. THERE ARE POSTED SIGNS WITHIN THE HOSPITAL NOTIFYING PATIENTS/COMMUNITY MEMBERS ON ASSISTANCE. D. FOR PATIENTS UNABLE TO INTERACT WITH AN ELIGIBILITY SPECIALIST AT THE TIME OF ARRIVAL THROUGH THE EMERGENCY ROOM, THE DEMOGRAPHICS AND INFORMATION SHEET IS VIEWED BY THE SPECIALIST AND CONTACT IS MADE WITH EACH ONE TO DISCUSS ELIGIBILITY. E. THERE IS A STATEMENT ON EACH BILL SENT TO ALL PATIENTS ABOUT ELIGIBILITY ASSISTANCE.
PART VI, LINE 4	COMMUNITY INFORMATION	THE HOSPITAL UTILIZED THE DEMOGRAPHIC INFORMATION PROVIDED BY THE ASSESSMENT ON THE POPULATIONS OF THE CITIES WITHIN COCHISE COUNTY AND INFUSED THESE FINDINGS INTO OUR PLAN. WE LOOKED AT THE POPULATION SIZE AND DENSITY, DISTRIBUTION, AND VITAL STATISTICS OF EACH CITY COUPLED WITH THE HEALTH NEED FINDINGS TO ESTABLISH EDUCATION AND PROGRAMS FOR THE POPULACE. SOME OF THE DEMOGRAPHIC INFLUENCES UNIQUE TO OUR SERVICE AREA INCLUDE THE FOLLOWING: A. DUE TO ANTICIPATED POPULATION GROWTH, THE NEED FOR SERVICES WILL GROW BY 50% OVER THE NEXT 20 YEARS B. THE POPULACE OF 50+ YEARS IS PROJECTED TO GROW BY 54% OVER THE NEXT 20 YEARS C. RETIREE GROWTH IS ALSO PROJECTED TO GROW BY 18% OVER THE NEXT 20 YEARS D. POPULATIONS DENSITY VARIES (FROM 500 TO 65,000) DUE TO MOST OF OUR SERVICE AREA BEING RURAL E. ALL OF OUR SERVICE AREA HAS CULTURAL SENSITIVITY CHARACTERISTICS F. THE POPULACE HAS SPECIAL POPULATIONS WITHIN OF GROUP HOMES, ARMED FORCES, CIVILIAN VETERANS (TWO AGE GROUPS - 18 TO 64 AND OVER 64) G. DEMOGRAPHICS SHOW HIGH HEALTH RISK BEHAVIOR LEVELS, POOR HEALTH STATUS, AND CONSIDERABLE CONCERN BY COMMUNITY LEADERS AND KEY HEALTH CARE PROVIDERS WITHIN THE COUNTY H. ACCESS TO CARE WAS A MAJOR CONCERN IDENTIFIED FOR THE COUNTY I. THE COUNTY RELIES ON THE EMERGENCY ROOM FOR CARE MORE THAN ANY OTHER COUNTY IN THE STATE
PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH	SEE NARRATIVE FOR SCHEDULE H, PART II.
PART VI, LINE 6	AFFILATED HEALTH CARE SYSTEM	THE HOSPITAL WAS NOT PART OF AN AFFILIATED HEALTH SYSTEM.
PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT	THERE ARE NO STATES IN WHICH THE ORGANIZATION FILES A COMMUNITY BENEFIT REPORT.

Schedule H (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

SIERRA VISTA REGIONAL HEALTH CENTER INC

Employer identification number

86-0186064

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2011

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 column (E) for that individual.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1) MARGARET HEPBURN - SVRH	(i) (ii)	292,395 0	135,607 0	8,664 0	30,522 0	17,950 0	485,138 0	0 0
(2) MARGARET HEPBURN - CHN	(i) (ii)	119,376 0	0 0	10,838 0	0 0	0 0	130,214 0	0 0
(3) BRUCE NORTON	(i) (ii)	216,944 0	74,291 0	3,804 0	29,593 0	23,376 0	348,008 0	0 0
(4) MARIE WURTH	(i) (ii)	156,668 0	50,082 0	2,058 0	0 0	20,722 0	229,530 0	0 0
(5) REBECCA MCCALMONT	(i) (ii)	140,712 0	47,671 0	2,118 0	16,332 0	21,069 0	227,902 0	0 0

Schedule J (Form 990) 2011

Page 3

Part III

Supplemental Information

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

Identifier	Return Reference	Explanation
SCHEDULE J, PART II	ADDITIONAL COMPENSATION INFORMATION	ON APRIL 17, 2010 SIERRA VISTA REGIONAL HEALTH CENTER (SVRHC) ENTERED INTO AN AFFILIATION AGREEMENT WITH THE CARONDELET HEALTH NETWORK (CHN). AS A RESULT OF THAT AGREEMENT THE EMPLOYMENT OF MS HEPBURN, CEO, WAS TERMINATED. SHE WAS PAID BY SVRHC ACCORDING TO THE TERMS OF HER EMPLOYMENT CONTRACT. BEGINNING APRIL 17, 2010, MS HEPBURN BECAME EMPLOYED BY THE CHN. SHE WAS ASSIGNED BY CHN TO SERVE AS THE CEO OF SVRHC FOR THE PURPOSE OF CARRYING OUT THE GOALS AND OBJECTIVES OF THE AFFILIATION AGREEMENT. UNDER THE AGREEMENT SVRHC REIMBURSED THE CHN FOR THOSE SERVICES BEGINNING APRIL 17, 2010. SVRHC TERMINATED ITS AFFILIATION AGREEMENT WITH CHN IN APRIL 2011. AS A RESULT, MS HEPBURN, CEO, THEN BECAME AN EMPLOYEE OF SVRHC. IN ORDER TO MORE CLEARLY REFLECT HER 2011 COMPENSATION FROM EACH ORGANIZATION, TWO LINES OF DISCLOSURE HAVE BEEN PRESENTED ON THE FORM 990 PART VII AND SCHEDULE J PART II.
SCHEDULE J, PART I, LINE 4B	ADDITIONAL COMPENSATION INFORMATION	MARGARET HEPBURN, BRUCE NORTON, MARIE WURTH AND REBECCA MCCALMONT ALL PARTICIPATE IN A SERP PLAN.
SCHEDULE J, PART I, LINE 7	BONUS PROGRAM	THE EXECUTIVE TEAM, WHICH CONSISTS OF THE CEO, CFO, VICE PRESIDENTS, DIRECTORS, AND MANAGERS, ARE ELIGIBLE FOR PARTICIPATION IN THE BONUS PROGRAM. THE AMOUNT OF BONUS IS DETERMINED BY A BONUS MATRIX, ONE OF THE COMPONENTS OF WHICH IS AN EARNINGS TRIGGER. NONE OF THE BONUS MATRIX IS DISCRETIONARY OR NON-FIXED; THEREFORE, THIS QUESTION IS ANSWERED NO.

Schedule J (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

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

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
SIERRA VISTA REGIONAL HEALTH CENTER INC

Employer identification number
86-0186064

Part I

Bond Issues

(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	(g) Defeased		(h) On Behalf of Issuer		(i) Pool financing
(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	Yes	No	Yes	No	Yes	No
A	THE INDUSTRIAL DEV AUTHORITY OF COUNTY OF COCHISE	86-0445518	191320BL3	06-05-2003	2,670,000	REFUND BONDS ISSUED ON 12/31/1996		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . .	0
2 Amount of bonds legally defeased . . . . . . . . . .	0
3 Total proceeds of issue . . . . . . . . . . . . .	2,670,000
4 Gross proceeds in reserve funds . . . . . . . .	0
5 Capitalized interest from proceeds . . . . . . . . . .	0
6 Proceeds in refunding escrows . . . . . . . . . . .	0
7 Issuance costs from proceeds . . . . . . . . . . .	53,400
8 Credit enhancement from proceeds . . . . . . . . . .	0
9 Working capital expenditures from proceeds . . . . . . .	0
10 Capital expenditures from proceeds . . . . . . . . . .	2,670,000
11 Other spent proceeds . . . . . . . . . . .	0
12 Other unspent proceeds . . . . . . . . . . .	0
13 Year of substantial completion . . . . . . . . . . .	2003
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . .	X
15 Were the bonds issued as part of an advance refunding issue? . . . .		X
16 Has the final allocation of proceeds been made? . . . . . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . .	X

Part III

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2011

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . .		X
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .		X
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0.00000%		%		%		%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0.00000%		%		%		%
6 Total of lines 4 and 5 . . .. . . . . . . . .	0.00000%		%		%		%
7 Does the bond issue meet the private security or payment test? . . .	X
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .		X
2 Is the bond issue a variable rate issue?		X
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider . . . . . . . .	0
c Term of hedge . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was a hedge terminated? . . . . .
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .
b Name of provider . . . . . .	0
c Term of GIC . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .		X
6 Did the bond issue qualify for an exception to rebate? .	X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X

Schedule K (Form 990) 2011

Page 3

Part V

Procedures To Undertake Corrective Action

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? . . . . . . . . . . . . . . YesNo

Part VI

Supplemental Information

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

Identifier	Return Reference	Explanation

Schedule K (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

SIERRA VISTA REGIONAL HEALTH CENTER INC

Employer identification number

86-0186064

Identifier	Return Reference	Explanation
FORM 990, PART I, LINE 6	VOLUNTEER SERVICES	VOLUNTEERS IMPACT EVERY DEPARTMENT AND ARE A SOURCE OF COMFORT TO PATIENTS AND FAMILY MEMBERS. THE QUALITY OF CARE THAT SVRHC PROVIDES IS NOT JUST A RESULT OF THE OUTSTANDING STAFF AND PHYSICIANS, BUT ALSO A DIRECT IMPACT FROM THE FRIENDLINESS AND CHEERY ATTITUDES EACH VOLUNTEER GIVES TO THE HOSPITAL. VOLUNTEERS SACRIFICE THEIR TIME AND ENERGY AS AMBASSADORS FOR SVRHC AND ARE TRUE GEMS IN THE COMMUNITY. WE UTILIZE VOLUNTEERS IN MOST OF THE DEPARTMENTS HERE AT THE HOSPITAL. THESE AREAS INCLUDE CLINICAL DEPARTMENTS SUCH AS MATERNAL CHILD, MED. SURGICAL, ICU/TELE, EMERGENCY DEPARTMENTS AND REHABILITATION SERVICES. OUR VOLUNTEERS WORK CLOSELY WITH OUR NURSING STAFF AND TECHNICIANS TO LEND ASSISTANCE WHENEVER NEEDED. THEY HELP GREET PATIENTS AND FAMILY MEMBERS, ANSWER PHONES, STOCK SMALL SUPPLIES, CREATE PACKETS, HELP WITH CHARTS AND TAKE ITEMS TO PATIENTS' ROOMS SUCH AS FLOWERS OR MAIL. OUR NON-CLINICAL DEPARTMENTS INCLUDE MEDICAL RECORDS, CLIENT SERVICES, HUMAN RESOURCES, PATIENT ACCOUNTS AND NUTRITION & FOOD SERVICES. OUR VOLUNTEERS HELP OUT IN THESE AREAS BY MAKING COPIES, DATA ENTRY, PUTTING TOGETHER PACKETS, ANSWERING PHONES, COVERING THE OFFICE FOR MEETINGS, MAKING FILES AND DOING FOOD PREPARATION. TRAINING IS REQUIRED WHICH PROVIDES VOLUNTEERS THE NECESSARY TRAINING AND TOOLS TO ASSIST THESE SPECIAL CLIENTS IN THEIR DAILY LIVES. WE ARE REQUIRED TO HAVE A CERTAIN PERCENTAGE OF VOLUNTEER HOURS TO STAFF HOURS TO MAINTAIN OUR STATUS AND MEET MEDICARE GUIDELINES.
FORM 990, PART III, LINE 4A	EXEMPT PURPOSE ACHIEVEMENTS	SIERRA VISTA REGIONAL HEALTH CENTER (SVRHC) OPERATES AN 84 BED SHORT-TERM PRIMARY CARE FACILITY IN RURAL ARIZONA. SVRHC PROVIDES A FULL RANGE OF INPATIENT, OUTPATIENT, DIAGNOSTIC AND REHABILITATION SERVICES. SERVICES PROVIDED FOR YEAR ENDED JUNE 30, 2012 INCLUDED 15,273 INPATIENT PATIENT DAYS, 100,064 OUTPATIENT REGISTRATIONS AND 26,301 EMERGENCY ROOM VISITS. IN SUPPORT OF ITS MISSION AND PHILOSOPHY THE HOSPITAL PROVIDES CARE TO ALL PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE AND ACCORDINGLY THEY ARE NOT RECORDED AS REVENUE. CHARITY CARE SERVICES TOTALED APPROXIMATELY $1,431,000 WHEN MEASURED AT THE HOSPITAL'S ESTABLISHED RATES. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO HAVE ENTERED THE COMMUNITY ILLEGALLY. THE CHARGES FOR THESE PATIENTS ARE PARTIALLY REIMBURSED UNDER SECTION 1011 OF THE MEDICARE PRESCRIPTION DRUG IMPROVEMENT AND MODERNIZATION ACT OF 2003. THE UNREIMBURSED COSTS FOR SERVING THESE PATIENTS WERE APPROXIMATELY $1,000. PUBLIC PROGRAMS SUCH AS AHCCCS AND MEDICARE PROVIDE FOR THE POOR, INDIGENT AND ELDERLY. PUBLIC PROGRAMS DO NOT ALWAYS COVER THE COSTS OF PROVIDING THESE SERVICES; THE UNREIMBURSED COSTS OF THE MEDICARE PROGRAM WERE APPROXIMATELY $8,544,000. BENEFITS PROVIDED TO THE COMMUNITY INCLUDE THE COST OF PROVIDING SERVICES TO OTHER POPULATIONS WHO MAY QUALIFY AS POOR BUT MAY NEED SPECIAL SERVICES AND SUPPORT. THIS TYPE OF COMMUNITY BENEFIT INCLUDES THE COST OF PROGRAMS FOR SENIOR CITIZENS SUCH AS HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, IT ALSO INCLUDES COSTS INCURRED BY THE HOSPITAL FOR TRAINING HEALTH PROFESSIONALS SUCH AS MEDICAL RESIDENTS, NURSING STUDENTS IN ALLIED HEALTH PROFESSIONALS. THE HOSPITAL ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE FINANCIALLY VIABLE. THE DEVELOPMENT OF THESE PROGRAMS IS BASED UPON A COMMUNITY ASSESSMENT PERFORMED BY AN INDEPENDENT COMPANY. SUCH ENDEAVORS INCLUDE LOCAL CHARITIES, NOT-FOR-PROFIT ORGANIZATIONS, YOUTH GROUPS AND OTHER PATIENT SUPPORT GROUPS SUCH AS BUT NOT INCLUSIVE OF: HEALTH SCREENINGS AND ASSESSMENTS, CANCER AND OTHER SUPPORT GROUPS, FREE TRANSPORTATION, MEALS AND MEDICATIONS FOR TRANSIENT PATIENTS WHEN NEEDED, THE AMERICAN HEART ASSOCIATION, MARCH OF DIMES, CANCER SOCIETY, AMERICAN RED CROSS, PRENATAL CLASSES, SENIOR OLYMPICS, HEALTH FAIRS, BLOOD PRESSURE CHECKS, HEALTH CAREER SCHOLARSHIPS FOR HIGH SCHOOL AND COLLEGE STUDENTS, BOY SCOUTS OF AMERICA, LITTLE LEAGUE AND PARTICIPATION IN REGULAR BLOOD DRIVES.
FORM 990, PART VI, LINE 11B	PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990	THE 990 IS PREPARED BY THE CONTROLLER CAREFULLY CONSIDERING THE ORGANIZATION'S ENTRIES ON THE RETURN. THOSE QUESTIONS CONCERNING COMPENSATION HAVE BEEN REVIEWED WITH THE VICE PRESIDENT OF HUMAN RESOURCES AND ALL COMPENSATION HAS BEEN SUPPLIED BY THE HUMAN RESOURCES DEPARTMENT. THE ENTIRE RETURN HAS BEEN REVIEWED FOR CORRECTNESS WITH THE CFO. ONCE COMPLETED THE RETURN WAS THEN REVIEWED BY E&Y TAX DEPARTMENT. BEFORE THE FINAL RETURN IS FILED, THE COMPLETED 990 IS REVIEWED WITH THE FINANCE COMMITTEE OF THE BOARD HIGHLIGHTING THE AREAS OF CONCERN TO A GOVERNING BODY. A COMPLETED COPY IS MADE AVAILABLE FOR ALL TRUSTEES TO REVIEW PRIOR TO FILING. ANSWERS ARE PROVIDED TO ANY QUESTIONS OR CONCERNS.
FORM 990, PART VI, LINE 12C	PROCESS TO MONITOR TRANSACTIONS FOR CONFLICT OF INTEREST	THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. THE FOLLOWING PROCEDURES ARE EMPLOYED. ALL OFFICERS, LEADERS OR IDENTIFIED OTHERS SHALL COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AND SUBMIT IT TO THE HOSPITAL ANNUALLY. THE TERM "CONFLICT OF INTEREST" MEANS THAT CIRCUMSTANCES WHERE THE BEST INTERESTS OF SIERRA VISTA REGIONAL HEALTH CENTER (SVRHC) CONFLICT WITH EITHER THE ECONOMIC, PROFESSIONAL, POLITICAL OR PERSONAL INTERESTS OF ONE OR MORE OFFICERS, LEADERS OR IDENTIFIED OTHER OF SVRHC. THE RELATIONSHIP BETWEEN SVRHC AND ITS OFFICERS, LEADERS AND IDENTIFIED OTHERS IS ONE WHICH IS COMPLEX AND CHANGING. THERE ARE CIRCUMSTANCES WHICH MAY EXIST WHICH MAY INTERTWINE THE INTERESTS OF SVRHC AND ITS OFFICERS, LEADERS AND IDENTIFIED OTHERS. IN ORDER TO RECOGNIZE AND EFFECTIVELY DEAL WITH CIRCUMSTANCES OF THIS NATURE THE FOLLOWING POLICY HAS BEEN ADOPTED. ANY AND ALL CONFLICTS OF INTEREST SHALL BE DISCLOSED TO THE HOSPITAL EITHER AT THE TIME OF HIRE, INCEPTION OF RELATIONSHIP AND/OR AT THE TIME OF AN INITIAL AGREEMENT/CONTRACT OR AT ANY TIME A CONFLICT OF INTEREST OCCURS. A CONFLICT OF INTEREST QUESTIONNAIRE IS SUBMITTED TO THE HOSPITAL. FAILURE TO COMPLETE AND SUBMIT A QUESTIONNAIRE WILL RESULT IN THE OFFICER LEADER OR IDENTIFIED OTHER BEING REMOVED FROM THEIR RELATIONSHIP WITH THE HOSPITAL. WHILE THIS IS AN ANNUAL REQUIREMENT, IT IS NOT MEANT TO TAKE THE PLACE OF IMMEDIATE AND APPROPRIATE DISCLOSURE OF A CONFLICT OF INTEREST BY AN OFFICER, LEADER OR IDENTIFIED OTHER TO THE HOSPITAL WHEN CIRCUMSTANCES OCCUR. ANY POTENTIAL CONFLICT OF INTEREST SHALL BE DISCLOSED TO THE HOSPITAL. THE POTENTIAL CONFLICT WILL BE REVIEWED EITHER BY THE CEO/PRESIDENT OR HIS/HER DESIGNEE(S) OR BY THE BOARD OF TRUSTEES' CHAIRPERSON OR HIS/HER DESIGNEE(S) DEPENDING ON THE NATURE OF THE POTENTIAL CONFLICT. A DECISION PERTAINING TO THE CONFLICT OF INTEREST AND THE OFFICER'S, LEADER'S AND IDENTIFIED OTHER'S ABILITY TO CONTINUE IN HIS/HER POSITION AND/OR RELATIONSHIP WILL BE DETERMINED AND SHARED WITH THE OFFICER, LEADER OR IDENTIFIED OTHER.
FORM 990, PART VI, LINES 15A AND 15B	PROCEDURES USED TO DETERMINE COMPENSATION	IT IS THE POLICY OF SIERRA VISTA REGIONAL HEALTH CENTER THAT AN EXECUTIVE'S BASE SALARY WILL BE MAINTAINED AT OR ABOVE THE 50TH PERCENTILE AND THAT ANNUALLY THE BOARD OF TRUSTEES WILL DEVELOP A COMPENSATION PLAN UTILIZING A THIRD PARTY CONSULTANT AND CURRENT MARKET DATA. IT IS THE POLICY OF SIERRA VISTA REGIONAL HEALTH CENTER THAT EXECUTIVES WILL BE PAID AN INCENTIVE BONUS BASED UPON AN ANNUAL PLAN COMPRISED OF FINANCIAL AND NON-FINANCIAL METRICS APPROVED BY THE BOARD OF TRUSTEES, THE PLAN WILL BE APPROPRIATELY ALIGNED WITH THE PROBABILITY OF ACHIEVEMENT. PROCEDURE: - ENGAGE AN INDEPENDENT COMPANY TO CONDUCT A COMPENSATION VALUATION STUDY OF COMPENSATION ARRANGEMENTS IN TAX- EXEMPT ORGANIZATIONS UNDER THE INTERMEDIATE SANCTIONS LEGISLATION. - THE INDEPENDENT COMPANY WILL PROVIDE THE SVRHC BOARD OF TRUSTEES' EXECUTIVE COMPENSATION COMMITTEE COMPETITIVE MARKET DATA TO INCLUDE: A CONFIRMATION OF THE SCOPE, DATA CUTS AND SURVEY SOURCES WITH THE HUMAN RESOURCE TEAM. PROVIDE MARKET COMPARABILITY DATA IN ORDER TO REVIEW THE COMPETITIVENESS OF SVRHC'S PROGRAM. RESEARCH MARKET PRACTICES FOR BOTH SHORT AND LONG TERM PLANS TO DETERMINE ALIGNMENT. REVIEW EXECUTIVE BENEFIT AND PERQUISITE PREVALENCE DATA. - THE INDEPENDENT COMPANY WILL SELECT RELEVANT DATA AND ADJUST THE DATA TO ACCURATELY REFLECT THE SIZE AND SCOPE OF SVRHC'S ROLES AND MEDIAN REVENUE SIZE. - THE INDEPENDENT COMPANY WILL UTILIZE THE SAME METHODOLOGY TO CONDUCT A REVIEW OF INCENTIVE BONUS PLANS FOR THE EXECUTIVE STAFF. - THE INDEPENDENT COMPANY WILL CONSIDER THE FOLLOWING WHEN REVIEWING A PARTICULAR INDIVIDUAL'S COMPENSATION: PRIOR SKILLS AND EXPERIENCE OF INCUMBENTS IN THE ROLE. THE MIX OF COMPENSATION ELEMENTS AND OTHER REWARD COMPONENTS. THE HOSPITAL'S PERFORMANCE VERSUS COMPARABLE PEER PERFORMANCE. THE ABILITY OF THE HOSPITAL TO PAY AT COMPETITIVE LEVELS. - THE INDEPENDENT COMPANY WILL MAKE RECOMMENDATIONS FOR COMPENSATION AND BONUS PERCENTAGES FOR THE EXECUTIVE STAFF TO THE SVRHC BOARD OF TRUSTEES EXECUTIVE COMPENSATION COMMITTEE. - THE COMMITTEE WILL REVIEW THE RECOMMENDATIONS AND FORWARD THEM TO THE ENTIRE SVRHC BOARD OF TRUSTEES FOR APPROVAL.
FORM 990, PART VI, LINE 19	AVAILABILITY OF CERTAIN DOCUMENTS TO GENERAL PUBLIC	THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 5	OTHER CHANGES IN NET ASSETS	UNREALIZED GAIN ON INVESTMENTS $46,788 TEMPORARILY RESTRICTED GRANTS AND CONTRIBUTIONS 23,200 ASSETS RELEASED FROM RESTRICTIONS (27,445) __________ TOTAL $42,543 ==========

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

SIERRA VISTA REGIONAL HEALTH CENTER INC

Employer identification number

86-0186064

Part I

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

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) SVRHC PROPERTIES LLC 300 EL CAMINO REAL SIERRA VISTA,AZ85635 86-0186064	MOB	AZ	0	0	NA
(2) SVRHC OFFICE COMPLEX LLC 300 EL CAMINO REAL SIERRA VISTA,AZ85635 45-5165711	ASSOCIATION	AZ	0	0	NA

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) SVRHC FOUNDATION 300 EL CAMINO REAL SIERRA VISTA,AZ85625 86-0729397	FUND RAISING	AZ	501 (C)(3)	509 (A)(2)	NA		No
(2) SIERRA VISTA COMMUNITY HOSPITAL AUX INC 300 EL CAMINO REAL SIERRA VISTA,AZ85625 86-0431251	FUND RAISING	AZ	501 (C)(3)	509 (A)(2)	NA		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2011

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership
(1) ARIZONA FAMILY CARE ASSOCIATES 6 SOUTH 2ND ST SIERRA VISTA,AZ85635	PHYSICIANS GROUP	AZ	NA	C CORP	0	0	61.110 %

Schedule R (Form 990) 2011

Page 3

Part V

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

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

Yes

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

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

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

Yes

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

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) SVRHC FOUNDATION	C	129,420	ACCRUAL
(1)
(2)
(3)
(4)
(5)
(6)

Schedule R (Form 990) 2011

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2011

Page 5

Part VII

Supplemental Information

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

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SIERRA VISTA REGIONAL HEALTH CENTER WILL: BE COMMITTED TO CUSTOMER-FOCUSED QUALITY HEALTH CARE THROUGH EXCELLENCE IN PRACTICE, SERVICE, AND LEADERSHIP.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	10
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	888
6	Total number of volunteers (estimate if necessary) ....	6	143
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	261,249	260,882
9	Program service revenue (Part VIII, line 2g) .........	97,244,892	90,184,151
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,343,994	1,421,889
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-241,646	2,206,981
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	98,608,489	94,073,903
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	5,500	0
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)	44,048,407	44,763,624
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	48,013,433	45,597,806
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	92,067,340	90,361,430
19	Revenue less expenses. Subtract line 18 from line 12.......	6,541,149	3,712,473
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	114,139,847	115,335,896
21	Total liabilities (Part X, line 26).............	39,990,443	37,431,476
22	Net assets or fund balances. Subtract line 21 from line 20.....	74,149,404	77,904,420

Sign Here

	Signature of officer	Date

	Type or print name and title.


4a	(Code: ) (Expenses $ 65,545,577 including grants of $ 0 ) (Revenue $ 92,308,577 )
	SEE SCHEDULE O

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 65,545,577

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) REBECCA MCCALMONT VICE PRESIDENT	40.0	X		190,501	0	37,401
(19) THERESA FRENCH STAFF NURSE	40.0		X	126,309	0	1,062
(20) ANDREA WHITE CLINICAL EDUCATOR	40.0		X	127,101	0	18,612
(21) STEVEN CALABRESE CONTROLLER	40.0		X	123,109	0	26,772
(22) DAMIEN WHEELER ULTRASOUND SONOGRAPHER	40.0		X	120,744	0	6,964
(23) MARK GRABOWSKA ADMINISTRATIVE DIRECTOR	40.0		X	114,843	0	26,142

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	2,036,899	0	239,116

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		129,420
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		131,462
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			260,882
			Business Code
2a	NET PATIENT SERVICE (MEDICARE/MEDICAID)		446,199	43,755,508	43,755,508
b	NET PATIENT SERVICE (OTHER)		446,199	45,518,109	45,518,109
c	MOB/RENTAL		531,120	82,555			82,555
d	CAFETERIA		722,210	399,724	399,724
e	RADIOLOGY PRO FEE		541,900	231,384	231,384
f	All other program service revenue .			196,871	196,871
g	Total. Add lines 2a–2f........			90,184,151
3	Investment income (including dividends, interest
	and other similar amounts).....			1,607,447			1,607,447
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses		185,558
c	Gain or (loss)		-185,558
d	Net gain or (loss)..........			-185,558			-185,558
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..			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...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	MEANINGFUL USE - EHR		900,099	2,080,812	2,080,812
b	MANAGEMENT FEE SAMC		541,610	126,169	126,169
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			2,206,981
12	Total revenue. See Instructions....			94,073,903	92,308,577	0	1,504,444


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			14,883,870	1	14,891,010
2	Savings and temporary cash investments .......			0	2	0
3	Pledges and grants receivable, net .........			0	3	0
4	Accounts receivable, net .........			8,593,614	4	8,783,078
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			0	5	0
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........			0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			2,390,380	8	1,991,099
9	Prepaid expenses and deferred charges ............			2,759,565	9	4,218,753
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	93,129,283
b	Less: accumulated depreciation. .....	10b	55,986,949	34,802,744	10c	37,142,334
11	Investments—publicly traded securities ..........			48,915,289	11	46,207,199
12	Investments—other securities. See Part IV, line 11 ......			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			82,535	13	0
14	Intangible assets .........			0	14	0
15	Other assets. See Part IV, line 11 ...........			1,711,850	15	2,102,423
16	Total assets. Add lines 1 through 15 (must equal line 34)...			114,139,847	16	115,335,896
17	Accounts payable and accrued expenses .			4,205,335	17	4,666,366
18	Grants payable ..........			0	18	0
19	Deferred revenue ..........			0	19	0
20	Tax-exempt bond liabilities ..........			25,552,129	20	24,322,261
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	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 ..			264,220	23	119,597
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.....			9,968,759	25	8,323,252
26	Total liabilities. Add lines 17 through 25.....			39,990,443	26	37,431,476
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			74,101,315	27	77,860,577
28	Temporarily restricted net assets .....			48,089	28	43,843
29	Permanently restricted net assets .....			0	29	0
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			74,149,404	33	77,904,420
34	Total liabilities and net assets/fund balances .....			114,139,847	34	115,335,896