TY 2012 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
Phoenix Cardiac Surgery PC, 3131 E Clarendon Ave Suite 102PHOENIXAZ850167069	Medical	1,245,152
NAZ HOSPITALISTS, PO BOX 11720PRESCOTTAZ86304	Medical	1,218,333
Ecatalyst Consulting, 26368 N 73rd AvePEORIAAZ85383	consulting	903,971
Prescott Anesthesia LLC, 1003 Willow Creek RoadPRESCOTTAZ86301	Medical	851,703
Yavapai Laborist Physicians, 1005 Division StreetPRESCOTTAZ86301	Medical	604,050
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 32

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	11,297	11,297
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 ....	3,991,119	3,432,363	546,783	11,973
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	91,677,273	78,842,455	12,559,786	275,032
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,983,455	2,565,771	408,733	8,951
9	Other employee benefits .......	11,465,847	9,860,628	1,570,821	34,398
10	Payroll taxes ...........	6,926,994	5,957,215	948,998	20,781
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	495,089	425,777	67,827	1,485
c	Accounting ...........	174,047	149,680	23,845	522
d	Lobbying ...........	28,306		28,306
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	17,611,954	15,146,280	2,412,838	52,836
12	Advertising and promotion ....	496,911	427,343	68,077	1,491
13	Office expenses .......	6,724,874	5,783,392	921,308	20,174
14	Information technology ......	6,240,639	5,366,950	854,967	18,722
15	Royalties ..	0
16	Occupancy ...........	3,308,122	2,844,985	453,213	9,924
17	Travel ............	459,288	394,988	62,922	1,378
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	153,879	132,336	21,081	462
20	Interest ...........	5,531,942	4,757,470	757,876	16,596
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	11,842,565	10,184,606	1,622,431	35,528
23	Insurance ..............	1,605,640	1,380,850	219,973	4,817
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	36,494,013	36,494,013
b	BAD DEBT	16,258,021	16,258,021
c	REPAIRS & MAINTENANCE	6,264,360	5,387,350	858,217	18,793
d	MINOR EQUIPMENT	2,571,174	2,211,210	352,251	7,713
e	All other expenses	2,105,971	1,951,497	150,557	3,917
25	Total functional expenses. Add lines 1 through 24e	235,422,780	209,966,477	24,910,810	545,493
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	51,645,568	1	31,918,979
2	Savings and temporary cash investments .........	35,892,246	2	10,493,095
3	Pledges and grants receivable, net ...........	0	3	0
4	Accounts receivable, net .............	41,770,634	4	53,228,422
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		344,272	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	1,829,439	7	1,460,235
8	Inventories for sale or use ..............	4,732,073	8	4,938,053
9	Prepaid expenses and deferred charges ..........	3,360,139	9	1,817,771
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	265,989,407
b	Less: accumulated depreciation .....	10b	106,531,435	148,702,194	10c	159,457,972
11	Investments—publicly traded securities ..........	30,204,619	11	77,216,770
12	Investments—other securities. See Part IV, line 11 .....	3,508,176	12	3,508,176
13	Investments—program-related. See Part IV, line 11 .....	6,471,568	13	6,386,317
14	Intangible assets ...............	30,000	14	0
15	Other assets. See Part IV, line 11 ...........	3,973,759	15	4,422,752
16	Total assets. Add lines 1 through 15 (must equal line 34)......	332,464,687	16	354,848,542
	17	Accounts payable and accrued expenses .........	19,815,419	17	20,351,932
18	Grants payable .................	0	18	0
19	Deferred revenue ................	1,820,247	19	1,818,434
20	Tax-exempt bond liabilities .............	113,545,000	20	110,655,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	11,586,182	23	9,653,167
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....................	1,760,949	25	7,718,558
26	Total liabilities. Add lines 17 through 25.........	148,527,797	26	150,197,091
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	183,917,375	27	204,629,810
28	Temporarily restricted net assets ...........	19,515	28	21,641
29	Permanently restricted net assets ...........	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	183,936,890	33	204,651,451
34	Total liabilities and net assets/fund balances ........	332,464,687	34	354,848,542

- 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

2012

Open to Public
Inspection

Name of the organization

Yavapai Community Hospital Association
dba Yavapai Regional Medical Center

Employer identification number

86-0098923

Part I

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

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

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

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

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

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

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

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

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

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

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

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

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

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

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

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

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

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

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

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

Yes

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

11g(i)

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

11g(ii)

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

11g(iii)

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) .........

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

16a

33 1/3% support test—2012. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2011. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2012

Page 3

Part III

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) .........

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

Section D. Computation of Investment Income Percentage

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

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

19a

33 1/3% support tests—2012. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2011. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

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

Schedule A (Form 990 or 990-EZ) 2012

Page 4

Part IV

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

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
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

2012

Name of the organization

Yavapai Community Hospital Association
dba Yavapai Regional Medical Center

Employer identification number

86-0098923

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

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

Page 2

Name of organization Yavapai Community Hospital Association dba Yavapai Regional Medical Center

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

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

Page 3

Name of organization Yavapai Community Hospital Association dba Yavapai Regional Medical Center

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

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

Page 4

Name of organization
Yavapai Community Hospital Association
dba Yavapai Regional Medical Center

Employer identification number

86-0098923

Part III

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

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

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

Additional Data

Software ID:
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

2012

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

Yavapai Community Hospital Association
dba Yavapai Regional Medical Center

Employer identification number

86-0098923

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities 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 Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2012

Page 2

Part II-A

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

A Check SchCMd Bullet

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 SchCMd Bullet

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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2012

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

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

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

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

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

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

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

Yes

28,306

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

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

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

28,306

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, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

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

Schedule C (Form 990 or 990EZ) 2012

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

2012

Open to Public Inspection

Name of the organization

Yavapai Community Hospital Association
dba Yavapai Regional Medical Center

Employer identification number

86-0098923

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No

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


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

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

Yes No

If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

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

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	19,515	30,749	165,949	226,473	240,410
b	Contributions ........	2,099	-11,315	-102,126	45,530	29,908
c	Net investment earnings, gains, and losses	23	81	51	174	35,933
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........			33,125	106,228	79,778
f	Administrative expenses ....
g	End of year balance ......	21,637	19,515	30,749	165,949	226,473

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

0 %

Temporarily restricted endowment SchDMd Bullet

100.000 %

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	6,891,768		6,891,768
b	Buildings ................	134,141,747	27,088,683	107,053,064
c	Leasehold improvements ............	12,628,292	7,154,517	5,473,775
d	Equipment ................	72,411,601	52,968,356	19,443,245
e	Other .................	39,915,999	19,319,879	20,596,120
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				159,457,972

Schedule D (Form 990) 2012

Page 3

Part VII

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

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








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

Part VIII

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

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









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

Part IX

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

(a) Description				(b) Book value









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

Part X

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

1.(a) Description of liability		(b) Book value
Federal income taxes		0
ACCRUED BOND INTEREST		1,742,660
OTHER LIABILITY- EMR		5,975,898







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		7,718,558
2. Fin 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	256,245,893
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	-250,729
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	129,582
e	Add lines 2a through 2d .....................			2e	-121,147
3	Subtract line 2e from line 1.....................			3	256,367,040
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	4,492
c	Add lines 4a and 4b.......................			4c	4,492
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	256,371,532

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements ...........			1	235,531,332
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	113,044
e	Add lines 2a through 2d......................			2e	113,044
3	Subtract line 2e from line 1.....................			3	235,418,288
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b	4,492
c	Add lines 4a and 4b.......................			4c	4,492
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	235,422,780

Part XIII

Supplemental Information

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

Identifier	Return Reference	Explanation
PART V, LINE 4	INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS	TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY THE ORGANIZATION HAS BEEN LIMITED BY DONORS TO SPECIFIED TIME PERIOD OR PURPOSE.
PART X, LINE 2	UNCERTAIN TAX POSITIONS	Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.
PART XI, LINE 2D	OTHER REVENUE ON BOOKS, NOT ON RETURN	CHANGE IN SPLIT INTEREST AGREEMENT 16,538 GIFT SHOP COST OF GOODS SOLD 113,044 Total 129,582
PART XI, LINE 4B	OTHER REVENUE ON RETURN, NOT ON BOOKS	EXPENSE RECLASSED FROM REVENUE 4,492
PART XII, LINE 2D	OTHER EXPENSE ON BOOKS, NOT ON RETURN	GIFT SHOP COST OF GOODS SOLD 113,044
PART XII, LINE 4B	OTHER EXPENSE ON RETURN, NOT ON BOOKS	EXPENSE RECLASSED FROM REVENUE 4,492

Schedule D (Form 990) 2012

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

2012

Open to Public Inspection

Name of the organization

Yavapai Community Hospital Association
dba Yavapai Regional Medical Center

Employer identification number

86-0098923

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	2,795,480	0	2,795,480	1.260 %
b	Medicaid (from Worksheet 3, column a) ....	24,303,850	20,299,570	4,004,280	1.800 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .	900,728	595,637	305,091	0.140 %
d	Total Financial Assistance and Means-Tested Government Programs .	28,000,058	20,895,207	7,104,851	3.200 %
Other Benefits		1,021,461	4,316	1,017,145	0.450 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	1,021,461	4,316	1,017,145	0.450 %
f	Health professions education (from Worksheet 5) ..	25,271	0	25,271	0.010 %
g	Subsidized health services (from Worksheet 6) ..	11,894,642	9,005,035	2,889,607	1.300 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	127,024	0	127,024	0.060 %
j	Total. Other Benefits ..	13,068,398	9,009,351	4,059,047	1.820 %
k	Total. Add lines 7d and 7j .	41,068,456	29,904,558	11,163,898	5.020 %

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

Schedule H (Form 990) 2012

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	1	0	2,014		2,014
3	Community support	2	206	13,526	8,479	5,047
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1	85	2,693		2,693
7	Community health improvement advocacy	1	14	3,205		3,205
8	Workforce development	1	0	24,000		24,000	0.010 %
9	Other
10	Total	6	305	45,438	8,479	36,959	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

16,258,021

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

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

Section B. Medicare

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

62,207,180

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

89,608,175

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

-27,400,995

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

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

Schedule H (Form 990) 2012

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?2 Name, address, and primary website address					Facility reporting group
1	Yavapai Regional Medical Center- West 1003 Willow Creek Road Prescott,AZ86301 www.yrmc.org	X	X	X	a
2	Yavapai Regional Medical Center- East 7700 E Florentine Road Prescott Valley,AZ86314 WWW.YRMC.ORG	X	X	X	a

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	A
Name of hospital facility or facility reporting group

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

Yes

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

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

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The health needs of the community

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

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

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

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

Other (describe in Part VI)

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

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ....................

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

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

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

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

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

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

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

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

Prioritization of health needs in its community

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

Other (describe in Part VI)

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

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

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

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

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 250.% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	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 website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

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

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........

Yes

If “No,” indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Part VI)

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

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

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

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

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

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................

If “Yes,” explain in Part VI.

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

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?15
Name and address		Type of Facility (describe)
1	YRMC - Del E Webb Outpatient Center 3262 Windsong Road Prescott Valley,AZ86314	Outpatient diagnostics, Rehabilitation & laboratory
2	Pendleton Wellness Center 930 Division Street Prescott,AZ86301	Cardiac rehabilitation, physical therapy, & wellness outpatient center
3	PRESCOTT OUTPATIENT SURGICAL CENTER 815 AINSWORTH DR Prescott,AZ86301	OUTPATIENT SURGICAL CENTER
4	Prescott Medical Imaging (PMI) 810 Whipple Street Prescott,AZ86301	Medical imaging center
5	YRMC PC Internal Medicine I 3120 Clearwater Dr Prescott,AZ86305	Physician Practice - Internal Medicine
6	YRMC PC Family Medicine I 7712 E Florentine Prescott Valley,AZ86314	Physician Practice - Family Medicine
7	YRMC PC Family Medicine II 1050 Gail Gardner Way Ste 300 Prescott,AZ86305	Physician Practice - Family Medicine
8	YRMC PC FAMILY MEDICINE III 7880 E FLORENTINE RD Prescott Valley,AZ86314	Physician Practice - FAMILY MEDICINE
9	YRMC PC FAMILY MEDICINE IV 12 HOPE DRIVE BAGDAD,AZ86321	PHYSICIAN PRACTICE - FAMILY MEDICINE
10	YRMC PC CARDIOLOGY I 802 E AINSWORTH DR SUITE A PRESCOTT,AZ86301	PHYSICIAN PRACTICE - CARDIOLOGY
11	YRMC PC CARDIOLOGY II 3188 N WINDSONG DR PRESCOTT VALLEY,AZ86314	PHYSICIAN PRACTICE - CARDIOLOGY
12	YRMC PC CARDIOLOGY III 726 GAIL GARDNER WAY SUITE A PRESCOTT,AZ86305	PHYSICIAN PRACTICE - CARDIOLOGY
13	YRMC PC CARDIOLOGY IV 980 WILLOW CREEK ROAD PRESCOTT,AZ86301	PHYSICIAN PRACTICE - CARDIOLOGY
14	YRMC PC NEUROSURGERY 1001 DIVISION STREET PRESCOTT,AZ86301	PHYSICIAN PRACTICE - NEUROSURGERY
15	YRMC PC GASTROENTROLOGY 811 AINSWORTH STREET PRESCOTT,AZ86301	PHYSICIAN PRACTICE - GASTROENTROLOGY

Schedule H (Form 990) 2012

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

Identifier	ReturnReference	Explanation
SCHEDULE H, PART I, LINE 7, COLUMN F	BAD DEBT EXPENSE	Total bad debt expense removed from the denominator prior to the percentage calculation = 16,258,021.
SCHEDULE H, PART I, LINE 7	CALCULATION OF COMMUNITY BENEFIT EXPENSES	The organization used a cost-to charge ratio for line 7a & 7b. The cost-to-charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. The organization used a cost accounting amount for the other means tested programs on line 7c that related to the MSO and joint ventures. The information for lines 7e through 7h was derived from information in the general ledger and other financial data related specifically to the various types of community benefits. Sch H, Part I, Line 7g Subsidized Services The subsidized services on line 7g include physician clinics in prescott and prescott valley. The clinics improve community access to healthcare services such as cardiology and neurosurgery. Without the cardiology clinics, the community would be underserved, as this would cause a shortage of access for this type of care. The demographics are mainly that of the medicare population, and additional travel time for residents to obtain similar care in other areas would be difficult for residents. The neurosurgey clinic is the only center available in the city of prescott.
SCHEDULE H, PART III, LINE 4	BAD DEBT EXPENSE	Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Organization analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounting and provision for bad debts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Organization analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Organization records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Organization's allowance for doubtful accounts for self-pay patients remained comparable to December 31, 2011 at 71% of self-pay accounts receivable at December 31, 2012. In addition, the Organization's provision for uncollectible accounts decreased approximately $600,000 from approximately $16,900,000 for the year ended December 31, 2011, to approximately $16,300,000 for the year ended December 31, 2012. Bad debt expense is determined using the methodology as described in the note to financial statements as shown above. The hospital recognizes its responsibility to provide for the needs of the community, regardless of patients' ability to pay. In many cases, patients are unwilling or unable to pay after services have been provided, eventually resulting in bad debt. Nevertheless, if these services were not provided by the organization, the healthcare needs of these patients might not otherwise be fulfilled within the community. Therefore, the organization believes that the services not paid for should be included in community benefit.
SCHEDULE H, PART III, LINE 8	MEDICARE	The shortfall from Medicare should be considered community benefit to the extent that the organization could not reasonably reduce it's costs to a lower level. While hard to project the potential savings from various possible cost cutting measures, it is reasonable to assume that at least 50% of the shortfall might not otherwise be recovered through savings measures. Because the organization is committed to meeting the needs of the community, any patient that presents for medical treatment who is covered under Medicare will be served, despite the potential detrimental impact on the organization's financials. With respect to the source used to determine the Medicare allowable cost on line 6, the following lines from the Medicare cost report were used: Line 53 (total program inpatient operating cost excluding capital related, nonphysician anesthetist, and medical education costs) and line 104 (net charges for ancillary service cost centers.) Schedule H, Part III, Line 9b Debt Collection Policies If it was not known at the point of service that the patient had the inability to pay, the patient may be screened: 1) by phone or 2) in person by the Customer Services Representative. The Customer Service Representative will utilize the Financial Assistance worksheet to determine the patient's ability/inability to pay. If the determination indicates the patient has the ability to pay, other options for payments will be explained. If there is no ability to pay, then the application will be submitted for consideration.
SCHEDULE H, PART VI	NEEDS ASSESSMENT	YRMC uses several measures by which to assess community health needs. One measure is our migration by service. As an example, prior to opening our cardiovascular surgery program in 2007, we saw many hundreds of people leaving our community to go to Phoenix - 100 miles away - for open heart surgery. This was an indication of a need in our community that required YRMC's focused attention and efforts that culminated in The Heart Center at YRMC. YRMC constantly monitors volume and utilization data in its service lines to help determine level of need in the community for each service line. When volume figures vary from anticipated volume, YRMC carefully explores reasons behind those variances and addresses them appropriately. For example, if a drop in surgical volume is related to a need for more general surgeons, efforts ensue to recruit additional surgeons. YRMC also spends a great deal of time listening to the community by way of focus groups, community involvement by senior management, patient survey feedback, and community outreach efforts. As our CEO has stated, "We learn more by listening than by talking." YRMC is regarded by the community as a key resource and an asset. Consequently, community members feel very comfortable and free in sharing their perceptions and perspectives. YRMC also engages National Research Corporation (NRC) to conduct community needs assessment research. The study objectives include the following: a. Measure and evaluate health status and healthcare utilization within the community. b. Identify the prevalence of chronic conditions within various demographic segments within the community. c. Profile high-risk populations. d. Identify gaps in care and preventive health behaviors among various demographic segments within the community. In 2011, YRMC engaged Dixon Hughes Goodman to perform a community health needs assessment. Work continued in 2012 and the assessment was approved by the board in 2013. The assessment will be published in December of 2013.
SCHEDULE H, PART VI	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	When patients present for admission, they are asked to review and initial a patient consent form. The patient consent form contains a paragraph entitled "Financial Assistance Programs." This paragraph indicates that the patient may be considered for financial assistance if eligibility criteria are met. The patient is required to initial a box next to the paragraph indicating they have read it and consent. This same form also contains language regarding the assignment of benefits if eligible for Medicare. In addition to the above, patients may work directly with patient financial services at the hospital to make payment arrangements or apply for financial assistance. Education regarding assistance generally occurs as the need arises.
SCHEDULE H, PART VI	COMMUNITY INFORMATION	YRMC serves the rural communities in the western portion of Yavapai County in northern Arizona. YRMC's serves approximately 175,000 men, women and children living in an area larger than the state of New Jersey. Prescott is the Yavapai county seat and has been a very popular retirement area for many years. Consequently, the demographics of YRMC's service area is skewed towards the Medicare population. In fact, more than 21% of the population is over the age of 65. This region's economy is based primarily on the service industry. There are no large corporate headquarters or major presence here. YRMC is a major employer in the County with over 1,600 employees.
SCHEDULE H, PART VI	PROMOTION OF COMMUNITY HEALTH	The hospital is dedicated to meeting community needs and promoting the general health of the population. Recently, for example, it completed construction and opened a new women's pavilion and family birthing center, not because it believed that this would be a profitable service line (70% of admits to OB are on the state's medicaid program) but because it understood there was a community need for expanded services. And in further support of the health of the community, the hospital completed construction and opened for patients a new breast care center in October, 2011. In addition, the hospital is actively recruiting physicians to the community and has recently implemented an employed physician model in order to further assist the community in addressing a severe shortage of physicians. The hospital's board of directors is community based and selected by a council of electors comprised of representatives from various government and community agencies and non-profit groups from throughout the hospital's service area. The hospital invests and utilizes any excess funds from operations as a safeguard for potential financial challenges and to fund future capital needs.
SCHEDULE H PART II	Community Building Activities	As mentioned in the Part VI narrative regarding promotion of community health, the hospital is dedicated to promoting the general health of the population. The activities in Part II contribute to the vitality of the community which is one of many factors that impact the health of the community and provides a benefit of our community.
Schedule H, Part V, Line 19		The hospital's FAP is based on income and the ability to pay. The patient is informed but must choose to apply. The federal poverty grid is used and a multiplying factor based upon income attached to the grid.

Schedule H (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
Yavapai Community Hospital Association
dba Yavapai Regional Medical Center

Employer identification number
86-0098923

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) Yavapai Regional Medical Center Foundation 1003 Willow Creed Road Prescott,AZ86301	86-1038463	501(c)(3)	11,297	Healthcare

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2012

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

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

Part IV

Supplemental Information.

Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

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

Schedule I (Form 990) 2012

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

2012

Open to Public Inspection

Name of the organization

Yavapai Community Hospital Association
dba Yavapai Regional Medical Center

Employer identification number

86-0098923

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of 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 filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)Timothy J BarnettCEO	(i) (ii)	463,508 0	60,000 0	1,274,098 0	71,538 0	28,647 0	1,897,791 0	1,146,523 0
(2)Diane DrexlerCNO	(i) (ii)	159,254	20,000	22,020	27,306	5,980	234,560	0
(3)Larry P BurnsCOO	(i) (ii)	206,012	20,000	43,381	11,720	15,502	296,615	37,109
(4)Brian L HoefleCFO	(i) (ii)	211,137	20,000	77,693	38,949	15,076	362,855	37,683
(5)John R AmosEC Administrator	(i) (ii)	185,447	20,000	70,323	34,036	18,138	327,944	42,415
(6)Joseph H GoldbergerCMO	(i) (ii)	147,047	10,000	36,992	17,422	13,373	224,834	15,922
(7)Roberta NicolDir of Philanthropy	(i) (ii)	140,926	15,000	61,766	27,317	19,395	264,404	33,675
(8)Mohammad RahmanCIO	(i) (ii)	146,999	20,000	20,513	29,438	25,212	242,162	0
(9)Mark TimmDir of HR	(i) (ii)	132,727	15,000	34,592	25,670	22,672	230,661	12,934
(10)Harvey G ThomasPhysician	(i) (ii)	452,787	0	1,813	12,115	14,558	481,273	0
(11)George T RizkPhysician	(i) (ii)	340,633	86,567	631	12,500	6,158	446,489	0
(12)Robert J StomelPhysician	(i) (ii)	221,968	110,073	8,409	12,500	9,293	362,243	0
(13)Sergio F SotoPhysician	(i) (ii)	217,007	92,580	1,813	10,677	16,771	338,848	0
(14)James D D'AntonioPhysician	(i) (ii)	266,748	14,770	201	0	13,865	295,584	0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

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

Identifier	Return Reference	Explanation
nonqualified retirement plan	Part I, Line 4b	The following individuals participated in or received payment from a non-qualified supplemental retirement plan. The amounts listed include amounts in W-2 Box 5 wages and amounts included in deferred compensation. W-2 Box 5 Deferred Comp Timothy J. Barnett 1,146,523 59,038 Diane Drexler - 20,519 Larry P. Burns 37,109 - Brian L. Hoefle 37,683 26,449 John R. Amos 42,415 22,274 Joseph H. Goldberger 15,922 8,357 Roberta Nicol 33,675 18,023 Mohammad Rahman - 19,612 Mark Timm 12,934 16,906
Non-Fixed Payments	Part I, Line 7	The hospital provided performance awards to its executive team in 2012. While the performance awards provided rewarded outstanding performance, they were not contingent on achieving a stated revenue or net earnings amount and were soley at the discretion of the hospital's CEO.
compensation reported as deferred in prior 990s	Part II, column f	Amounts listed in column f represent the amount of compensation that is included in the 2012 W-2, Box 5. These amounts were reported in previous 990s as deferred compensation.

Schedule J (Form 990) 2012

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

2012

Open to Public
Inspection

Name of the organization
Yavapai Community Hospital Association
dba Yavapai Regional Medical Center

Employer identification number
86-0098923

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	THE INDUST DEV'T AUTH OF THE COUNTY OF YAVAPAI	86-0376099	985900BL2	08-28-2003	41,494,716	CONSTRUCT HOSPITAL		X		X		X
B	THE INDUST DEV'T AUTH OF THE COUNTY OF YAVAPAI	86-0376099	985900BM0	02-06-2008	20,400,000	REFUND 2003 BONDS & PURCH EQUIP		X		X		X
C	THE INDUST DEV'T AUTH OF THE COUNTY OF YAVAPAI	86-0376099	958900BR9	05-08-2008	29,577,215	CONSTRUCTION & PURCH EQUIP		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	3,490,000		0		0
2 Amount of bonds legally defeased . . . . . . . . . . .	0		0		0
3 Total proceeds of issue . . . . . . . . . . . . . .	42,904,476		20,400,000		30,519,966
4 Gross proceeds in reserve funds . . . . . . . . . . . .	4,730,055		0		2,219,417
5 Capitalized interest from proceeds . . . . . . . . . . .	3,626,111		0		2,572,535
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		17,895,587		0
7 Issuance costs from proceeds . . . . . . . . . . . .	584,908		3,488,890		459,950
8 Credit enhancement from proceeds . . . . . . . . . . .	865,715		155,113		0
9 Working capital expenditures from proceeds . . . . . . . . .	0		0		0
10 Capital expenditures from proceeds . . . . . . . . . . .	35,158,097		1,969,675		24,343,792
11 Other spent proceeds . . . . . . . . . . . . . .	0		0		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		0		0
13 Year of substantial completion . . . . . . . . . . . .	2006		2008		2011
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X	X			X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X

Part III

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2012

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X		X
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%		0.00000%		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%		0.00000%		0.00000%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0.00000%		0.00000%		0.00000%		%
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	0.00000%		%		0.00000%		%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .	X		X		X
b Exception to rebate? . . . . . . . .		X		X		X
c No rebate due? . . . . . . . . . .		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X	X			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider . . . . . . . . .	0		0		0
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .
e Was a hedge terminated? . . . . . . .

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X
b Name of provider . . . . . . . . .	0		0		0
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X	X			X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X			X

Part V

Procedures To Undertake Corrective Action

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

Part VI

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

Identifier	Return Reference	Explanation

Schedule K (Form 990) 2012

Additional Data

Software ID:
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

2012

Open to Public
Inspection

Name of the organization

Yavapai Community Hospital Association
dba Yavapai Regional Medical Center

Employer identification number

86-0098923

Identifier	Return Reference	Explanation
Program Service Description	Form 990, Part III, Line 4a	Yavapai Regional Medical Center (YRMC) provides health, healing and hope for every man, woman and child living in our region through high quality inpatient and outpatient services as well as a wide range of valuable community outreach programs. YRMC proudly serves the healthcare needs of people of all ages and from all walks of life. We're pleased to meet those needs 24 hours a day, 365 days a year. YRMC's sole purpose is to provide high-quality healthcare for the communities we serve. There are no stockholders to whom we must pay dividends; we focus instead on the people we serve. The "dividends" they receive are healthier lives for themselves and those they love. Any money remaining after YRMC has paid its bills goes back into the organization to help expand programs and add new services for the people in our communities. YRMC's Vision is Creating a Total Healing Environment, in which the people associated with YRMC work in partnership with patients and their families who are seeking peace of mind and peace of heart as well as physical cure and comfort because we honor the indivisible relationship that exists between body, mind and the human spirit. The spirit of caring is a higher calling that resonated throughout YRMC in 2012. YRMC's family which is comprised of board members, community supporters, donors, employees, physicians and volunteers did not waver from this spirit of caring. YRMC has two hospitals; one in Prescott, YRMC West, and one in Prescott Valley, YRMC East. YRMC is truly two great hospitals with one caring spirit. Consider that in 2012, YRMC embraced its not-for-profit mission by providing more than nine million dollars in community benefit to the people of western Yavapai County. This includes direct healthcare services as well as programs that improve health and prevent illness. In 2012, YRMC touched more than 493,000 area residents through our community benefit programs. The spirit of YRMC is one of treating each patient as a unique and valuable human being. The long-awaited tiny newborn taking her first breath at YRMC is one of those special people. The frail yet feisty 89-year-old blind gentleman who enjoys entertaining his assisted living neighbors with his piano music and who now struggles with congestive heart failure is one of those special people. The young mother of four small children who recently had the frightening diagnosis of cancer and is planning her treatment with the help of our BreastCare Center is one of those special people. YRMC provides peace of mind and peace of heart year in and year out to all our patients, each one of whom is a special person. YRMC also offers a patient assistance program to help people who have no insurance or who have limited insurance coverage. At no time has this kind of support been more important - or more welcomed - than now. YRMC works diligently with patients to allow them to worry less about paying for services and be able to focus more directly on recovering and getting back on their feet. 2012 was another year of providing personalized care to many thousands of people. For example, 924 babies entered the world in YRMC's obstetrics department. These little ones represent the love, dreams and hopes of their parents and are also the promise of tomorrow for the world. And to add to the excellent care that growing Quad City families already receive, the talented staff at YRMC's Family Birthing Center successfully completed the application and evaluation process for Level II Nursery certification. In addition, YRMC helped prepare 517 new moms and dads for delivery through its Childbirth Education Program. Increasingly, discouraging economic conditions along with the added challenges of new babies can create stress that's unmanageable for many young families. Consequently, YRMC provides Family Resource Center services that include free parenting education, counseling services and coordination with other community resources that can help support young families. This program has also provided much-needed necessities to new families such as baby formula and diapers. In 2012 thousands of area residents participated in this remarkable program. The Family Resource Center advised 1,906 parents on how to care for their newborns through the First Steps program. And visits were provided to 142 families for ongoing support through YRMC's Healthy Families Program. These programs have virtually eliminated child abuse and neglect among participating families. This is a remarkable achievement at a time when economic stressors have increased along with the national rate of child abuse and neglect. YRMC is also pleased to offer the Partners for Healthy Students program. This is a school-based health program for children who are uninsured or underinsured. The program is led by a pediatric nurse practitioner who works in conjunction with a local pediatrician. School-age children and their siblings are diagnosed and treated for a wide variety of health problems. A specially-equipped van is sent to local schools and children receive the care and treatment they need. Some children have previously undiagnosed chronic health problems like asthma, allergies, ear infections and subsequent hearing loss, or vision problems. Many children have never seen a dentist and have painful tooth decay to the point that their teeth are literally rotted down to the gums. These children suffer unimaginable pain every day. The program helps ensure all these children are given the care and treatment they need but could not otherwise receive. Health problems can seriously impede children's ability to learn and to grow up healthy. More than 1,052 children in 27 school-based clinics benefited from services provided by the Partners for Healthy Students program last year, and grant funding was also approved for a new state-of-the-art mobile clinic. YRMC is proud to provide these services at no charge. There are also numerous beneficial programs provided for adults by YRMC. For example, in 2012 more than 1,646 people suffering with respiratory problems were helped to breathe easier through the hospital's respiratory wellness programs. YRMC also offered smoking cessation classes for 56 people who wanted to give up tobacco in 2012. The James Family Heart Center at YRMC performs hundreds of cardiac and thoracic cases and has also perfected a blood management program which greatly benefits patients. In 2012, YRMC helped 1,170 individuals with diabetes better manage their health in order to prevent hospitalization. Many newly-diagnosed diabetics learned more about their condition and how to maintain and optimize their health. Many people who have lived with diabetes for years learned new information about how to live healthier lives. A vigorous community outreach program reached an average of 41,000 residents each month throughout 2012 with complimentary, current health information. This includes free community newsletters and mailers, health fairs and a speakers bureau service, providing presentations from YRMC health professionals about health-related topics to over 5,373 people. Many speakers also distribute additional free take-home information provided by YRMC for future reference, whether it be about fitness, nutrition, stress management or whatever topic the group requests. YRMC's Physical Rehabilitation department also provides a free stroke support group for stroke patients and their caregivers. Everyone can benefit from the fall risk assessment program which helps determine an individual's risk of falling down. Falls can lead to debilitating injuries and even death, especially for those over the age of 65. This assessment program helps identify risk factors and physical rehab can help assist people with specific strengthening exercises to help prevent falls. YRMC's healthcare team - nurses, physicians and other medical professionals - cared for 11,302 inpatients in 2012. That same year, 63,970 people, which is 1,230 people a week, received care in YRMC's Emergency Departments. YRMC is extremely proud of the fact that it is one of the largest employers in Yavapai County and has an outstanding reputation for attracting top healthcare professionals. Another source of pride is YRMC's dedicated volunteer force of 823 people who collectively donated 105,166 hours, breaking the 100,000-hour mark for the fifth year in a row. This is yet another example of the community's strong support for YRMC and how YRMC is regarded as a treasured community asset by the entire region.
Members of the Organization	Form 990, Part VI, Question 6	Each resident of the Central Yavapai Hospital District who is at least (18) years of age shall be a member of the Association (Hospital) at his will and shall be eligible to cast one vote in person upon any issue presented at an annual or special meeting. There shall be no proxy or cumulative voting.
Members or Stockholders who can elect members of the governing body, etc.	Form 990, Part VI, Question 7a & 7b	The council of electors (the council) is charged with the responsibility of selecting individuals from the community to serve on the Association's Board of Trustees. The council is composed of publicly elected officials and representatives from selected government and non-profit organizations from throughout the community. Members must approve amendments to the Bylaws or Articles of Incorporation.
Process to Review the Form 990	Form 990, Part VI, Question 11b	The completed 990 is presented to the Audit Committee of the Board of Trustees in a special session for review prior to filing. The committee has the opportunity to review the form in detail during this meeting and to ask questions of the preparer. The committee then presents the results of their review to the full Board of Trustees and obtains final approval for filing from the Board. The full Board is also given the opportunity to review a copy of the 990.
Process for Monitoring Compliance with Conflict of Interest Policy	Form 990, Part VI, Question 12c	In January of each year, a Conflict of Interest form and the related policy are sent to each member of the Board of Trustees, officers and directors of the association, managers and key employees, all other exempt employees, members of professional advisory committees, and the medical executive committee. Recipients are asked to review the policy and sign the form each year at this time. In addition, all exempt new hires are asked to review the policy and sign the conflict of interest statement. The returned forms are reviewed and kept on file if no conflict has been identified. If conflicts are identified, the forms are sent to the CEO for review. During discussions at board meetings, those with conflicts identified through this process are excused from discussion and voting on the related matter.
Review of CEO or Top Mgmt Official Compensation	Form 990, Part VI, Question 15a	Under the direction of the Hospital Board of Directors, an independent consultant was selected to perform a market equity analysis for the CEO compensation and benefit package. In 2011, Integrated Healthcare Strategies (IHS) was retained to conduct a total compensation review, including an analysis of all elements of CEO total compensation, including salary, incentives, benefits and perquisites compared to market practices. They provided the Hospital Human Resources Committee (a subcommittee of the hospital board) with a comprehensive description and valuation of all cash compensation and benefit practices and assessed compensation for competitiveness and compliance with regulatory requirements. In addition, IHS provided appropriate recommendations for modifying the total compensation program. Any changes to the CEO total compensation were approved by the Hospital Board of Directors. Compensation arrangements are documented in the minutes of the Human Resources Committee and by signed compensation agreements in personnel files maintained by HR.
Review of Other Officer or Key Employees Compensation	Form 990, Part VI, Question 15b	In 2010, under the direction of the CEO, an independent consultant, Integrated Healthcare Strategies (IHS), was selected to perform a market equity analysis of the compensation and benefit package for hospital officers and key employees of the organization. This included an analysis of all elements of executive total compensation, including salary, incentives, benefits and perquisites compared to market practices. They provided the Hospital Human Resources Committee (a subcommittee of the hospital board) with a comprehensive description and valuation of all cash compensation and benefit practices and assessed compensation for competitiveness and compliance with regulatory requirements. In addition, IHS provided appropriate recommendations for modifying the total compensation program. Any changes to executive total compensation were approved by the CEO. In 2012, compensation for officers and key employees of the organization was reviewed again, with input from IHS, as part of the committee's annual compensation review process. Compensation arrangements are documented in the minutes of the Human Resources Committee and by signed compensation agreements in personnel files maintained by HR.
Public Disclosure of Documents	Form 990, Part VI, Question 19	The financial statements are summarized in the annual report published on the hospital internet site. The organization's governing documents, conflict of interest policy, and financial statements are made available to the public upon request.
Other changes in net assets	form 990, Part XI, Line 9	CHANGE IN SPLIT INTEREST AGREEMENT 16,538

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
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

2012

Open to Public Inspection

Name of the organization

Yavapai Community Hospital Association
dba Yavapai Regional Medical Center

Employer identification number

86-0098923

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) Yavapai Reg'l Med Ctr Physician Care LLC 1003 Willow Creek Road Prescott,AZ86301 26-3257358	Medical Svcs	AZ	9,439,198	3,837,395	YRMC

Part II

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

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

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

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) PRESCOTT MEDICAL IMAGING LLC 810 WHIPPLE PRESCOTT,AZ86301 77-0603441	MEDICAL IMAGING	AZ	YRMC	RELATED	-8,816	270,707		No		Yes		50.000 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2012

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

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

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

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

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

(a) Name of other organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Yavapai Regional Medical Center Foundation	c	819,999	cash transfer

Schedule R (Form 990) 2012

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2012

Page 5

Part VII

Supplemental Information

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

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: To provide comprehensive, high-quality healthcare consistent with our communities' needs.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	2,042
6	Total number of volunteers (estimate if necessary) .............	6	823
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,551,196	1,772,236
9	Program service revenue (Part VIII, line 2g) .........	253,942,898	249,750,537
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	619,575	841,766
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,381,896	4,006,993
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	259,495,565	256,371,532
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	55,745	11,297
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)	117,237,605	117,044,688
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 545,493
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	111,406,381	118,366,795
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	228,699,731	235,422,780
19	Revenue less expenses. Subtract line 18 from line 12.......	30,795,834	20,948,752
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	332,464,687	354,848,542
21	Total liabilities (Part X, line 26).............	148,527,797	150,197,091
22	Net assets or fund balances. Subtract line 21 from line 20.....	183,936,890	204,651,451

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 209,966,477 including grants of $ 11,297 ) (Revenue $ 251,721,016 )
	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 expenses209,966,477

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) Mike Shaffer........................................................................ Vice Chairman	5.0 .......................	X	X
(2) Steve Binkley........................................................................ Secretary	5.0 .......................	X	X
(3) Clifford Morgan........................................................................ Treasurer	5.0 .......................	X	X
(4) Joe Jackson........................................................................ Trustee	5.0 .......................	X
(5) Oren Thompson........................................................................ Trustee	5.0 .......................	X
(6) Linda Medina........................................................................ Trustee	5.0 .......................	X
(7) Paula Kneisl........................................................................ Trustee	5.0 .......................	X
(8) Jane Bristol........................................................................ Trustee	5.0 .......................	X
(9) John MacKenzie........................................................................ Chairman	5.0 .......................	X	X		0	0	0
(10) Timothy J Barnett........................................................................ CEO	39.0 .......................1.0		X		1,797,606	0	100,185
(11) Diane Drexler........................................................................ CNO	40.0 .......................		X		201,274		33,286
(12) Larry P Burns........................................................................ COO	40.0 .......................		X		269,393		27,222
(13) Brian L Hoefle........................................................................ CFO	39.0 .......................1.0		X		308,830		54,025
(14) John R Amos........................................................................ EC Administrator	40.0 .......................		X		275,770		52,174
(15) Joseph H Goldberger........................................................................ CMO	40.0 .......................		X		194,039		30,795
(16) Mohammad Rahman........................................................................ CIO	40.0 .......................		X		187,512		54,650
(17) Roberta Nicol........................................................................ Dir of Philanthropy	39.0 .......................1.0			X	217,692		46,712

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Mark Timm........................................................................ Dir of HR	40.0 .......................	X		182,319	48,342
(19) Harvey G Thomas........................................................................ Physician	40.0 .......................		X	454,600	26,673
(20) George T Rizk........................................................................ Physician	40.0 .......................		X	427,831	18,658
(21) Robert J Stomel........................................................................ Physician	40.0 .......................		X	340,450	21,793
(22) Sergio F Soto........................................................................ Physician	40.0 .......................		X	311,400	27,448
(23) James D D'Antonio........................................................................ Physician	40.0 .......................		X	281,719	13,865

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	5,450,435	0	555,828

				(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		819,999
e	Government grants (contributions)1e		270,000

f	All other contributions, gifts, grants, and similar amounts not included above1f		682,237

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			1,772,236
			Business Code
2a	PATIENT SERVICE REVENUE		900099	243,292,984	243,292,984
b	ELECTRONIC HEALTH INCENTIVE PAYMENTS		900099	4,488,400	4,488,400
c	INPATIENT PROSPECTIVE PAYMENTS		900099	1,438,000	1,438,000
d	WELNESS PROGRAMS		900099	113,620	113,620
e	INCOME FROM EQUITY INVESTEE		900099	-6,621	-6,621
f	All other program service revenue .			424,154	394,633		29,521
g	Total. Add lines 2a–2f........			249,750,537
3	Investment income (including dividends, interest, and other similar amounts).......			688,505			688,505
4	Income from investment of tax-exempt bond proceeds..			367,329			367,329
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	737,595
b	Less: rental expenses	0
c	Rental income or (loss)	737,595	0
d	Net rental income or (loss).......			737,595			737,595
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	12,352,806	71,815
b	Less: cost or other basis and sales expenses	12,638,689	0
c	Gain or (loss)	-285,883	71,815
d	Net gain or (loss)..........			-214,068			-214,068
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		148,933
b	Less: cost of goods sold ..b		113,044
c	Net income or (loss) from sales of inventory..			35,889			35,889
Miscellaneous Revenue			Business Code
11a	INPATIENT PROSPECTIVE PMT SETTLEMENT		900099	2,000,000	2,000,000
b	CAFETERIA		722514	1,161,966			1,161,966
c	VENDING/SNACK CART		900099	23,251			23,251
d	All other revenue ....			48,292			48,292
e	Total. Add lines 11a–11d ......			3,233,509
12	Total revenue. See Instructions......			256,371,532	251,721,016		2,878,280


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			51,645,568	1	31,918,979
2	Savings and temporary cash investments .........			35,892,246	2	10,493,095
3	Pledges and grants receivable, net ...........			0	3	0
4	Accounts receivable, net .............			41,770,634	4	53,228,422
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				344,272	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			1,829,439	7	1,460,235
8	Inventories for sale or use ..............			4,732,073	8	4,938,053
9	Prepaid expenses and deferred charges ..........			3,360,139	9	1,817,771
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	265,989,407
b	Less: accumulated depreciation .....	10b	106,531,435	148,702,194	10c	159,457,972
11	Investments—publicly traded securities ..........			30,204,619	11	77,216,770
12	Investments—other securities. See Part IV, line 11 .....			3,508,176	12	3,508,176
13	Investments—program-related. See Part IV, line 11 .....			6,471,568	13	6,386,317
14	Intangible assets ...............			30,000	14	0
15	Other assets. See Part IV, line 11 ...........			3,973,759	15	4,422,752
16	Total assets. Add lines 1 through 15 (must equal line 34)......			332,464,687	16	354,848,542
17	Accounts payable and accrued expenses .........			19,815,419	17	20,351,932
18	Grants payable .................			0	18	0
19	Deferred revenue ................			1,820,247	19	1,818,434
20	Tax-exempt bond liabilities .............			113,545,000	20	110,655,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			11,586,182	23	9,653,167
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....................			1,760,949	25	7,718,558
26	Total liabilities. Add lines 17 through 25.........			148,527,797	26	150,197,091
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			183,917,375	27	204,629,810
28	Temporarily restricted net assets ...........			19,515	28	21,641
29	Permanently restricted net assets ...........			0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			183,936,890	33	204,651,451
34	Total liabilities and net assets/fund balances ........			332,464,687	34	354,848,542