Attach to Form 990 or Form 990-EZ.
See separate instructions.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization in col. (i) listed in your governing document? | (v) Did you notify the organization in col. (i) of your support? | (vi) Is the organization in col. (i) organized in the U.S.? | (vii) Amount of monetary support | |||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (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). | ||||||






Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (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.).. | ||||||




| Facts And Circumstances Test |
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| Explanation |
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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE UNIVERSITY OF ARIZONA HEALTH NETWORK (UAHN) AND THE UNIVERSITY OF ARIZONA MEDICAL CENTER (UAMC), COMPONENTS OF A VERTICALLY AND HORIZONTALLY INTEGRATED HEALTH NETWORK, ENTERED INTO A MASTER INTERCOMPANY SERVICES AGREEMENT ON MARCH 18, 2013 WHEREBY UAHN PROVIDES CERTAIN CORPORATE SERVICES ON A COORDINATED BASIS. SPECIFICALLY, UAHN PROVIDES ADMINISTRATION, INFORMATION SYSTEMS SUPPORT, MARKETING, LEGAL, ACCOUNTING, FINANCE, HUMAN RESOURCES, RISK MANAGEMENT, OCCUPANCY AND CAPITAL PLANNING, CREDENTIALING, PATIENT RELATIONS, AND PURCHASING AND MATERIALS MANAGEMENT. ALL EMPLOYEES ARE EMPLOYED BY UAHN, WHO DETERMINES THE PERSONNEL NECESSARY TO PROVIDE SERVICES TO UAMC AND ACCORDINGLY LEASES THE APPROPRIATE PERSONNEL TO UAMC. UAHN COMPENSATION IS INCLUDED AT PART VII, SECTION A, COLUMN (E) AND REPRESENTS ALL COMPENSATION EARNED FOR SERVICES RENDERED TO UAHN, INCLUDING THOSE SERVICES LEASED TO UAMC. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE UNIVERSITY OF ARIZONA HEALTH NETWORK IS THE SOLE MEMBER OF THE UNIVERSITY OF ARIZONA MEDICAL CENTER. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE UNIVERSITY OF ARIZONA HEALTH NETWORK, AS THE SOLE MEMBER OF THE UNIVERSITY OF ARIZONA MEDICAL CENTER, ELECTS THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE UNIVERSITY OF ARIZONA HEALTH NETWORK, AS THE SOLE MEMBER OF THE UNIVERSITY OF ARIZONA MEDICAL CENTER, RESERVES THE AUTHORITY TO APPROVE DECISIONS REGARDING THE FOLLOWING MATTERS: STRATEGIC PLAN, OPERATING AND CAPITAL BUDGETS, INSURANCE AND RISK MANAGEMENT, STAFFING, COMPENSATION, BENEFIT PLANS, AND ANY OTHER MATERIAL ACTION TAKEN OUTSIDE OF THE NORMAL COURSE OF BUSINESS. |
| FORM 990, PART VI, SECTION B, LINE 11 | UNIVERSITY MEDICAL CENTER CORPORATION'S FORM 990 IS DISTRIBUTED TO THE EXECUTIVE OFFICERS AND THE BOARD OF DIRECTORS AFTER FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE UNIVERSITY OF ARIZONA MEDICAL CENTER BOARD OF DIRECTORS HAS ADOPTED WRITTEN CONFLICT OF INTEREST POLICIES WHICH ESTABLISH PROCEDURES FOR THE IDENTIFICATION AND DISCLOSURE OF CONFLICTS OF INTEREST. UNDER THESE POLICIES, CONFLICTED DIRECTORS, OFFICERS AND EMPLOYEES ARE TO REFRAIN FROM PARTICIPATING IN ANY DECISION OR ACTION BY UAMC INVOLVING THE CONFLICT. DIRECTORS AND MEMBERS OF SENIOR MANAGEMENT OF UAMC ARE REQUIRED ANNUALLY TO REVIEW UAMC'S CONFLICT OF INTEREST POLICY AND COMPLETE AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE UNIVERSITY OF ARIZONA MEDICAL CENTER HIRES A THIRD PARTY CONSULTANT TO REVIEW COMPENSATION AND BENEFITS. IN ADDITION, THE UNIVERSITY OF ARIZONA MEDICAL CENTER COMPLETES A SURVEY COMPARING THE COMPENSATION PACKAGES TO SIMILAR ORGANIZATIONS. THE CHIEF EXECUTIVE OFFICER HAS A WRITTEN EMPLOYMENT CONTRACT THAT IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE AND BOARD OF DIRECTORS. THE LAST COMPENSATION REVIEW WAS PERFORMED IN MAY 2013. |
| FORM 990, PART VI, SECTION C, LINE 19 | POLICIES ARE POSTED ON THE UNIVERSITY OF ARIZONA MEDICAL CENTER'S INTRANET. GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 79,578,181. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 79,578,181. UAHN LEASED EMPLOYEES: PROGRAM SERVICE EXPENSES 253,121,736. MANAGEMENT AND GENERAL EXPENSES 3,964,962. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 257,086,698. |
| FORM 990, PART XI, LINE 9: | WRITE-OFF OF CAPITALIZED BOND ISSUANCE COSTS -3,068,857. |
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Affiliated Group Business Name:
THE UNIVERSITY OF ARIZONA HEALTH NETWORK INC Address. Either US or Foreign Type:
1501 N CAMPBELL AVENUE
TUCSON,
AZ
85724
EIN:
27-2936985 Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
410,101
Total Lobbying Expenditures:
410,101
Other Exempt Purpose Expenditures:
537,280,852
Total Exempt Purpose Expenditures:
537,690,953
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
UNIVERSITY PHYSICIANS HEALTHCARE Address. Either US or Foreign Type:
1501 N CAMPBELL AVENUE
TUCSON,
AZ
85724
EIN:
94-2958258 Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
25,000
Total Lobbying Expenditures:
25,000
Other Exempt Purpose Expenditures:
465,331,842
Total Exempt Purpose Expenditures:
465,356,842
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|