Attach to Form 990 or Form 990-EZ.
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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | 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 6 | Question 6, 7a & 7b Vail Health Services, the sole member of Vail Clinic, Inc. dba Vail Valley Medical Center, can appoint board members. The following governance decisions are also subject to approval by the sole member: - Appointing and removing the President of the Corporation - Amending or approving all amendments to the Corporation's articles of incorporation or bylaws - Approving budgets - Approving unbudgeted expenditures in excess of $100,000 - Approving Unbudgeted Borrowings in excess of $1,000,000 - Voluntary dissolution, merger, consolidation or bankruptcy - Approving sale of assets in excess of $1,000,000 - Creating a subsidiary or affiliate - Selecting Public accountants - Establishing investment policies - Establishing policies on the distribution and use of funds - Adding/deleting major program/service lines |
| Form 990, Part VI, Section B, line 11b | The form 990 is prepared by a third party. The 990 was reviewed by members of the Accounting Department prior to its filing. The review included reading it for accuracy of disclosure and comparing the numbers to those in the audited financial statements. A copy of the form 990 is provided to the Board of Directors before filing with the IRS. |
| Form 990, Part VI, Section B, line 12c | Directors and Officers are covered by the conflict of interest policy. The accounting group that issues checks and prepares the financial statements would advise the Board of any apparent or clear conflict of interest. The Board authorizes, approves, or ratifies any conflict in regard to voting rights based on good faith and fairness to the organization. An interested person may make a presentation at the meeting considering the matter giving rise to the conflict, however, they must leave the meeting during the discussion of and the vote on the matter. A committee might be appointed to investigate alternatives to the proposed arrangement. |
| Form 990, Part VI, Section B, line 15a | A formal external review is conducted every year. Executive compensation was last formally reviewed in 2015 by Sullivan Cotter. This review evaluates total compensation of the executive against compensation data for the same or similar job by industry, revenue size and geographic location and other factors to ensure that the compensation paid is appropriate and reasonable. That information is then reviewed by the compensation committee and the Board of Directors. Internal reviews are performed as well at time of hire and on an ongoing basis using compensation surveys. |
| Form 990, Part VI, Section B, line 15b | A formal external review is conducted every year. Other Officer and Key Employee compensation was last formally reviewed in 2015 by Sullivan Cotter. This review evaluates total compensation of the individual against compensation data for the same or similar job by industry, revenue size and geographic location and other factors to ensure that the compensation paid is appropriate and reasonable. That information is then reviewed by the compensation committee and the Board of Directors. Internal reviews are performed as well at time of hire and on an ongoing basis using compensation surveys. |
| Form 990, Part VI, Section C, line 19 | The governing documents, conflict of interest policy, and financial statements are available for viewing by the public for valid business purposes. |
| Form 990, Part XI, Line 9 | OTHER CHANGES IN NET ASSETS (228,022) Net revenue passed thru from the Colorado Hospital Association Trust for Worker's Compensation (7,772,433) Transfer of interest in Vail Health Services Foundation to Vail Health Services ----------- (8,000,455) |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:6353233 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CODING SERVICES TOTAL FEES:596378 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:FACILITIES SERVICES TOTAL FEES:691954 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:RADIOLOGY/IMAGING SERVICES TOTAL FEES:2904872 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LABORATORY SERVICES TOTAL FEES:912578 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:HEALTH INFORMATION SERVICES TOTAL FEES:604533 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:FOOD & NUTRITION SERVICES TOTAL FEES:1708492 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING SERVICES TOTAL FEES:1130612 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:FINANCIAL SERVICES/COLLECTION TOTAL FEES:1926672 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:THERAPY TOTAL FEES:114800 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:HUMAN RESOURCES TOTAL FEES:324487 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:ADMISSIONS TOTAL FEES:149818 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAUNDRY SERVICES TOTAL FEES:723397 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:REPAIRS & MAINTENANCE TOTAL FEES:700404 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:ADMINISTRATIVE SERVICES TOTAL FEES:417243 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER MISC SERVICES TOTAL FEES:248698 |
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