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 (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | 2,253,093 | 3,722,586 | 1,044,585 | 1,342,004 | 1,091,403 | 9,453,671 |
| 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 | 2,253,093 | 3,722,586 | 1,044,585 | 1,342,004 | 1,091,403 | 9,453,671 |
| 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).. | 4,874,361 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 4,579,310 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 2,253,093 | 3,722,586 | 1,044,585 | 1,342,004 | 1,091,403 | 9,453,671 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 169,330 | 227,620 | 277,414 | 286,495 | 296,914 | 1,257,773 |
| 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.).. | 36,742 | 36,742 | ||||
| 11 | Total support. Add lines 7 through 10. | 10,748,186 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) |
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| 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) |
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| 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): |
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| 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 | ||||
| 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 2015 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-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, 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 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
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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 B, line 11 | THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY THE FINANCE DEPARTMENT. THE 990 IS THEN REVIEWED BY MANAGEMENT IN THE FINANCE DEPARTMENT. |
| Form 990, Part VI, Section B, line 12 | THE FOUNDATION OF YRMC RECOGNIZES THAT THE POTENTIAL FOR CONFLICTS OF INTEREST EXISTS FOR DECISION-MAKERS AT ALL LEVELS WITHIN THE ORGANIZATION. LEVELS WITHIN THE ORGANIZATION INCLUDE VOLUNTEERS AND BOARD MEMBERS. THE FOUNDATION REQUIRES THE DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST SO THAT APPROPRIATE ACTION MAY BE TAKEN TO ENSURE THAT SUCH CONFLICTS WILL NOT INAPPROPRIATELY INFLUENCE IMPORTANT DECISIONS. BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY AND ALL POTENTIAL CONFLICTS OF INTEREST THAT COULD INAPPROPRIATELY INFLUENCE DECISIONS. THIS WOULD INCLUDE BECOMING INVOLVED AS A VENDOR OR RECEIVING REMUNERATION OF OTHER BENEFIT FROM A VENDOR. THIS INCLUDES IMMEDIATE FAMILY MEMBERS. IF A TRANSACTION IS PLANNED, THE BOARD MEMBER MUST DISCLOSE THE FOLLOWING INFORMATION TO THE FOUNDATION DIRECTOR: THE BOARD MEMBER'S OR FAMILY MEMBER'S PERSONAL INTEREST AND A DESCRIPTION OF THE PROPOSED TRANSACTION INCLUDING ALL RELEVANT INFORMATION. DOCUMENTS SIGNED BY MEMBERS OF THE FOUNDATION BOARD OF DIRECTORS ARE KEPT WITH THE BOARD COORDINATOR. |
| Form 990, Part VI, Section B, line 15 | THE COMPENSATION OF THE EXECUTIVE DIRECTOR OF THE FOUNDATION OF YUMA REGIONAL MEDICAL CENTER IS DETERMINED BY THE BOARD OF DIRECTORS OF YUMA REGIONAL MEDICAL CENTER. THE POLICY IS AS FOLLOWS: THE BOARD OF YUMA REGIONAL MEDICAL CENTER HAS ADOPTED A COMPETITIVE PAY STRATEGY IN ORDER TO ATTRACT AND RETAIN QUALIFIED EXECUTIVES TO LEAD OUR ORGANIZATION AND TO FAIRLY COMPENSATE EXECUTIVES FOR ADVANCING THE MISSION OF YUMA REGIONAL MEDICAL CENTER. THE POLICY IS ALSO INTENDED TO ESTABLISH A FORMAL, CONSISTENT PROCESS FOR GOVERNING EXECUTIVE COMPENSATION DECISIONS. THIS PROCESS IS MEANT TO ESTABLISH A "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER IRC SECTION 4958. TO SECURE A LEGAL "REBUTTABLE PRESUMPTION OF REASONABLENESS" IN DETERMINING COMPENSATION OF THE CEO AND OTHER EXECUTIVES CONSIDERED DISQUALIFIED INDIVIDUALS, AN OUTSIDE CONSULTANT IS ENGAGED PERIODICALLY TO PROVIDE COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION IN SETTING UP TOTAL COMPENSATION PACKAGES INCLUDING AN INCENTIVE PAY PROGRAM KNOWN AS "PAY AT RISK AND EXECUTIVE RETIREMENT PROGRAMS. I. OUR TOTAL COMPENSATION PHILOSOPHY IS COMPRISED OF THE FOLLOWING ELEMENTS: A. ROLE OF THE EXECUTIVE COMMITTEE THE BOARD'S EXECUTIVE COMMITTEE, AFTER REVIEWING THE MATERIAL PROVIDED BY THE CONSULTANT, SETS THE COMPENSATION FOR THE PRESIDENT/CEO AS WELL AS THE COMPENSATION POLICY AND STRATEGY FOR OTHER EXECUTIVES. THE EXECUTIVE COMMITTEE WILL REVIEW AND APPROVE, OR MODIFY AS APPROPRIATE, THE CEO'S RECOMMENDATIONS FOR OTHER EXECUTIVES. THE EXECUTIVE COMMITTEE PRESENTS ITS RECOMMENDATIONS TO THE FULL BOARD FOR ENDORSEMENT. B. PEER GROUP A NATIONAL PEER GROUP OF HEALTH CARE ORGANIZATIONS COMPARABLE TO YRMC IN REVENUE, STRUCTURE, MISSION AND SCOPE OF OPERATIONS WILL BE USED IN COLLECTING COMPARABILITY DATA. C. COMPETITIVE POSITIONING SALARY RANGE MIDPOINTS ARE SET AT THE 60TH PERCENTILE OF THE PEER GROUP. INDIVIDUAL SALARIES ARE POSITIONED WITHIN THE SALARY RANGES BASED ON FACTORS SUCH AS QUALIFICATIONS, EXPERIENCE AND PERFORMANCE AS WELL AS RECRUITMENT AND RETENTION NEEDS. ANNUAL INCENTIVE OPPORTUNITY FOR THE PRESIDENT/CEO, VICE PRESIDENTS AND DIRECTORS ARE POSITIONED ON PAR WITH THE AVERAGE LEVELS PROVIDED TO INDIVIDUALS OCCUPYING COMPARABLE POSITIONS IN THE PEER GROUP. BENEFIT EXPENDITURES ARE POSITIONED ABOVE THE 75TH PERCENTILE AND DESIGNED TO ENCOURAGE RETENTION AND STABILITY OF THE EXECUTIVE TEAM. OUR TOTAL COMPENSATION INCLUDING CASH COMPENSATION AND BENEFITS WILL BE POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE FOR EXPECTED PERFORMANCE. TOTAL COMPENSATION ABOVE THE 75TH PERCENTILE MAY BE ACHIEVED FOR EXCEPTIONAL OR SUPERIOR PERFORMANCE. D. APPROPRIATE PERQUISITES WILL BE PROVIDED BASED ON POSITION LEVEL AND TYPICALLY WILL BE FUNDED BY A PERQ ALLOWANCE. E. A MODERATE SEVERANCE POLICY IS ALSO PROVIDED BASED ON POSITION LEVEL. SEE THE SEVERANCE POLICY FOR FURTHER DETAIL. II. PAY AT RISK INCENTIVE PROGRAM A. YRMC'S ANNUAL INCENTIVE PLAN (OUR "PAY AT RISK" PROGRAM) USES A COMBINATION OF ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE MEASURES. ORGANIZATIONAL MEASURES ALIGNED WITH THE ORGANIZATION'S PILLARS OF PERFORMANCE INCLUDING QUALITY/SAFETY; SERVICE SATISFACTION; PEOPLE, SYSTEMS, PROCESSES; FINANCE AND GROWTH ARE ESTABLISHED ANNUALLY AND APPROVED BY THE BOARD EXECUTIVE COMMITTEE. THE WEIGHTING FOR EACH MEASURE IS ESTABLISHED ANNUALLY AND SLIGHTLY MORE WEIGHT MAY APPLY TO ANY OF THESE FIVE CATEGORIES. TRIGGERS ARE ESTABLISHED TO DEFINE CERTAIN MINIMUM PERFORMANCE LEVELS THAT MUST BE MET BEFORE INCENTIVE AWARDS MAY BE PAID. 1. NET OPERATING MARGIN MUST BE ACHIEVED AT A MINIMUM OF 80% OF BUDGET. 2. ACCREDITATION MUST BE MAINTAINED. B. PERFORMANCE MEASURES ARE TYPICALLY EXPRESSED IN TERMS OF DEFINED OUTCOMES: EACH PERFORMANCE MEASURE INCLUDES THREE LEVELS OF PERFORMANCE THAT CORRESPOND TO THREE LEVELS OF AWARD OPPORTUNITY. 1. A THRESHOLD LEVEL OF PERFORMANCE REPRESENTING "SIGNIFICANT PROGRESS" TOWARD ACHIEVING THE PLANNED PERFORMANCE OBJECTIVE. (TARGET) 2. A STRETCH LEVEL OF PERFORMANCE INDICATING THAT THE PLANNED PERFORMANCE OBJECTIVE HAS BEEN FULLY ACHIEVED. (WINNING) 3. AN OUTSTANDING LEVEL OF PERFORMANCE REPRESENTING RESULTS THAT "CLEARLY EXCEED" THE PLANNED PERFORMANCE OBJECTIVE. (MAXIMUM OR CHAMPION) TARGETS ARE SET AT THE 60TH PERCENTILE OF NATIONAL DATA WHEN AVAILABLE. WINNING LEVEL IS SET AT THE 75TH PERCENTILE AND CHAMPION LEVEL IS THE 90TH PERCENTILE. FOR FINANCIAL MEASURES, WINNING IS SET AT THE BUDGET LEVEL WITH 95% EQUALING TARGET AND 105% EQUALING CHAMPION LEVEL. EACH YEAR, THE CEO RECOMMENDS TO THE COMMITTEE THE OUTCOMES REQUIRED TO ACHIEVE EACH GOAL LEVEL AND PROVIDES SUPPORTING RATIONALE AND DATA FOR THE RECOMMENDATIONS. THE COMMITTEE REVIEWS THE RECOMMENDATIONS, MODIFIES AS APPROPRIATE, AND APPROVES THE FINAL GOALS AND REQUIRED OUTCOMES. PERFORMANCE LEVEL PERCENTAGES ARE SET BASED ON POSITION. DIRECTOR'S WINNING LEVEL EQUALS 10% OF MIDPOINT OF SALARY RANGE WITH A MINIMUM OF 5% AND A MAXIMUM OF 15% WITH 60% WEIGHTING ON ORGANIZATIONAL GOALS, 40% WEIGHTING FOR DIVISION GOALS. C. THE AMOUNT, IF ANY, DUE WILL BE PAID PRIOR TO THE DECEMBER 31 FOLLOWING THE CLOSE OF THE FISCAL YEAR. III. INSURANCE PRODUCTS THE CURRENT AVAILABLE PROGRAMS ARE: 1. LONG-TERM CARE INSURANCE FOR THE EXECUTIVE AND SPOUSE 2. EXECUTIVE DISABILITY COVERAGE (THIS WOULD SUPPLEMENT THE BASIC HOSPITAL PLAN) 3. SURVIVOR LIFE INSURANCE - FOR EXECUTIVES ENROLLING IN THIS BENEFIT, THE HOSPITAL WILL PAY THE EXECUTIVE'S PREMIUM. UNDER APPLICABLE TAX RULES, THE PREMIUM PAYMENTS MADE BY THE HOSPITAL WILL BE TREATED AS A LOAN. THE EXECUTIVE MUST PAY INTEREST ON HOSPITAL PAID PREMIUMS. THE HOSPITAL WILL BE REPAID FROM THE CASH SURRENDER VALUE OF THE POLICY OR THE FACE AMOUNT OF THE POLICY IN THE EVENT OF DEATH. THIS ARRANGEMENT IS DOCUMENTED BY AN AGREEMENT ACCEPTABLE TO THE HOSPITAL. IV. PAID LEAVE TIME CASH OUT REFER TO THE EXECUTIVE PAID LEAVE TIME CASH OUT POLICY FOR DETAILS. THE PURPOSE OF THIS POLICY IS TO ALLOW EXECUTIVES TO CASH OUT A LIMITED AMOUNT OF PLT TO FUND PREMIUMS OR OTHER COSTS FOR INSURANCE OR TO USE THE PROCEEDS IN WHATEVER MANNER THEY WISH. THE EXECUTIVE HAS TO MEET CERTAIN CRITERIA TO QUALIFY. |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. |
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