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 | 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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 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.") . | 372,786 | 566,892 | 238,172 | 260,124 | 0 | 1,437,974 |
| 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...... | 5,861,961 | 5,362,483 | 4,885,120 | 6,843,982 | 43,428,264 | 66,381,810 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 6,234,747 | 5,929,375 | 5,123,292 | 7,104,106 | 43,428,264 | 67,819,784 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| 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. | 553,547 | 431,203 | 349,465 | 90,764 | 0 | 1,424,979 |
| c | Add lines 7a and 7b.. | 553,547 | 431,203 | 349,465 | 90,764 | 0 | 1,424,979 |
| 8 | Public support. (Subtract line 7c from line 6.) | 66,394,805 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 6,234,747 | 5,929,375 | 5,123,292 | 7,104,106 | 43,428,264 | 67,819,784 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,720 | 3,237 | 75 | 1,635 | 970,660 | 977,327 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 6,245 | 6,245 | ||||
| c | Add lines 10a and 10b. | 1,720 | 3,237 | 75 | 1,635 | 976,905 | 983,572 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 117,812 | 80,572 | 251,466 | 439,771 | 2,620,865 | 3,510,486 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 6,354,279 | 6,013,184 | 5,374,833 | 7,545,512 | 47,026,034 | 72,313,842 |
| 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 | ||||
| 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) |
||||
| 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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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 III, LINE 2 | Beginning July 2015, Northern Arizona Healthcare became the member of Northern Arizona Healthcare Provider Group (NAHPG). NAHPG was formerly A LIMITED LIABILITY COMPANY (TAXED AS A PARTNERSHIP) owned by both Flagstaff Medical Center and Verde Valley Medical Center. NAHPG provides patient care in both Flagstaff and Verde Valley. |
| FORM 990, PART III, LINE 3 | Beginning April 2016, Northern Arizona Homecare/Hospice sold seventy-five percent of the service line to LHC Group for 1.3 million dollars. NAH and LHC formed a partnership for homecare and hospice services in the Flagstaff and Verde Valley area. This partnership is managed by LHC group, and is accounted for as an investment for NAH. |
| FORM 990, PART III, LINE 4 | NORTHERN ARIZONA HEALTHCARE IS THE PARENT CORPORATION OF FLAGSTAFF MEDICAL CENTER AND VERDE VALLEY MEDICAL CENTER. NAH IS DEDICATED TO IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE IN NORTHERN AND CENTRAL ARIZONA. NAH IS THE LARGEST HEALTHCARE ORGANIZATION IN NORTHERN ARIZONA SERVING ALMOST ONE HALF OF THE STATE. THE HEALTHCARE PROVIDER EMPLOYS MORE THAN 3,700 HEALTHCARE PROFESSIONALS AND, THROUGH ITS AFFILIATES, SERVICES A POPULATION OF MORE THAN 300,000 PEOPLE IN THE SERVICE AREA. NAH IS DEDICATED TO PROVIDING THE HIGHEST QUALITY, MOST COST EFFECTIVE HEALTH CARE DELIVERY SYSTEM TO THE VISITORS AND RESIDENTS OF NORTHERN AND CENTRAL ARIZONA. NAH ENCOURAGES PATIENTS TO BE PART OF THEIR OWN TREATMENT THROUGH EDUCATION AND WELLNESS PROGRAMS. PHYSICIANS, EMPLOYEES AND VOLUNTEERS ALL WORK FOR A COMMON GOAL, AND THE COMMUNITY BENEFITS FROM ORGANIZATIONAL OUTREACH THAT CONTRIBUTES TO RICHER AND HEALTHIER LIVING. NORTHERN ARIZONA HEALTHCARE'S MISSION, VISION, AND VALUES -------------------------------------------------------- Mission - Northern Arizona Healthcare will provide patients with exceptional care while transforming the health of the communities we serve. Vision - Northern Arizona Healthcare will be a model healthcare system distinguished by our people, quality, service and our dedication to community health solutions. Values - Patients: We are committed to meeting the needs and exceeding the expectations of our patients. - Colleagues: We will create an organizational culture where colleagues feel valued and take a sense of pride in their work. - Quality: We continuously strive to achieve excellence at all levels in the organization. - Safety: We are committed to maintaining a safe environment for our patients, visitors and colleagues. - Leadership: We promote leadership as an attitude, not a position, putting value on both people and the work they do. - Teamwork: We are colleagues working together, sharing knowledge, talents and skills to achieve common goals. - Integrity: We will be forthright, honest and respectful. -Diversity: We embrace the diversity of our people, patients and the communities we serve. NORTHERN ARIZONA HEALTHCARE PARTNERSHIPS ---------------------------------------- LITTLE COLORADO MEDICAL CENTER (WINSLOW MEMORIAL HOSPITAL) - NORTHERN ARIZONA HEALTHCARE HAS A MANAGEMENT AGREEMENT IN PLACE WITH LITTLE COLORADO MEDICAL CENTER (LCMC), A 25-BED CRITICAL ACCESS TAX-EXEMPT HOSPITAL IN WINSLOW, ARIZONA. THE LCMC BOARD OF DIRECTORS RETAINS ULTIMATE RESPONSIBILITY FOR THE OPERATIONS AND ACTIVITIES OF THE HOSPITAL. NAH AND LCMC MAINTAIN A RELATIONSHIP TO ENHANCE LCMC'S SERVICE TO THE COMMUNITY. THE PEAKS - THE PEAKS IS A SENIOR LIVING, LEARNING AND WELLNESS COMMUNITY THAT IS PART OF AN INTERGENERATIONAL CAMPUS IN FLAGSTAFF, ARIZONA. THROUGH THE INTERGENERATIONAL LEARNING, MENTORING AND VOLUNTEER OPPORTUNITIES, THE PEAKS OFFERS AN UNPARALLELED SENIOR RETIREMENT LIFESTYLE. NORTHERN ARIZONA HOMECARE - NORTHERN ARIZONA HOMECARE, A DIVISION OF NAH, PROVIDES QUALITY, PROFESSIONAL HEALTHCARE IN THE COMFORT OF THE PATIENT'S HOME. NORTHERN ARIZONA HOSPICE - HOSPICE, A DIVISION OF NAH, IS FOR PATIENTS WHO HAVE A TERMINAL ILLNESS AND HAVE DECIDED TO SHIFT THE FOCUS OF CARE FROM CURE TO COMFORT. HOSPICE CARE EMPHASIZES THE QUALITY OF REMAINING LIFE AND ALLOWS THE PATIENT TO REMAIN AT HOME IN FAMILIAR SURROUNDINGS WHILE RECEIVING EXPERT HEALTHCARE. |
| FORM 990, PART V, LINE 2A; PART VII, SECTION A, AND PART IX | FLAGSTAFF MEDICAL CENTER (FMC) AND VERDE VALLEY MEDICAL CENTER (VVMC) ARE RELATED ORGANIZATIONS OF NORTHERN ARIZONA HEALTHCARE CORPORATION (NAH). NEITHER FMC NOR VVMC HAVE EMPLOYEES; RATHER, EACH SHARES THE COST OF PERSONNEL, SERVICES, AND EXPENSES WITH NAH. |
| FORM 990, PART VI, LINE 1 | THE BOARD OF DIRECTORS DELEGATES AUTHORITY TO AN EXECUTIVE COMMITTEE IN AN EMERGENCY SITUATION. THE MEMBERS OF THE EXECUTIVE COMMITTEE INCLUDE THE BOARD OFFICERS, THE PRESIDENT, AND ANY OTHER PARTY THE BOARD OF DIRECTOR APPOINTS. THE EXECUTIVE COMMITTEE POSSESSES AND MAY EXERCISE THE POWERS OF THE BOARD OF DIRECTORS IN BETWEEN MEETINGS. THE EXECUTIVE COMMITTEE REVIEWS THE PERFORMANCE AND COMPENSATION OF THE CEO EACH YEAR. THE EXECUTIVE COMMITTEE DOES NOT POSSESS THE AUTHORITY TO REMOVE ANY DIRECTOR, FIX DIRECTOR COMPENSATION, EXERCISE ANY RESERVED POWER WHICH REQUIRES SUBSIDIARY BOARD APPROVAL, OR EXERCISE ANY AUTHORITY PROHIBITED BY LAW. |
| FORM 990, PART VI, LINE 11B | THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM BASED ON DATA GATHERED BY THE CONTROLLER AND THE ORGANIZATION'S FINANCIAL OPERATIONS GROUP. THE CFO REVIEWS THE DRAFT FORM 990 AND PROVIDES ADDITIONAL COMMENTS. THE FINAL DRAFT VERSION OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE MAY 15 DUE DATE. ANY ADDITIONAL COMMENTS SUGGESTED BY THE GOVERNING BODY ARE THEN INCORPORATED INTO THE FINAL VERSION OF THE FORM 990 TO BE FILED WITH THE IRS BY THE FINAL DUE DATE. IF ANY SUGGESTED CHANGES ARE MATERIAL OR SIGNIFICANT, AN ADDITIONAL DRAFT IS DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING. |
| FORM 990, PART VI, LINE 12C | THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY (BOARD POLICY 6.1). THIS IS ACCOMPLISHED BY A NUMBER OF MECHANISMS. FIRST, THE CONFLICT OF INTEREST QUESTIONNAIRE IS REVIEWED BY THE GOVERNANCE COMMITTEE OF THE BOARD. AS PART OF THE QUESTIONNAIRE, SELF-DISCLOSURE IS REQUIRED BY BOARD MEMBERS, OFFICERS, AND VPS. IN ADDITION, INDIVIDUAL DISCLOSURE BY BOARD MEMBERS OCCURS AT BOARD MEETINGS WHEN NECESSARY. A BOARD MEMBER MUST EXCLUDE HIMSELF OR HERSELF FROM VOTING ON AN ISSUE IN WHICH HE OR SHE MAY HAVE A CONFLICT OF INTEREST. THE CONTROLLER REVIEWS POTENTIAL CONFLICTS AND FOLLOWS UP WITH ANY ADDITIONAL QUESTIONS, IF NECESSARY. THEN THE SUMMARY OF RESPONSES AND CONFLICTS ARE BROUGHT BEFORE THE GOVERNANCE COMMITTEE, WHICH MAKES A DETERMINATION AS TO WHETHER A CONFLICT EXISTS. |
| FORM 990, PART VI, LINES 15A AND 15B | THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO AND OTHER OFFICERS INCLUDES THE PREPARATION OF COMPARABLE DATA BY TOWERS WATSON, AN INDEPENDENT CONSULTING FIRM. IN ADDITION, THIS INFORMATION IS REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD AND DOCUMENTED IN THE BOARD MINUTES. THE MOST RECENT REVIEW WAS PERFORMED IN SEPTEMBER 2016. |
| FORM 990, PART VI, LINE 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE ARIZONA DEPARTMENT OF HEALTH SERVICES. IN ADDITION, THEY ARE AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) AS PART OF THE ORGANIZATION'S CONTINUING DISCLOSURE DOCUMENTS THAT ARE REQUIRED BY ITS PUBLIC DEBT REQUIREMENTS. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, AS THIS IS NOT REQUIRED. FORM 990, PART VII NORTHERN ARIZONA HEALTHCARE CORPORATION (NAH) PAID $446,634 TO THE COKER GROUP HOLDINGS, LLC ("COKER") FOR THE SERVICES OF THE INTERIM CFO RICHARD LANGOSCH, WHO IS AN EMPLOYEE OF COKER GROUP. |
| FORM 990, PART XI, LINE 9 | NET ASSET TRANSFERS FROM AFFILIATE $ 54,678,497 DECREASE IN UNFUNDED PENSION LIABILITY $ (4,659,971) ROUNDING $ 3 ------------- TOTAL $ 50,018,529 |
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