Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 3,272 | 5,424 | 13,949 | 22,645 | ||
| 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 | 2,099,929 | 1,810,874 | 2,922,837 | 1,090,599 | 313,878 | 8,238,117 |
| 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 | 2,103,201 | 1,816,298 | 2,922,837 | 1,090,599 | 327,827 | 8,260,762 |
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 8,260,762 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 2,103,201 | 1,816,298 | 2,922,837 | 1,090,599 | 327,827 | 8,260,762 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 2,263,546 | 1,866,317 | 1,716,307 | 1,502,363 | 1,734,706 | 9,083,239 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 2,263,546 | 1,866,317 | 1,716,307 | 1,502,363 | 1,734,706 | 9,083,239 |
| 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.).. | 4,366,747 | 3,682,615 | 4,639,144 | 2,592,962 | 2,062,533 | 17,344,001 |
| 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): |
|||||
| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE OF THE BOARD IS AUTHORIZED TO ACT FOR THE BOARD BETWEEN REGULAR MEETINGS TO HANDLE EMERGENCY SITUATIONS WHICH ARE TIME SENSITIVE. A MAJORITY OF THE MEMBERS OF THE EXECUTIVE COMMITTEE IS REQUIRED TO TRANSACT BUSINESS. MINUTES OF ALL MEETINGS OF THE EXECUTIVE COMMITTEE ARE PROVIDED TO THE BOARD AT THE NEXT REGULAR MEETING TO BE REVIEWED AND RATIFIED BY THE FULL BOARD. |
| FORM 990, PART VI, SECTION A, LINE 3 | THE FOUNDATION CONTRACTS WITH BRUCE NORTON FOR FINANCIAL AND BOOKKEEPING SERVICES. MR. NORTON COMPILES MONTHLY FINANCIAL STATEMENTS, CONTROLS BANKING AND CASH FUNCTIONS AND ASSISTS WITH PROVIDING NECESSARY FINANCIAL INFORMATION TO THE OUTSIDE AUDITORS, TAX PREPARERS, PAYROLL COMPANY AND RETIREMENT PLAN COMPANY. MR. NORTON IS OVERSEEN BY MANAGEMENT AND THE FINANCE COMMITTEE. $42,440 WAS PAID TO MR. NORTON IN 2017 FOR THE ABOVE SERVICES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS PREPARED BY THE FOUNDATION'S INDEPENDENT CPA, AND REVIEWED BY THE CONTRACTED CONTROLLER AND CEO BEFORE DISTRIBUTION TO THE FINANCE COMMITTEE. THE COMPLETED 990 IS REVIEWED WITH THE FINANCE COMMITTEE OF THE BOARD HIGHLIGHTING THE AREAS OF CONCERN TO A GOVERNING BODY. A COMPLETED COPY IS MADE AVAILABLE FOR ALL BOARD MEMBERS. ANSWERS ARE PROVIDED TO ANY QUESTIONS OR CONCERNS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. THE FOLLOWING PROCEDURES ARE EMPLOYED. ALL OFFICERS, LEADERS OR IDENTIFIED OTHERS SHALL COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AND SUBMIT IT TO THE FOUNDATION ANNUALLY. FOUNDATION LEADERS ARE DEFINED AS BOARD MEMBERS, CEO, AND OTHERS WHO MAY HOLD A DECISION-MAKING LEADERSHIP ROLE WITH THE FOUNDATION. THE TERM "CONFLICT OF INTEREST" MEANS A CIRCUMSTANCE IN WHICH A FOUNDATION LEADER HAS ANY IMPEDIMENT TO BEING IMPARTIAL AND LOYAL SUCH AS: 1) A PERSONAL, PROFESSIONAL OR VOLUNTEER POSITION, INTEREST OR RESPONSIBILITY, OR 2) A CONFLICTING DUTY TO ANOTHER ENTITY, WHERE THE INDIVIDUAL'S ALLEGIANCE MAY BE DIVIDED BETWEEN THE FOUNDATION AND ANOTHER ORGANIZATION OR RELATIONSHIP. ANY AND ALL CONFLICTS OF INTEREST SHALL BE DISCLOSED TO THE FOUNDATION AT THE INCEPTION OF THE RELATIONSHIP, AND/OR AT ANY TIME A CONFLICT/DUALITY OF INTEREST OCCURS. INFORMATION RELATING TO THE FOUNDATION'S BUSINESS WILL NOT BE DISCLOSED FOR THE PERSONAL PROFIT OR ADVANTAGE OF THE FOUNDATION'S LEADERS OR THEIR IMMEDIATE FAMILY MEMBERS. THE FOUNDATION WILL PERIODICALLY AND WHENEVER NECESSARY, REVIEW ITS EXTERNAL RELATIONSHIPS TO DETERMINE WHETHER CONFLICTS OF INTERESTS EXIST AND TO ENSURE THESE RELATIONSHIPS ARE WITHIN LAW AND REGULATION. A REVIEW FOR CONFLICT/DUALITY OF INTEREST WILL BE DONE PRIOR TO ENTERING INTO AGREEMENTS AND/OR CONTRACTS AND AGAIN AT THE TIME OF RENEWAL. CERTAIN BOARD MEMBERS HAVE DUAL MEMBERSHIP WITH BOTH THE FOUNDATION BOARD AND THE REGIONAL CARE HOSPITAL PARTNERS-SIERRA VISTA REGIONAL HEALTH CENTER BOARD OR ANOTHER ENTITY. INHERENT IN THIS DUAL MEMBERSHIP IS THE POTENTIAL FOR CONFLICT/DUALITY OF INTEREST FOR THE BOARD MEMBER. TO MITIGATE REAL OR PERCEIVED CONFLICT ASSOCIATED WITH DUAL BOARD MEMBERSHIP, THE FOLLOWING PROTOCOLS HAVE BEEN ADOPTED BY THE FOUNDATION BOARD WHEN IT DISCUSSES, DELIBERATES, AND DECIDES ON ANY ACTION IMPACTED BY THE DUAL BOARD MEMBERSHIP OR IN THE EVENT OF ANY OTHER CONFLICT/DUALITY OF INTEREST: A. CONFLICTED MEMBERS OF THE BOARD OF DIRECTORS SHOULD DECLARE THEIR CONFLICT OF INTEREST B. FOR REGULAR OR SPECIAL MEETINGS OF THE BOARD, A QUORUM FOR TRANSACTION OF BUSINESS SHALL CONSIST OF A MAJORITY OF THE BOARD OF DIRECTORS. ANY DIRECTOR HAVING A CONFLICT/DUALITY OF INTEREST SHALL ABSTAIN FROM VOTING ON THE PROPOSED TRANSACTION AND SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE VOTE ON THE PROPOSED TRANSACTION. C. MOTIONS AND SECONDS FOR ACTIONS SHOULD BE MADE BY NON-CONFLICTED MEMBERS OF THE BOARD. D. THE CONFLICTED DIRECTOR SHALL NOT USE PERSONAL INFLUENCE ON THE MATTER OR REMAIN IN THE MEETING ROOM DURING THE DISCUSSION AND VOTE ON THE MATTER, BUT MAY BRIEFLY STATE HIS/HER POSITION AND MAY ANSWER PERTINENT QUESTIONS FROM OTHER DIRECTORS SINCE HIS/HER KNOWLEDGE MAY BE OF GREAT ASSISTANCE. RECUSED DIRECTORS SHALL REMAIN AVAILABLE AND MAY BE RECALLED AT THE REQUEST OF THE BOARD CHAIR. E. ONLY NON-CONFLICTED MEMBERS MAY VOTE ON THE PROPOSED ACTION. CERTAIN BOARD MEMBERS MAY HAVE CONFLICTS ON INTEREST WITH SOME GRANTEES. IN THIS CASE, THE MEMBER WILL IDENTIFY THE CONFLICT. IF THE MEMBER IS IN THE PHILANTHROPY COMMITTEE, THEY WILL NOT BE ALLOWED TO EVALUATE THE PROPOSAL (A QUESTION ABOUT CONFLICTS ARE ASKED OF EACH EVALUATOR FOR EACH PROPOSAL). WHEN TAKEN TO THE FULL BOARD, THE MEMBER WILL BE ALLOWED TO HEAR DISCUSSION ABOUT THE POSSIBLE AWARD AND PROVIDE INSIGHT. THE MEMBER IS THEN EXCUSED FOR FINAL DELIBERATIONS, DECISION-MAKING AND VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15 | IT IS THE POLICY OF THE FOUNDATION BOARD TO DEVELOP AN ANNUAL COMPENSATION PLAN FOR THE CEO. A THIRD PARTY COMPENSATION CONSULTANT WILL BE PERIODICALLY ENGAGED BY THE BOARD FOR THE PURPOSE OF OBTAINING MARKET COMPARISON DATA FOR USE IN DEVELOPING THE PLAN. PROCEDURE: * ENGAGE AN INDEPENDENT COMPANY TO CONDUCT A COMPENSATION VALUATION STUDY OF COMPENSATION ARRANGEMENTS IN TAX-EXEMPT ORGANIZATIONS INCLUDING FOUNDATIONS. * THE INDEPENDENT COMPANY WILL PROVIDE THE FOUNDATION BOARD, CEO AND EXECUTIVE COMPENSATION COMMITTEE AS APPOINTED BY THE BOARD CHAIR, COMPETITIVE MARKET DATA TO INCLUDE: A CONFIRMATION OF THE SCOPE, DATA CUTS, AND SURVEY SOURCES. PROVIDE MARKET COMPARABILITY DATA IN ORDER TO REVIEW THE COMPETITIVENESS OF THE FOUNDATION'S PROGRAM. RESEARCH MARKET PRACTICES FOR BOTH SHORT AND LONG TERM PLANS TO DETERMINE ALIGNMENT. REVIEW EXECUTIVE BENEFIT AND PERQUISITE PREVALENCE DATA. * THE INDEPENDENT COMPANY WILL SELECT RELEVANT DATA AND ADJUST THE DATA TO ACCURATELY REFLECT THE SIZE AND SCOPE OF THE FOUNDATION'S ROLES AND SIZE. * THE INDEPENDENT COMPANY WILL UTILIZE THE SAME METHODOLOGY TO CONDUCT A REVIEW OF FRINGE BENEFIT PLANS FOR THE EXECUTIVES AND STAFF. * THE INDEPENDENT COMPANY WILL CONSIDER THE FOLLOWING WHEN REVIEWING A PARTICULAR INDIVIDUAL'S COMPENSATION: THE PRIOR SKILLS AND EXPERIENCE OF INCUMBENTS IN THE ROLE. THE MIX OF COMPENSATION ELEMENTS AND OTHER REWARD COMPONENTS. * THE INDEPENDENT COMPANY WILL MAKE RECOMMENDATIONS FOR COMPENSATION AND BENEFITS FOR THE EXECUTIVE STAFF TO THE FOUNDATION BOARD, EXECUTIVE COMPENSATION COMMITTEE (FOR THE CEO) AND THE CEO (FOR OTHER STAFF). * THE COMMITTEE WILL MOVE FORWARD THE RECOMMENDATIONS OF THE THIRD PARTY CONSULTANT FOR THE CEO TO THE ENTIRE FOUNDATION BOARD OF DIRECTORS WITH FULL DISCLOSURE. * THE CEO WILL REVIEW THE RECOMMENDATIONS FOR THE OTHER STAFF AND MAKE A DECISION BASED ON THE DATA, THE INDIVIDUAL AND THE BUDGET SALARY PLAN. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Software ID: | |
| Software Version: |