Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2020
Open to Public Inspection
For calendar year 2020, or tax year beginning 01-01-2020 , and ending 12-31-2020
Name of foundation
ARIZONA HEALTHIEST STATE FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)2800 NORTH CENTRAL AVENUE NO 1450
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
PHOENIX, AZ850041051
A Employer identification number

94-2851811
B Telephone number (see instructions)

(602) 445-4300
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$521,797J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule) 550,495
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 589 589 589
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)... 0
8 Net short-term capital gain......... 0
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment 450 0 450
12 Total. Add lines 1 through 11........ 551,534 589 1,039
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0 0 0
14 Other employee salaries and wages...... 169,493 0 0 153,028
15 Pension plans, employee benefits....... 30,830 0 0 30,830
16a Legal fees (attach schedule)......... Click to see attachment 2,004 0 0 2,004
b Accounting fees (attach schedule)....... Click to see attachment 2,425 0 0 2,425
c Other professional fees (attach schedule).... Click to see attachment 64,494 150 0 63,756
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 100 0 0 0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy.............. 208 0 0 208
21 Travel, conferences, and meetings....... 1,579 0 0 1,579
22 Printing and publications.......... 559 0 0 559
23 Other expenses (attach schedule)....... Click to see attachment 3,150 0 0 3,150
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 274,842 150 0 257,539
25 Contributions, gifts, grants paid....... 100,000 100,000
26 Total expenses and disbursements. Add lines 24 and 25 374,842 150 0 357,539
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 176,692
b Net investment income (if negative, enter -0-) 439
c Adjusted net income (if negative, enter -0-)... 1,039
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2020)
Form 990-PF (2020)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 135,671 329,975 329,975
2 Savings and temporary cash investments......... 191,383 191,822 191,822
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 327,054 521,797 521,797
Liabilities 17 Accounts payable and accrued expenses.......... 21,702 17,054
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet) Click to see attachment36,858 Click to see attachment59,557
23 Total liabilities (add lines 17 through 22)......... 58,560 76,611
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions........... 268,494 213,568
25 Net assets with donor restrictions............   231,618
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 268,494 445,186
30 Total liabilities and net assets/fund balances (see instructions). 327,054 521,797
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
268,494
2
Enter amount from Part I, line 27a .....................
2
176,692
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
445,186
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
445,186
Form 990-PF (2020)
Form 990-PF (2020)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1a
b
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2  
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE
1 Reserved
(a)
Reserved 		(b)
Reserved 		(c)
Reserved 		(d)
Reserved
2
Reserved...........................
2
3
Reserved...........................
3
4
Reserved...........................
4
5
Reserved...........................
5
6
Reserved...........................
6
7
Reserved...........................
7
8
Reserved,..........................
8
Form 990-PF (2020)
Form 990-PF (2020)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Reserved................................ 1 6
c All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 6
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 6
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a 33
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 33
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 27
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet27 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletAZ
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .Click to see attachment
    8b
     
    No
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2020 or the taxable year beginning in 2020? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
    Yes
     
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. Click to see attachment...............................
    10
    Yes
     
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletWWW.AZHHA.ORG
    14
    The books are in care ofbulletKARLA HARTLINE DIRECTOR OF FINANCE & OPERATIONS Telephone no.bullet (602) 445-4344

    Located atbullet2800 NORTH CENTRAL AVENUE NO 1450PHOENIXAZ ZIP+4bullet850041051
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2020, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
     
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2020?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2020, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2020?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2020 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2020.)..................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2020?
    4b
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......
    5b
     
    No
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    BACHER BETH DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    BEHRENDT RACHEL DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    CARNAHAN DAVID DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    DEMPSEY JACK DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    FRENCH DAVID DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    HUMBLE WILL DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    KNOX ROLAND DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    MCARTHUR RON DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    MENKOSKY PAULA DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    PURVES STEVE DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    SELMAN DAVID DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    SCHOMBURG JENNIFER DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    STRANGE JULIA DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    TRENSCHEL BOB DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    WALDO BRUCE DIRECTOR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    PATTERSON MICHAEL CHAIR
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    AMOS JOHN CHAIR-ELECT
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    ALAMEDDIN ANN-MARIE PRESIDENT & CEO
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    JENSEN NEAL SECRETARY/TREASURER
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    HAYNES JAMES SENIOR VP & CFO
    1.00     		0 0 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    SANDY SEVERSON VP, CARE IMPROVEMENT
    36.00     		160,827 17,220 0
    2800 NORTH CENTRAL AVENUE 1450
    PHOENIX,AZ85004
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    DISCERN LLC RESEARCH STUDY 55,000
    1120 N CHARLES STREET SUITE 200
    BALTIMORE,MD21201
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 THE ARIZONA HEALTHIEST STATE FOUNDATION (AHSF) BRINGS ARIZONA LEADERS TOGETHER TO HELP EMPOWER ARIZONANS TO MAKE THEIR LIFE WISHES AND CARE DIRECTIVES KNOWN AND TO EQUIP THEIR HEALTHCARE TEAMS WITH RESOURCES TO HONOR THESE DECISIONS. DURING 2020:-AHSF CONVENED A GROUP OF OVER 40 COMMUNITY LEADERS AND FORMED A COALITION TO TRANSFORM SERIOUS ILLNESS CARE. AHSF ALSO DESIGNED A PROGRAM TO BRING HOME AND COMMUNITY BASED PALLIATIVE CARE TO COMMUNITIES.-AHSF TAUGHT CLASSES FOR ADVANCE CARE PLANNING, CONVERSATIONS IN SERIOUS ILLNESS AND POLST TO A TOTAL OF 1,129 PEOPLE. AHSF TAUGHT 51 CLASSES IN 2020.-AHSF SERVED AS THE STATE LEAD FOR POLST AND BECAME AN ENDORSED STATE BY NATIONAL POLST.-AHSF PRODUCED 2 EDUCATIONAL VIDEOS ABOUT PALLIATIVE CARE. THE INTENDED AUDIENCE FOR THE VIDEOS IS THE PUBLIC AND HEALTHCARE PROFESSIONALS. AHSF SERVED AS INVITED PRESENTERS AT 3 CONFERENCES IN 2020. 357,539
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    0
    b
    Average of monthly cash balances.......................
    1b
    442,667
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    442,667
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    442,667
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    6,640
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    436,027
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    21,801
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
     
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
     
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
     
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
     
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
     
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
     
    Part XII
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
    357,539
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    357,539
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    357,539
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2019     		(c)
    2019     		(d)
    2020
    1 Distributable amount for 2020 from Part XI, line 7  
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2020:
    a From 2015......  
    b From 2016......  
    c From 2017......  
    d From 2018......  
    e From 2019......  
    fTotal of lines 3a through e........  
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$  
    a Applied to 2019, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2020 distributable amount.....  
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2020.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5  
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2020. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2021 ..........     		 
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2015 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......     		 
    10 Analysis of line 9:
    a Excess from 2016....  
    b Excess from 2017....  
    c Excess from 2018....  
    d Excess from 2019....  
    e Excess from 2020....  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2020, enter the date of the ruling....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2020 (b) 2019 (c) 2018 (d) 2017
    1,039 3,797 3,499 0 8,335
    b 85% of line 2a ......... 883 3,227 2,974 0 7,085
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		357,539 243,885 309,274 0 910,698
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		100,000 0 0 0 100,000
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		257,539 243,885 309,274 0 810,698
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......         0
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		         0
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		14,534 9,313 10,882 0 34,729
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		        0
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		        0
    (3) Largest amount of support
    from an exempt organization    		         0
    (4) Gross investment income         0
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    ACACIA HEALTH CENTER
    4555 E MAYO BLVD
    PHOENIX,AZ85050     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    ADELANTE HEALTHCARE
    3033 N CENTRAL AVENUE SUITE 145
    PHOENIX,AZ85013     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    ADVANCED HEALTH CARE OF GLENDALE
    16825 N 63RD AVENUE
    GLENDALE,AZ85306     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    ADVANCED HEALTH CARE OF SCOTTSDALE
    9846 N 95TH STREET
    SCOTTSDALE,AZ85258     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    AGAPE HOSPICE
    2980 N SWAN ROAD SUITE 222
    TUCSON,AZ85712     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    AGAVE FAMILY PHYSICIANS
    21300 N JOHN WAYNE PKWY 123
    MARICOPA,AZ85139     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    ALPHA HEALTHCARE LLC
    16042 N 32ND STREET SUITE 2B
    PHOENIX,AZ85032     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    AMERICAN HOME HEALTH SERVICES
    2045 S VINEYARD
    MESA,AZ85210     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    ARIA HOSPICE COMFORT CARE
    7225 N MONA LISA RD 100
    TUCSON,AZ85741     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    ARISTA HEALTHCARE
    1636 N SWAN ROAD SUITE 250
    TUCSON,AZ85712     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    ASSISTEO HOME HEALTH
    122 N CORTEZ SUITE 108
    PRESCOTT,AZ86301     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    AVEANNA HEALTHCARE
    4745 N 7TH STREET 432
    PHOENIX,AZ85014     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    AZTEC
    7400 W OLIVE AVENUE SUITE 24
    PEORIA,AZ85345     		NONE PC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    BANDERA HEALTHCARE
    2121 W ELGIN STREET
    CHANDLER,AZ85224     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    BAYADA HOME HEALTH CARE
    18001 N 79TH AVE SUITE A-3
    GLENDALE,AZ85308     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    BEATITUDES HEALTH CARE CENTER
    1712 W GLENDALE AVE
    PHOENIX,AZ85021     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    BENSON HOSPITAL
    450 S OCOTILLO
    BENSON,AZ85062     		NONE PC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    CANYON VISTA MEDICAL CENTER
    5700 E HIGHWAY 95
    SIERRA VISTA,AZ85635     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    CANYONLANDS HEALTH CARE
    467 VISTA AVENUE
    PAGE,AZ86040     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    CARONDELET HEALTH NETWORK
    1601 W ST MARYS ROAD
    TUCSON,AZ85745     		NONE PC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    CENTRIX HEALTH RESOURCES
    1840 E UNIVERSITY DR
    MESA,AZ85203     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    CENTURION
    1305 E BUTTE AVENUE
    FLORENCE,AZ85132     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    CHIRICAHUA CHC
    1205 F AVENUE
    DOUGLAS,AZ85607     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    CIRCLE THE CITY
    300 W CLARENDON AVENUE STE 200
    PHOENIX,AZ85013     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    COMMONWEALTH PRIMARY CARE ACO
    4801 S LAKESHORE DR 106
    TEMPE,AZ85253     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    COMMUNITY HEALTH CENTER OF YAVAPAI
    1090 COMMERCE DR
    PRESCOTT,AZ86305     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    CONNECTIONS HEALTH SOLUTIONS
    1201 S 7TH AVENUE SUITE 150
    PHOENIX,AZ85007     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    COPPER QUEEN COMMUNITY HOSPITAL
    101 COLE AVE
    BISBEE,AZ85603     		NONE PC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    COPPER QUEEN HEALTH CENTER
    101 COLE AVENUE
    BISBEE,AZ85603     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    COVENANT HEALTH NETWORK
    3877 N 7TH ST
    PHOENIX,AZ85014     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    CREEK VALLEY HEALTH CLINIC
    20 S COLVIN STREET
    COLORADO CITY,AZ86021     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    CURAHEALTH TUCSON HOSPITAL
    355 N WILMOT ROAD
    TUCSON,AZ85711     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    DEPENDABLE HOME HEALTH
    1121 N EL DORADO CIRCLE SUITE 300
    TUCSON,AZ85715     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    DESERT SENITA COMMUNITY HEALTH CENTER
    410 N MALACATE
    AJO,AZ85321     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    DESERT VALLEY HOSPICE AND PALLIATIVE CARE
    11225 N 28TH DR D112
    PHOENIX,AZ85029     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    DEVON GABLES REHABILITATION CENTER
    6150 E GRANT ROAD
    TUCSON,AZ85712     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    DIGNITY HEALTH HOSPICE
    19820 N 7TH STREET SUITE 210
    PHOENIX,AZ85024     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    EL RIO HEALTH
    450 W PASEO REDONDO
    TUCSON,AZ85701     		NONE PC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    EMBLEM HOSPICE TUCSON
    7225 N ORACLE ROAD SUITE 202
    TUCSON,AZ85704     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    ENCOMPASS HEALTH REHABILITATION HOSPITAL OF EAST VALLEY
    5652 E BASELINE RD
    MESA,AZ85212     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    ENCOMPASS HEALTH REHABILITATION INSTITUTE OF TUCSON
    2650 N WYATT DR
    TUCSON,AZ85712     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    ENCOMPASS HEATH REHABILITATION HOSPITAL OF NORTHWEST TUCSON
    1921 N HOSPITAL DRIVE
    TUCSON,AZ85704     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    FLAGSTAFF MEDICAL CENTER
    1200 N BEAVER STREET
    FLAGSTAFF,AZ86001     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    FOUR PEAKS SURGERY CENTER
    9425 W BELL ROAD
    SUN CITY,AZ85351     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    GATEWAY SURGERY CENTER
    690 N COFCO CENTER COURT
    PHOENIX,AZ85008     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    GENESIS HEALTHCARE CO ESTRELLA CENTER
    350 E LA CANADA BLVD
    AVONDALE,AZ85323     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    GILA RIVER INDIAN COMMUNITY
    1576C S NELSON DRIVE
    CHANDLER,AZ85226     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    GOLD CANYON INTERNAL MEDICINE PLLC
    6788 S KINGS RANCH ROAD
    MESA,AZ85118     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    HACIENDA HOME HEALTH CARE INC
    5549 E GRANT RD
    TUCSON,AZ85712     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    HANDMAKER JEWISH SERVICES FOR THE AGING
    2221 N ROSEMONT BLVD
    TUCSON,AZ85712     		NONE PC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    HARBOR LIGHT HOSPICE
    4703 N 1ST AVE
    TUCSON,AZ85718     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    HAVEN BEHAVIORAL HOSPITAL OF PHOENIX
    1201 S 7TH AVE 200
    PHOENIX,AZ85007     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    HAVEN OF PHOENIX
    4202 N 20TH AVENUE
    PHOENIX,AZ85015     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    HAVEN OF SAFFORD
    1933 PEPPERTREE DR
    SAFFORD,AZ85546     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    HAVEN HOME HEALTH OF TUCSON
    1607 N WILMOT ROAD SUITE 104D
    TUCSON,AZ85712     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    HAVEN HOSPICE
    1609 N WILMOT ROAD SUITE 105C
    TUCSON,AZ85712     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    HORIZON HEALTH & WELLNESS
    625 N PLAZA DRIVE
    APACHE JUNCTION,AZ85120     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    HOSPICE OF AMERICA
    1837 S MESA DRIVE
    MESA,AZ85210     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    HOSPICE OF HAVASU
    365 LAKE HAVASU AVENUE
    LAKE HAVASU CITY,AZ86403     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    IMMANUEL CAMPUS OF CARE
    11301 N 99TH AVENUE
    PEORIA,AZ85345     		NONE PC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    INSPIRING HOME HEALTH
    10000 N 31ST AVENUE D402
    PHOENIX,AZ85051     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    KAIBAB PAIUTE TRIBE
    1 N PIPE SPRINGS
    FREDONIA,AZ86022     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    KPC PROMISE HOSPITAL OF PHOENIX LLC
    433 E 6TH ST
    MESA,AZ85203     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    LOVIN MANOR ASSISTED LIVING
    29192 N 76TH ST
    SCOTTSDALE,AZ85266     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    MARAVILLA CARE CENTER
    8825 S 7TH ST
    PHOENIX,AZ85042     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    MARIPOSA COMMUNITY HEALTH CENTER
    1852 N MASTICK WAY
    NOGALES,AZ85621     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    MAXIM HEALTHCARE SERVICES
    3300 N CENTRAL AVENUE SUITE 2500
    PHOENIX,AZ85012     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    MAYO CLINIC
    5777 E MAYO BLVD
    PHOENIX,AZ85054     		NONE PC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    MOUNTAIN PARK HEALTH CENTER
    3003 N CENTRAL AVENUE STE 1600
    PHOENIX,AZ85012     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    MOUNTAIN PARK HEALTH CENTERS
    635 E BASELINE ROAD
    PHOENIX,AZ85042     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    MOUNTAIN VISTA MEDICAL CENTER
    1301 S CRISMON RD
    MESA,AZ85209     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    MT GRAHAM REGIONAL MEDICAL CENTER
    1600 S 20TH STREET
    SAFFORD,AZ85546     		NONE PC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    NATIVE HEALTH
    4041 N CENTRAL AVENUE BLDG C
    PHOENIX,AZ85012     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    NEIGHBORHOOD OUTREACH ACCESS TO HEALTH
    7500 N DREAMY DRAW DRIVE STE 145
    PHOENIX,AZ85020     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    NOBLE CARE SERVICES LLC
    3707 E SOUTHERN AVENUE 2017
    MESA,AZ85206     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    OASIS HOSPITAL
    750 N 40TH STREET
    PHOENIX,AZ85008     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    PACIFIC COAST HOSPICE
    2919 S ELLSWORTH ROAD SUITE 129
    MESA,AZ85212     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    PATIENT CARE ADVOCATES LLC
    2223 E SPEEDWAY BLVD
    TUCSON,AZ85719     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    PEAKS SENIOR LIVING
    3150 N WINDING BROOK ROAD
    FLAGSTAFF,AZ86001     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    PHI AIR MEDICAL
    2800 N 44TH ST
    PHOENIX,AZ85008     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    PRESCOTT NURSING AND REHAB
    864 DOUGHERTY ST
    PRESCOTT,AZ86305     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    QUAIL RUN BEHAVIORAL HEALTH CENTER
    2545 W QUAIL AVE
    PHOENIX,AZ85027     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    QUECHAN INDIAN TRIBE (FORT YUMA HEALTH CENTER)
    401 E PICACHO ROAD
    WINTERHAVEN,CA92283     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    REMITA HOSPICE
    6375 E TANQUE VERDE RD STE 180
    TUCSON,AZ85715     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    RUMMEL EYE CENTER
    1022 WILLOW CREEK ROAD
    PRESCOTT,AZ86301     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SAGE HOSPICE AND PALLIATIVE CARE
    5111 N SCOTTSDALE ROAD SUITE 204
    SCOTTSDALE,AZ85250     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SANTA ROSA CARE CENTER
    1650 N SANTA ROSA AVENUE
    TUCSON,AZ85712     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SANTE OF MESA
    5358 E BASELINE ROAD
    MESA,AZ85206     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SANTE OF NORTH SCOTTSDALE
    17490 N 93RD STREET
    SCOTTSDALE,AZ85255     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SAPPHIRE OF TUCSON NURSING AND REHAB
    2900 E MILBER STREET
    TUCSON,AZ85714     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SCOTTSDALE DETOX
    7283 E EARLL DRIVE
    SCOTTSDALE,AZ85251     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SCOTTSDALE EYE INSTITUTE
    215 S POWER ROAD SUITE 112
    MESA,AZ85206     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SCOTTSDALE SURGERY CENTER
    3320 N MILLER ROAD
    SCOTTSDALE,AZ85251     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SELECT SPECIALTY HOSPITAL
    1111 E MCDOWELL ROAD 11TH FLOOR
    PHOENIX,AZ85013     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SENSORY TESTING SYSTEMS
    8655 E VIA DE VENTURA STE E160
    SCOTTSDALE,AZ85258     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SHANTI HOSPICE
    501 W RAY ROAD SUITE 6
    CHANDLER,AZ85225     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 781
    SOULISTIC HOSPICE
    2344 E SPEEDWAY BLVD
    TUCSON,AZ85719     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    SOUTHERN ARIZONA VA HEALTH CARE SYSTEM
    3601 S 6TH AVENUE
    TUCSON,AZ85723     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    SOUTHLAND HOSPICE
    4527 N 16TH STREET 201
    PHOENIX,AZ85016     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    SUMMIT HEALTH CARE SERVICES
    7310 N 16TH ST
    PHOENIX,AZ85020     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    SUN CITY ENDOSCOPY CENTER
    13640 N 99 AVE STE 700
    SUN CITY,AZ85351     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    SUN LIFE FAMILY HEALTH CENTER
    865 N ARIZOLA ROAD
    CASA GRANDE,AZ85122     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    SUNCREST HEALTH CARE
    2211 SOUTHERN AVENUE
    PHOENIX,AZ85040     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    SUNRISE AT RIVER ROAD
    4975 N 1ST AVENUE
    TUCSON,AZ85718     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    SUNSET COMMUNITY HEALTH CENTER
    2060 W 24TH STREET
    YUMA,AZ85364     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    SURGERY CENTER AT RIVER ROAD
    2490 E RIVER ROAD SUITE 150
    TUCSON,AZ85718     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    SWAN SURGERY CENTER LLC
    1505 N SWAN ROAD
    TUCSON,AZ85712     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    THE CENTER AT TUCSON
    5020 E GLENN STREET
    TUCSON,AZ85712     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    THE CORE INSTITUTE SPECIALTY HOSPITAL
    6501 N 19TH AVENUE
    PHOENIX,AZ85015     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    THE EYE CLINIC
    401 S CALVARY WAY
    COTTONWOOD,AZ86326     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    THE GUIDANCE CENTER INC
    2187 N VICKEY STREET
    FLAGSTAFF,AZ86004     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    THEMA HEALTH SERVICES
    1725 E OSBORN RD
    PHOENIX,AZ85016     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    THRIVE SKILLED PEDIATRIC CARE
    2403 N STOCKTON HILL ROAD STE 3
    KINGMAN,AZ86401     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    TSEHOOTSOOI MEDICAL CENTER
    CORNERS OF ROUTES N12 N7
    FORT DEFIANCE,AZ86504     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    TUBA CITY REGIONAL HEALTH CARE CO MOBILE HEALTH PROGRAM
    167 N MAIN STREET
    TUBA CITY,AZ86045     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    TUCSON MEDICAL CENTER
    5301 E GRANT ROAD
    TUCSON,AZ85712     		NONE PC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    UNITY HOSPICE
    1635 N GREENFIELD ROAD SUITE 126
    MESA,AZ85205     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    UNIVERSITY OF ARIZONA CAMPUS HEALTH SERVICES
    1224 E LOWELL ST
    TUCSON,AZ85721     		NONE GOV PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    VALLE DEL SOL
    3807 N 7TH STREET
    PHOENIX,AZ85014     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    VALLEY HOSPITAL
    3550 E PINCHOT AVENUE
    PHOENIX,AZ85018     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    VOLUNTEERS OF AMERICA WESTCHESTER CARE CENTER
    6100 S RURAL ROAD
    TEMPE,AZ85283     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    WELBROOK TRANSITIONAL REHABILITATION
    1521 N PINE CLIFF DRIVE
    FLAGSTAFF,AZ86001     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    WELLSPRINGS OF PHOENIX
    3008 N 3RD STREET
    PHOENIX,AZ85012     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    WESLEY COMMUNITY & HEALTH CENTER
    1300 S 10TH STREET
    PHOENIX,AZ85034     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    WESTERN ARIZONA REGIONAL MEDICAL CENTER
    2735 SILVER CREEK ROAD
    BULLHEAD CITY,AZ86442     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    WINDSOR MARYLAND GARDENS
    31 W MARYLAND AVENUE
    PHOENIX,AZ85013     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    WINSLOW INDIAN HEALTH CARE CENTER
    500 N INDIANA AVE
    WINSLOW,AZ86047     		NONE NC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    YAVAPAI REGIONAL MEDICAL CENTER
    1003 WILLOW CREEK ROAD
    PRESCOTT,AZ86301     		NONE PC PPE FOR HEALTHCARE WORKERS DURING COVID-19 OUTBREAK 782
    Total .................................bullet 3a 100,000
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities....     14 589  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		         
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aSEMINARS     		        450
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 589 450
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    1,039
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    11B SEMINAR AND TRAINING REVENUE
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2020)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2020
    Name of the organization
    ARIZONA HEALTHIEST STATE FOUNDATION
     
    Employer identification number

    94-2851811
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2
    Name of organization
    ARIZONA HEALTHIEST STATE FOUNDATION
          		Employer identification number
    94-2851811
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    THE DAVID AND LURA LOVELL FOUNDATION
     
    1735 E FORT LOWELL ROAD 3
     
    TUCSON, AZ85719

    		$ 309,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
    COALITION TO TRANSFORM ADVANCED CARE
     
    900 16TH STREET NW SUITE 400
     
    WASHINGTON, DC20006

    		$ 80,494


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    3
    WELLS FARGO
     
    550 S 4TH STREET
     
    MINNEAPOLIS, MN55415

    		$ 100,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    4
    ARIZONA COMMUNITY FOUNDATION
     
    2201 E CAMELBACK ROAD SUITE 405B
     
    PHOENIX, AZ85016

    		$ 50,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    5
    SCOTT H O'CONNOR
     
    3636 E DENTON LANE
     
    PARADISE VALLEY, AZ85253

    		$ 10,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Page 3
    Name of organization
    ARIZONA HEALTHIEST STATE FOUNDATION
          		Employer identification number

    94-2851811
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Page 4
    Name of organization
    ARIZONA HEALTHIEST STATE FOUNDATION
          		Employer identification number

    94-2851811
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2020 AccountingFeesSchedule
    Name:
    ARIZONA HEALTHIEST STATE FOUNDATION
    EIN:
    94-2851811
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 2,425 0 0 2,425

    TY 2020 ExplnOfNonFilingWithAGStmt
    Name:
    ARIZONA HEALTHIEST STATE FOUNDATION
    EIN:
    94-2851811
    Statement:
    ARIZONA DOES NOT REQUIRE A COPY OF FORM 990-PF TO BE FILED WITH THE ARIZONA DEPARTMENT OF REVENUE OR THE ARIZONA ATTORNEY GENERAL.

    TY 2020 LegalFeesSchedule
    Name:
    ARIZONA HEALTHIEST STATE FOUNDATION
    EIN:
    94-2851811
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES 2,004 0 0 2,004


    TY 2020 OtherExpensesSchedule
    Name:
    ARIZONA HEALTHIEST STATE FOUNDATION
    EIN:
    94-2851811
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    SUPPLIES 167 0 0 167
    MISCELLANEOUS 1,926 0 0 1,926
    COMMUNITY ENGAGEMENT EVENTS 1,026 0 0 1,026
    BANK FEES 31 0 0 31


    TY 2020 OtherIncomeSchedule2
    Name:
    ARIZONA HEALTHIEST STATE FOUNDATION
    EIN:
    94-2851811
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    SEMINARS 450   450


    TY 2020 OtherLiabilitiesSchedule
    Name:
    ARIZONA HEALTHIEST STATE FOUNDATION
    EIN:
    94-2851811
    Description Beginning of Year - Book Value End of Year - Book Value
    DUE TO AFFILIATES 36,858 59,557


    TY 2020 OtherProfessionalFeesSchedule
    Name:
    ARIZONA HEALTHIEST STATE FOUNDATION
    EIN:
    94-2851811
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    CONTRACTED SERVICES 58,750 0 0 58,750
    PROFESSIONAL SERVICES 594 0 0 6
    INVESTMENT FEES 150 150 0 0
    DATA COLLECTION AND REPORTING 5,000 0 0 5,000


    TY 2020 SubstantialContributorsSch
    Name:
    ARIZONA HEALTHIEST STATE FOUNDATION
    EIN:
    94-2851811
    Name Address
    WELLS FARGO
          		550 S 4TH STREET
    MINNEAPOLIS,MN55415
    ARIZONA COMMUNITY FOUNDATION
          		2201 E CAMELBACK ROAD SUITE 405B
    PHOENIX,AZ85016


    TY 2020 TaxesSchedule
    Name:
    ARIZONA HEALTHIEST STATE FOUNDATION
    EIN:
    94-2851811
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXCISE TAXES 100 0 0 0