TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) FLORENCE SPYROW NAH PRESIDENT/CEO	6.0 ................. 34.0	X	X		1,284,451	32,656
(2) Janet Corrigan DIRECTOR/CHAIR (CHAIR THRU 09/21)	1.0 ................. 2.0	X	X		0	0
(3) KENNETH SALCE MD DIRECTOR/SECRETARY (THRU 11/21)	1.0 ................. 2.0	X	X		0	0
(4) MICHAEL MARTINELL DIRECTOR/VICE CHAIR (AS OF 10/21)	1.0 ................. 2.0	X	X		0	0
(5) WILLIAM RILEY DIRECTOR/CHAIR (AS OF 10/21)	1.0 ................. 2.0	X	X		0	0
(6) Alice Gagnaire RN DIRECTOR	1.0 ................. 2.0	X			0	0
(7) CHARLES MARR DIRECTOR	1.0 ................. 2.0	X			0	0
(8) Charlie Agee DIRECTOR (AS OF 9/21)	1.0 ................. 2.0	X			0	0
(9) ERIC CROWELL DIRECTOR	1.0 ................. 2.0	X			0	0
(10) GUADALUPE WOODSON FNP DIRECTOR (THRU 7/21)	1.0 ................. 2.0	X			0	0
(11) JOHN RIVERS DIRECTOR/SECRETARY (AS OF 10/21)	1.0 ................. 2.0	X			0	0
(12) Randall Garrison DIRECTOR	1.0 ................. 2.0	X			0	0
(13) Troy Lorents Director (AS OF 7/21)	1.0 ................. 2.0	X			0	0
(14) WILLIAM JEFFERS DIRECTOR/TREASURER (AS OF 10/21)	1.0 ................. 2.0	X			0	0
(15) CLIFFORD LOADER Chief Financial Officer	8.0 ................. 32.0		X		581,017	18,705
(16) JOSHUA TINKLE CHIEF OPERATING OFFICER	10.0 ................. 30.0		X		572,835	35,385
(17) Derek Feuquay Chief Medical Officer	10.0 ................. 30.0			X	529,875	31,875

(A) Name and business address	(B) Description of services	(C) Compensation
AYA HEALTHCARE INC PO BOX 123519 DALLAS,TX75312	CONTRACT LABOR	9,066,752
MAYO CLINIC MAYO MEDICAL LABOR PO BOX 9146 MINNEAPOLIS,MN55480	MEDICAL SERVICES	930,920
CRITICAL CARE CONSULTANTS OF AZ PO BOX 967 FLAGSTAFF,AZ86002	MEDICAL SERVICES	618,104
GE MED SYSTEMS ULTRASOUND PRIMARY CARE PO BOX 74008831 CHICAGO,IL60674	CONTRACT LABOR	482,148
INSTRUMENTATION LABORATORY COMPANY PO BOX 347934 PITTSBURGH,PA15251	LABORATORY SERVICES	258,061
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 14

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

Verde Valley Medical Center

Employer identification number

86-0100882

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2021

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2021

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on 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.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2021

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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 0.015 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 0.035	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2021

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Verde Valley Medical Center

Employer identification number

86-0100882

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2021

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

4,933

Total. Add lines 1c through 1i ....................................................................................................

4,933

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	VERDE VALLEY MEDICAL CENTER PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION, THE AMERICA'S ESSENTIAL HOSPITALS AND THE HEALTH SYSTEM ALLIANCE OF ARIZONA. A PERCENTAGE OF THIS AMOUNT, TOTALING $4,933, WAS ESTIMATED TO BE ATTRIBUTABLE TO LOBBYING RELATED TO HEALTHCARE ADVOCACY AT THE FEDERAL, STATE, REGIONAL, AND LOCAL LEVELS.

Schedule C (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Verde Valley Medical Center

Employer identification number

86-0100882

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	4,238,797		4,238,797
b	Buildings ....	134,924,422	81,800,568	53,123,854
c	Leasehold improvements	1,014,335	948,329	66,006
d	Equipment ....	85,197,280	65,769,548	19,427,732
e	Other .....	13,058,706	6,493,138	6,565,568
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				83,421,957

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	10,989,388
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION'S MANAGEMENT IS NOT AWARE OF ANY EVENTS THAT WOULD CAUSE THE CORPORATION TO LOSE ITS TAX-EXEMPT STATUS. MANAGEMENT HAS REVIEWED ALL OPEN TAX YEARS AND HAS DETERMINED THAT THE CORPORATION HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS.

Schedule D (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Verde Valley Medical Center

Employer identification number

86-0100882

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			10,444,624	0	10,444,624	6.25 %
b	Medicaid (from Worksheet 3, column a) . . . . .			33,096,478	15,699,321	17,397,157	10.41 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .			0	0	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	43,541,102	15,699,321	27,841,781	16.66 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			1,144,120	187,312	956,808	0.57 %
f	Health professions education (from Worksheet 5) . . .			0	0	0	0 %
g	Subsidized health services (from Worksheet 6) . . . .			0	0	0	0 %
h	Research (from Worksheet 7) .			0	0	0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			0	0	0	0 %
j	Total. Other Benefits . .	0	0	1,144,120	187,312	956,808	0.57 %
k	Total. Add lines 7d and 7j .	0	0	44,685,222	15,886,633	28,798,589	17.24 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	0	0	0	0

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

8,289,944

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

11,530,677

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

49,479,203

Enter Medicare allowable costs of care relating to payments on line 5.....

41,834,062

Subtract line 6 from line 5. This is the surplus (or shortfall)........

7,645,141

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2021

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	VERDE VALLEY MEDICAL CENTER 269 S CANDY LANE COTTONWOOD,AZ86326 HTTPS://NAHEALTH.COM H0122	X	X	X

Schedule H (Form 990) 2021

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	VERDE VALLEY MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTPS://NAHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTPS://NAHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	VERDE VALLEY MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0%
and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.NAHEALTH.COM/BILLING-INSURANCE/NORTHERN-ARIZONA-HEALTHCARES-FINANCIAL-ASSISTANCE-PROGRAM/

The FAP application form was widely available on a website (list url):

WWW.NAHEALTH.COM/BILLING-INSURANCE/NORTHERN-ARIZONA-HEALTHCARES-FINANCIAL-ASSISTANCE-PROGRAM/

A plain language summary of the FAP was widely available on a website (list url):
WWW.NAHEALTH.COM/BILLING-INSURANCE/NORTHERN-ARIZONA-HEALTHCARES-FINANCIAL-ASSISTANCE-PROGRAM/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	VERDE VALLEY MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	VERDE VALLEY MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - VERDE VALLEY MEDICAL CENTER. AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, A FOCUS GROUP WAS HELD IN 2022 COLLABORATION WITH COCONINO COUNTY HEALTH AND HUMAN SERVICES AND YAVAPAI COUNTY COMMUNITY HEALTH SERVICES AS PART OF THEIR COMMUNITY HEALTH IMPROVEMENT PLANS. THE FOCUS GROUP INCLUDED KEY INFORMANTS IN THE COMMUNITY, SUCH AS: REPRESENTATIVES FROM PUBLIC HEALTH; PHYSICIANS; OTHER HEALTH PROFESSIONALS; SOCIAL SERVICE PROVIDERS; AND OTHER COMMUNITY LEADERS. AGENCIES REPRESENTED WERE: COCONINO COUNTY CHIP ACCESS TO CARE GROUP: NORTH COUNTRY HEALTHCARE, FLAGSTAFF UNIFIED SCHOOL DISTRICT, NORTHERN ARIZONA UNIVERSITY, NATIVE AMERICANS FOR COMMUNITY ACTION, NORTHERN ARIZONA REGIONAL BEHAVIORAL HEALTH AUTHORITY, HIGHLANDS FIRE DISTRICT, SALVATION ARMY, UNITED WAY OF NORTHERN ARIZONA, NORTHERN ARIZONA COUNCIL ON AGING, FIRST THINGS FIRST, FLAGSTAFF FAMILY FOOD BANK, AND NORTHERN ARIZONA INTERGOVERNMENTAL PUBLIC TRANSPORTATION AUTHORITY. YAVAPAI COUNTY CHIP GROUP: YAVAPAI JUSTICE MENTAL HEALTH COALITION, SPECTRUM HEALTHCARE, COTTONWOOD-OAK CREEK UNIFIED SCHOOL DISTRICT, NAMI SEDONA, NAMI YAVAPAI, CARE 1ST, FAMILY INVOLVEMENT CENTER, EXPECT MORE AZ, NACOG-AAA, VERDE VALLEY CAREGIVERS, ALZHEIMER'S ASSOCIATION, AND FIRST THINGS FIRST. PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED A REPRESENTATIVE OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS. WRITTEN COMMENTS WERE SOLICITED BY THE GROUPS AND INDIVIDUALS LISTED ABOVE, AS WELL AS THE COMMUNITIES SERVED AT LARGE THROUGH A SURVEY MONKEY INSTRUMENT. COMMUNITY MEMBERS ARE ENCOURAGED TO PROVIDE FEEDBACK AND INPUT FOR OUR PRIOR AND CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN. COMMENTS MAY BE EMAILED TO: PUBLICRELATIONS@NAHEALTH.COM.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - VERDE VALLEY MEDICAL CENTER. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN CONJUNCTION WITH ITS RELATED HOSPITAL FACILITY, FLAGSTAFF MEDICAL CENTER.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - VERDE VALLEY MEDICAL CENTER. THE FOLLOWING "AREAS OF OPPORTUNITY" REPRESENT THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY, BASED ON THE INFORMATION GATHERED THROUGH THIS COMMUNITY HEALTH NEEDS ASSESSMENT. FROM THESE DATA, OPPORTUNITIES FOR HEALTH IMPROVEMENT EXIST IN THE AREA WITH REGARD TO THE FOLLOWING HEALTH ISSUES. THE AREAS OF OPPORTUNITY WERE DETERMINED AFTER CONSIDERATION OF VARIOUS CRITERIA, INCLUDING: STANDING IN COMPARISON WITH BENCHMARK DATA (PARTICULARLY NATIONAL DATA); IDENTIFIED TRENDS; THE PREPONDERANCE OF SIGNIFICANT FINDINGS WITHIN TOPIC AREAS; THE MAGNITUDE OF THE ISSUE IN TERMS OF THE NUMBER OF PERSONS AFFECTED; AND THE POTENTIAL HEALTH IMPACT OF A GIVEN ISSUE. THESE ALSO TAKE INTO ACCOUNT THOSE ISSUES OF GREATEST CONCERN TO THE COMMUNITY STAKEHOLDERS (KEY INFORMANTS) GIVING INPUT TO THIS PROCESS. AREAS OF OPPORTUNITY IDENTIFIED THROUGH THIS ASSESSMENT: ACCESS TO HEALTH SERVICES - COST OF PHYSICIAN VISITS (FLAGSTAFF REGION) - ACCESS TO PRIMARY CARE PHYSICIANS (VERDE VALLEY REGION) - ADULT ROUTINE MEDICAL CARE - RATINGS OF LOCAL HEALTH CARE RESOURCES AVAILABLE FOR ACCESS TO HEALTH SERVICES (INCLUDING TRANSPORTATION AS A BARRIER) APRICUS CANYON LANDS HEALTH CARE CATHOLIC SOCIAL SERVICES CITY OF FLAGSTAFF COCONINO COUNTY COMMUNITY HEALTH CENTER OF YAVAPAI COMMUNITY HEALTH LEADERS CONCIERGE PRACTICES DENTIST'S OFFICES DOCTOR'S OFFICES FLAGSTAFF MEDICAL CENTER FLAGSTAFF SHELTER SERVICES THE GUIDANCE CENTER, INC. HAVEN HEALTH HOSPITALS NATIVE AMERICANS FOR COMMUNITY ACTION (NACA) NORTH COUNTRY HEALTHCARE NORTHERN ARIZONA HEALTHCARE BEHAVIORAL HEALTH NORTHERN ARIZONA HEALTHCARE MEDICAL GROUP OPIOID OVERDOSE PREVENTION PROGRAM PATHFINDER HEALTH POORE MEDICAL CLINIC RED ROCK PEDIATRICS SPECTRUM HEALTHCARE TERROS HEALTH UNIVERSITY URGENT CARE VERA WHOLE HEALTH VERDE VALLEY MEDICAL CENTER VETERAN'S ADMINISTRATION YAVAPAI COUNTY HEALTH DEPARTMENT ACTIONS/CHANGES FOR ACCESS TO HEALTHCARE SINCE 2019 CHNA NORTHERN ARIZONA HEALTHCARE CONDUCTED ITS LAST CHNA IN 2019 AND REVIEWED THE HEALTH PRIORITIES IDENTIFIED THROUGH THAT ASSESSMENT. TAKING INTO ACCOUNT THE TOP-IDENTIFIED NEEDS - AS WELL AS HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION, GOALS AND STRATEGIC PRIORITIES - IT WAS DETERMINED AT THAT TIME THAT NORTHERN ARIZONA HEALTHCARE, WHICH OPERATES FLAGSTAFF MEDICAL CENTER AND VERDE VALLEY MEDICAL CENTER, WOULD FOCUS ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INITIATIVES TO IMPROVE: - ACCESS TO HEALTH SERVICES - MENTAL HEALTH MENTAL DISORDERS - CHRONIC DISEASE STRATEGIES FOR ADDRESSING THESE NEEDS WERE OUTLINED IN NORTHERN ARIZONA HEALTHCARE'S IMPLEMENTATION STRATEGY. PURSUANT TO IRS REQUIREMENTS, THE FOLLOWING SECTIONS PROVIDE AN EVALUATION OF THE IMPACT OF THE ACTIONS TAKEN BY FLAGSTAFF MEDICAL CENTER AND VERDE VALLEY MEDICAL CENTER TO ADDRESS THESE SIGNIFICANT HEALTH NEEDS IN OUR COMMUNITY. PRIORITY AREA: ACCESS TO HEALTH SERVICES STRATEGY #1: BUILD THE CAPACITY OF EMPLOYED PRIMARY CARE CLINICS RESULTS: - IMMEDIATE CARE CREATED AT VVMC - VIRTUAL CARE SERVICES EXPANDED TO PRIMARY CARE AT FMC AND VVMC. - FMC AND VVMC EXPANDED OFFICE HOURS TO INCLUDE SAME DAY AND SATURDAY APPOINTMENTS - NON-EMERGENT ED APPOINTMENTS DECREASED FOR THE NAH EMPLOYEES AND DEPENDENTS 3.5% FROM 2020 TO 2021. - AMOUNT PAID PER ED VISITS DECREASED 29.3% FROM 2020 TO 2021. - WELL VISITS AND PREVENTATIVE SCREENINGS VISITS INCREASED FOR THE NAH EMPLOYEE AND DEPENDENT POPULATION FROM 39% IN 2019 TO 40% IN 2021. - NAH PRIMARY CARE HAS INCREASED BY 2699 PATIENTS BETWEEN 2019 AND 2021. STRATEGY #2: PROVIDE REMOTE PATIENT MONITORING RESULTS: - TELEHEALTH VISITS INCREASED 76.8% BETWEEN 2020 AND 2021 FOR NAH EMPLOYEES AND DEPENDENTS - 86 PATIENTS WERE ENROLLED IN REMOTE PATIENT MONITORING BETWEEN 2019 AND 2021 STRATEGY #3: IDENTIFY APPROPRIATE PATIENTS TO ENROLL IN COMMUNITY CARE NETWORK PROGRAM RESULTS: - NAH SAVED AN ADDITIONAL $76,858 FROM 2020 AND 2021 IN COMPLEX CARE MANAGEMENT OF EMPLOYEES AND DEPENDENTS - 773 PATIENTS WERE ENROLLED IN COMMUNITY CARE MANAGEMENT IN 2021 PRIORITY AREA: CHRONIC DISEASE STRATEGY #1: SETTING UP AND RUNNING A COVID-19 VACCINATION CLINIC RESULTS: - OVER 32,000 COVID VACCINATIONS GIVEN STRATEGY #2: DEVELOP A COMPREHENSIVE CARDIOVASCULAR SERVICE LINE RESULTS: - INCREASED ACCESS TO CARDIOVASCULAR CARE BY O ADDED 2 NEW PROVIDERS SINCE 2019 - ADDED ELECTROPHYSIOLOGY SINCE 2019 - ADDED TO AND UPGRADED PHONE SYSTEM - ADDED SUPPORT STAFF TO MEET COMMUNITY NEED - NAH EMPLOYEES AND DEPENDENTS INCREASED CHOLESTEROL SCREENINGS BY 3% FROM 2019 TO 2021 STRATEGY #3: CONDUCT CARDIOVASCULAR / DIABETES AND TOBACCO COMMUNITY SCREENINGS RESULTS: - 1900 NORTHERN AZ RURAL AND UN/UNDER INSURED COMMUNITY MEMBERS WERE SCREENED FOR CHOLESTEROL, DIABETES, AND TOBACCO USE - THE COVID WORLDWIDE PANDEMIC PAUSED THE COMMUNITY SCREENINGS FOR 2020 AND 2021 PRIORITY AREA: MENTAL HEALTH AND MENTAL DISORDERS STRATEGY #1: PARTNER WITH COMMUNITY AGENCIES TO PROVIDE COLLABORATIVE CARE RESULTS: - VVMC PARTNERED WITH SPECTRUM HEALTHCARE TO CREATE A COMMUNITY FOCUSED APPROACH TO ED PATIENTS WITH MENTAL HEALTH NEEDS - CPI TRAINING FOR SITTERS AND ED STAFF AT FMC AND VVMC - NAHMG INTEGRATED BEHAVIORAL HEALTH WITH PRIMARY CARE - NAH FOUNDATION PROVIDED GRANTS TO NACA FOR SUICIDE PREVENTION - FMC PARTNERED WITH NAU TO SURVEY EMPLOYEES WITH THEIR UNDERSTANDING OF BEHAVIORAL AND MENTAL HEALTH - THE 2020 FLAGSTAFF LEADERSHIP PROGRAM CHOSE MENTAL HEALTH AS THEIR COMMUNITY LEADERSHIP PROJECT - DEPRESSION SUBSTANCE ABUSE SCREENING AT NAHMG PRIMARY CARE CLINICS - CREATION OF THE PEDIATRIC BEHAVIORAL HEALTH COLLABORATIVE IN 2019 - FMC SUPPORTS DUI/DRUG COURT TREATMENT PROGRAM - FMC ED STARTED TRAUMA START SCREENINGS AND BRIEF INTERVENTION / ASSESSMENT STRATEGY #2: SUPPORT MENTAL HEALTH FIRST AID TRAINING RESULTS: - FMC AND VVMC OFFER MENTAL HEALTH FIRST AID TRAINING FOR EMPLOYEES AND COMMUNITY MEMBERS - NAH FOUNDATION RAISED FUNDS FOR MENTAL HEALTH FIRST AID TRAINING - FMC IS A SUPPORTING MEMBER OF THE STRONGER AS ONE COLLABORATIVE STRATEGY #3: BEHAVIORAL HEALTH SERVICES OFFERED VIA TELEHEALTH RESULTS: - 393 NAH EMPLOYEES AND DEPENDENTS HAD TELEHEALTH BH VISITS IN 2021 - 19 NAH EMPLOYEES AND DEPENDENTS WERE ENROLLED IN COMPLEX CARE PROGRAM, VIA TELEHEALTH, FOR BH AND SA IN 2021
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - VERDE VALLEY MEDICAL CENTER. TO BE ELIGIBLE FOR NAH'S FINANCIAL ASSISTANCE PROGRAM, YOU MUST BE: - INELIGIBLE FOR MEDICAID; APPROVED FOR MEDICAID AFTER THE DATE OF MEDICAL SERVICE; OR MEDICAID-ELIGIBLE BUT RECEIVING SERVICES NOT COVERED BY MEDICAID - RECEIVING MEDICALLY NECESSARY CARE - ABLE TO DEMONSTRATE FINANCIAL NEED ACCORDING TO THE FEDERAL POVERTY LEVEL, OR FPL, WHICH MEANS YOUR GROSS INCOME IS LESS THAN 400 PERCENT OF THE MINIMUM AMOUNT REQUIRED TO SUSTAIN A FAMILY AS DETERMINED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Schedule H (Form 990) 2021

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?7
Name and address		Type of Facility (describe)
1	VVMC SEDONA CAMPUS 3700 WEST HIGHWAY 89A SEDONA,AZ86366	EMERGENCY SERVICE, LAB, RADIOLOGY, PHYSICIAN OFFICE
2	VVMC MEDICAL OFFICE BUILDING 294 WEST HIGHWAY 89A COTTONWOOD,AZ86326	PHYSICIAN OFFICES, VVMIC RADIOLOGY
3	VVMC CAMP VERDE CAMPUS 1298 WEST FINNIE FLAT RD CAMP VERDE,AZ86322	PHYSICIAN OFFICES, LAB, RADIOLOGY, PHYSICAL THERAPY
4	ENTIRECARE REHAB SPORT MED - SEDONA 35 DRY CREEK ROAD SEDONA,AZ86366	PHYSICAL THERAPY
5	ENTIRECARE REHAB SPORT MEDICINE - VOC 6560 HIGHWAY 179 SUITES 118 120 VILLAGE OF OAK CREEK,AZ86351	PHYSICAL THERAPY
6	VVMC MEDICAL OFFICE BLDG - VOC 61 BELL ROCK PLAZA SUITE A B C VILLAGE OF OAK CREEK,AZ86351	PHYSICIAN OFFICES, LAB
7	NAHMG-MANZANITA BLDG 450 S WILLARD ST STE 101 COTTONWOOD,AZ86326	PHYSICIAN OFFICE
8
9
10

Schedule H (Form 990) 2021

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Schedule H, Part I, Line 3 FEDERAL POVERTY LEVEL WRITE-OFF PERCENTAGES	EXPLANATION FOR VARIOUS PERCENTAGES USED: 200% OF THE FEDERAL POVERTY LEVEL ("FPL") = 100% CHARITY WRITE-OFF. 201-250% OF FPL = 75% CHARITY WRITE-OFF. 251-300% OF FPL = 50% WRITE-OFF. 301-350% OF FPL = 25% WRITE-OFF. 351-400% OF FPL = 15% WRITE-OFF.
Schedule H, Part I, Line 3c DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE	CHARITY CARE INCOME LEVELS ARE BASED ON THE FEDERAL POVERTY GUIDE PUBLISHED IN THE FEBRUARY FEDERAL REGISTER ON AN ANNUAL BASIS. A TIERED METHOD IS UTILIZED FOR DETERMINING WHETHER A PATIENT IS ELIGIBLE FOR 100%, 75%, 50%, 25%, OR 15% WRITE-OFF OF THE SELF-PAY BALANCE.
Schedule H, Part I, Line 6a COMMUNITY BENEFIT REPORT	THE INFORMATION FOR THE COMMUNITY BENEFITS REPORT IS GATHERED BY THE COMMUNITY RELATIONS DEPARTMENT WHICH IS A DEPARTMENTS OF NORTHERN ARIZONA HEALTHCARE. FLAGSTAFF MEDICAL CENTER AND VERDE VALLEY MEDICAL CENTER ARE IDENTIFIED SEPARATELY ON THESE REPORTS. THE COMMUNITY BENEFIT REPORT IS AVAILABLE AT: HTTPS://NAHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
Schedule H, Part I, Line 7 EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE	VERDE VALLEY MEDICAL CENTER USED A COST-TO-CHARGE RATIO, WHERE APPLICABLE, TO CALCULATE THE MOST ACCURATE COST OF CHARITY CARE AND OTHER COMMUNITY BENEFITS REPORTED IN LINE 7.
Schedule H, Part II Community Building Activities	COMMUNITY BUILDING IS A FOCUS AT VERDE VALLEY MEDICAL CENTER. COMMUNITY BUILDING IS ADVANCED BY VERDE VALLEY MEDICAL CENTER THROUGH ITS SUPPORT OF PHYSICIAN RECRUITMENT AND WORK WITH VARIOUS COMMUNITY ORGANIZATIONS, INCLUDING LOCAL SCHOOLS, THE COTTONWOOD AND SEDONA CHAMBER OF COMMERCE, AND THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	THE COSTING METHODOLOGY USED TO DETERMINE THE BAD DEBT COST COMES FROM THE PERCENTAGE CALCULATED IN SCHEDULE H, PART I, WORKSHEET 2.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	VERDE VALLEY MEDICAL CENTER'S CALCULATION OF FINANCIAL ASSISTANCE COST IS BASED ON ACTUAL FINANCIAL ASSISTANCE WRITE-OFFS BY THE BUSINESS OFFICE MULTIPLIED BY THE COST-TO-CHARGE RATIO. ALL OF THE FINANCIAL ASSISTANCE WRITE-OFFS ARE ATTRIBUTABLE TO PATIENTS WHO QUALIFIED UNDER THE FINANCIAL ASSISTANCE POLICY. AS A NOT-FOR-PROFIT ENTITY, SERVICES ARE PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND MAKING THIS AVAILABLE TO THE COMMUNITY QUALIFIES BAD DEBT AS A COMMUNITY BENEFIT.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	FOOTNOTE 2 TO THE FINANCIAL STATEMENTS INDICATES NET PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE HAVE BEEN ADJUSTED TO THE ESTIMATED AMOUNTS EXPECTED TO BE RECEIVED. THESE ESTIMATED AMOUNTS ARE SUBJECT TO FURTHER ADJUSTMENTS UPON REVIEW BY THIRD-PARTY PAYORS. MANAGEMENT ESTIMATES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON THE HISTORICAL COLLECTION EXPERIENCE.
Schedule H, Part III, Line 8 Community benefit methodology for determining medicare costs	THE SOURCE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS THE FY2022 MEDICARE COST REPORT FOR THE ORGANIZATION. A CONTRACTED COST REPORT PROFESSIONAL PREPARED AN ANALYSIS OF THE AMOUNT BASED ON THE SUBMITTED COST REPORT FOR VERDE VALLEY MEDICAL CENTER. FOR FY2022 MEDICARE IS A SURPLUS PRIMARILY DUE TO A RATE INCREASE AFFECTING THE COST TO CHARGE RATIO RESULTING IN AN IMPROVEMENT TO COST OR A DECREASE IN COST, PLUS AN INCREASE IN MEDICARE REIMBURSEMENT, INDICATING AN INCREASE IN VOLUME AND/OR COMPLEX CASES FOR MEDICARE TYPE PATIENTS. ORGANIZATION'S MANAGEMENT HAS BEEN WORKING ON CONTROLLING AND MAINTAINING COST TO REDUCE THE COST TO PATIENTS.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	ACCORDING TO OUR CHARITY CARE POLICY, THE FINANCIAL COUNSELORS ASSESS THE PATIENT'S ABILITY TO PAY AT TIME OF ADMISSION/REGISTRATION. IF THE PATIENT STATES THAT THEY ARE UNABLE TO PAY OUT OF-POCKET EXPENSES, A DETERMINATION IS MADE WHETHER COVERAGE IS AVAILABLE THROUGH AHCCS OR OTHER MEDICAID PROGRAMS. IF NO OUTSIDE ASSISTANCE IS AVAILABLE, APPLICATION IS GIVEN TO THE PATIENT TO BE SUBMITTED FOR CHARITY CARE CONSIDERATION. IF THE PATIENT DOESN'T QUALIFY FOR CHARITY CARE ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR A LONG-TERM PAYMENT PROGRAM. IF THE CHARITY APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW-UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT.
Schedule H, Part V, Section B, Line 16a FAP website	- VERDE VALLEY MEDICAL CENTER: Line 16a URL: WWW.NAHEALTH.COM/BILLING-INSURANCE/NORTHERN-ARIZONA-HEALTHCARES-FINANCIAL-ASSISTANCE-PROGRAM/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- VERDE VALLEY MEDICAL CENTER: Line 16b URL: WWW.NAHEALTH.COM/BILLING-INSURANCE/NORTHERN-ARIZONA-HEALTHCARES-FINANCIAL-ASSISTANCE-PROGRAM/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- VERDE VALLEY MEDICAL CENTER: Line 16c URL: WWW.NAHEALTH.COM/BILLING-INSURANCE/NORTHERN-ARIZONA-HEALTHCARES-FINANCIAL-ASSISTANCE-PROGRAM/;
Schedule H, Part VI, Line 2 Needs assessment	VERDE VALLEY MEDICAL CENTER ASSESSED COMMUNITY HEALTHCARE NEEDS THROUGH A SURVEY DESIGNED AND ADMINISTERED BY PROFESSIONAL RESEARCH CONSULTANTS, INC. THIS SURVEY WAS LAST CONDUCTED IN 2022 AND WAS A FOLLOW-UP TO OTHER SURVEYS THE HOSPITAL HAS CONDUCTED. THE SURVEY INSTRUMENT USED FOR THIS STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS, AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	ACCORDING TO OUR FINANCIAL ASSISTANCE POLICY, FINANCIAL COUNSELORS ASSESS THE PATIENT'S ABILITY TO PAY AT TIME ADMISSION/REGISTRATION. IF THE PATIENT STATES THAT THEY ARE UNABLE TO PAY OUT OF-POCKET EXPENSES, A DETERMINATION IS MADE WHETHER COVERAGE IS AVAILABLE THROUGH AHCCCS OR OTHER MEDICAID PROGRAMS. IF NO OUTSIDE ASSISTANCE IS AVAILABLE, AN APPLICATION IS GIVEN TO THE PATIENT TO BE SUBMITTED FOR FINANCIAL ASSISTANCE CONSIDERATION. IF THE PATIENT DOESN'T QUALIFY FOR FINANCIAL ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR A LONG-TERM PAYMENT PROGRAM. IF THE CHARITY APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT. THE VERDE VALLEY MEDICAL CENTER (VVMC) WEBSITE HAS A BILLING CONTACT NUMBER. BEFORE PRE-ADMISSION, PATIENTS ARE CONTACTED BY VVMC'S CASHIER. WHEN PATIENTS ARE CONTACTED, THEY ARE EDUCATED OF THE FINANCIAL ASSISTANCE POLICY. VVMC FINANCIAL COUNSELORS ASSIGNED TO EACH NURSING UNIT ARE ABLE TO ANSWER OR ASSIST WITH BILLING QUESTIONS. AT EACH PATIENT REGISTRATION DESK ARE DISPLAYS AND BROCHURES OF THE BILLING INFORMATION, INCLUDING THE FINANCIAL ASSISTANCE POLICY.
Schedule H, Part VI, Line 4 Community information	THE STUDY AREA FOR THE SURVEY EFFORT (REFERRED TO AS THE "NAH SERVICE AREA OR "FLAGSTAFF OR VERDE VALLEY REGION" IN THIS REPORT) INCLUDES THE FOLLOWING COUNTIES REPRESENTED IN NORTHERN AZ: COCONINO AND YAVAPAI. COCONINO COUNTY (CC)- AS OF JULY 1, 2021 ESTIMATES, THE TOTAL POPULATION IN COCONINO COUNTY WAS 141,274. THE POPULATION IS 50.6% FEMALE AND 49.4% MALE. THE POPULATION WAS FOUND TO BE 63.9% WHITE (NOT HISPANIC OR LATINO), 26.6% AMERICAN INDIAN OR ALASKAN NATIVE, 14.1% HISPANIC OR LATINO, 1.5% BLACK OR AFRICAN AMERICAN, AND 2.1% ASIAN. YAVAPAI COUNTY (YC)- IN 2018 THERE WERE 228,067 INDIVIDUALS LIVING IN YAVAPAI COUNTY. THE POPULATION IS 50.8% FEMALE AND 49.2% MALE. THE MAJORITY OF THE POPULATION IS WHITE (NOT HISPANIC OR LATINO) AT 91.3%. THE POPULATION IS 14.5% HISPANIC OR LATINO, 2.2% AMERICAN INDIAN OR ALASKAN NATIVE, 1.3% ASIAN, AND 1% BLACK OR AFRICAN AMERICAN. AGE DISTRIBUTION: CC-IN 2021, PERSONS UNDER THE AGE OF 18 IS 20.7%, NEARING THE STATE AVERAGE OF 23.2%. AN ESTIMATED 12.0% OF THE POPULATION IS 65 YEARS OR OLDER. YC- AN ESTIMATED 30.6% OF THE POPULATION IS 65 YEARS OR OLDER AND 16.5% IS UNDER THE AGE OF 18. EDUCATION: CC- A PERCENTAGE OF 38.7% OF PERSONS 25 YEARS OR OLDER, HAS EARNED A BACHELOR'S DEGREE. THESE RATES ARE HIGHER THAN THE STATE AVERAGE OF 28.4%. EDUCATIONAL ATTAINMENT IN THE COUNTY IS HIGHER THAN THE STATE'S AVERAGE WITH RESPECT TO ADULTS THAT HAVE GRADUATED FROM HIGH SCHOOL. YC- 28.0% OF THE POPULATION (25+) HAS EARNED A BACHELOR'S DEGREE. YAVAPAI HAD A HIGH SCHOOL GRADUATION RATE OF 92% FOR THOSE AGED 25 OR OLDER. INCOME AND POVERTY: CC-THE MEDIAN HOUSEHOLD INCOME IN THE COCONINO COUNTY IS $61,888, AND 17.6% OF THE POPULATION ARE BELOW THE POVERTY LEVEL. COCONINO COUNTY HAS 51,037 HOUSEHOLDS WITH AN AVERAGE HOUSEHOLD SIZE OF 2.56. YC- THE MEDIAN HOUSEHOLD INCOME IN YAVAPAI COUNTY IS $56,170, AND 13.0% OF THE YAVAPAI COUNTY POPULATION IS BELOW THE POVERTY LEVEL. THERE ARE 103,934 HOUSEHOLDS IN YAVAPAI COUNTY WITH AN AVERAGE OF 2.20 PERSONS PER HOUSEHOLD.
Schedule H, Part VI, Line 5 Promotion of community health	COMMUNITY HEALTH AND COMMUNITY BUILDING ARE A FOCUS AT VERDE VALLEY MEDICAL CENTER AS EVIDENCED BY THE NUMEROUS ACTIVITIES SPONSORED EACH YEAR. THE CANCER CENTER AT SEDONA CAMPUS HOSTS A SERIES OF FREE OR LOW-COST SCREENINGS DESIGNED TO HELP RESIDENTS IN THE COMMUNITY DETECT ISSUES AS SOON AS POSSIBLE. COMMUNITY BUILDING IS ADVANCED BY VERDE VALLEY MEDICAL CENTER THROUGH ITS SUPPORT OF PHYSICIAN RECRUITMENT AND WORK WITH VARIOUS COMMUNITY ORGANIZATIONS INCLUDING THE COTTONWOOD AND SEDONA CHAMBER OF COMMERCE AND THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION.
Schedule H, Part VI, Line 6 Affiliated health care system	VERDE VALLEY MEDICAL CENTER IS AFFILIATED WITH FLAGSTAFF MEDICAL CENTER. THE BOARD MEMBER MEETINGS ARE COMBINED. THE COMMUNITY BENEFIT REPORT IS SUMMARIZED TOGETHER AND POSTED ON THE HOSPITAL'S WEBSITE.

Schedule H (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Verde Valley Medical Center

Employer identification number

86-0100882

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2021

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1FLORENCE SPYROW NAH PRESIDENT/CEO	(i) (ii)	0 ------------- 716,323	0 ------------- 215,319	0 ------------- 352,809	0 ------------- 11,902	0 ------------- 20,754	0 ------------- 1,317,107	0 ------------- 0
2CLIFFORD LOADER Chief Financial Officer	(i) (ii)	0 ------------- 449,869	0 ------------- 130,047	0 ------------- 1,101	0 ------------- 11,871	0 ------------- 6,834	0 ------------- 599,722	0 ------------- 0
3JOSHUA TINKLE CHIEF OPERATING OFFICER	(i) (ii)	0 ------------- 450,020	0 ------------- 121,877	0 ------------- 938	0 ------------- 11,253	0 ------------- 24,132	0 ------------- 608,220	0 ------------- 0
4Derek Feuquay Chief Medical Officer	(i) (ii)	0 ------------- 422,287	0 ------------- 85,753	0 ------------- 21,835	0 ------------- 11,841	0 ------------- 20,034	0 ------------- 561,750	0 ------------- 0
5Leon Pontikes Chief Medical Officer (Thru 8/21)	(i) (ii)	0 ------------- 343,222	0 ------------- 100,625	0 ------------- 99,943	0 ------------- 11,797	0 ------------- 13,830	0 ------------- 569,417	0 ------------- 0
6Brett Brawley Clinical Manager	(i) (ii)	0 ------------- 154,613	0 ------------- 15,474	0 ------------- 8,910	0 ------------- 6,952	0 ------------- 23,455	0 ------------- 209,404	0 ------------- 0
7Cheryl Chase Manager Pharmacy Operations	(i) (ii)	0 ------------- 181,790	0 ------------- 20,753	0 ------------- 165	0 ------------- 8,124	0 ------------- 20,430	0 ------------- 231,262	0 ------------- 0
8Frank Rafie Chief Medical Radiation Physicist Clinicist	(i) (ii)	0 ------------- 260,931	0 ------------- 39,044	0 ------------- 12,291	0 ------------- 10,640	0 ------------- 20,518	0 ------------- 343,424	0 ------------- 0
9LORI SMITHSON Clinical Manager (As of 10/21)	(i) (ii)	0 ------------- 183,825	0 ------------- 19,795	0 ------------- 10,029	0 ------------- 8,836	0 ------------- 20,956	0 ------------- 243,441	0 ------------- 0
10Stewart Wilson Pharmacist	(i) (ii)	0 ------------- 178,211	0 ------------- 189	0 ------------- 4,569	0 ------------- 7,340	0 ------------- 8,272	0 ------------- 198,581	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, Line 7 Non-fixed payments	THE FOLLOWING INDIVIDUALS RECEIVED A ONE-TIME RELOCATION PAYMENT. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III): JOSHUA TINKLE $500
Schedule J, Part I, Line 1a SUPPLEMENTAL COMPENSATION INFORMATION	ALL COMPENSATION, BENEFITS AND REIMBURSEMENTS ARE PAID BY NORTHERN ARIZONA HEALTHCARE, THE PARENT ORGANIZATION. GROSS-UP OF TAXES IS DONE ON ALL EMPLOYEE GIFT CERTIFICATES OF $25 OR MORE. IN PRACTICE, BOARD MEMBER AND OFFICER BUSINESS TRAVEL EXPENSES ARE APPROVED BY THE NEXT HIGHEST LEVEL.
Schedule J, Part I, Line 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION	CEO COMPENSATION IS DERIVED BY THE PARENT ORGANIZATION, NORTHERN ARIZONA HEALTHCARE, BY THE FOLLOWING METHODS: COMPENSATION COMMITTEE, WRITTEN CONTRACT, INDEPENDENT CONSULTANT, COMPENSATION SURVEY, AND RECOMMENDATION OF COMPENSATION COMMITTEE TO BOARD FOR APPROVAL.
Schedule J, Part I, Line 4b OTHER INFORMATION DISCLOSURES - RETIREMENT	CERTAIN EMPLOYEES PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN DURING THE YEARS ARE AS FOLLOWS. THESE AMOUNTS WERE INCLUDED IN TAXABLE WAGES (SCHEDULE J, PART II, COLUMN (B)(III)) AND ALSO IN COLUMN (F) SINCE THESE AMOUNTS HAVE PREVIOUSLY BEEN REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990: FLORENCE SPYROW $315,250
Schedule J, Part I, Line 7 OTHER INFORMATIONAL DISCLOSURES	NORTHERN ARIZONA HEALTHCARE CORPORATION MAKES DISCRETIONARY MANAGEMENT INCENTIVE PAYMENTS BASED ON METINGS VARIOUS ORGANIZATION GOALS. THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(II): FLORENCE SPYROW $215,319 CLIFFORD LOADER $130,047 JOSHUA TINKLE $121,877 FRANK RAFIE $39,044 LORI SMITHSON $18,920 CHERYL CHASE $20,753 BRETT BRAWLEY $14,838
Schedule J, Part I, Line 7 OTHER INFORMATIONAL DISCLOSURES	THE FOLLOWING INDIVIDUALS CASHED OUT ACCUMULATED PTO DURING THE YEAR. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III): FRANK RAFIE $11,693 LORI SMITHSON $9,279 BRETT BRAWLEY $8,801 STEWART WILSON $4,471

Schedule J (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
Verde Valley Medical Center

Employer identification number
86-0100882

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY	86-0376099	000000000	06-30-2015	37,340,563	SEE PART VI		X		X		X
B	INDUSTRIAL DEVELOPMENT AUTHORITY YAVAPAI COUNTY	86-0376099	000000000	07-06-2021	5,350,198	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	1,429,897		0
2 Amount of bonds legally defeased ..............	0		0
3 Total proceeds of issue ..................	37,340,563		5,350,198
4 Gross proceeds in reserve funds .............	0		0
5 Capitalized interest from proceeds .............	0		0
6 Proceeds in refunding escrows ...............	0		0
7 Issuance costs from proceeds ...............	338,010		55,872
8 Credit enhancement from proceeds .............	0		0
9 Working capital expenditures from proceeds .............	0		0
10 Capital expenditures from proceeds .............	0		0
11 Other spent proceeds .............	37,002,553		5,294,326
12 Other unspent proceeds .............	0		0
13 Year of substantial completion .............	2015		2021
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............	X			X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X			X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X
b Exception to rebate? ........	X		X
c No rebate due? .........		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference

Explanation

Schedule K, Part I, Column (f) SCHEDULE K, PART I, COLUMN F

BOND A - THE NAME OF THE ISSUE IS HOSPITAL REVENUE REFUNDING BONDS (NORTHERN ARIZONA HEALTHCARE SYSTEM) SERIES 2015A AND 2015B. THIS ISSUE REFUNDS THE 2008A AND 2008B BONDS. THE TOTAL ISSUANCE PRICE OF SERIES 2015A WAS $80,395,000 WHICH WAS ALLOCATED $37,213,977 TO FLAGSTAFF MEDICAL CENTER (FMC), $9,274,438 TO VERDE VALLEY MEDICAL CENTER, AND $33,906,585 TO NORTHERN ARIZONA HEALTHCARE OUTPATIENT SURGERY CENTER. THE 2015A BONDS WERE ALSO USED, IN PART, TO FINANCE "NEW MONEY" PROJECTS. $33,611,679 WAS USED FOR ACQUISITION OF SUMMIT SURGERY CENTER. TOTAL ISSUANCE PRICE OF SERIES 2015B WAS $45,635,975 WHICH WAS ALLOCATED $17,569,850 TO FLAGSTAFF MEDICAL CENTER (FMC) AND $28,066,125 TO VERDE VALLEY MEDICAL CENTER. BOND B - THE NAME OF THE ISSUE IS HOSPITAL REVENUE REFUNDING BONDS (NORTHERN ARIZONA HEALTHCARE SYSTEM) SERIES 2021. THIS ISSUE REFUNDS THE 2011 SERIES BONDS. THE TOTAL ISSUANCE PRICE WAS $30,572,562 WHICH WAS ALLOCATED $25,222,364 TO FLAGSTAFF MEDICAL CENTER (FMC) AND $5,350,198 TO VERDE VALLEY MEDICAL CENTER.

Schedule K (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

Verde Valley Medical Center

Employer identification number

86-0100882

Return Reference	Explanation
Form 990, Part I, Line 6 VOLUNTEERS	VOLUNTEERS WORK IN ALMOST EVERY DEPARTMENT IN THE HOSPITAL AND AT OUR OFFSITE LOCATIONS, SUCH AS VERDE VALLEY MEDICAL CENTER (VVMC) SEDONA CAMPUS, CAMP VERDE, AND VILLAGE OF OAK CREEK. THEY PERFORM CLERICAL AND RECEPTION DUTIES IN MANY DEPARTMENTS, SERVE AS PATIENT AND VISITOR GREETERS, SUPPLY DISTRIBUTION, LANDSCAPING, NUTRITIONAL SERVICES - PASS TRAYS, PARTICIPATE IN VARIOUS ACTIVITIES WITH LIBRARY, TRANSPORT, AND MAKE PILLOWS AND TEDDY BEARS (CRAFTS).
Form 990, Part III, Line 1 ORGANIZATION MISSION	VERDE VALLEY MEDICAL CENTER'S MISSION AND VISION -------------------------------------------------------------- MISSION - IMPROVING HEALTH, HEALING PEOPLE. VISION - ALWAYS BETTER CARE. EVERY PERSON, EVERY TIME...TOGETHER.
Form 990, Part V, Line 2a NUMBER OF EMPLOYEES REPORTED ON FORM W-3	VERDE VALLEY MEDICAL CENTER DOES NOT HAVE EMPLOYEES, BUT SHARES THE COST OF PERSONNEL, SERVICES, AND EXPENSES WITH NORTHERN ARIZONA HEALTHCARE CORPORATION, A RELATED TAX-EXEMPT ORGANIZATION AND VVMC'S SOLE MEMBER.
Form 990, Part VI, Line 1a NUMBER OF VOTING MEMBERS OF THE GOVERNING BODY	THE BOARD OF DIRECTORS DELEGATES AUTHORITY TO AN EXECUTIVE COMMITTEE IN AN EMERGENCY SITUATION ONLY. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE INDIVIDUALS THEN SERVING AS THE EXECUTIVE COMMITTEE OF NAH, AUTOMATICALLY AND WITHOUT SEPARATE ELECTION. THE EXECUTIVE COMMITTEE SHALL ONLY MEET IF A QUORUM OF THE BOARD IS IMPOSSIBLE AND AN URGENT BOARD VOTE IS REQUIRED. IN SUCH CASES IT SHALL EXERCISE THE POWER AND AUTHORITY OF THE BOARD, AND SHALL REPORT ANY ACTIONS TAKEN AT THE FOLLOWING BOARD MEETING.
Form 990, Part VI, Line 6 Classes of members or stockholders	NORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE CORPORATE MEMBER OF VERDE VALLEY MEDICAL CENTER.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	THE BOARD OF DIRECTORS IS DETERMINED BY THE ORGANIZATION'S MEMBER, NORTHERN ARIZONA HEALTHCARE (NAH). THE DIRECTORS AT ALL TIMES SHALL BE, AUTOMATICALLY AND WITHOUT THE NEED OF A SEPARATE ELECTION, THE INDIVIDUALS SERVING AS DIRECTORS OF NAH.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	NORTHERN ARIZONA HEALTHCARE CORPORATION IS THE SOLE VOTING MEMBER. THE FOLLOWING ACTIONS MAY BE INITIATED BY THE MEMBER IN ITS SOLE AND ABSOLUTE DISCRETION: A) ADOPTION OF THE CONSOLIDATED ANNUAL BUDGET FOR THE SYSTEM AND ANY AMENDMENTS B) THE SELECTION AND RETENTION OF THE PRESIDENT AND CHIEF ADMINISTRATIVE OFFICER OF THIS CORPORATION C) THE SELECTION OF BANKING AFFILIATIONS, ACCOUNTING FIRMS, LEGAL COUNSEL AS WELL AS APPROVAL OF THE ENGAGEMENT OF ANY CONSULTANTS NOT SPECIFICALLY PROVIDED FOR IN AN APPROVED BUDGET D) THE SELECTION OF THE MANNER AND LOCATION OF INVESTMENT OF ANY RETAINED EARNINGS E) AUTHORIZATION OF STANDING OR ADHOC COMMITTEES FOR CONTROLLED SUBSIDIARIES WITHIN THE SYSTEM. THE MEMBER MAY NOT TRANSFER ITS MEMBERSHIP OR ANY RIGHTS ARISING THEREFROM.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM BASED ON DATA GATHERED BY THE CORPORATE TREASURER/INTERNAL AUDIT DIRECTOR AND THE ORGANIZATION'S FINANCIAL OPERATIONS GROUP. THE CEO AND/OR 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 FILING. 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 Conflict of interest policy	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 BOARD DEVELOPMENT COMMITTEE. 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 BOARD DEVELOPMENT COMMITTEE, WHICH MAKES A DETERMINATION AS TO WHETHER A CONFLICT EXISTS.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO AND OTHER OFFICERS INCLUDES THE PREPARATION OF COMPARABLE DATA BY WILLIS TOWERS WATSON, AN INDEPENDENT CONSULTING FIRM. IN ADDITION, THIS INFORMATION IS REVIEWED BY THE BOARD EXECUTIVE COMMITTEE AND DOCUMENTED IN BOARD MINUTES. THE MOST RECENT COMPREHENSIVE REVIEW WAS PERFORMED IN MARCH 2021, AND MOST OFFICER ROLES HAVE BEEN REVIEWED ON AN INDIVIDUAL BASIS SINCE THEN WITHIN THE LAST THREE YEARS.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO AND OTHER OFFICERS INCLUDES THE PREPARATION OF COMPARABLE DATA BY WILLIS TOWERS WATSON, AN INDEPENDENT CONSULTING FIRM. IN ADDITION, THIS INFORMATION IS REVIEWED BY THE BOARD EXECUTIVE COMMITTEE AND DOCUMENTED IN BOARD MINUTES. THE MOST RECENT COMPREHENSIVE REVIEW WAS PERFORMED IN MARCH 2021, AND MOST OFFICER ROLES HAVE BEEN REVIEWED ON AN INDIVIDUAL BASIS SINCE THEN WITHIN THE LAST THREE YEARS.
Form 990, Part VI, Line 19 Required documents available to the public	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 VIII, Line 11d Other Miscellaneous Revenue	All Other Revenue - Total Revenue: 1975788, Related or Exempt Function Revenue: 1975788, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	INCREASE PENSION PLAN VALUATION - 1426772; LOSS ON EXTINGUISHMENT OF BONDS - 101254; VVMC Rounding Adjustment - 1208; TRANSFER TO AFFILIATES - -59304713;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Verde Valley Medical Center

Employer identification number

86-0100882

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)FLAGSTAFF MEDICAL CENTER POST OFFICE BOX 1268 FLAGSTAFF,AZ86002 86-0110232	HEALTHCARE	AZ	501(c)(3)	3	NAH	Yes
(2)NORTHERN ARIZONA HEALTHCARE CORPORATION POST OFFICE BOX 1268 FLAGSTAFF,AZ86002 74-2410946	HEALTHCARE	AZ	501(c)(3)	10	NA		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2021

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

Yes

i Exchange of assets with related organization(s) ............................

Yes

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) FLAGSTAFF MEDICAL CENTER	P	83,244,981	COST

Schedule R (Form 990) 2021

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

1	Briefly describe the organization’s mission or most significant activities: IMPROVING HEALTH, HEALING PEOPLE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	7
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	370,979
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	5,955,282	5,032,057
9	Program service revenue (Part VIII, line 2g) .........	175,713,011	193,870,140
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	14,412,145	7,881,737
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	3,551,746	3,161,856
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	199,632,184	209,945,790
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	64,749,592	75,648,064
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	95,889,651	91,436,737
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	160,639,243	167,084,801
19	Revenue less expenses. Subtract line 18 from line 12.......	38,992,941	42,860,989
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	444,389,010	370,915,260
21	Total liabilities (Part X, line 26).............	91,770,893	66,441,425
22	Net assets or fund balances. Subtract line 21 from line 20.....	352,618,117	304,473,835

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 140,967,408 including grants of $ 0 ) (Revenue $ 181,786,073 )
	TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. TO PROVIDE HEALTH CARE SERVICES TO THE COMMUNITY THROUGH INPATIENT, OUTPATIENT AND EMERGENCY HOSPITAL CARE AND RELATED MEDICAL SERVICES, CHARITY CARE AND COMMUNITY SERVICE. TOTAL INPATIENT DISCHARGES WERE 5,386 AND 21,138 PATIENT DAYS. OUTPATIENT VISITS APPROXIMATED 602,381 AND 22,077 EMERGENCY VISITS.

4b	(Code: ) (Expenses $ 7,009,311 including grants of $ 0 ) (Revenue $ 15,202,847 )
	TO PROVIDE EMERGENCY SERVICES, CANCER TREATMENT, AND OTHER ANCILLARY SERVICES TO THE COMMUNITY THROUGH THE OPERATION OF THE VERDE VALLEY MEDICAL CENTER SEDONA CAMPUS. EMERGENCY VISITS WERE 7,962. RADIATION ONCOLOGY PROCEDURES WERE 11,575. MEDICAL IMAGING PROCEDURES WERE 13,977. LABORATORY PROCEDURES WERE 35,107. PHYSCIAL THERAPY VISITS WERE 34,373.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses147,976,719

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) Leon Pontikes Chief Medical Officer (Thru 8/21)	10.0 .......................30.0	X		0	543,790	25,627
(19) Brett Brawley Clinical Manager	40.0 .......................0.0		X	0	178,997	30,407
(20) Cheryl Chase Manager Pharmacy Operations	40.0 .......................0.0		X	0	202,708	28,554
(21) Frank Rafie Chief Medical Radiation Physicist Clinicist	40.0 .......................0.0		X	0	312,266	31,158
(22) LORI SMITHSON Clinical Manager (As of 10/21)	40.0 .......................0.0		X	0	213,649	29,792
(23) Stewart Wilson Pharmacist	40.0 .......................0.0		X	0	182,969	15,612

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	4,602,556	279,771

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	5,032,057

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		5,032,057

		Business Code
2a	NET PATIENT SERVICES REVENUE	622110	170,777,451	170,777,451
b	LABORATORY SERVICES	621500	18,283,324	18,277,815	5,509
c	LABORATORY PATHOLOGY SERVICES	621500	4,443,895	4,443,895
d	PHARMACY RETAIL	446110	365,470		365,470
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		193,870,140

3 Investment income (including dividends, interest, and othersimilar amounts) ......			6,736,977			6,736,977
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		43,076	6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	43,076	6c
d	Net rental income or (loss).......			43,076			43,076
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	513,359	631,401	7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)	513,359	631,401	7c
d	Net gain or (loss).........			1,144,760			1,144,760
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA SALES		722514	988,050	988,050
b	340B REVENUE		446110	74,916	74,916
c	GIFT SHOP SALES		900099	80,026	80,026
d	All other revenue ....			1,975,788	1,975,788	0	0
e	Total. Add lines 11a–11d ......			3,118,780
12	Total revenue. See instructions.....			209,945,790	196,617,941	370,979	7,924,813

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......	0	0
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	65,186,029	56,953,628	8,232,401
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	585,586	476,439	109,147
9	Other employee benefits .......	6,511,565	5,297,882	1,213,683
10	Payroll taxes ...........	3,364,884	2,737,707	627,177
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........	90,021		90,021
d	Lobbying ...........	4,933		4,933
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	7,287,945	5,096,899	2,191,046	0
12	Advertising and promotion ....	1,613	1,212	401
13	Office expenses .......	8,971,560	6,825,396	2,146,164
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	149,953	149,953
17	Travel ............	119,604	47,700	71,904
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	1,030,578	765,148	265,430
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	9,219,641	8,013,617	1,206,024
23	Insurance ...	1,495,379	1,301,563	193,816
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	30,100,479	30,100,479
b	EXPENSE REIMBURSEMENT TO NAH	23,000,124	20,361,309	2,638,815
c	AHCCCS ASSESSMENTS	7,860,599	7,860,599
d	MEDICAL PURCHASE SERVICES	1,685,355	1,685,355
e	All other expenses	418,953	301,833	117,120	0
25	Total functional expenses. Add lines 1 through 24e	167,084,801	147,976,719	19,108,082	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			5,993	1	5,745
2	Savings and temporary cash investments .........			104,111,058	2	59,061,811
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			22,124,558	4	25,413,856
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			4,457,509	8	4,738,727
9	Prepaid expenses and deferred charges ......			2,280,932	9	1,577,777
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	238,433,540
b	Less: accumulated depreciation	10b	155,011,583	88,796,583	10c	83,421,957
11	Investments—publicly traded securities .			218,086,768	11	192,192,495
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			4,525,609	15	4,502,892
16	Total assets. Add lines 1 through 15 (must equal line 33)...			444,389,010	16	370,915,260

17	Accounts payable and accrued expenses .....	15,049,013	17	9,743,501
18	Grants payable ...	0	18	0
19	Deferred revenue .........	19,903,350	19	4,820,632
20	Tax-exempt bond liabilities .........	42,097,297	20	40,887,904
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	14,721,233	25	10,989,388
26	Total liabilities. Add lines 17 through 25..	91,770,893	26	66,441,425

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	352,618,117	27	304,473,835
28	Net assets with donor restrictions ...........	0	28	0
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....	0	29	0
30	Paid-in or capital surplus, or land, building or equipment fund ...	0	30	0
31	Retained earnings, endowment, accumulated income, or other funds	0	31	0
32	Total net assets or fund balances ...........	352,618,117	32	304,473,835
33	Total liabilities and net assets/fund balances ........	444,389,010	33	370,915,260