SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/form990 for instructions and the latest informtion.
OMB No. 1545-0047
2017
Open to Public Inspection
Name of the organization
Yavapai Community Hospital Association
 
Employer identification number

86-0098923
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
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? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
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) . . . 		    2,371,757   2,371,757 0.760 %
b Medicaid (from Worksheet 3, column a) . . . . .     44,017,005 29,914,741 14,102,264 4.490 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     46,388,762 29,914,741 16,474,021 5.250 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 32 348,225 920,051 84,671 835,380 0.270 %
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . . 1 1,262 37,765,279 18,044,652 19,720,627 6.280 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 4 3,720 209,134   209,134 0.070 %
j Total. Other Benefits . . 37 353,207 38,894,464 18,129,323 20,765,141 6.620 %
k Total. Add lines 7d and 7j . 37 353,207 85,283,226 48,044,064 37,239,162 11.870 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2017
Schedule H (Form 990) 2017
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 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development 1   10,200   10,200 0.320 %
3 Community support 2 1,200 2,267   2,267 0.070 %
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building 1   4,827   4,827 0.150 %
7 Community health improvement advocacy            
8 Workforce development 1   706,174   706,174 22.490 %
9 Other            
10 Total 5 1,200 723,468   723,468 23.030 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
17,678,898
3
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. ......
3
 
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
90,523,607
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
98,208,478
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-7,684,871
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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 %
1Prescott Outpatient
  		OUTPATIENT SURGERY CENTER 20 %   80 %
2Surgical Center
  		       
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2017
Schedule H (Form 990) 2017
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?2Name, 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) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Yavapai Regional Medical Center West
1003 Willow Creek Road
Prescott,AZ86301
WWW.YRMC.ORG
H0115 		X X         X     A
2 Yavapai Regional Medical Center East
7700 E Florentine Road
Prescott Valley,AZ86314
WWW.YRMC.ORG
H3964 		X X         X     A
Schedule H (Form 990) 2017
Schedule H (Form 990) 2017
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)
A
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 No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 16
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C FOR URL
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2017
Schedule H (Form 990) 2017
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
see part v, section c for url
b
see part v, section c for url
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2017
Schedule H (Form 990) 2017
Page 6
Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2017
Schedule H (Form 990) 2017
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2017
Schedule H (Form 990) 2017
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, 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 IN CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR YAVAPAI COUNTY, YAVAPAI REGIONAL MEDICAL CENTER (YRMC) CONDUCTED A COMMUNITY HEALTH NEEDS SURVEY. PRIMARY DATA COLLECTION WAS DIVIDED INTO A WEB BASED SURVEY PROCESS AND PERSONAL INTERVIEWS WITH LOCAL ORGANIZATIONS. SURVEY RECIPIENTS WERE CHOSEN BASED ON THE CRITERIA OF BEING PROFESSIONALS SERVING THE HEALTH NEEDS OF THE COMMUNITY AND THE SURVEYS WERE DISTRIBUTED ELECTRONICALLY DURING THE YEAR. PERSONAL INTERVIEWS WERE CONDUCTED BY STAFF AT YAVAPAI REGIONAL MEDICAL CENTER. YRMC CONDUCTED LIVE, ONE ON ONE MEETINGS WITH THREE KEY LOCAL ORGANIZATIONS - THE COUNTY HEALTH DEPARTMENT, YAVAPAI TRIBE, AND A MENTAL HEALTH PROVIDER.
SCHEDULE H, PART V, SECTION B, LINE 6A HOSPITAL FACILITIES INCLUDED IN THE CHNA: YAVAPAI REGIONAL MEDICAL CENTER OPERATES TWO HOSPITAL FACILITIES, THE WEST CAMPUS AND THE EAST CAMPUS. BOTH HOSPITALS WERE INCLUDED IN THE CHNA.
SCHEDULE H, PART V, SECTION B, LINE 7a & 10a URL WHERE CHNA REPORT AND IMPLEMENTATION PLAN IS MADE WIDELY AVAILABLE: https://www.yrmc.org/support-and-community/community-health
SCHEDULE H, PART V, SECTION B, LINE 11 DESCRIBE HOW THE HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AND ANY SUCH NEEDS NOT BEING ADDRESSED. Web-Based Physical Activity Program Arizona and the local community rank very low in support of childrens services and education, including physical education and sports. In order to help remedy those challenges, YRMC provides a free web-based comprehensive program to all local schools. The web-based program is called GoNoodle and includes hundreds of movement games and videos to get kids moving, jumping, stretching, deep breathing and more. Kids look forward to exercising which re-energizes them, focuses attention, improves behavior and allows for better academic performance. The program also can be customized by the user and can report on minutes of physical activity much like FitBits do for adults. GoNoodle provides Arizona Department of Education core subject-aligned videos and is a great motivator for increasing childrens involvement. This is especially important when many kids have issues with their weight and lack of physical activity. Physical education and sports are no longer a routine, free option for school kids due to budget cuts. GoNoodle supports healthier kids, encourages them to spend time away from computer games and cell phones to be physically active, and provides families free use of the program at home. To give children a head start for a healthy future, YRMC invested $40,000 in 2017 to support local health education. Partners for Healthy Students Because of the large number of working poor families in our area, many children go without much needed primary care. Our Partners for Healthy Students (PHS) program is a free school-based clinic that has four fixed sites as well as a mobile clinic to connect with the outlying communities in our huge geographic service area. School-age children and their younger siblings are eligible to participate. PHS is staffed with two pediatric nurse practitioners (PNPs) who work under the guidance of a pediatrician who serves as Medical Director. The PNPs see hundreds of children from uninsured and underinsured families. Many of the children they see suffer from chronic conditions such as asthma, malnutrition, poor dental health, etc. Because of the PNPs diligence, there have been several major instances of serious health problems that have been identified and served. One case was a preschooler who was identified to have a congenital heart defect through PHS. The child was referred to a pediatric cardiac surgeon in Phoenix, transportation and lodging was arranged and the child today is a healthy, happy little girl. Another case was a middle-school girl who was found to have a suspicious growth on her breast. She was diagnosed with breast cancer and was immediately placed into a care plan for treatment and support. The less dramatic stories are also important. For example, the children with black, rotting teeth that need multiple root canals assuming theres enough tooth left and crowns so that the child can eat painlessly. This condition can also lead to severe social isolation and embarrassment due to discolored or missing teeth and halitosis. The PNPs also treat ear infections which may have previously gone untreated and may result in hearing loss. Throat infections, scabies and other ailments are also diagnosed and treated. The PHS program covers the entire range of health needs in children and also coordinates specialized care as necessary. In 2017, our pediatric nurse practitioners care for 1,137 children who wouldnt have otherwise been able to receive care. Local Health Fairs YRMC is very visible in local health fairs of all types. In 2017, we participated in 36 different health fairs and reached an estimated 7,000 people in our service area. The premier health fair of the year is the Annual Health Expo named Celebrate Life, sponsored by YRMC and held at the local indoor shopping mall, the Gateway Center. We invited other non-profit agencies from throughout the community to participate and share information about their programs and services. We had more than 80 various exhibitors, including a number of YRMC departments that were present. Some YRMC departments offered basic screening and health education such as Physical Therapists providing young people a throwing clinic for sports. They also provided helpful information about how to prevent falls for older adults. The YRMC BreastCare Center exhibited valuable information about breast cancer and much more health education information. The Health Expo was designed to highlight YRMCs many programs and to help centralize many fragmented efforts by non-profits to a single point of information to educate local residents about community services. This is not only an example of promoting health education but also an example of building collaboration among non-profit agencies. Speakers Bureau We sponsor a Speakers Bureau that has become extraordinarily popular with local groups, clubs, civic organizations, faith-based communities, etc. In 2017 we provided 110 health presentations for groups in our community. Each presentation was planned, designed and presented by an expert in the respective field requested by the host site. We reached approximately 2,072 people in groups of varying sizes. Topics ranged from suicide prevention to exercise to nutrition and many more. The Speakers Bureau topics are listed on our website and contact information is provided to facilitate ease of scheduling through our Community Outreach Department. THE FOLLOWING NEEDS WERE NOT SELECTED TO BE ADDRESSED IN THE CHNA: FOOD INSECURITY: THIS WILL NOT BE ADDRESSED BY YRMC BECAUSE THERE ARE A NUMBER OF COMMUNITY ORGANIZATIONS THAT WORK ON THIS ISSUE THAT ARE BETTER SUITED TO MEET THIS NEED. TRANSPORTATION FOR THE UNINSURED: PEOPLE WHO CARE IS ONE OF THE LOCAL ORGANIZATIONS THAT PROVIDE TRANSPORTATION FOR THOSE IN NEED. TEEN PREGNANCY: THIS ISSUE WAS NOT SELECTED AS A TOP PRIORITY FOR YRMC TO ADDRESS IN ITS PROGRAMS BECAUSE OF A LACK OF RESOURCES TO DO SO. MOTOR VEHICLE DEATHS: THIS ISSUE WAS NOT SELECTED AS A TOP PRIORITY FOR YRMC TO ADDRESS IN ITS PROGRAMS BECAUSE OF A LACK OF RESOURCES TO DO SO. GRADUATION RATE: THIS ISSUE IS NOT AN AREA THAT YRMC CAN ADDRESS SINCE IT IS NOT WITHIN YRMC'S MISSION.
SCHEDULE H, PART V, SECTION B, LINE 16a, 16b, & 16c URL where the FAP, FAP application form, and plain language summary can be found: http://www.yrmc.org/patient-financial-services/financial-assistance
Schedule H, part V, Section B, Line 16i Translation of FAP into primary langauge spoken by LEP populations: YRMC has translated the FAP into spanish and would consider translating into another language when it is known that patients will need the translation and are not served by the current forms and statements. YRMC uses demographic data from their system and the counties to determine if a patient population exists that is over 1,000 individuals that do not speak English or Spanish.
PART V, SECTION B, LINE 22D DESCRIBE HOW THE HOSPITAL FACILITY DETERMINED THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESARRY CARE: THE QUALIFYING LEVEL OF ASSISTANCE FOR PATIENTS ELIGIBLE FOR THE FAP WILL BE BASED ON CHARGES AFTER AN UNINSURED DISCOUNT OF 20% OF YRMC'S BILLED CHARGES HAS BEEN APPLIED. PATIENTS THAT QUALIFY UNDER THE FAP WILL NOT BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) FOR SERVICES RENDERED. AGB IS CALCULATED ANNUALLY BY DETERMINING THE AVERAGE PERCENTAGE PAID FOR SERVICES RENDERED TO MEDICARE AND PRIVATE INSURANCE PAYERS. A COPY OF THIS CALCULATION IS AVAILABLE UPON REQUEST BY CALLING THE YRMC BUSINESS OFFICE. THEREAFTER, FINANCIAL ASSISTANCE WILL BE DETERMINED USING A SLIDING-FEE SCALE BASED UPON HOUSEHOLD INCOME AS COMPARED TO THE FEDERAL POVERTY LEVEL (FPL) AND SUBJECT TO A REDUCTION BASED ON QUALIFYING ASSETS.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2017
Schedule H (Form 990) 2017
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?19
Name and address Type of Facility (describe)
1 YRMC - Del E Webb Outpatient Center
3262 Windsong Road
Prescott Valley,AZ86314 		OUTPATIENT DIAGNOSTICS, Rehabilitation & laboratory
2 Pendleton Wellness Center
930 Division Street
Prescott,AZ86301 		Cardiac rehabilitation, physical therapy, & wellness outpatient center
3 PRESCOTT OUTPATIENT SURGICAL CENTER
815 AINSWORTH DR
Prescott,AZ86301 		OUTPATIENT SURGICAL CENTER
4 YRMC PC Internal Medicine I
3120 Clearwater Dr
Prescott,AZ86305 		Physician Practice - Internal Medicine
5 YRMC PC Family Medicine I
7712 E Florentine
Prescott Valley,AZ86314 		Physician Practice - Family Medicine
6 YRMC PC BREAST CARE
7700 E FLORENTINE ROAD BLD B SUIT
PRESCOTT VALLEY,AZ86314 		PHYSICIAN PRACTICE-SURGERY
7 YRMC PC FAMILY MEDICINE III
1050 GAIL GARDNER WAY SUITE B
PRESCOTT,AZ86301 		Physician Practice - FAMILY MEDICINE
8 YRMC PC FAMILY MEDICINE IV-BAGDAD
12 HOPE DRIVE
BAGDAD,AZ86321 		PHYSICIAN PRACTICE - FAMILY MEDICINE
9 YRMC PC CARDIOLOGY I
802 E AINSWORTH DR SUITE A
PRESCOTT,AZ86301 		PHYSICIAN PRACTICE - CARDIOLOGY
10 YRMC PC CARDIOLOGY II
7700 E FLORENTINE RD BLD B SUITE
PRESCOTT VALLEY,AZ86314 		PHYSICIAN PRACTICE - CARDIOLOGY
11 YRMC PC CARDIOLOGY III
726 GAIL GARDNER WAY SUITE A
PRESCOTT,AZ86305 		PHYSICIAN PRACTICE - CARDIOLOGY
12 YRMC PC CARDIOLOGY IV
980 WILLOW CREEK ROAD
PRESCOTT,AZ86301 		PHYSICIAN PRACTICE - CARDIOLOGY
13 YRMC PC NEUROSURGERY
1001 DIVISION STREET
PRESCOTT,AZ86301 		PHYSICIAN PRACTICE - NEUROSURGERY
14 YRMC PC GASTROENTROLOGY
811 AINSWORTH STREET
PRESCOTT,AZ86301 		PHYSICIAN PRACTICE - GASTROENTROLOGY
15 YRMC PC PEDIATRICS
2120 CENTERPOINTE WEST
PRESCOTT,AZ86301 		PHYSICIAN PRACTICE - PEDIATRICS
16 YRMC PC PALLIATIVE CARE
1003 WILLOW CREEK ROAD
PRESCOTT,AZ86301 		PHYSICIAN PRACTICE - PALLIATIVE CARE
17 YRMC PC SURGERY III
810 AINSWORTH DRIVE
PRESCOTT,AZ86301 		PHYSICIAN PRACTICE-SURGERY
18 YRMC PC SURGERY IV
810 AINSWORTH DRIVE
PRESCOTT,AZ86301 		PHYSICIAN PRACTICE-SURGERY
19 YRMC PC PRIMARY CARE
7700 E FLORENTINE RD BLD B SUITE
PRESCOTT VALLEY,AZ86314 		PHYSICIAN PRACTICE-FAMILY MEDICINE
Schedule H (Form 990) 2017
Schedule H (Form 990) 2017
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 7 CALCULATION OF COMMUNITY BENEFIT EXPENSES: THE ORGANIZATION USED A COST-TO CHARGE RATIO FOR LINE 7A-7C & 7G. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. THE ORGANIZATION USED A COST ACCOUNTING AMOUNT FOR THE OTHER MEANS TESTED PROGRAMS ON LINE 7C THAT RELATED TO THE JOINT VENTURES. THE INFORMATION FOR LINES 7E THROUGH 7I WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS.
SCHEDULE H, PART I, LINE 7G CLINICS INCLUDED AS SUBSIDIZED SERVICES: THE SUBSIDIZED SERVICES ON LINE 7G INCLUDE PHYSICIAN CLINICS IN PRESCOTT AND PRESCOTT VALLEY. THE CLINICS IMPROVE COMMUNITY ACCESS TO HEALTHCARE SERVICES SUCH AS CARDIOLOGY AND NEUROSURGERY. WITHOUT THE CARDIOLOGY CLINICS, THE COMMUNITY WOULD BE UNDERSERVED, AS THIS WOULD CAUSE A SHORTAGE OF ACCESS FOR THIS TYPE OF CARE. THE DEMOGRAPHICS ARE MAINLY THAT OF THE MEDICARE POPULATION, AND ADDITIONAL TRAVEL TIME FOR RESIDENTS TO OBTAIN SIMILAR CARE IN OTHER AREAS WOULD BE DIFFICULT FOR RESIDENTS. THE NEUROSURGEY CLINIC IS THE ONLY CENTER AVAILABLE IN THE CITY OF PRESCOTT.
SCHEDULE H, PART I, LINE 7, COLUMN F BAD DEBT EXPENSE: TOTAL BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR PRIOR TO THE PERCENTAGE CALCULATION = $17,678,898.
SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL IS DEDICATED TO PROMOTING THE GENERAL HEALTH OF THE POPULATION. THE ACTIVITIES IN PART II CONTRIBUTE TO THE VITALITY OF THE COMMUNITY WHICH IS ONE OF MANY FACTORS THAT IMPACT THE HEALTH OF THE COMMUNITY AND PROVIDES A BENEFIT OF OUR COMMUNITY.
SCHEDULE H, PART III, SECTION A, LINE 2 & 4 See page 9 of the attached audited financial statements for the footnote that describes bad debt expense. Bad debt expense is determined using the methodology as described in the note to financial statements as shown above. The hospital recognizes its responsibility to provide for the needs of the community, regardless of patients' ability to pay. In many cases, patients are unwilling or unable to pay after services have been provided, eventually resulting in bad debt. Nevertheless, if these services were not provided by the organization, the healthcare needs of these patients might not otherwise be fulfilled within the community. Therefore, the organization believes that the services not paid for should be included in community benefit.
SCHEDULE H, PART III, SECTION A, LINE 3 THE ORGANIZATION DOES NOT CONSIDER ANY OF ITS BAD DEBT EXPENSE TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
SCHEDULE H, PART III, SECTION B, LINE 8 THE SHORTFALL FROM MEDICARE SHOULD BE CONSIDERED COMMUNITY BENEFIT TO THE EXTENT THAT THE ORGANIZATION COULD NOT REASONABLY REDUCE ITS COSTS TO A LOWER LEVEL. WHILE HARD TO PROJECT THE POTENTIAL SAVINGS FROM VARIOUS POSSIBLE COST CUTTING MEASURES, IT IS REASONABLE TO ASSUME THAT AT LEAST 50% OF THE SHORTFALL MIGHT NOT OTHERWISE BE RECOVERED THROUGH SAVINGS MEASURES. BECAUSE THE ORGANIZATION IS COMMITTED TO MEETING THE NEEDS OF THE COMMUNITY, ANY PATIENT THAT PRESENTS FOR MEDICAL TREATMENT WHO IS COVERED UNDER MEDICARE WILL BE SERVED, DESPITE THE POTENTIAL DETRIMENTAL IMPACT ON THE ORGANIZATION'S FINANCIALS. WITH RESPECT TO THE SOURCE USED TO DETERMINE THE MEDICARE ALLOWABLE COST ON LINE 6, THE FOLLOWING LINES FROM THE MEDICARE COST REPORT WERE USED: LINE 53 (TOTAL PROGRAM INPATIENT OPERATING COST EXCLUDING CAPITAL RELATED, NON-PHYSICIAN ANESTHETIST, AND MEDICAL EDUCATION COSTS) AND LINE 104 (NET CHARGES FOR ANCILLARY SERVICE COST CENTERS.)
SCHEDULE H, PART III, SECTION C, LINE 9B IF IT WAS NOT KNOWN AT THE POINT OF SERVICE THAT THE PATIENT HAD THE INABILITY TO PAY, THE PATIENT MAY BE SCREENED: 1) BY PHONE OR 2) IN PERSON BY THE CUSTOMER SERVICES REPRESENTATIVE. THE CUSTOMER SERVICE REPRESENTATIVE WILL UTILIZE THE FINANCIAL ASSISTANCE WORKSHEET TO DETERMINE THE PATIENT'S ABILITY/INABILITY TO PAY. IF THE DETERMINATION INDICATES THE PATIENT HAS THE ABILITY TO PAY, OTHER OPTIONS FOR PAYMENTS WILL BE EXPLAINED. IF THERE IS NO ABILITY TO PAY, THEN THE APPLICATION WILL BE SUBMITTED FOR CONSIDERATION.
SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: Yrmc uses several measures by which to assess community health needs. One measure is our migration by service. As an example, prior to opening our cardiovascular surgery program in 2007, we saw many hundreds of people leaving our community to go to phoenix - 100 miles away - for open heart surgery. This was an indication of a need in our community that required yrmc's focused attention and efforts that culminated in the heart center at yrmc. Yrmc constantly monitors volume and utilization data in its service lines to help determine level of need in the community for each service line. When volume figures vary from anticipated volume, yrmc carefully explores reasons behind those variances and addresses them appropriately. For example, if a drop in surgical volume is related to a need for more general surgeons, efforts ensue to recruit additional surgeons. Yrmc also spends a great deal of time listening to the community by way of focus groups, community involvement by senior management, patient survey feedback, and community outreach efforts. As our ceo has stated, we learn more by listening than by talking. Yrmc is regarded by the community as a key resource and an asset. Consequently, community members feel very comfortable and free in sharing their perceptions and perspectives. Yrmc also engages national research corporation (nrc) to conduct community needs assessment research. The study objectives include the following: a. Measure and evaluate health status and healthcare utilization within the community. B. Identify the prevalence of chronic conditions within various demographic segments within the community. C. Profile high-risk populations. D. Identify gaps in care and preventive health behaviors among various demographic segments within the community.
SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: WHEN PATIENTS PRESENT FOR ADMISSION, THEY ARE ASKED TO REVIEW AND INITIAL A PATIENT CONSENT FORM. THE PATIENT CONSENT FORM CONTAINS A PARAGRAPH ENTITLED FINANCIAL ASSISTANCE PROGRAMS. THIS PARAGRAPH INDICATES THAT THE PATIENT MAY BE CONSIDERED FOR FINANCIAL ASSISTANCE IF ELIGIBILITY CRITERIA ARE MET. THE PATIENT IS REQUIRED TO INITIAL A BOX NEXT TO THE PARAGRAPH INDICATING THEY HAVE READ IT AND CONSENT. THIS SAME FORM ALSO CONTAINS LANGUAGE REGARDING THE ASSIGNMENT OF BENEFITS IF ELIGIBLE FOR MEDICARE. IN ADDITION TO THE ABOVE, PATIENTS MAY WORK DIRECTLY WITH PATIENT FINANCIAL SERVICES AT THE HOSPITAL TO MAKE PAYMENT ARRANGEMENTS OR APPLY FOR FINANCIAL ASSISTANCE. EDUCATION REGARDING ASSISTANCE GENERALLY OCCURS AS THE NEED ARISES.
SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: YRMC SERVES THE RURAL COMMUNITIES IN THE WESTERN PORTION OF YAVAPAI COUNTY IN NORTHERN ARIZONA. YRMC'S SERVES APPROXIMATELY 175,000 MEN, WOMEN AND CHILDREN LIVING IN AN AREA LARGER THAN THE STATE OF NEW JERSEY.
SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: The hospital is dedicated to meeting community needs and promoting the general health of the population. When YRMC built and opening the family birthing center, it was not because it believed that this would be a profitable service line (70% of admits to OB are on the state's Medicaid program) but because it understood there was a community need for expanded services. YRMC also subsidizes the Family Resource Center, a program that helps young parents learn healthy parenting skills and matches them to local resources they need. The staff works closely with the OB staff in visiting all new Moms who deliver babies at YRMC. They are presented with a growth and development calendar to help them understand what can be expected in their babies first year. Staff also invites new parents to participate in the Family Resource Center programs. In addition, the hospital is actively recruiting physicians to the community and has implemented an employed physician model in order to further assist the community in addressing a severe shortage of physicians.The hospital's board of directors is community based and selected by a council of electors comprised of representatives from various government and community agencies and non-profit groups from throughout the hospital's service area. The hospital invests and utilizes any excess funds from operations as a safeguard for potential financial challenges and to fund future capital needs.
Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEM Yavapai Regional Medical Center is not part of an affiliated health care system.
Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT Yavapai Regional Medical Center does not file a community benefit report with the state.
SCHEDULE H, PART VI ADDITIONAL COMMUNITY BENEFIT OVERVIEW FOR 2017: Yavapai Regional Medical Center proudly serves a 5,500 square mile area of western Yavapai County. YRMC is deeply committed to supporting the local community in multiple ways, many of which are provided at no cost (or at a financial loss) to benefit our community, its growth and development, people who are in search of more information about their health and how to take better care of themselves, and those who are vulnerable. YRMC is the major employer in all of Yavapai County with 1,984 employees. Our annual salaries, wages and benefits of about $120,365,857 turn over multiple times throughout the community and support the local economy. We are honored to have more than 700 Volunteers from the local community who dedicate their time and talent to helping YRMC, our programs, services and patients. This is another testament to the strong presence of YRMC and the community's appreciation for all we do. With a medical staff of approximately 250 physicians representing a wide range of specialties and touting training for highly prestigious locations such as Johns Hopkins, Harvard, UCLA, Duke University, Mayo Clinic and more, we clearly have a robust healthcare team to serve the community. YRMC prides itself in its involvement in local community-building and community outreach activities such as active participation in all the local Chambers of Commerce, sponsoring a walking club at the local indoor shopping mall, being a national leader in Patient Blood Management and much more. YRMC greatly enhanced its presence in electronic and social media in 2017. YRMCs premier website is a trusted health information source. It includes information about our services, our physicians, our Community Benefit programs, our many Community Outreach efforts, and links with other valuable online sites. YRMCs active presence on Facebook and Twitter are examples of the many ways YRMC connects with the community in real time. Obstetrics and Nursery Services: As a sole community provider for this region, YRMC provides obstetrics services for young families. Because this area is based on tourism and service industries, there is very little opportunity for workers to earn a sufficient living so we have a prevalence of "working poor." As a result, our Family Birthing Center provides care to a market that is predominantly covered by the Arizona Health Care Cost Containment System (AHCCCS), Arizona's brand of Medicaid. And because we are located more than 90 miles from a hospital that provides specialized neonate care, we earned licensure as a Level II Nursery in our Family Birthing Center. This Nursery cares for premature babies as well as those that are born addicted to controlled substances. Although this specialized care is very expensive for YRMC to provide, it eliminates the need for parents to go to Phoenix to be with their new baby or to juggle childcare for other children in the family as well as what jobs they may have. Our entire obstetrics service line is a community benefit in a day and age where many hospitals in Arizona have closed their OB services entirely. As the community's hospital, this was not an option to be considered at YRMC. In 2017, 956 babies entered the world at YRMC's Family Birthing Center. 2017 operating expenses for the Family Birthing center were $5,832,276.00. Family Resource Center In addition to comprehensive obstetrics services and programs, YRMC also supports young families who are experiencing stress related to parenthood, financial pressures, lack of extended family support locally and lack of good modeling in their own childhood of parenting infants and young children. The Family Resource Center (FRC) is a certified program that provides support and education to young families in an effort to reduce and eliminate child abuse and neglect. Since we have a predominance of working poor families in our community, stress related to parenting is exacerbated by financial issues. Every new mother who delivers her baby at YRMC is visited by an FRC representative and is given a child development calendar so the mother will know what the guidelines are for developmental expectations during the child's first year of life. They are introduced to the program and are invited to reach out to FRC for more information and for services. Some mothers are referred by Child Protective Services and those women are required to participate in FRC programs. FRC provides education, motivation, support and training for these families. The FRC staff consists of trained family support specialists who make home visits and work with each family in an individualized care plan. FRC also provides opportunities for support with social events to help young children learn appropriate social skills and to provide their parents with the ability to network with other young men and women who are facing similar challenges. The family care staff remains in constant contact with each family throughout their children's early years. In 2017, the First Steps Program in Family Resource Center advised 949 parents on how to care for their newborns and the Healthy Families program completed 1,596 visits with 104 families. 2017 operating expenses for the Family Resource Center were $325,117.00. Community Outreach YRMC was touted in its Community Health Needs Assessment by many respondents for its excellent Community Outreach efforts. Outreach provides health and wellness news from YRMC and also describes specific service lines and often includes personal stories of patients whose lives were changed by those services. The Community Outreach Department also plans and produces a monthly community calendar that provides date, time and location of the multiple programs and support groups that are provided by YRMC. This calendar has become a key resource for thousands of people throughout our communities for information on when and where they can find help or can learn more about a topic of personal interest. Programs and activities highlighted in the monthly calendar include such things as Parkinson's Disease exercise classes, respiratory wellness classes, valuable information on prescription medications, improving balance to minimize falls programs, lymphedema support groups, Family Birthing classes, pre-operative hip replacement preparation and information, reversing heart disease, depression in the older adult, stress management, pre-operative knee replacement preparation and information, diabetes self-management and more. The Yavapai Community Foundation publishes a resource directory for families entitled the "Big and Little Kids Book." Because this provides such important information for families in need throughout our service area, YRMC's Community Outreach supports that publication with descriptions of our children's services and also supports the Community Foundation with $5,000 to enable them to print this worthwhile resource. In addition, Community Outreach supports, promotes and organizes many charity walks with YRMC teams. Because the 1,900 employees and their families are an important component of our local communities, Community Outreach is also a key player in YRMC efforts to keep employees and their families healthy. Community Outreach also assists the Volunteer-based Physician Listing Service when they need support or information regarding new physicians and specialties. In addition, for each new physician or physician extender who joins YRMC's Physician Care employed network, Community Outreach coordinates photos and bios on each person. These are compiled into notebooks for each physician's reception area so patients can peruse the books and read about the background, experience and expertise of each physician. New physicians are also introduced to the community via display ads in local publications, press releases HealthConnect 2.0 and local journals such as Prescott Woman Magazine. Community Outreach organizes and produces the annual Patient Blood Management Symposium that attracts nearly 400 people each year. Local and national experts are brought in to present fascinating research and information in terms that the lay public can understand. In 2017 the Symposium was live streamed globally and reached 1,900 viewers. The Symposium is also developed into a special DVD for distribution to other interested audience members. The Medical Director of YRMC's James Family Heart Center is an expert on the topic and he has developed the patient blood management program here at YRMC. This program is known worldwide. Because of YRMC's expertise in Patient Blood Management, patients actively seek out this hospital for heart surgery and orthopedic surgery. We have had patients come from all over Arizona, California, Oregon and other states specifically to have their surgery with these specialized techniques. This not only meets the needs of those who for faith reasons do not accept blood products but research is demonstrat
Schedule H (Form 990) 2017
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