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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
Yavapai Community Hospital Association
 
Employer identification number
86-0098923
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) Yavapai Regional Medical Center Foundation
1003 Willow Creed Road
Prescott,AZ86301 		86-1038463 501(c)(3) 155,730       Healthcare
(2) Yavapai College Foundation
1100 e sheldon St
Prescott,AZ86301 		23-7232985 501(C)(3) 17,400       Scholars Program
(3) COALITION FOR COMPASSION AND JUSTICE
PO BOX 1882
PRESCOTT,AZ86302 		47-0851633 501(C)(3) 6,200       Homeless Projects
(4) West Yavapai Guidance Clinic
3343 N Windsong Dr
Prescott,AZ86314 		86-0206928 501(c)(3)   7,800 FMV   To Support Organization
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
4
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2017

Schedule I (Form 990) 2017
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I, Line 2 GRANT MONITORING PROCESS: Grants are made to the YRMC Foundation (the Foundation) a supporting organization of the Hospital. Generally, grants reported on the Hospital's 990 represent funds originally intended for the Foundation but paid to the order of the YRMC. These funds are deposited with the Foundation, but an entry is recorded to recognize receipt of the contribution by the Hospital. An entry is then made to record the grant to recognize the deposit of funds with the Foundation. YRMC also gives out various cash and non-cash grants to local community agencies and organizations in order to help support community development.
Schedule I (Form 990) 2017



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