efile Public Visual Render
ObjectId: 201633169349301168 - Submission: 2016-11-11
TIN: 86-0181654
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.
Attach to Form 990.
Information about Schedule R (Form 990) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
15
Open to Public Inspection
Name of the organization
SCOTTSDALE HEALTHCARE HOSPITALS
Employer identification number
86-0181654
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
(1)
JOHN C LINCOLN LLC
8125 N HAYDEN ROAD
SCOTTSDALE
,
AZ
85258
86-0828589
PHYS PRACTICE
AZ
85,346,982
11,930,338
SHH
(2)
JOHN C LINCOLN ACO LLC
8125 N HAYDEN ROAD
SCOTTSDALE
,
AZ
85258
35-2437265
ACO
AZ
591,656
209,029
SHH
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?
Yes
No
(1)
Scottsdale Healthcare Corp
8125 N Hayden Road
Scottsdale
,
AZ
85258
94-2735850
Healthcare
AZ
501(c)(3)
11, TYPE I
SHH
Yes
(2)
HONORHEALTH Foundation
8125 N Hayden Road
Scottsdale
,
AZ
85258
74-2355411
Foundation
AZ
501(c)(3)
7
SHH
Yes
(3)
Scottsdale Memorial Health Services Co
8125 N Hayden Road
Scottsdale
,
AZ
85258
94-2735859
Healthcare
AZ
501(c)(3)
3
SHH
Yes
(4)
SCOTTSDALE HEALTHCARE AUXILIARY
8125 N Hayden Road
Scottsdale
,
AZ
85258
23-7264497
FUNDRAISING
AZ
501(c)(3)
9
SHC
Yes
(5)
JOHN C LINCOLN HEALTH FDN (THRU 1215)
2500 W UTOPIA ROAD SUITE 100
PHOENIX
,
AZ
85027
95-3320185
FUNDRAISING
AZ
501(c)(3)
7
SHH
Yes
(6)
DESERT MISSION INC
8125 N Hayden Road
SCOTTSDALE
,
AZ
85258
86-0096941
COMMUNITY SVC
AZ
501(c)(3)
7
SHH
Yes
(7)
DESERT MISSION NEIGHBORHOOD RENEWAL
2500 W UTOPIA ROAD SUITE 100
PHOENIX
,
AZ
85027
86-0746598
HOUSING/REHAB
AZ
501(c)(3)
7
SHH
Yes
(8)
LINCOLN AMBULATORY CARE CORPORATION
2500 W UTOPIA ROAD SUITE 100
PHOENIX
,
AZ
85027
94-2842736
Healthcare
AZ
501(c)(3)
3
shh
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Page 2
Schedule R (Form 990) 2015
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
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(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
Yes
No
Yes
No
(1)
Scottsdale Healthcare ASC LLC
3621 N Wells Fargo Ave
Scottsdale
,
AZ
85251
27-1450828
Healthcare
DE
SHC
RELATED
0
0
No
0
No
(2)
Globalrehab-Scottsdale LLC
1420 W Mockingbird Lane Ste 100
Dallas
,
TX
75247
27-4160293
Healthcare
AZ
SHH
RELATED
409,549
2,203,840
No
0
No
51.000 %
(3)
SCOTTSDALE SURG PARTNERS LLC
9522 E SAN SALVADOR
SCOTTSDALE
,
AZ
85258
20-1808351
HEALTHCARE
DE
SHC ASC LLC
related
0
0
No
0
No
(4)
MESA SURGICAL CENTER LLC
27271 LAS RAMBLAS SUITE 350
MISSION VIEJO
,
CA
92691
20-5322697
HEALTHCARE
DE
SHC ASC LLC
related
0
0
No
0
No
(5)
BILTMORE SURGICAL PARTNERS LLC
27271 LAS RAMBLAS SUITE 350
MISSION VIEJO
,
CA
92691
26-4509307
HEALTHCARE
DE
SHC ASC LLC
related
0
0
No
0
No
(6)
UNION HILLS PAIN PARTNERS LLC
27271 LAS RAMBLAS SUITE 350
HEALTHCARE
,
AZ
92691
47-3325492
HEALTHCARE
DE
SHC ASC LLC
related
0
0
No
0
No
(7)
SCOTTSDALE LINCOLN CLINICAL SPECIALISTS
SEE PART VII
SCOTTTSDALE
,
AZ
85258
47-5332541
HEALTHCARE
AZ
shh
related
No
0
Yes
51.000 %
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?
Yes
No
(1)
SCOTTSDALE CAPTIVE INSURANCE COMPANY
PO BOX 1085 5TH FLOOR
GEORGE TOWN
,
GRAND CAYMAN
KY1-1102
CJ
CAPTIVE INS.
CJ
SHH
FOREIGN
16,200,850
88,602,445
100.000 %
Yes
(2)
SCOTTSDALE MSO INC
8125 N HAYDEN ROAD
SCOTTSDALE
,
AZ
85258
86-0512895
MSO, GROUP PURCH.
AZ
SHC
C CORP
0
0
Yes
Schedule R (Form 990) 2015
Page 3
Schedule R (Form 990) 2015
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
No
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
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
Yes
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
No
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
Yes
o
Sharing of paid employees with related organization(s)
............................
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
Yes
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
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)
DESERT MISSION
B
590,519
Cost
(2)
DESERT MISSION NEIGHBORHOOD RENEWAL
B
218,199
Cost
(3)
HONORHEALTH FOUNDATION
C
8,770,522
COST
(4)
JOHN C LINCOLN HEALTH FOUNDATION
C
2,241,057
COST
(5)
SCOTTSDALE HEALTHCARE CORP
O
555,982,605
COST
(6)
SCOTTSDALE CAPTIVE INSURANCE COMPANY
R
18,210,174
COST
Schedule R (Form 990) 2015
Page 4
Schedule R (Form 990) 2015
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(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
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2015
Page 5
Schedule R (Form 990) 2015
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
SCHEDULE R, PART III, COLUMN (A)
SCOTTSDALE HEALTHCARE ASC, LLC EIN: 27-1450828 ADDRESS: 8125 N. HAYDEN ROAD, SCOTTSDALE, AZ 85258 GLOBALREHAB-SCOTTSDALE, LLC EIN: 27-4160293 ADDRESS: 4714 GETTYSBURG ROAD, MECHANICSBURG, PA 17055 SCOTTSDALE SURGICAL PARTNERS, LLC EIN: 20-1808351 ADDRESS: 9522 E SAN SALVADOR, SCOTTSDALE, AZ 85258 MESA SURGICAL CENTER, LLC EIN: 20-5322697 ADDRESS: 27271 LAS RAMBLAS, SUITE 350, MISSION VIEJO, CA 92691 BILTMORE SURGICAL PARTNERS, LLC EIN: 26-4509307 ADDRESS: 27271 LAS RAMBLAS, SUITE 350, MISSION VIEJO, CA 92691 UNION HILLS PAIN PARTNERS, LLC EIN: 47-3325492 ADDRESS: 27271 LAS RAMBLAS, SUITE 350, MISSION VIEJO, CA 92691 SCOTTSDALE LINCOLN CLINICAL SPECIALISTS, LLC EIN: 47-5332541 ADDRESS: 8125 N. HAYDEN ROAD, SCOTTSDALE, AZ 85258
Schedule R (Form 990) 2015
Additional Data
Software ID:
Software Version: