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25430 characters
Town of Wickenburg
Bed Tax Marketing Grant Application
Organization Name: Wickenburg Community Hospital (WHC)
Address: 520 Rose Lane, Wickenburg AZ 85391
Phone: 928-684-0483 9% Phone:
Email: wan. wickhosp com
Contact Name andTitle: Claudia Summers Grant Manager
Scope of Work:
Wickenburg Community Hospital “Enhancing Health and Wellness Tourism
and regional outreach that align with the economic and promtional goals oif the Town.
WCH provides essential medical services to hundreds of out-of-town patients -- including
winter visitors, touristis, and rural residents.
Funding Amount Requested: $5,000.00
Claudia Summers Grant Manager 7/21/2025
Authorized Agency Representative Title Date
Enhancing Health and Wellness Tourism through Wickenburg Community
Hospital
Wickenburg Community Hospital respectfully submits this request for consideration under
the Town of Wickenburg Bed Tax Marketing Award by highlighting its integral role in
supporting health-related tourism, seasonal visitor services, and regional outreach that
align with the economic and promotional goals of the Town.
As a nonprofit Critical Access Hospital serving a 3,300-square-mile rural and medically
underserved region, WCH plays a vital role in ensuring high-quality healthcare for both
year-round residents and the thousands of seasonal visitors who travel to Wickenburg
between October and April. Each year, WCH provides essential medical services to
hundreds of out-of-town patients—including tourists, winter visitors, and rural residents
from Aguila, Congress, Wittmann, Morristown, and Yarnell—many of whom combine their
medical appointments with overnight stays in local hotels, resorts, or RV parks, directly
contributing to the hospitality economy that the Bed Tax program supports.
To further expand its positive impact, WCH has launched a “Wellness in Wickenburg”
marketing initiative that includes:
¢ Promoting outpatient and diagnostic services to seasonal visitors and traveling retirees.
© Partnering with local hotels, resorts, and RV communities to provide health and
wellness education, preventive screenings, and convenient care access points.
e Actively participating in community events such as Gold Rush Days, the Bluegrass
Festival, and seasonal art walks by offering on-site first aid, wellness checks, and health
information booths.
e Collaborating with the Wickenburg Art Center to showcase healing arts exhibits at the
hospital, drawing cultural tourists and art enthusiasts during peak visitation periods.
WCH further supports the Town’s tourism and outreach goals through additional impactful
programs, including:
¢ Pink Ribbon Angels, a volunteer-led initiative offering free breast exams and
mammogram referrals to women in need, with outreach targeting both local and
visiting populations.
e The WCH Mobile Clinic, which brings preventive and urgent care services to outlying
and underserved communities, including seasonal encampments and event locations.
e A Prescription Transportation Vehicle funded by Pink Ribbon Angels to ensure patients
—particularly seniors and those without transportation—can access necessary
medications from town pharmacies.
e Ongoing collaboration with the Wickenburg Rotary Club during key community events,
where WCH provides voluntary health services and strengthens civic ties through
shared outreach.
3
e Participation in Chamber of Commerce initiatives, ensuring continued growth of
community relationships and promoting WCH as a central partner in regional economic
development.
Funding through the Bed Tax Marketing Award will enable WCH to create visitor-focused
digital and print media, develop seasonal campaigns highlighting Wickenburg as a health-
forward destination, and deploy outreach materials at community events and hospitality
sites, These efforts will position Wickenburg not only as a hub for Western heritage and
recreation, but also as a trusted place of rest, rejuvenation, and care.
With over a century of commitment to the health and well-being of the region, Wickenburg
Community Hospital is proud to align with the Town’s vision of tourism-driven economic
vitality, and respectfully requests support to expand its role in wellness-focused visitor
engagement.
Brief Description of the Proposed Program/Event/Activity (25 points, max 500
words)
Wickenburg Community Hospital (WCH), a nonprofit Critical Access Hospital, proposes the
“Enhancing Health and Wellness Tourism” initiative to promote Wickenburg as a destination for
accessible, quality health care integrated into a Western heritage experience. This initiative aligns with
the Town’s economic and tourism goals by supporting seasonal visitor services, regional outreach, and
community-based health programming.
Each year, WCH provides services to thousands of winter visitors, health tourists, and regional
residents from Aguila, Yarnell, Morristown, Wittmann, and Congress. Many of these patients combine
their medical visits with tourism and seasonal stays. WCH's Mobile Clinic extends primary and
preventive services to outlying areas and supports regional health fairs, while the hospital campus
provides outpatient surgery, imaging, rehabilitation, and urgent care, making it a central draw for
health-minded tourists.
The proposed Bed Tax Marketing Grant (BTMG) funds—up to $5,000—will be used to develop digital
marketing content, community engagement materials, and promotional media to increase awareness of
WCH’s regional services. Marketing will focus on seasonal publications, social media campaigns,
event promotion (e.g., wellness fairs), and outreach materials targeting visiting populations.
This initiative builds on existing partnerships with:
* Pink Ribbon Angels (free breast screenings and education),
* WCH Mobile Health Clinic (serving outlying towns),
* Wickenburg Rotary Club (volunteer staffing at outreach events), and
* Wickenburg Chamber of Commerce (joint promotion at community events).
With the BTMG's support, WCH aims to enhance its visibility as a wellness destination and economic
asset while continuing to serve the medical needs of tourists and residents alike. 251
2. Demonstrate the Need for the Project/Program (25 points, max 300 words)
Wickenburg sits at the heart of a 3,300-square-mile service area, drawing thousands of seasonal visitors
and tourists, many of whom are seniors with ongoing health needs. This medically underserved region
often lacks access to specialty care, preventive screenings, and urgent services. As a result, WCH has
become a regional hub for health access.
Despite WCH’s role in providing care for these visitors, its visibility in tourism and marketing spaces
remains limited. Health tourism is a growing industry, and Wickenburg has untapped potential to serve
this niche by promoting its medical infrastructure as part of the overall visitor experience. Visitors often
seek destinations where health and wellness are supported—especially in cases of recurring seasonal
stays or chronic condition management.
o
By funding targeted marketing efforts, the Town can support WCH in reaching these audiences more
effectively, encouraging longer visitor stays, repeat travel, and trust in local services. This effort
complements the Town’s broader economic goals by making Wickenburg not only a historical and
recreational destination but also a reliable health and wellness provider. 172
3. Specify Total Number of People Expected to Be Served (20 points, max 300
words)
During the proposed funding year, the “Enhancing Health and Wellness Tourism” initiative is expected
to serve over 7,500 individuals, including:
* 5,000+ seasonal visitors and tourists who access WCH services during peak months (October
to April),
+ 2,000 rural residents from surrounding communities (Congress, Aguila, Yarnell, Morristown,
Wittmann),
* 500+ Wickenburg full-time residents who benefit from the increased access to community
events, health screenings, and education through promotional partnerships.
The outreach impact will be amplified through digital content targeting thousands more via social
media platforms, the Chamber of Commerce visitor page, community event booths, and cross-
promotion with tourism agencies.
This initiative will also support the Town’s economic development by encouraging return visits,
increasing length of stays, and promoting Wickenburg as a safe and health-conscious destination for
retirees, families, and working professionals alike. 132
4. Identify One Goal and Three Measurable Objectives (20 points, max 300 words)
Goal:
Position Wickenburg as a recognized destination for health and wellness tourism, promoting local
services and community wellbeing.
Objective 1:
Create and distribute at least 5 targeted digital marketing pieces (including social media ads, seasonal
outreach, and wellness service promotions) to reach an estimated 15,000 online viewers during the
funded year.
Objective 2:
Increase the number of visitors participating in WCH-affiliated health events (e.g., screenings, fairs,
info booths) by 15% compared to the previous year, tracked via sign-in sheets and program metrics.
Objective 3:
Establish at least three collaborative promotions with local organizations (e.g., Chamber of
Commerce, tourism vendors, senior centers) to jointly market WCH’s health and wellness services as
part of the Wickenburg visitor experience.
These measurable activities ensure that the investment directly contributes to tourism growth and better
public health outcomes. 133
5, Provide Evidence of Other Leveraged Resources (10 points, max 300 words)
WCH will leverage multiple internal and external resources to maximize the impact of the Bed Tax
Marketing Grant:
* In-Kind Support from WCH Marketing Team: Design and content creation will be
completed in-house, eliminating outsourcing costs.
* Partnerships: The Wickenburg Chamber of Commerce will provide co-marketing opportunities
at visitor events and town-wide festivals; the Rotary Club provides volunteer support for
outreach programs.
* Pink Ribbon Angels and WCH Foundation: Provide funding and volunteer staffing for free
breast screening clinics and health education events promoted through this campaign.
* Mobile Clinic Program: Already funded through general operating grants and mobile outreach
initiatives; BTMG marketing efforts will highlight the reach and value of this service in
attracting visitors.
Together, these partnerships and contributions will extend the value of the Town’s investment and
demonstrate strong community collaboration. 134
Marketing Activity Estimated Annual Cost ($)
Design and printing of visitor brochures 300
Seasonal digital ad placements (Google/Facebook) 1200
‘Health & wellness event outreach materials 800
iRV park & hotel health promo partnerships 600
Visitor welcome packet inserts (local events) 500
Chamber of Commerce & tourism guide inclusion 500
First aid booth signage and supplies 500
5000)
Total
Wickenburg Community Hospital Board as of July 21, 2025
Ed Kientz - Chairman
Dennis Lauterbah — Vice Chairman
Dean Sandvick — Treasurer
John Summers — Secretary
Deborah Bateman — Director
Penny Marin — Director
Jeanie Hawkins — Director
Cynthia Clark — Director
Dr. Aspasia Angelou — Director
Sharon Lind — Director
Brian Warnock — Director
Harry Oberg — Director
George Valverde - Director
internal Revenue Service
Date: May 12, 2003
Community Hospital Association, Inc.
520 Rose Lane
Wickenberg, AZ 85390-1447
Department of the Treasury
P. O. Box 2508
Cincinnati, OH 45201
Person to Contact:
Jeremy L. Vogelpohi 31-03888
Customer Service Representative
Toll Free Telephone Number:
9:00 am. to 6:36 pm. EST
877-829-5500
Fax Number:
513-263-3756
Federal identification Number:
86-0096775
Accounting Period Ends:
December 31
Dear Sir or Madam:
This is In response to your request of May 12, 2003 regarding your organization's tax exempt
status.
In February 1948 we issued a determination letter that recognized your organization as exempt
from federat income tax. Our records indicate that your organization is currently exempt under
section 501(c)(3) of the intemal Revenue Code.
We classified your organization as a publicly supported erganization, and not a private
foundation, because it Is described in sections 509(a){1) and 170(b)(1)(A) (li) of the Code. This
classification was based on the assumption that your organization's operations would continue
as stated in the application. If your organization's purposes, character, method of operations,
or sources of support have changed, please let us know so we can consider the effect of the
change on the organization's exempt status and foundation status.
Your organization is required to file Form 990, Return of Organization Exempt from Income
Tax, only if its gross receipts each year are normally more than $25,000. if a retum is
required, it must be filed by the 15th day of the fifth month after the end of the organization's
annual accounting period. The law imposes a penalty of $20 a day, up to a maximum of
$10,000, when a retum Is filed late, untess there is reasonable cause for the delay.
As of January 1, 1984, your organization is liable for taxes under the Federal Insurance
Contributions Act (social security taxes) on remuneration of $100 or more the organization
pays to each of its employees during a calendar year. There is no liability for the tax imposed
under the Federal Unemployment Tax Act (FUTA).
Organizations that are not private foundations are not subject to the excise taxes under
Chapter 42 of the Code. However, these organizations are not automatically exempt from
other federal excise taxes. If you have any questions about excise, employment, or other
federal taxes, please let us know.
Form W-9
(Rev. March 2024)
Department of the Treasury
internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Go to www.irs.gov/FormW¢9 for instructions and the latest information.
Give form to the
requester. Do not
send to the IRS.
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
4 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded
entity's name on line 2.)
5 DOW win Mes dal Descc ok oA \ We
vow name/disregarded entity ngme if different from above.
A Zivie L®e, ORCeEYU YY
a4 Hesse tal
only one of the fallowing seven boxes.
0 C corporation S corporation
oO Individual/sole proprietor
box for the tax classification of its owner.
ob Other (see instructions)
3a Check the appropriate box for feddral tax classification of the entity/individual whose name is dntered on line 1. Check
LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership}
Note: Check the “LLC” box above and, in the entry space, enter the appropriate code (C, S, or P} for the tax
classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the apprapriate
4 Exemptions (codes apply only to
certain entities, not individuals;
see instructions on page 3):
C) Partnership C0 Trsvestate
Exempt payee code (if any)
Exemption from Foreign Account Tax
Compliance Act (FATCA) reporting
code (if any)
Print or type.
3b If on line 3a you checked “Partnership” or “Trustestate,” or checked “LLC” and entered “P" as its tax classification,
and you ara providing this form to a partnership, trust, or estate in which you have an ownership interest, check
this box if you have any foreign partners, owners, or beneficiaries. See instructions © 6 6 - ee ee
(Applies to accounts maintained
outside the United States.)
See Specific Instructions on page 3.
5 Address (number, street, and apt. or suite no.). See instructions.
Requester’s name and address (optional)
6 City, state, and ZIP code
7 List account number(s) here (optional)
[EG Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid [Social security number ]
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part |, later. For other i -
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a or
TIN, later.
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
if Employer Identification number
Ka-bp 4b?
HIS]
GE Certification
Under penalties of perjury, § certify that:
14. The number shown on this form is my correct taxpayer identification number (or | am waiting for a number to be issued to me); and
2. | am not subject to backup withholding because (a) | am exempt fram backup withholding, or (b) | have not been notified by the Internal Revenue
Service (IRS) that | am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that | am
no fonger subject to backup withholding; and
3. lam a U.S. citizen or other U.S. person (defined below}; and
4. The FATCA codets) entered on this form {if any) indicating that | am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report alll interest and dividends on your tax return. For reat estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends, you are got required-te-sign-the certification, but you must provide your correct TIN. See the instructions for Part li, later.
Sign
Here
pate “/— 23) - DOQl
General Instructions
Section references are to the internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/FarmWw9.
What’s New
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
appropriate box for the tax classification of its owner. Otherwise, it
should check the "LLC” box and enter its appropriate tax classification.
New line 3b has been added to this form. A flow-through entity is
required to complete this line to indicate that it has direct or indirect
foreign partners, owners, or beneficiaries when it provides the Form W-9
to another flow-through entity in which it has an ownership interest. This
change is intended to provide a flow-through entity with information
regarding the status of its indirect foreign partners, owners, or
beneficiaries, so that it can satisfy any applicable reporting
requirements. For example, a partnership that has any indirect foreign
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information retum with the IRS is giving you this form because they
Gat. No. 10231X
Form W+9 (Rev. 3-2024)
i
It appears that the IRS has not yet made available the Form 990 for Wickenburg Community
Hospital (EIN 86-0096775) for the 2024 fiscal year. According to ProPublica’s Nonprofit
Explorer, the organization’s Form 990 for fiscal year ending December 2024 (filed in 2025) is
currently not publicly accessible, whereas the 2023 return (filed October 11, 2024) is available
GuideStar+4ProPublica+4Cause 10+4.
Current Status Summary
Entity Tax Period Filing Status/Public Access
Wickenburg Community 2023 (ending Available (via IRS/Cause 1Q) GuideStar+7Cause
Hospital (86-0096775) Dec 2023) 10+7GuideStar+7ProPublica
Wickenburg Community 2024 (ending . .
Hospital (86-0096775) Dec 2024) Not available yet ProPublica
i What this means
» The most recently available Form 990 for Wickenburg Community Hospital itself is
for the 2023 tax year, received by the IRS on October 11, 2024
TaxExemptWorld+8Cause 10+8Cause 10+8.
« No Form 990 for the 2024 fiscal year is currently accessible, and it’s common for
filings to appear several months after close of the tax year—often in late 2025.
« The Hospital Foundation has posted filings up through 2022; the 2023 and 2024 returns
are still pending publication Wickenburg Community Hospital FoundationProPublica.
/ 2
Vefile GRAPHIC print__] Submission Date - 2024-10-11 |
DLN: 93493285006404 |
moO Return of Organization Exempt From income Tax
Under section 501(c), 527, or 4947(a}{1) of the Internal Revenue Code (except private foundations) 2 O 2 3
Do not enter sociaf security numbers on this form as it may be made public
Oepartment of the
Treasury
lotecnal Beyoouo,
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
Open to Pubtic
inspection
023 and ending 12-31-2023
berfler the 2023 calendar yeag or tax ear beginning 0
‘Name of organization D Employer identification number
8 Check if applicable Community Hospitat Association inc Ploy
O aadress change 86-0096775
O Name change -
‘Daing business as
O initiat return Wickenburg Community Hospital
O final returnst
Number and street (or PO, box If mail is not delivered to street address) | Roomysulte £ Telephone number
© Amended return §20 Rose Lane
panpncaton (928) 684-5421
= o City or town, state or province, county. and ZIP or foreign postal code
Wickenburg, AZ 85390
G Gross receipts $ 49,785,409
F Name and address of principal officer
David Woodruff
520 Rose Lane
Wickenburg, AZ 85390
Tax- it statu: 4
J Tacexempt status sores, OC soner( rtinsertnoy © asaranayor O s27
} Website: www.wickhosp.com
H(a) Is this a group return for
subordinates? Oves Eno
Are afl subordinates
HOP) included? Ores Ono
if “No,” attach a list. See instructions
Hic) Group exemption number
K Form of organization Corporation (J trust © association O otner
L Year of formation: 1946 M State of legal domicile. AZ
Summary
1 Briefly describe the organization's mission or most significant activities
Provide quality health and wellness services where patient. family and community come first
8
&
5
Es 2 Check this box oO if the organization discontinued its operations or disposed of more than 25% of its net assets.
oO 3 Number of voting members of the governing body (Part VI, line la) 6 6 © 6 8 et 3 12
6 4 Number of independent voting members of the governing body (Part Viline lb) 2 6 eee 4 12
g 5 Total number of individuals employed in calendar year 2023 (Part V, line 2a}. + eee 5 346
5 6 Total number of volunteers (estimate if mecessary} - 6 «© © 8 8 fF . . 6 45
a Ya Total unrelated business revenue from Part Vill. columa (C), line 12. 0 coe ee 7a 0
Net unrelated business taxable income from Form 990-7, Part line ll . - coe ees 7b oO
° Prior Year Current Year
8 Contributions and grants (Part Vill, ine lh} - 6 6 ee tt 537,681 2,085,080
z 9 Program service revenue {Part Vl, line2g) - - © 6 © oe 8 fe 44,678,759 47,582,708
2 10 Investment income (Part Vill, column (A), lines B.4,and7d) 2. 2 « 114,031 24,160
11 Other revenue (Part VIN, column (A). lines 5, 6d, 8c, 9c, 10¢c, and 1le) 101,118) 85,260
12 Total revenue—add lines 8 through 11 (must equal Part Vill, column (A), tine 42) 45,431,559) 49,777,208
13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) 2. 0. « O| 0
14 Benefits paid to or for members (Part IX, column (A), line 4). 0. + +s iy )
g 15 Salaries, other compensation, employee benefits (Part 1X. column (A), lines 5-10) 18,709,734) 20,761,415
§ 16a Professional fundraising fees (Part IX, column (A), fine lle) 2 ee et fv} 0
a b Total fundraising expenses (Part IX, column (D), line 25) 170,698
4 17 Other expenses (Part IX, column {A}, lines ila-lld, 11f-24e) - - + « 29,987,291) 28,665,663
18 Total expenses. Add tines 13-17 (must equal Part IX, column (A), line 25} 48,697,025, 49,427,078
19 Revenue less expenses. Subtract fine 18 from finel2 . .« 2 8 © ee -3,.265,466 350,130
3 g Beginning of Current Year| End of Year
a
ua 20 Total assets (PartX, tine 16) 6 6 ee et 31,918,445 32,125,877
2 21 Total liabilities (Part X.line26) - © 2 © 2 s 8 8 FFF 26,832,530 26,801,135
Ze }22 Netassets or fund balances Subtract line 21 from line 20-06. ew ee 5,085,915 5.324.742
Signature Block
Under penalties of perjury, | declare that | have examined this retum, including accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, correct, and complete. Declaration of preparer {other than officer) is based on all information of which preparer has.
any knowledge
. [2024-10-11
Sign Signature of officer Date
Here David Woodruff CFO
Type or print name and uve
Print/lype preparers name Preparers signature Date PTIN
. 2024-20-11 | Check C) i | pooi93as3
Paid seifemployed
Preparer Firm's name Elde Bally LLP
Firm's EIN 45-0250958
Use Only [Fins address 4585 Coternan st Ste 200
Phone no. (701) 255-1091
4