SKY LAKES MEDICAL CENTER FOUNDATION INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: SKY LAKES MEDICAL CENTER FOUNDATION INC (EIN 93-0946020)
Tax period: 2021-10-01 to 2022-09-30
Filed: 2023-08-15
IRS object ID: 202312279349302901
Schema version: 2021v4.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-08-15T12:37:02-05:00	ReturnTs
Tax Period End	2022-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	910189318	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	MOSS ADAMS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	805 SW BROADWAY STE 1400	AddressLine1Txt
City	PORTLAND	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97205	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	930946020	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SKY LAKES MEDICAL CENTER FOUNDATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	SKYL	BusinessNameControlTxt
Phone	5412744768	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2865 DAGGETT AVENUE	AddressLine1Txt
City	KLAMATH FALLS	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97601	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	RICHARD RICO	PersonNm
Person Title	VP/CFO	PersonTitleTxt
Phone	5412744768	PhoneNum
Signature	2023-08-11	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	RICHARD	PersonFirstNm
Person Last	RICO	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	WENDY CAMPOS	PreparerPersonNm
PTIN	P00448102	PTIN
Phone	5032421447	PhoneNum
Preparation	2023-08-09	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	PAUL STEWART	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2865 DAGGETT AVENUE	AddressLine1Txt
City	KLAMATH FALLS	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97601	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$7,627,372	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.SKYLAKES.ORG/FOUNDATION/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1986	FormationYr
Legal Domicile State	OR	LegalDomicileStateCd
Activity Or Mission	TO ADVANCE THE VISION AND MISSION OF SKY LAKES MEDICAL CENTER THROUGH PHILANTHROPY; THE FOUNDATION'S WORK IS FUNDRAISING AND STEWARDSHIP.	ActivityOrMissionDesc
Voting Members Governing Body	18	VotingMembersGoverningBodyCnt
Voting Members Independent	17	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	17	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,264,489	PYContributionsGrantsAmt
CY Contributions Grants	$1,824,151	CYContributionsGrantsAmt
PY Program Service Revenue	$0	PYProgramServiceRevenueAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$1,781,833	PYInvestmentIncomeAmt
CY Investment Income	$701,412	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	-$7,640	CYOtherRevenueAmt
PY Total Revenue	$3,046,322	PYTotalRevenueAmt
CY Total Revenue	$2,517,923	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,942,011	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,772,733	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$202,218	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$241,633	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$140,684	CYTotalFundraisingExpenseAmt
PY Other Expenses	$35,698	PYOtherExpensesAmt
CY Other Expenses	$507,366	CYOtherExpensesAmt
PY Total Expenses	$2,179,927	PYTotalExpensesAmt
CY Total Expenses	$2,521,732	CYTotalExpensesAmt
PY Revenues Less Expenses	$866,395	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$3,809	CYRevenuesLessExpensesAmt
Total Assets BOY	$25,816,593	TotalAssetsBOYAmt
Total Assets EOY	$21,463,408	TotalAssetsEOYAmt
Total Liabilities BOY	$157,457	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$483,399	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$25,659,136	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$20,980,009	NetAssetsOrFundBalancesEOYAmt
Mission	TO ADVANCE THE VISION AND MISSION OF SKY LAKES MEDICAL CENTER THROUGH PHILANTHROPY; THE FOUNDATION'S WORK IS FUNDRAISING AND STEWARDSHIP.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$1,580,474	ExpenseAmt
Grant	$1,580,474	GrantAmt
Desc	SKY LAKES MEDICAL CENTER - FUNDS UTILIZED TO PURCHASE SPECIFIC EQUIPMENT FOR CONSTRUCTION AND OTHER PROJECTS AND PROGRAMS OF THE MEDICAL CENTER.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$508,361	ExpenseAmt
Grant	$192,259	GrantAmt
Desc	OTHER PROGRAMS INCLUDING: (1) PATIENT ASSISTANCE PROGRAMS FOR ITEMS OF COMFORT DURING TREATMENT AND FINANCIAL ASSISTANCE WHEN NEEDED UNDER THE DIRECTION OF THE DIRECTOR OF THE CANCER TREATMENT CENTER AND A CANCER COMMITTEE. PATIENT ASSISTANCE IS ALSO USED BY THE RESOURCE MANAGEMENT DEPARTMENT FOR ITEMS THAT CANNOT BE PURCHASED BY PATIENTS OR THEIR FAMILIES BUT ARE A NECESSITY FOR TREATMENT OR TRAVEL. (2) SCHOLARSHIPS PROVIDED FOR HEALTHCARE PROFESSIONALS AND PLAY AN IMPORTANT ROLE IN SUPPORTING THE HOSPITAL IN ATTRACTING AND RETAINING EXCEPTIONAL CLINICAL STAFF. (3) CHILD ABUSE RESPONSE AND EVALUATION SERVICES (CARES).	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$2,088,835	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	Yes (1)	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	0	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	Yes (1)	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
DAF Excess Business Holdings	0	DAFExcessBusinessHoldingsInd
Taxable Distributions	0	TaxableDistributionsInd
Distribution To Donor	0	DistributionToDonorInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	18	GoverningBodyVotingMembersCnt
Independent Voting Member	17	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	0	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	OR	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	LAUREN JESPERSEN	PersonNm
Phone	5412744768	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2865 DAGGETT AVENUE	AddressLine1Txt
City	KLAMATH FALLS	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97601	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
MARTY LEDGERWOOD
CHAIR	3.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
TOM SCHIESS
VICE CHAIR	1.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
PAUL STEWART
BOARD MEMBER	1.00	50.00	Yes (X)		$0	$957,351	$54,224
ROBERT JACKMAN MD
BOARD MEMBER	1.00	1.00	Yes (X)		$0	$0	$0
JOHN BELL
BOARD MEMBER	1.00	3.00	Yes (X)		$0	$0	$0
DOUG MCINNIS DVM
BOARD MEMBER	1.00	1.00	Yes (X)		$0	$0	$0
HEIDI NEEL BIGGS
BOARD MEMBER	1.00	1.00	Yes (X)		$0	$0	$0
JEAN PHILLIPS
BOARD MEMBER	1.00	1.00	Yes (X)		$0	$0	$0
WENDY WARREN MD
BOARD MEMBER	1.00	1.00	Yes (X)		$0	$0	$0
ROD WENDT
BOARD MEMBER	1.00	1.00	Yes (X)		$0	$0	$0
AMY BOIVIN
BOARD MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
RAY HOLLIDAY
BOARD MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
CHRIS KANDRA
BOARD MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
DAVID KING
BOARD MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
SARAH NEVUE
BOARD MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
JENNIFER SCANLAN
BOARD MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
RADU MOISA MD
BOARD MEMBER	1.00	1.00	Yes (X)		$0	$0	$0
DAVID CAUBLE
BOARD MEMBER	1.00	50.00	Yes (X)		$0	$0	$0
LAUREN JESPERSEN
SECRETARY/DIRECTOR	40.00	0.00		Yes (X)	$123,208	$0	$7,089

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$123,208	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$957,351	TotReportableCompRltdOrgAmt
Total Other Compensation	$61,313	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Fundraising	$26,310	FundraisingAmt
Related Organizations	$60,000	RelatedOrganizationsAmt
Government Grants	$369,919	GovernmentGrantsAmt
All Other Contributions	$1,367,922	AllOtherContributionsAmt
Noncash Contributions	$15,103	NoncashContributionsAmt
Total Contributions	$1,824,151	TotalContributionsAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$226,018	TotalRevenueColumnAmt
Exclusion	-$226,018	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$6,014,739	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$5,087,309	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$927,430	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$927,430	TotalRevenueColumnAmt
Exclusion	$927,430	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$14,500	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$26,310	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$22,140	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$7,640	TotalRevenueColumnAmt
Exclusion	-$7,640	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,517,923	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$693,772	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$1,693,452	TotalAmt
Program Services	$1,693,452	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$79,281	TotalAmt
Program Services	$79,281	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$128,635	TotalAmt
Program Services	$25,727	ProgramServicesAmt
Management And General	$51,454	ManagementAndGeneralAmt
Fundraising	$51,454	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$74,283	TotalAmt
Program Services	$14,857	ProgramServicesAmt
Management And General	$29,713	ManagementAndGeneralAmt
Fundraising	$29,713	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$10,905	TotalAmt
Program Services	$2,181	ProgramServicesAmt
Management And General	$4,362	ManagementAndGeneralAmt
Fundraising	$4,362	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$14,250	TotalAmt
Program Services	$2,850	ProgramServicesAmt
Management And General	$5,700	ManagementAndGeneralAmt
Fundraising	$5,700	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$13,560	TotalAmt
Program Services	$2,712	ProgramServicesAmt
Management And General	$5,424	ManagementAndGeneralAmt
Fundraising	$5,424	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,550	TotalAmt
Program Services	$510	ProgramServicesAmt
Management And General	$1,020	ManagementAndGeneralAmt
Fundraising	$1,020	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$8,465	TotalAmt
Program Services	$1,693	ProgramServicesAmt
Management And General	$3,386	ManagementAndGeneralAmt
Fundraising	$3,386	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$151,529	TotalAmt
Management And General	$151,529	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$18,503	TotalAmt
Program Services	$3,701	ProgramServicesAmt
Management And General	$7,401	ManagementAndGeneralAmt
Fundraising	$7,401	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$32,342	TotalAmt
Program Services	$6,468	ProgramServicesAmt
Management And General	$12,937	ManagementAndGeneralAmt
Fundraising	$12,937	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,745	TotalAmt
Program Services	$549	ProgramServicesAmt
Management And General	$1,098	ManagementAndGeneralAmt
Fundraising	$1,098	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$14,180	TotalAmt
Program Services	$2,836	ProgramServicesAmt
Management And General	$5,672	ManagementAndGeneralAmt
Fundraising	$5,672	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$31,292	TotalAmt
Program Services	$6,258	ProgramServicesAmt
Management And General	$12,517	ManagementAndGeneralAmt
Fundraising	$12,517	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
MOORE PARK PROJECT	$155,111	$155,111
OTHER EXPENSES	$44,681	$44,681
EULANA PARK PUMP TRACK	$33,945	$33,945
EULANA PARK LIGHTING	$12,023	$12,023

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,521,732	TotalAmt
Program Services	$2,088,835	ProgramServicesAmt
Management And General	$292,213	ManagementAndGeneralAmt
Fundraising	$140,684	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$344,765	BOYAmt
EOY	$224,582	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$113,485	BOYAmt
EOY	$116,215	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$750,000	BOYAmt
EOY	$750,000	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$24,608,343	BOYAmt
EOY	$20,372,611	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$25,816,593	BOYAmt
EOY	$21,463,408	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$124,294	BOYAmt
EOY	$120,559	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$33,163	BOYAmt
EOY	$362,840	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$157,457	BOYAmt
EOY	$483,399	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$17,375,382	BOYAmt
EOY	$13,070,640	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$8,283,754	BOYAmt
EOY	$7,909,369	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$25,659,136	BOYAmt
EOY	$20,980,009	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$25,816,593	BOYAmt
EOY	$21,463,408	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$3,809	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$4,675,316	NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments	-$2	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Supporting Organization509a3	Yes (X)	SupportingOrganization509a3Ind
Supporting Org Type1	Yes (X)	SupportingOrgType1Ind
IRS Written Determination	Yes (X)	IRSWrittenDeterminationInd
Supported Organizations	1	SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	SKY LAKES MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
EIN	930508781	EIN
Organization Type	3	OrganizationTypeCd
Governing Document Listed	Yes (1)	GoverningDocumentListedInd
Support	$1,580,474	SupportAmt
Other Support	$0	OtherSupportAmt

Field	Value	IRS element (for citing)
Supported Organizations Total	1	SupportedOrganizationsTotalCnt
Support Sum	$1,580,474	SupportSumAmt
Other Support Sum	$0	OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

Field	Value	IRS element (for citing)
Listed By Name Governing Doc	Yes (1)	ListedByNameGoverningDocInd
Suprt Org No IRS Determination	0	SuprtOrgNoIRSDeterminationInd
Supported Org Section C456	0	SupportedOrgSectionC456Ind
Supported Org Not Organized US	0	SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org	0	OrganizationChangeSuprtOrgInd
Support Non Supported Org	0	SupportNonSupportedOrgInd
Payment Substantial Contribtr	0	PaymentSubstantialContribtrInd
Loan Disqualified Person	0	LoanDisqualifiedPersonInd
Controlled Disqualified Prsn	0	ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int	0	DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int	0	DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules	0	ExcessBusinessHoldingsRulesInd
Contribution Controller	0	ContributionControllerInd
Contribution Family	0	ContributionFamilyInd
Contribution35 Controlled	0	Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

Field	Value	IRS element (for citing)
Power Appoint Majority Dir Trst	Yes (1)	PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org	0	OperateBenefitNonSuprtOrgInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Donor Advised Funds Held	8	DonorAdvisedFundsHeldCnt
Funds And Other Accounts Held	31	FundsAndOtherAccountsHeldCnt
Donor Advised Funds Contri	$674,284	DonorAdvisedFundsContriAmt
Funds And Other Accounts Contri	$888,777	FundsAndOtherAccountsContriAmt
Donor Advised Funds Grants	$4,223	DonorAdvisedFundsGrantsAmt
Funds And Other Accounts Grants	$1,894,532	FundsAndOtherAccountsGrantsAmt
Donor Advised Funds Vl EOY	$6,336,735	DonorAdvisedFundsVlEOYAmt
Funds And Other Accounts Vl EOY	$14,763,860	FundsAndOtherAccountsVlEOYAmt
Disclosed Org Leg Ctrl	Yes (1)	DisclosedOrgLegCtrlInd
Disclosed For Charitable Prps	Yes (1)	DisclosedForCharitablePrpsInd

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,981,087	BeginningYearBalanceAmt
Contributions	$674,284	ContributionsAmt
Investment Earnings Or Losses	-$1,322,860	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$4,223	GrantsOrScholarshipsAmt
End Year Balance	$6,328,288	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$5,079,505	BeginningYearBalanceAmt
Contributions	$220,491	ContributionsAmt
Investment Earnings Or Losses	$1,757,202	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$39,000	GrantsOrScholarshipsAmt
Other Expenditures	$37,111	OtherExpendituresAmt
End Year Balance	$6,981,087	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,567,616	BeginningYearBalanceAmt
Contributions	$1,700	ContributionsAmt
Investment Earnings Or Losses	$538,586	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$29,111	GrantsOrScholarshipsAmt
Other Expenditures	-$714	OtherExpendituresAmt
End Year Balance	$5,079,505	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,337,398	BeginningYearBalanceAmt
Contributions	$33,078	ContributionsAmt
Investment Earnings Or Losses	$237,779	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$40,455	GrantsOrScholarshipsAmt
Other Expenditures	$184	OtherExpendituresAmt
End Year Balance	$4,567,616	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,795,751	BeginningYearBalanceAmt
Contributions	$189,824	ContributionsAmt
Investment Earnings Or Losses	$561,415	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$209,418	GrantsOrScholarshipsAmt
Other Expenditures	$174	OtherExpendituresAmt
End Year Balance	$4,337,398	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.00000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	1.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd
Total Book Value Land Buildings	$0	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	DUE TO SLMC	Desc
Amt	$362,840	Amt

Field	Value	IRS element (for citing)
Total Liability	$362,840	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 4:

ENDOWMENTS ARE HELD BY SKY LAKES MEDICAL CENTER FOUNDATION FOR THE BENEFIT OF SKY LAKES MEDICAL CENTER, A RELATED ORGANIZATION.

PART X, LINE 2:

UNCERTAIN TAX POSITION FOOTNOTE - THE MEDICAL CENTER AND FOUNDATION ARE TAX-EXEMPT ORGANIZATIONS AND ARE NOT SUBJECT TO STATE OR FEDERAL INCOME TAXES, EXCEPT ON UNRELATED BUSINESS INCOME, IN ACCORDANCE WITH SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEDICAL CENTER AND FOUNDATION HAD NO UNRECOGNIZED TAX BENEFITS AT SEPTEMBER 30, 2022 OR 2021. THE MEDICAL CENTER AND FOUNDATION RECOGNIZE INTEREST ACCRUED AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AS AN ADMINISTRATIVE EXPENSE. DURING THE YEARS ENDED SEPTEMBER 30, 2021 AND 2020, THE MEDICAL CENTER AND FOUNDATION RECOGNIZED NO INTEREST AND PENALTIES. THE MEDICAL CENTER FILES AN EXEMPT ORGANIZATION INFORMATION RETURN AND AN UNRELATED BUSINESS INCOME TAX RETURN IN THE U.S. FEDERAL JURISDICTION AND AN UNRELATED BUSINESS INCOME TAX RETURN WITH THE OREGON DEPARTMENT OF REVENUE. THE FOUNDATION FILES AN EXEMPT ORGANIZATION INFORMATION RETURN IN THE U.S. FEDERAL JURISDICTION.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt
SKY LAKES MEDICAL CENTER
2865 DAGGETT ST	KLAMATH FALLS	OR	97601	930508781	501(C)(3)	$1,580,474	$0	ANNUAL GIFT, CARES, HRSA GRANT
KLAMATH HEALTH PARTNERSHIP
2074 S 6TH STREET	KLAMATH FALLS	OR	97601	931230223	501(C)(3)	$112,978	$0	HRSA GRANT

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
ACADEMIC SCHOLARSHIPS	29	$18,986
PATIENT ASSISTANCE	49	$18,980
CASCADE COMPREHENSIVE CARE BENEVOLENT FUND	75	$41,315

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	FUNDS ARE SET UP AND TRACKED ON A FUND BY FUND BASIS. THE DIRECTOR AND ACCOUNTANT BOTH MONITOR THAT FUNDS ARE CORRECTLY CREDITED AND THAT FUNDS ARE SPENT AS ALLOWED BY THE RULES FOR THAT FUND, WHETHER THOSE RULES ARE ESTABLISHED BY THE DONOR, THE BOARD, GRANT APPLICATIONS OR SPECIFIC PEOPLE ENTRUSTED WITH SPENDING THE FUNDS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

Field	Value	IRS element (for citing)
Person	PAUL STEWART	PersonNm
Title	BOARD MEMBER	TitleTxt
Base Compensation Filing Org	$0	BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs	$571,277	CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization	$0	BonusFilingOrganizationAmount
Bonus Related Organizations	$386,074	BonusRelatedOrganizationsAmt
Other Compensation Filing Org	$0	OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs	$0	OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org	$0	DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs	$38,312	DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org	$0	NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs	$15,912	NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org	$0	TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs	$1,011,575	TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org	$0	CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs	$0	CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND CFO AND CONTROLLER BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12C	IT IS THE DUTY OF THE BOARD OF DIRECTORS OF SKY LAKES MEDICAL CENTER FOUNDATION TO SAFEGUARD THE TAX EXEMPT STATUS OF THE FOUNDATION, AND AS SUCH THE BOARD WILL TAKE SERIOUSLY ANY CONFLICT OF INTEREST ON THE PART OF ANY BOARD MEMBER OR POTENTIAL BOARD MEMBER. ALL BOARD MEMBERS AND POTENTIAL MEMBERS MUST DISCLOSE THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. AN UPDATED STATEMENT OF SUCH POTENTIAL CONFLICTS SHALL BE SUBMITTED YEARLY BY ALL BOARD MEMBERS FOR REVIEW AT THE BOARD'S ANNUAL MEETING. AFTER DISCLOSURE OF THE POTENTIAL CONFLICT OF INTEREST AND AFTER ANY DISCUSSION WITH THE INTERESTED PARTY, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THE MINUTES OF THE BOARD AND ALL COMMITTEES OF THE BOARD SHALL CONTAIN 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST; 2) THE NATURE OF THE FINANCIAL INTEREST; 3) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR THE DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT; 4) THE CONTENT OF THE DISCUSSION INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; 5) ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT; AND, 6) THE BOARD OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED.
FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE ALL MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
SKY LAKES MEDICAL CENTER
2865 DAGGETT AVENUE	KLAMATH FALLS	OR	97601	930508781	HEALTHCARE	OR	501(C)(3)	LINE 3	N/A	0
KLAMATH CARE SERVICES INC
2865 DAGGETT AVENUE	KLAMATH FALLS	OR	97601	930946018	SUPPORT MEDICAL CENTER (INACTIVE)	OR	501(C)(3)	LINE 12C, III-FI		0	SKY LAKES MEDICAL CENTER

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	KLAMATH MEDICAL BUSINESS CENTER LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2865 DAGGETT AVENUE	AddressLine1Txt
City	KLAMATH FALLS	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97601	ZIPCd

Field	Value	IRS element (for citing)
EIN	020731372	EIN
Primary Activities	REAL AND PERSONAL PROPERTY RENTAL	PrimaryActivitiesTxt
Legal Domicile State	OR	LegalDomicileStateCd
Direct Controlling NA	N/A	DirectControllingNACd
Disproportionate Allocations	0	DisproportionateAllocationsInd
General Or Managing Partner	0	GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	WEST PHYSICIAN SERVICES LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2865 DAGGETT AVENUE	AddressLine1Txt
City	KLAMATH FALLS	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97601	ZIPCd

Field	Value	IRS element (for citing)
EIN	870696029	EIN
Primary Activities	PHYSICIAN SERVICES	PrimaryActivitiesTxt
Legal Domicile State	OR	LegalDomicileStateCd
Direct Controlling NA	N/A	DirectControllingNACd
Entity Type	C	EntityTypeTxt
Controlled Organization	0	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd