2023-11-02T08:13:38-05:00 2022-12-31 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2022-01-01 930854433 MID-COLUMBIA HEALTH FOUNDATION MID- 5412967275 PO BOX 1580 THE DALLES OR 97058 AMY SCHANNO-SUGG BOARD CHAIR 5412967275 2023-11-01 1 AMY SCHANNO-SUGG 999009999 0 TERRI REXRODE CPA MST P00096513 9206620016 2023-11-01 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z AMANDA EVANS PO BOX 1580 THE DALLES OR 97058 1775754 0 X WWW.MCMC.NET/FOUNDATION X 1983 OR TO WORK TOGETHER WITH AND PROVIDE FINANCIAL SUPPORT TO MID-COLUMBIA MEDICAL CENTER IN ORDER TO PROVIDE ACCESS TO QUALITY HEALTHCARE FOR OUR COMMUNITY. 12 9 0 66 0 0 785232 1160209 0 0 783126 123375 61410 60952 1629768 1344536 436404 1087176 0 0 286035 277458 0 0 0 208715 325215 931154 1689849 698614 -345313 7391294 6241327 260967 167649 7130327 6073678 TO WORK TOGETHER WITH AND PROVIDE FINANCIAL SUPPORT TO MID-COLUMBIA MEDICAL CENTER IN ORDER TO PROVIDE ACCESS TO QUALITY HEALTHCARE FOR OUR COMMUNITY. 0 0 1154964 1087176 0 THE PRIMARY PURPOSE OF THE FOUNDATION IS TO PROVIDE FUNDRAISING FOR THE MID-COLUMBIA MEDICAL CENTER (ID# 93-0386936) AS WELL AS GRANTS/SCHOLARSHIPS TO THE GENERAL PUBLIC SUPPORT. 1154964 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 12 9 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X WENDY APLAND 5412961111 PO BOX 1580 THE DALLES OR 97058 AMY SCHANNO-SUGG SECRETARY 1.00 40.00 X X 0 116890 26813 KRISTI TIMMONS CHAIR (THRU DECEMBER) 1.00 X X 0 0 0 DR FRANK TODA TREASURER 1.00 X X 0 0 0 SHAE KASINGER SECRETARY 1.00 X X 0 0 0 PAT ASHMORE VICE CHAIR 1.00 X X 0 0 0 JORGE BARRAGAN JR DIRECTOR 1.00 X 0 0 0 DEAN DOLLARHIDE DIRECTOR 1.00 X 0 0 0 DENNIS KNOX DIRECTOR 1.00 40.00 X 0 599211 30855 DR KERRY PROCTOR DIRECTOR 1.00 40.00 X 0 155458 4069 LORI ROSEBRAUGH DIRECTOR 1.00 X 0 0 0 MEREDITH SMITH DIRECTOR 1.00 X 0 0 0 JUDY URNESS DIRECTOR 1.00 X 0 0 0 AMANDA EVANS EXECUTIVE DIRECTOR 40.00 X 0 107676 17308 0 979235 79045 0 0 1 0 0 1250 257295 901664 1160209 100516 100516 429283 406424 22859 22859 22859 85746 1250 24794 60952 60952 1344536 0 0 184327 971758 971758 115418 115418 124984 124984 125459 125459 7483 7483 1877 1877 17655 17655 3500 3500 17133 17133 93008 93008 10177 10177 4381 4381 34516 34516 61541 61076 465 621 621 839 839 REPAIRS AND MAINTENANCE 2191 2191 DUES AND SUBSCRIPTIONS 1133 1133 TAXES AND LICENSES 75 75 MEDICAL SUPPLIES 65 65 96035 96035 1689849 1154964 534885 0 466281 257858 1816462 1085413 290690 254926 4817861 4627872 0 15258 7391294 6241327 23101 0 237866 167649 260967 167649 X 4253055 3379946 2877272 2693732 7130327 6073678 7391294 6241327 X -345313 -943408 277458 -45386 X 0 1 X 1 0 X 1095656 780176 1003494 785232 1160209 4824767 1095656 780176 1003494 785232 1160209 4824767 2267434 2557333 91712 756481 419642 784014 100516 2152365 6977132 432718 0.36650 0.35050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2005097 69249 61562 41959 2093949 1942329 30138 56280 23650 2005097 2135976 58970 47174 14500 285291 1942329 2044538 52326 59362 20250 2135976 1644624 403368 10096 13550 2044538 0.68660 0.20430 0.10910 0 0 0 CRUT LIABILITY 157458 OTHER LIABILITIES 10191 167649 X PART V, LINE 4: MCHF ENDOWMENT FUND WAS ESTABLISHED IN 1987 FOR THE SPECIFIC PURPOSE OF FINANCING THE FOUNDATION'S OPERATING EXPENSES. IT IS UNDERSTOOD THAT ONLY THE INTEREST, NOT THE PRINCIPAL, MAY BE USED TOWARD THE FOUNDATION OPERATING EXPENSES. THE PURPOSE OF OTHER EVELYN KASER NURSING SCHOLARSHIP, LORNA & JOSEPH HALLIDAY FAMILY NURSING SCHOLARSHIP, MCMC BOARD OF TRUSTEES SCHOLARSHIP AND PERMANENT SCHOLARSHIP IS TO GAIN INTEREST TO USE AS SCHOLARSHIP FOR SECONDARY EDUCATION OF STUDENTS. PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. FESTIVAL OF TREES 48745 350 48395 5115 2795 1251 TOURNAMENT OF TRADITION 36046 800 35246 2067 5028 7356 1028 1 2205 100 2105 39 115 86996 1250 85746 2067 10143 10190 2394 24794 60952 1 MID-COLUMBIA MEDICAL CENTER 1700 E 19TH ST THE DALLES OR 97058 930386936 501(C)(3) 480608 0 EQUIPMENT PURCHASES THE NEXT DOOR 209 OAK STREET SUITE 202 HOOD RIVER OR 67031 930600421 501(C)(3) 8756 0 WOMEN'S GIVING CIRCLE GRANT 2 0 RANDY ROOD MEMORIAL SCHOLARSHIP 39 85418 WASCO LODGE MASONIC SCHOLARSHIP 4 8000 NON-TRADITIONAL NURSING SCHOLARSHIP 3 4500 MCMC DEPENDENT SCHOLARSHIP 9 4250 TRUSTEES FUTURE HEALTHCARE PROFESSIONALS 2 4000 MCMC EMPLOYEE SCHOLARSHIP 3 3500 EVELYN KASER NURSING SCHOLARSHIP 5 3250 LORNA & JOSEPH HALLIDAY NURSING SCHOLARSHIP 5 2500 PART I, LINE 2: FUNDING IS TRACKED THROUGH OUR JOURNAL SHEETS OF ALL THE DIFFERENT FUNDS WE HAVE. THE GRANTEES ARE REQUIRED TO PROVIDE AN END OF YEAR REPORT ON HOW FUNDS WERE USED. 0 0 0 0 0 0 0 0 0 DENNIS KNOX DIRECTOR 0 524906 0 48480 0 25825 0 16262 0 14593 0 630066 0 0 DR KERRY PROCTOR DIRECTOR 0 146067 0 0 0 9391 0 4069 0 0 0 159527 0 0 FORM 990, PART VI, SECTION A, LINE 6 MID-COLUMBIA MEDICAL CENTER EXISTS AS THE PARENT OVER THE AFFILIATES OF THE FOUNDATION AND DRY HOLLOW. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE RETURN IS SUBMITTED TO THE BOARD OF TRUSTEES FOR REVIEW. UPDATES ARE MADE AS NECESSARY BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C WE ANNUALLY REQUIRE DIRECTORS, OFFICERS AND COMMITTEE MEMBERS TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT, THEY WOULD BE SUBJECT TO CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION FOR VIOLATION OF OUR POLICY. IF THEY SELF-DISCLOSED A POTENTIAL CONFLICT OF INTEREST ON THE FORM, WE WOULD GATHER INFORMATION ON THE ISSUE AND MAKE A DETERMINATION ON HOW SEVERE THE CONFLICT IS AND WHETHER OR NOT THE EMPLOYEE OR DIRECTOR COULD REMAIN AN OFFICER, DIRECTOR OR EMPLOYEE. THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION COMMITTEE WAS DESIGNED WHICH INCLUDED MEMBERS OF THE BOARD OF TRUSTEES, HR DIRECTOR, AND COMPENSATION SPECIALIST. COMPENSATION COMMITTEE AGED AND/OR UPDATED PREVIOUSLY SUPPLIED COMPENSATION DATA FROM OUTSIDE FIRM BASED ON COMMERCIALLY AVAILABLE SALARY SURVEYS. THE CEO THEN NEGOTIATES WITH THE BOARD, WHICH COMPARES THE COMPENSATION DISCUSSED WITH THE ANALYSIS PREVIOUSLY DESCRIBED AND VOTES ON AND APPROVES A NEW CONTRACT IN EXECUTIVE SESSION WITHOUT CEO PRESENCE OR PARTICIPATION IN THE VOTE. COMPENSATION OF THE ORGANIZATIONS OFFICERS OR KEY EMPLOYEES IS DETERMINED BY A SURVEY OF MARKET RATES FOR SIMILAR POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL INFORMATION AVAILABLE TO THE PUBLIC AT THE CHARITABLE ACTIVITIES DIVISION OF THE OREGON DEPARTMENT OF JUSTICE. THE DOCUMENTS ARE AVAILABLE UPON REQUEST AS WELL. FORM 990, PART XI, LINE 9: CHANGE IN CRUT (SPLIT-INTEREST AGREEMENT) -45,386. MID-COLUMBIA MEDICAL CENTER 1700 E 19TH STREET THE DALLES OR 97058 930386936 ACUTE HOSPITAL OR 501(C)(3) LINE 3 N/A 1 DRY HOLLOW PROFESSIONAL CENTER INC PO BOX 1580 THE DALLES OR 97058 930631350 RENTAL BUILDING OR N/A C 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 1 0 0