SPOKANE TEACHING HEALTH CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SPOKANE TEACHING HEALTH CENTER (EIN 46-4139065)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202213199349331266
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-15T20:01:28-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 208149084 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANASTASI MOORE & MARTIN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9 S WASHINGTON ST STE 600 | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 464139065 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPOKANE TEACHING HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SPOK | BusinessNameControlTxt |
| Phone | 5096269900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 624 E FRONT STREET | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99202 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ALVIN BARTHOLOMEW | PersonNm |
| Person Title | FINANCE DIRECTOR | PersonTitleTxt |
| Phone | 5096269900 | PhoneNum |
| Signature | 2022-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ALVIN | PersonFirstNm |
| Person Last | BARTHOLOMEW | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PAUL ANASTASI CPA | PreparerPersonNm |
| PTIN | P00395796 | PTIN |
| Phone | 5093230272 | PhoneNum |
| Preparation | 2022-11-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ALVIN BARTHOLOMEW | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 624 E FRONT STREET | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,142,319 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | SPOKANETEACHINGHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE EDUCATION TO HEALTH CARE PROFESSIONALS THROUGH SPONSORSHIP OR GRADUATE MEDICAL EDUCATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 4 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,445,879 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,142,319 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $3,445,879 | PYTotalRevenueAmt |
| CY Total Revenue | $4,142,319 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,960 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $10,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $372,640 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $344,064 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,214,777 | PYOtherExpensesAmt |
| CY Other Expenses | $3,229,871 | CYOtherExpensesAmt |
| PY Total Expenses | $3,598,377 | PYTotalExpensesAmt |
| CY Total Expenses | $3,583,935 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$152,498 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $558,384 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,396,912 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,446,772 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $755,371 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,246,847 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,641,541 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,199,925 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ENTITY IS ORGANIZED AND OPERATED SPECIFICALLY TO PROMOTE, CONDUCT, AND SPONSOR EDUCATIONAL ACTIVITIES RELATED TO GRADUATE MEDICAL EDUCATION, INCLUDING PHYSICIAN RESIDENCY PROGRAMS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,856,665 | ExpenseAmt |
| Grant | $10,000 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | GRADUATE MEDICAL EDUCATION (GME) -- INTERNAL AND FAMILY MEDICINE RESIDENCY PROGRAMS:ACCREDITED SPONSORSHIP OF EXPANDED FAMILY AND INTERNAL MEDICINE RESIDENCY PROGRAMS, INCLUDING HRSA-FUNDED, IN A TEACHING HEALTH CENTER SETTING IN SPOKANE, WA. IN 2021 THE ORGANIZATION MAINTAINED ITS FINANCIAL OBLIGATIONS FOR THE FUNDING OF 18 TOTAL HRSA-FUND RESIDENTS, OF WHICH 6 COMPLETED THEIR TRAINING AND GRADUATED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $46,049 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | MEDICAID WAIVER TRANSFORMATION EFFORT:THE ORGANIZATION WILL PARTNER WITH ITS REGIONAL ACCCOUNTABLE COMMUNITY OF HEALTH BY ENGAGING IN SPECIFIC PROJECTS AIMED AT ACHIEVING IMPROVED OUTCOMES AND COST SAVINGS IN THE DELIVERY OF MEDICAID-FUNDED SERVICES, SUCH AS THOSE RENDERED TO PATIENTS AT THE ORGANIZATION'S TEACHING SITES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $120,000 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | GRADUATE MEDICAL EDUCATION -- DEVELOPMENT OF A PEDIATRICS RESIDENCY: THE ORGANIZATION IS DEVELOPING A NEW PEDIATRICS RESIDENCY PROGRAM IN SPOKANE, WA. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $3,022,714 | 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 | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | 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 | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 4 | EmployeeCnt |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiledInd |
| 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 | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | 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 | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALVIN BARTHOLOMEW | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3105087417 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 624 E FRONT STREET | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99202 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt |
|---|---|---|---|---|---|---|---|
| ZEKE SMITH | |||||||
| DIRECTOR (CLASS A) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RICH HADLEY | |||||||
| PRESIDENT (CLASS B) | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JEFFREY COLLINS MD | |||||||
| VICE PRESIDENT (CLASS B) | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JEFFREY BELL | |||||||
| SECRETARY (CLASS A ) | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MICHAEL NOWLING | |||||||
| TREASURER (CLASS A) | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DARYLL DEWALD PHD | |||||||
| DIRECTOR (CLASS C) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDA GARRELTS MACLEAN | |||||||
| DIRECTOR (CLASS C) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DEB HARPER MD | |||||||
| DIRECTOR (CLASS A) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DEAN MARTZ MD | |||||||
| DIRECTOR (CLASS B) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TRACI RICHMOND COUTURE | |||||||
| EXECUTIVE DIRECTOR | 1.00 | $141,075 | $0 | $3,923 | Yes (X) | 40.00 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $141,075 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,923 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHRISTIAN ROCHOLL MD | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4821 W HAYDEN LANE | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99208 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | PEDIATRIC CONSULTING | ServicesDesc |
| Compensation | $120,000 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,014,589 | RelatedOrganizationsAmt |
| Government Grants | $3,127,230 | GovernmentGrantsAmt |
| All Other Contributions | $500 | AllOtherContributionsAmt |
| Total Contributions | $4,142,319 | TotalContributionsAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,142,319 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Program Services | $10,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,075 | TotalAmt |
| Management And General | $141,075 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,545 | TotalAmt |
| Management And General | $111,545 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,534 | TotalAmt |
| Management And General | $6,534 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,352 | TotalAmt |
| Management And General | $61,352 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,558 | TotalAmt |
| Management And General | $23,558 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,595 | TotalAmt |
| Management And General | $14,595 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,274 | TotalAmt |
| Program Services | $162,886 | ProgramServicesAmt |
| Management And General | $23,388 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,533 | TotalAmt |
| Program Services | $15,291 | ProgramServicesAmt |
| Management And General | $39,242 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,166 | TotalAmt |
| Program Services | $78,664 | ProgramServicesAmt |
| Management And General | $17,502 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,380 | TotalAmt |
| Management And General | $7,380 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $268,074 | TotalAmt |
| Program Services | $259,191 | ProgramServicesAmt |
| Management And General | $8,883 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,639 | TotalAmt |
| Program Services | $10,500 | ProgramServicesAmt |
| Management And General | $38,139 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,008 | TotalAmt |
| Management And General | $9,008 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,413 | TotalAmt |
| Program Services | $19,853 | ProgramServicesAmt |
| Management And General | $560 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,974 | TotalAmt |
| Management And General | $8,974 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| RESIDENCY PROGRAM | $2,021,038 | $2,021,038 | |
| EQUIPMENT LEASE & MAINT | $370,314 | $370,314 | |
| TAXES | $47,246 | $47,246 | |
| DUES, LICENSES, & MEMBE | $41,555 | $3,000 | $38,555 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,662 | TotalAmt |
| Program Services | $24,731 | ProgramServicesAmt |
| Management And General | $10,931 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,583,935 | TotalAmt |
| Program Services | $3,022,714 | ProgramServicesAmt |
| Management And General | $561,221 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,619,300 | BOYAmt |
| EOY | $1,604,131 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $765,133 | BOYAmt |
| EOY | $2,828,603 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,397 | BOYAmt |
| EOY | $8,199 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,119 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,280 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,082 | BOYAmt |
| EOY | $5,839 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,396,912 | BOYAmt |
| EOY | $4,446,772 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $755,371 | BOYAmt |
| EOY | $2,246,847 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $755,371 | BOYAmt |
| EOY | $2,246,847 | 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 | $1,585,938 | BOYAmt |
| EOY | $2,184,322 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,603 | BOYAmt |
| EOY | $15,603 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,641,541 | BOYAmt |
| EOY | $2,199,925 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,396,912 | BOYAmt |
| EOY | $4,446,772 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $558,384 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,208,457 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,731,857 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,837,985 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,445,879 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,142,319 | CurrentTaxYearAmt |
| Total | $18,366,497 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,208,457 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,731,857 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,837,985 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,445,879 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,142,319 | CurrentTaxYearAmt |
| Total | $18,366,497 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $18,366,497 | PublicSupportTotal170Amt |
| Total Support | $18,366,497 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $245,000 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,119 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,280 | DepreciationAmt |
| Book Value | $5,839 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,839 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $4,142,319 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,142,319 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,142,319 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,583,935 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $3,583,935 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $3,583,935 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE IRC. ACCORDINGLY, NO PROVISIONS FOR INCOME TAXES HAVE BEEN MADE IN THESE FINANCIAL STATEMENTS. THE ORGANIZATION HAS ADOPTED ASC 740-10, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS. ASC 740-10 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR ACCOUNTING FOR UNCERTAIN TAX POSITIONS AND ALSO PROVIDES GUIDANCE ON VARIOUS RELATED MATTERS SUCH AS DERECOGNITION, INTEREST, PENALTIES, AND DISCLOSURES REQUIRED. THE ORGANIZATION HAS NOT IDENTIFIED ANY UNCERTAINTY IN TAX POSITIONS THAT WOULD REQUIRE POSSIBLE RECOGNITION OR DISCLOSURE IN THE FINANCIAL RECORDS. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE HEALTH & SERVICES WASHINGTON (DBA PROVIDENCE MEDICAL GROUP) | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 W 8TH AVENUE | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 911303277 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $10,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | SUPPORT TO RECRUIT AND RETAIN GME FACULTY | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | TWO MEMBER CLASSES: CLASS A (EMPIRE HEALTH FOUNDATION); CLASS B (PROVIDENCE HEALTH AND SERVICES). |
| FORM 990, PART VI, SECTION A, LINE 7A | CLASS A MEMBER, EMPIRE HEALTH FOUNDATION, APPOINTS 5 OF 9 DIRECTORS. CLASS B MEMBER, PROVIDENCE HEALTH AND SERVICES, APPOINTS 2 OF 9 DIRECTORS; WASHINGTON STATE UNIVERSITY, A NON-MEMBER, APPOINTS 2 OF 9 DIRECTORS. ALL CLASSES OF BOARD APPOINTEES HAVE THE SAME VOTING RIGHTS. HOWEVER, VOTING ACTIONS OF THE BOARD REQUIRE THE AFFIRMATIVE VOTE OF AT LEAST ONE DIRECTOR FROM EACH CLASS--CONSEQUENTLY, NO CLASS OF BOARD APPOINTEES CONTROLS MORE THAN 50% OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING, CORPORATE COUNSEL AND THE EXECUTIVE DIRECTOR WERE PROVIDED WITH A COPY FOR REVIEW AND COMMENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | WRITTEN POLICY REQUIRES AFFIRMATIVE DISCLOSURE OF ACTUAL OR POTENTIAL CONFLICTS ANNUALLY--REVIEWED BY BOARD AND LEGAL COUNSEL. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE 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 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| EMPIRE HEALTH FOUNDATION | |||||||||
| 422 W RIVERSIDE AVE STE 1100 | SPOKANE | WA | 99201 | 263375286 | PRIVATE FOUNDATION | WA | 501(C)(3) | PF | 0 |
| PROVIDENCE HEALTH & SERVICES | |||||||||
| 101 E 8TH AVE | SPOKANE | WA | 99204 | 911303277 | HOSPITAL | WA | 501(C)(3) | LINE 3 | 0 |
| 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 | Yes (1) | 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 | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | 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 |
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