2022-11-07T12:34:26-06:00 2021-12-31 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2021-01-01 911030686 ISLAND HOSPITAL FOUNDATION ISLA 3602994201 1211 24TH STREET ANACORTES WA 98221 CONSTANCE MILLER TREASURER 3602994201 2022-11-04 1 CONSTANCE MILLER 999009999 TERRI REXRODE CPA MST P00096513 9206620016 2022-11-01 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z LAURA BROWN-SNIDER 1211 24TH STREET ANACORTES WA 98221 2414386 0 X WWW.ISLANDHOSPITALFOUNDATION.ORG X 1978 WA TO RAISE FUNDS TO SUPPORT ISLAND HOSPITAL AND ITS COMMITMENT TO COMMUNITY HEALTH. 14 14 0 30 0 0 2244825 1552924 0 0 96615 321040 0 -20739 2341440 1853225 1396814 935651 0 0 22967 58740 0 45000 51657 121412 141720 1541193 1181111 800247 672114 4563921 5869911 244571 515060 4319350 5354851 X THE MISSION OF THE FOUNDATION IS TO RAISE FUNDS TO SUPPORT ISLAND HOSPITAL AND ITS COMMITMENT TO COMMUNITY HEALTH IN AND AROUND ANACORTES, WASHINGTON. 0 0 1004532 935651 0 SINCE 1962, ISLAND HOSPITAL HAS PROVIDED HIGH QUALITY, COMPASSIONATE AND PERSONALIZED HEALTH CARE TO OUR COMMUNITY. ISLAND HOSPITAL MAINTAINS A PROGRESSIVE STAND IN DELIVERING THE BEST HEALTH CARE EXPERIENCES FOR PATIENTS AND THEIR FAMILIES BY PLACING THEIR EMOTIONAL AND MEDICAL NEEDS FIRST AND FOREMOST. ISLAND HOSPITAL FOUNDATION SUPPORTS ISLAND HOSPITAL'S VITAL MISSION BY RAISING MUCH-NEEDED FUNDS FOR THE BENEFIT OF COMMUNITY HEALTH. FOUNDED IN 1978, THE FOUNDATION IS AN INDEPENDENT, NONPROFIT CORPORATION HEADED BY A 21-MEMBER VOLUNTEER BOARD OF DIRECTORS. THESE DEDICATED COMMUNITY AND BUSINESS LEADERS GENEROUSLY DONATE THEIR TIME, TALENTS, AND ENERGY TO DIRECT THE FOUNDATION'S POLICIES, PROVIDE FIDUCIARY OVERSIGHT, IMPLEMENT THE ANNUAL FUNDRAISING PLAN AND TO SECURE ITS FINANCIAL FUTURE THROUGH FUNDRAISING. THE ISLAND HOSPITAL FOUNDATION PROVIDES FUNDING FOR COMMITMENTS TO THE ISLAND HOSPITAL THAT INCLUDE THE HEALTH RESOURCE CENTER, FREE AND LOW COST COMMUNITY HEALTH SCREENINGS, DIRECT CLINIC SUPPORT, MENTAL HEALTH COUNSELING THROUGH THE MENTAL HEALTH INTERVENTION SCHOOL PROGRAM, TWO EMERGENCY DEPARTMENT PATIENT NAVIGATOR POSITIONS ADDRESSING PSYCHIATRY AND BEHAVIORAL HEALTH ISSUES AND ELDER CARE, THE CHAPLAIN PROGRAM, AND PATIENT PROGRAMS INCLUDED ONCOLOGY RELIEF AND ONCOLOGY LODGING ASSISTANCE. NEW TECHNOLOGY EQUIPMENT ALONG WITH OTHER NEEDS ARE ALSO PROVIDED FOR AS THEY ARISE THROUGH THE YEAR. ADDITIONALLY, ISLAND HOSPITAL FOUNDATION PROVIDES FUNDING FOR HOSPITAL RENOVATION AND EXPANSION COSTS NOT MET BY TAX REVENUE. THIS INCLUDES THE MEDICAL ARTS PAVILION HOUSING CANCER CARE, PHYSICAL/OCCUPATIONAL/SPEECH THERAPY AND WOUND CARE. ISLAND HOSPITAL FOUNDATION COMMITTED TO FUND TWO PATIENT NAVIGATOR POSITIONS FOR THE EMERGENCY DEPARTMENT AT $140,000 PER YEAR FOR A COMMITMENT OF 5 YEARS. WE ALSO ESTABLISHED A COVID-19 EMERGENCY RELIEF FUND. WE ALSO FULFILLED THE $100,000 ANNUAL COMMITMENT FOR THE MERLE CANCER CARE CENTER. 1004532 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 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 14 14 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X X CINDY ANDERSON 3602991300 1211 24TH STREET ANACORTES WA 98221 JAMES TANGARO PRESIDENT 3.00 X X 0 0 0 LAURA BROWN-SNIDER VICE PRESIDENT 3.00 X X 0 0 0 DR PAUL HAMMER SECRETARY 1.00 X X 0 354696 22330 CONNIE MILLER TREASURER 1.00 X X 0 0 0 SHIRLEY VACANTI PAST-PRESIDENT 1.00 X X 0 0 0 DANA ANDRICH DIRECTOR 1.00 X 0 0 0 BRIAN HAYES DIRECTOR 1.00 X 0 0 0 ELLIOTT JOHNSON DIRECTOR 1.00 X 0 0 0 DIANNE KUHN DIRECTOR 1.00 X 0 0 0 TROY KUNZ DIRECTOR 1.00 X 0 0 0 BILL RABEL DIRECTOR 1.00 X 0 0 0 DON SCHMUDE DIRECTOR 1.00 X 0 0 0 GARY THEBAULT DIRECTOR 1.00 X 0 0 0 GINA WALSH DIRECTOR 1.00 X 0 0 0 SHERLE WEBB-ROBINS DIRECTOR 1.00 X 0 0 0 JANIE CRANE FOUNDATION DIRECTOR 40.00 X 0 82680 17274 0 437376 39604 0 0 1 0 0 483059 1069865 169772 1552924 120751 120751 694533 494244 200289 200289 200289 41324 483059 66917 -25593 -25593 4854 0 4854 4854 1853225 0 0 300301 915747 915747 19904 19904 58740 58740 5000 5000 45000 45000 22799 18249 4550 1072 549 523 99790 49239 46130 4421 968 968 12091 1393 9953 745 1181111 1004532 124922 51657 368562 819559 1233505 1469615 0 9121 1500 2600 2960354 3569016 4563921 5869911 244571 117997 0 397063 244571 515060 X 3784345 4058756 535005 1296095 4319350 5354851 4563921 5869911 672114 364423 -1036 0 X 1 X 0 0 0 X 1281214 1261108 1380746 2244825 1552924 7720817 1281214 1261108 1380746 2244825 1552924 7720817 1548167 6172650 79684 55519 66437 57197 120751 379588 8100405 442093 0.76200 0.77570 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2960354 685429 53968 22799 3569016 2729658 444468 198104 15668 2960354 2348626 401327 4700 15595 2729658 2552097 -179108 8055 16308 2348626 2255536 304829 8268 2552097 0.86650 0.05590 0.07760 0 0 0 X PART X, LINE 2: THE FOUNDATION HAS EVALUATED UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WERE CONSIDERED PROBABLE AND WERE REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2021 AND 2020, THE FOUNDATION HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL OR DISCLOSURE. PART V, LINE 4 THE INCOME FROM THE ENDOWMENTS IS TO BE USED FOR TWO PURPOSES: 1) HOSPITAL IDENTIFIED COMMUNITY HEALTH NEEDS 2) PROVIDE FUNDS FOR THE BENEFIT OF THE ISLAND HOSPITAL BIRTH CENTER X X X X X 1 ACCORDANT PHILANTHROPY 105 TEAL NEST COURT PONTE VEDRA BEACH FL 32082 CAPITAL CAMPAIGN FEASIBILITY STUDY 0 0 45000 -45000 45000 -45000 WA WELL JOURNEY ADVENTURE 362620 355043 7577 7577 2143 22152 ISLAND HOSPITAL GOLF CLASSIC 91002 57255 33747 3270 11980 13938 2144 1 70761 70761 3713 524383 483059 41324 10847 11980 16081 28009 66917 -25593 1 SKAGIT COUNTY PUBLIC HOSPITAL DISTRICT NO 2 (DBA ISLAND HOSPITAL) 1211 24TH STREET ANACORTES WA 98221 910729255 ISLAND HOSPITAL 912396 0 SUPPORT OF HOSPITAL 1 0 ONCOLOGY MEDICAL RELIEF GRANTS 40 16904 SCHOLARSHIPS 2 3000 PART I, LINE 2: COMMON EXECUTIVE MANAGEMENT ENSURE THAT ALL FUNDS TRANSFERRED TO ISLAND HOSPITAL ARE USED FOR INTENDED PURPOSES. FOUNDATION AND HOSPITAL LEADERS MET REGULARLY WITH THE ANACORTES SCHOOL DISTRICT TO DISCUSS PROGRESS IN THEIR MENTAL HEALTH PROGRAMS, DURING WHICH THE FOUNDATION ENSURED THAT THE FUNDS WERE USED FOR APPROPRIATE PURPOSES. INDIVIDUALS RECEIVING ONCOLOGY GRANTS PROVIDE RECEIPTS SHOWING QUALIFIED EXPENSES AND ARE REIMBURSED. SCHOLARSHIP FUNDS ARE GIVEN DIRECTLY TO THE INDIVIDUAL'S SCHOOL. 0 0 0 0 0 0 0 0 0 DR PAUL HAMMER SECRETARY 0 352885 0 0 0 1811 0 0 0 22330 0 377026 0 0 X 4 158291 FMV X IN-KIND GIFTS 1 11481 FMV 0 0 1 0 FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE COMMITTEE REVIEWED THE FULL FORM 990, INCLUDING DISCLOSURES, PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF THE COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS IHF IS A CHARITABLE ORGANIZATION AND IN ORDER TO MAINTAIN ITS FEDERAL TAX-EXEMPT STATUS MUST ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES EACH VOTING MEMBER OF THE BOARD SHALL ANNUALLY SIGN A STATEMENT WHICH DECLARES WHETHER SUCH PERSON IS AN INDEPENDENT DIRECTOR IF AT ANY TIME DURING THE YEAR, THE INFORMATION IN THE ANNUAL STATEMENT CHANGES MATERIALLY, THE DIRECTOR SHALL DISCLOSE SUCH CHANGES AND REVISE THE ANNUAL DISCLOSURE FORM THE EXECUTIVE COMMITTEE SHALL REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THIS POLICY BY REVIEWING ANNUAL STATEMENTS AND TAKING SUCH OTHER ACTIONS AS ARE NECESSARY FOR EFFECTIVE OVERSIGHT. FORM 990, PART VI, SECTION B, LINE 15 THE FOUNDATION HAS NO COMPENSATED EMPLOYEES FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. SKAGIT COUNTY PUBLIC HOSPITAL DIST #2 (DBA ISLAND HOSPITAL) 1211 24TH STREET ANACORTES WA 98221 910729255 HEALTH CARE WA 115(1) N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0