2021-11-12T11:26:46-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 8101 WEST GRANDRIDGE BLVD SUITE 130 KENNEWICK WA 99336 990 2020-01-01 464139065 SPOKANE TEACHING HEALTH CENTER SPOK 3105087417 PO BOX 11971 SPOKANE VALLEY WA 992111971 ALVIN BARTHOLOMEW FINANCE DIRECTOR 3105087417 2021-11-08 1 ALVIN BARTHOLOMEW 999009999 EMILY MCCANN P01759947 5097351561 2021-11-08 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z TRACI RICHMOND PO BOX 11971 SPOKANE VALLEY WA 992111971 3445879 0 X SPOKANETEACHINGHEALTH.ORG X 2013 WA PROVIDE EDUCATION TO HEALTH CARE PROFESSIONALS THROUGH SPONSORSHIP OF GRADUATE MEDICAL EDUCATION. 9 6 0 9 0 0 3837985 3445879 245000 0 0 0 0 0 4082985 3445879 10000 10960 0 0 16748 372640 0 0 0 3543601 3214777 3570349 3598377 512636 -152498 3330185 2396912 1551065 755371 1779120 1641541 X THE ENTITY IS ORGANIZED AND OPERATED SPECIFICALLY TO PROMOTE, CONDUCT AND SPONSOR EDUCATIONAL ACTIVITIES RELATED TO GRADUATE MEDICAL EDUCATION, INCLUDING PHYSICIAN RESIDENCY PROGRAMS. 0 1 2740036 10960 0 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 2020 THE ORGANIZATION MAINTAINED ITS FINANCIAL OBLIGATIONS FOR THE FUNDING OF 18 TOTAL HRSA-FUND RESIDENTS, OF WHICH 6 COMPLETED THEIR TRAINING AND GRADUATED. 79547 0 0 GRADUATE MEDICAL EDUCATION (GME)--DEVELOPMENT OF NEW RESIDENCY PROGRAMS AT AREA HOSPITALS:CONTINUING DEVELOPMENT OF NEW FAMILY MEDICINE RESIDENCY PROGRAM AT HOLY FAMILY HOSPITAL (SPOKANE, WA). THIS EFFORT WAS TERMINATED IN 2020. 0 0 0 MEDICAID WAIVER TRANSFORMATION EFFORT:THE ORGANIZATION WILL PARTNER WITH ITS REGIONAL ACCOUNTABLE 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. 122916 0 0 GRADUATE MEDICAL EDUCATION--DEVELOPMENT OF A PEDIATRICS RESIDENCY:THE ORGANIZATION IS DEVELOPING A NEW PEDIATRICS RESIDENCY PROGRAM IN SPOKANE, WA. 122916 0 0 2942499 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 0 0 0 0 X ALVIN BARTHOLOMEW 3105087417 PO BOX 11971 SPOKANE VALLEY WA 992111971 DAVID E LUHN CHIEF FINANCIAL OFFICER 0.50 40.00 X 0 143883 46292 TRACI RICHMOND COUTURE EXECUTIVE DIRECTOR 0.50 40.00 X 0 141258 31052 THOMAS E SMITH DIRECTOR (CLASS A) 0.50 40.00 X 0 77559 12080 RICH HADLEY PRESIDENT (CLASS B) 0.50 0.00 X X 0 0 0 JEFFREY COLLINS MD VICE PRESIDENT (CLASS B) 0.50 0.00 X X 0 0 0 JEFFREY BELL SECRETARY (CLASS A) 0.50 0.00 X X 0 0 0 MICHAEL NOWLING TREASURER (CLASS A) 0.50 0.00 X X 0 0 0 DARYLL DEWALD PHD DIRECTOR (CLASS C) 0.50 0.00 X 0 0 0 LINDA GARRELTS MACLEAN DIRECTOR (CLASS C) 0.50 0.00 X 0 0 0 DEB HARPER MD DIRECTOR (CLASS A) 0.50 0.00 X 0 0 0 COURTNEY LAW DIRECTOR (CLASS A) - THRU 6/2020 0.50 0.00 X 0 0 0 DEAN MARTZ MD DIRECTOR (CLASS B) 0.50 0.00 X 0 0 0 0 362700 89424 0 0 1 0 CHRISTIAN ROCHOLL MD 4821 W HAYDEN LANE SPOKANE WA 99208 PROGRAM DIRECTOR (PEDIATRICS DEVELOPMENT 130000 1 245821 3174058 26000 3445879 3445879 0 0 0 10960 10960 372640 372640 27372 27372 32058 32058 308822 220942 87880 44864 44864 70111 56649 13462 12529 12529 280104 271221 8883 72810 58519 14291 5175 5175 19426 18305 1121 16286 16286 RESIDENCY PROGRAM 2029411 2029411 0 EQUIPMENT LEASE & MAINT 216471 209946 6525 DUES, LICENSES & MEMBER 54453 41661 12792 24885 24885 3598377 2942499 655878 0 2279511 1619300 1037782 765133 12115 4397 12119 4037 777 8082 3330185 2396912 762193 755371 788872 0 1551065 755371 X 1736178 1585938 42942 55603 1779120 1641541 3330185 2396912 X -152498 14919 X X 0 1 X 1 0 X 1717685 3208457 3731857 3837985 3445879 15941863 1717685 3208457 3731857 3837985 3445879 15941863 15941863 15941863 245000 1.00000 0.99830 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12119 4037 8082 8082 X 3445879 0 3445879 0 3445879 3583458 -14919 -14919 3598377 0 3598377 PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE CODE. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -14,919. 1 PROVIDENCE HEALTH & SERVICES WASHINGTON (DBA PROVIDENCE MEDICAL GROUP) 101 W 8TH AVENUE SPOKANE WA 99204 911303277 501(C)(3) 10000 0 N/A N/A SUPPORT TO RECRUIT AND RETAIN GME FACULTY 1 0 X 0 0 0 0 0 0 0 0 0 DAVID E LUHN CHIEF FINANCIAL OFFICER 0 136735 0 6700 0 448 0 8633 0 37659 0 190175 0 0 TRACI RICHMOND COUTURE EXECUTIVE DIRECTOR 0 137708 0 6300 0 -2750 0 8640 0 22412 0 172310 0 0 PART I, LINE 3 WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE IS USED BY A RELATED ORGANIZATION. FORM 990, PART III, LINE 3 DEVELOPMENT OF FAMILY MEDICINE RESIDENCY PROGRAM AT HOLY FAMILY HOSPITAL (SPOKANE WA) WAS CEASED. 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 FORM 990, PART XI, LINE 9: BAD DEBT 14,919. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. EMPIRE HEALTH FOUNDATION 422 W RIVERSIDE AVE STE 1100 SPOKANE WA 99201 263375286 PRIVATE FOUNDATION WA 501(C)(3) PF N/A 0 PROVIDENCE HEALTH & SERVICES 101 E 8TH AVE SPOKANE WA 99204 911303277 HOSPITAL WA 501(C)(3) LINE 3 N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0