MOUNTAINS COMMUNITY HOSPITAL FOUNDATION: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- MOUNTAINS COMMUNITY HOSPITAL FOUNDATION (EIN 33-0530904)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-11
- IRS object ID
- 202133159349300708
- Schema version
- 2020v4.1
- 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 | 2021-11-11T06:26:34-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8010 | AddressLine1Txt |
| City | WAUSAU | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 544028010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330530904 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOUNTAINS COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MOUN | BusinessNameControlTxt |
| Phone | 9093363651 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 70 | AddressLine1Txt |
| City | LAKE ARROWHEAD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 923520070 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | YVONNE WAGGENER | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 9093363651 | PhoneNum |
| Signature | 2021-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | YVONNE | PersonFirstNm |
| Person Last | WAGGENER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARY A COATES CPA | PreparerPersonNm |
| PTIN | P00134220 | PTIN |
| Phone | 7158453111 | PhoneNum |
| Preparation | 2021-11-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | YVONNE WAGGENER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 70 | AddressLine1Txt |
| City | LAKE ARROWHEAD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 923520070 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $624,924 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MCHCARES.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | MOUNTAINS COMMUNITY HOSPITAL FOUNDATION'S MISSION IS TO SECURE HEALTH CARE FOR THE MOUNTAINS COMMUNITY BY PROVIDING CONSISTENT FINANCIAL SUPPORT TO THE SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 26 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 21 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 74 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,031,401 | PYContributionsGrantsAmt |
| CY Contributions Grants | $611,280 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $26,458 | PYInvestmentIncomeAmt |
| CY Investment Income | $13,644 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,057,859 | PYTotalRevenueAmt |
| CY Total Revenue | $624,924 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $71,336 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $218,278 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $3,002 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $112,936 | PYOtherExpensesAmt |
| CY Other Expenses | $98,247 | CYOtherExpensesAmt |
| PY Total Expenses | $184,272 | PYTotalExpensesAmt |
| CY Total Expenses | $316,525 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $873,587 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $308,399 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,937,402 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,216,432 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $78,493 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $33,582 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,858,909 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,182,850 | NetAssetsOrFundBalancesEOYAmt |
| Mission | MOUNTAINS COMMUNITY HOSPITAL FOUNDATION'S MISSION IS TO SECURE HEALTH CARE FOR THE MOUNTAINS COMMUNITY BY PROVIDING CONSISTENT FINANCIAL SUPPORT TO THE SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $218,278 | ExpenseAmt |
| Grant | $218,278 | GrantAmt |
| Desc | CONTRIBUTIONS TO SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT FOR CAPITAL PURPOSES. | Desc |
| Total Program Service Expenses | $218,278 | 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 | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | 0 | 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 |
| 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 26 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 21 | 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 | Yes (1) | 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 | 0 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YVONNE WAGGENER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9093363651 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 70 | AddressLine1Txt |
| City | LAKE ARROWHEAD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 923520070 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| YVONNE WAGGENER | ||||||
| TREASURER | 0.10 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KIM MCGUIRE | ||||||
| SECRETARY | 0.10 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CHARLES HARRISON | ||||||
| HOSPITAL CEO, BOARD MEMBER | 0.10 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LAWRENCE WELKER MD | ||||||
| HOSPITAL CHIEF OF STAFF, B | 0.10 | Yes (X) | $0 | $0 | $0 | |
| TOM BACHMAN | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| DENNIS BROWN | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| KIETH BURKART | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| KEN CAMARELLA | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| STEVE CERECEDES | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| PAT DAVIS | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| BARBARA DOUTT | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| BILL JOHNSON | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| BOB MALONE | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| HOWARD MILLER | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| GRANIA MURRAY | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| MIDGE REISMAN | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| BARRY ROBINSON | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| PETER VENTURINI | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| RONALYN WALKER | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| ANDREA WILLERTH | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| GLORIA WOLEN | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| BOB BEEMAN | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| CECILIA PONCE DE LEON | ||||||
| MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| GEORGE MEDAK | ||||||
| PRESIDENT | 0.10 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| NEALE PERKINS | ||||||
| VICE PRESIDENT | 0.10 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ROB ROY | ||||||
| VICE PRESIDENT | 0.10 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $611,280 | AllOtherContributionsAmt |
| Total Contributions | $611,280 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,644 | TotalRevenueColumnAmt |
| Exclusion | $13,644 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $624,924 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $13,644 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $218,278 | TotalAmt |
| Program Services | $218,278 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,433 | TotalAmt |
| Management And General | $14,433 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,650 | TotalAmt |
| Management And General | $19,650 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220 | TotalAmt |
| Management And General | $220 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,182 | TotalAmt |
| Fundraising | $2,182 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,906 | TotalAmt |
| Management And General | $6,906 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119 | TotalAmt |
| Management And General | $119 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|
| JOHN GOOD PROPERTY | $35,056 | $35,056 |
| OTHER EXPENSE | $16,314 | $16,314 |
| CREDIT CARD FEES | $1,472 | $1,472 |
| POSTAGE | $1,075 | $1,075 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $820 | TotalAmt |
| Fundraising | $820 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,525 | TotalAmt |
| Program Services | $218,278 | ProgramServicesAmt |
| Management And General | $95,245 | ManagementAndGeneralAmt |
| Fundraising | $3,002 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,959 | BOYAmt |
| EOY | $55,784 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $530,239 | BOYAmt |
| EOY | $408,781 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $583,102 | BOYAmt |
| EOY | $1,009,859 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $786,102 | BOYAmt |
| EOY | $742,008 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,937,402 | BOYAmt |
| EOY | $2,216,432 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,666 | BOYAmt |
| EOY | $500 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,827 | BOYAmt |
| EOY | $33,082 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,493 | BOYAmt |
| EOY | $33,582 | 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 | $592,676 | BOYAmt |
| EOY | $745,242 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,266,233 | BOYAmt |
| EOY | $1,437,608 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,858,909 | BOYAmt |
| EOY | $2,182,850 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,937,402 | BOYAmt |
| EOY | $2,216,432 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $308,399 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $15,542 | NetUnrlzdGainsLossesInvstAmt |
| 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 | $415,622 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $718,729 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $719,565 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,031,401 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $611,280 | CurrentTaxYearAmt |
| Total | $3,496,597 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $108,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $132,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $132,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $67,650 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $90,600 | CurrentTaxYearAmt |
| Total | $530,250 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $523,622 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $850,729 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $851,565 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,099,051 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $701,880 | CurrentTaxYearAmt |
| Total | $4,026,847 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $1,605,645 | SubstantialContributorsTotAmt |
| Public Support Total170 | $2,421,202 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $20,353 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,506 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20,465 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,375 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,644 | CurrentTaxYearAmt |
| Total | $83,343 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,110,190 | TotalSupportAmt |
| Public Support CY170 | 0.58910 | PublicSupportCY170Pct |
| Public Support PY170 | 0.49780 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ASSETS HELD UNDER CHARITABLE REMAINDER TRUST | $146,073 |
| PREPAID EXPENSES | $950 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $147,023 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ANNUITY OBLIGATION UNDER CHARITABLE REMAINDER TRUST | Desc |
| Amt | $33,082 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $33,082 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $730,846 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $15,542 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $90,600 | OtherRevenueAmt |
| Revenue Not Reported | $106,142 | RevenueNotReportedAmt |
| Revenue Subtotal | $624,704 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $220 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $220 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $624,924 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $406,905 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $90,600 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $90,600 | ExpensesNotReportedAmt |
| Expenses Subtotal | $316,305 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $220 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $220 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $316,525 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | IN-KIND CONTRIBUTIONS |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | IN KIND CONTRIBUTIONS |
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 | SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 29101 HOSPITAL ROAD | AddressLine1Txt |
| City | LAKE ARROWHEAD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92352 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 262201665 | RecipientEIN |
| IRC Section | GOVERNMENTAL | IRCSectionDesc |
| Cash Grant | $218,278 | CashGrantAmt |
| Purpose Of Grant | TO PROVIDE FUNDING TO THE SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FUNDING IS PROVIDED TO MOUNTAINS COMMUNITY HOSPITAL. MONITORING IS DONE BY THE FOUNDATION'S BOARD. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 IS MADE AVAILABLE TO THE GOVERNING BODY FOR THEIR REVIEW PRIOR TO FILING THE FINAL FORM 990 |
| FORM 990, PART VI, SECTION B, LINE 12C | A CONFLICT OF INTEREST STATEMENT IS REVIEWED AND SIGNED BY ALL BOARD MEMBERS WHEN THEY ARE FIRST AFFILIATED WITH THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | NO EMPLOYEES WERE COMPENSATED BY THE FOUNDATION, THEREFORE THIS PROCESS IS NOT APPLICABLE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, ETC. AVAILABLE TO THE PUBLIC UPON REQUEST. |
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