PTSO OF WASHINGTON: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
PTSO OF WASHINGTON (EIN 20-1082052)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-05-10
IRS object ID
202141309349302914
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

FieldValueIRS element (for citing)
Return2021-05-10T16:25:01-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN930743240PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1HOFFMAN STEWART & SCHMIDT PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13 CENTERPOINTE DRIVE SUITE 300AddressLine1Txt
CityLAKE OSWEGOCityNm
State AbbreviationORStateAbbreviationCd
ZIP970358663ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN201082052EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PTSO OF WASHINGTONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPTSOBusinessNameControlTxt
Phone5039432500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11881 SW NAITO PARKWAYAddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97201ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSEAN WHITELEY-ROSSPersonNm
Person TitleCFOPersonTitleTxt
Phone5039432500PhoneNum
Signature2021-05-06SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSEANPersonFirstNm
Person LastWHITELEY-ROSSPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonROBERT M PRILLPreparerPersonNm
PTINP00236613PTIN
Phone5032205900PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSEAN WHITELEY-ROSSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11881 SW NAITO PARKWAYAddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97201ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,134,060GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PTSOWA.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionPTSO OF WASHINGTON WAS ESTABLISHED TO IMPROVE ACCESS AND THE LEVEL AND QUALITY OF HEALTHCARE FOR THE MEDICALLY UNDERSERVED THROUGH THE IMPROVEMENTS OF INFORMATION TECHNOLOGY SERVICES AVAILABLE TO COMMUNITY HEALTH CENTERS AND OTHER SAFETY NET PROVIDERS.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee8TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$476,456PYContributionsGrantsAmt
CY Contributions Grants$154,521CYContributionsGrantsAmt
PY Program Service Revenue$4,891,837PYProgramServiceRevenueAmt
CY Program Service Revenue$1,826,657CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income-$679,174CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$79,034CYOtherRevenueAmt
PY Total Revenue$5,368,293PYTotalRevenueAmt
CY Total Revenue$1,381,038CYTotalRevenueAmt
PY Grants And Similar Paid$5,042,160PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,825,577CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$819,478PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$471,574CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses-$3,323,657PYOtherExpensesAmt
CY Other Expenses-$818,336CYOtherExpensesAmt
PY Total Expenses$2,537,981PYTotalExpensesAmt
CY Total Expenses$1,478,815CYTotalExpensesAmt
PY Revenues Less Expenses$2,830,312PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$97,777CYRevenuesLessExpensesAmt
Total Assets BOY$10,118,366TotalAssetsBOYAmt
Total Assets EOY$9,915,610TotalAssetsEOYAmt
Total Liabilities BOY$178,534TotalLiabilitiesBOYAmt
Total Liabilities EOY$73,555TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,939,832NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$9,842,055NetAssetsOrFundBalancesEOYAmt
MissionPTSO OF WASHINGTON WAS ESTABLISHED TO IMPROVE ACCESS AND THE LEVEL AND QUALITY OF HEALTHCARE FOR THE MEDICALLY UNDERSERVED THROUGH THE IMPROVEMENT OF INFORMATION TECHNOLOGY SERVICES AVAILABLE TO COMMUNITY HEALTH CENTERS AND OTHER SAFETY NET PROVIDERS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,037,619ExpenseAmt
Grant$1,825,577GrantAmt
Revenue$1,905,691RevenueAmt
DescCUSTOMIZED AND UPGRADED NEXTGEN EHR, EPM AND EDR APPLICATIONS TO MEET THE UNIQUE NEEDS OF OUR FQHC CUSTOMERS AND HELP THEM REALIZE AIU FUNDS. PREPARED FOR MEANINGFUL USE (MU STAGE 1)THROUGH MULTIPLE SYSTEM UPGRADES AND COMMENCED WORK ON MU STAGE 2. CONTINUED FORUMS FOR BEST PRACTICES AND LESSONS LEARNED.HRSA HEALTH CENTER CONTROLLED NETWORKS - HCCN GRANT - PTSO, E NET, HCHN NETWORKS PROVIDING BEST PRACTICES, OPTIMIZATION AND TRAINING AROUND PATIENT CENTERED MEDICAL HOME, MEANINGFUL USE AND EHR IMPLEMENTATION AND ADOPTION.Desc
Total Program Service Expenses$1,037,619TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document12IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee8EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SEAN WHITELEY-ROSS CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5039432500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11881 SW NAITO PARKWAYAddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97201ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
JESUS HERNANDEZ
BOARD MEMBER1.00Yes (X)$0$0$0
JANINE CHILDS
BOARD MEMBER1.00Yes (X)$0$0$0
THOMAS TROMPETER
BOARD MEMBER1.00Yes (X)$0$0$0
ABBY SEARS
BOARD MEMBER1.00Yes (X)$0$590,423$34,522
SEAN WHITELEY-ROSS
BOARD MEMBER1.00Yes (X)$0$408,647$44,490
JAMES MALDONADO
BOARD MEMBER1.00Yes (X)$0$326,334$25,175
ANITA MONOIAN
CHAIR1.00Yes (X)$0$0$0Yes (X)
LINDA MCVEIGH
TREASURER1.00Yes (X)$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,325,404TotReportableCompRltdOrgAmt
Total Other Compensation$104,187TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$154,521GovernmentGrantsAmt
Total Contributions$154,521TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescSERVICE FEE REVENUEDesc
Business518210BusinessCd
Total Revenue Column$1,826,657TotalRevenueColumnAmt
Related Or Exempt Func Income$1,826,657RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,826,657TotalProgramServiceRevenueAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$73,848OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$753,022OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$679,174OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$679,174TotalRevenueColumnAmt
Exclusion-$679,174ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Business518210BusinessCd
Total Revenue Column$79,034TotalRevenueColumnAmt
Related Or Exempt Func Income$79,034RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$79,034OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,381,038TotalRevenueColumnAmt
Related Or Exempt Func Income$1,905,691RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$679,174ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,825,577TotalAmt
Program Services$1,825,577ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$351,798TotalAmt
Program Services$348,548ProgramServicesAmt
Management And General$3,250ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$37,335TotalAmt
Program Services$37,237ProgramServicesAmt
Management And General$98ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$52,337TotalAmt
Program Services$40,437ProgramServicesAmt
Management And General$11,900ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$30,104TotalAmt
Program Services$29,267ProgramServicesAmt
Management And General$837ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$9,988TotalAmt
Management And General$9,988ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$964TotalAmt
Program Services$964ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$518,987TotalAmt
Program Services$452,374ProgramServicesAmt
Management And General$66,613ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$155,747TotalAmt
Program Services$8,904ProgramServicesAmt
Management And General$146,843ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,760TotalAmt
Program Services$3,760ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$19TotalAmt
Program Services$19ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$110,379TotalAmt
Program Services$80,205ProgramServicesAmt
Management And General$30,174ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$190TotalAmt
Management And General$190ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MISCELLANEOUS$138,516$35,904$102,612
TAXES, PERMITS, LICENSE$68,691$68,691
GRANTS TO SUPPORTING OR-$1,825,577-$1,825,577

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,478,815TotalAmt
Program Services$1,037,619ProgramServicesAmt
Management And General$441,196ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$231,268BOYAmt
EOY$5,907EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$516,286BOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$118,014BOYAmt
EOY$22,851EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$584,571BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$8,668,227BOYAmt
EOY$9,886,852EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,118,366BOYAmt
EOY$9,915,610EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$75,353BOYAmt
EOY$18,708EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$103,181BOYAmt
EOY$54,847EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$178,534BOYAmt
EOY$73,555EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,939,832BOYAmt
EOY$9,842,055EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,939,832BOYAmt
EOY$9,842,055EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,118,366BOYAmt
EOY$9,915,610EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$97,777ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type3 Func IntYes (X)SupportingOrgType3FuncIntInd
Supported Organizations5SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (5 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
COUNTRY DOCTOR COMMUNITY CLINIC
2371008687Yes (1)$20,063$0
FAMILY HEALTH CENTERS IN OKANOGAN
9112750117Yes (1)$35,018$0
HEALTHPOINT
91088441210Yes (1)$653,692$0
YAKIMA NEIGHBORHOOD HEALTH SERVICES
91092881710Yes (1)$140,760$0
NEIGHBORCARE HEALTH
9108932877Yes (1)$976,044$0
FieldValueIRS element (for citing)
Supported Organizations Total5SupportedOrganizationsTotalCnt
Support Sum$1,825,577SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

FieldValueIRS element (for citing)
Timely Provided DocumentsYes (1)TimelyProvidedDocumentsInd
Officers Close RelationshipYes (1)OfficersCloseRelationshipInd
Supported Org Voice InvestmentYes (1)SupportedOrgVoiceInvestmentInd

Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp

FieldValueIRS element (for citing)
Activities TestYes (X)ActivitiesTestInd
Activities Further Exempt PrpsYes (1)ActivitiesFurtherExemptPrpsInd
Activities Engaged Org InvlmntYes (1)ActivitiesEngagedOrgInvlmntInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, SECTION A, LINE 1SUPPORTING ORGANIZATIONS ARE NOTIFIED AT BOARD MEETINGS AS THEY REVIEW THE 990 AND UPDATE GOVERNING DOCUMENTS.
PART IV, SECTION D, LINE 3THE MANAGEMENT OF ALL AFFAIRS OF THE PTSO ARE VESTED IN THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS COMPRISED OF BOARD MEMBERS ELECTED BY OCHIN, INC. AND THE SUPPORTED ORGANIZATIONS.
PART IV, SECTION E, LINE 2APTSO IS ORGANIZED TO IMPROVE ACCESS AND THE LEVEL AND QUALITY OF HEALTH CARE FOR THE MEDICALLY UNDERSERVED THROUGH THE IMPROVEMENT OF INFORMATION TECHNOLOGY SERVICES AVAILABLE TO COMMUNITY HEALTH CENTERS. DURING THE YEAR, PTSO HAD 5 MEMBERS. SEE SCHEDULE I FOR DETAILS ON GRANT RECIPIENTS AND INTENDED USE OF GRANTS.
PART IV, SECTION E, LINE 2BPTSO IS ORGANIZED TO SECURE AND MANAGE INFORMATION SYSTEMS WHICH ARE A NECESSARY AND INTEGRAL PART OF THE DELIVERY OF HEALTH CARE. WITHOUT PTSO'S INVOLVEMENT, EACH MEMBER WOULD BE RESPONSIBLE WITH THE PURCHASE, MAINTENANCE AND IMPLEMENTATION OF THEIR OWN INFORMATION SYSTEMS.

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM OCHINDesc
Book Value$9,886,852BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$9,886,852TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
WAGES PAYABLE$34,312
DEFERRED LEASE$20,535
FieldValueIRS element (for citing)
Total Liability$54,847TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationMANAGEMENT BELIEVES THAT PTSO OF WASHINGTON DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceDescPurpose Of GrantPurposeOfGrantTxt
HEALTHPOINT
955 POWELL AVE SE SUITE ARENTONWA98057910884412501 C (3)$653,692VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT.SUPPORTIVE ASSISTANCE
NEIGHBORCARE HEALTH
905 SPRUCE STREET SUITE 300SEATTLEWA98104910893287501 C (3)$976,044VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT.SUPPORTIVE ASSISTANCE
YAKIMA NEIGHBORHOOD HEALTH SERVICES
PO BOX 2605YAKIMAWA98907910928817501 C (3)$140,760VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT.SUPPORTIVE ASSISTANCE
COUNTRY DOCTOR COMMUNITY CLINIC
500 19TH AVE EASTSEATTLEWA98112237100868501 C (3)$20,063VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT.SUPPORTIVE ASSISTANCE
FAMILY HEALTH CENTERS IN OKANOGAN
PO BOX 1340OKANOGANWA98840911275011501 C (3)$35,018VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT.SUPPORTIVE ASSISTANCE
FieldValueIRS element (for citing)
Total501c3 Org5Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATIONS RECEIVING ASSISTANCE ARE CLASS B MEMBERS AS IDENTIFIED IN PTSO'S GOVERNING DOCUMENTS. AS A SUPPORTING ORGANIZATION, PTSO MONITORS ITS SUPPORT TO ITS SUPPORTED ORGANIZATIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ABBY SEARS
BOARD MEMBER$0$499,393$0$82,030$0$9,000$0$20,476$0$14,046$0$624,945$0$0
SEAN WHITELEY-ROSS
BOARD MEMBER$0$344,063$0$64,584$0$0$0$21,095$0$23,395$0$453,137$0$0
JAMES MALDONADO
BOARD MEMBER$0$285,787$0$40,547$0$0$0$11,129$0$14,046$0$351,509$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2PTSO'S BOARD CONSISTS OF REPRESENTATIVES OF ITS MEMBERS. AS SUCH BOARD MEMBERS MAY HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER.
FORM 990, PART VI, SECTION A, LINE 6THE MEMBERSHIP OF PTSO CONSISTS OF TWO CLASSES OF MEMBERS. THE CLASS A MEMBER IS OCHIN, INC. CLASS B MEMBERS ARE COMMUNITY HEALTH CENTERS AND CURRENTLY CONSIST OF THE SUPPORTED ORGANIZATIONS REPORTED ON SCHEDULE A.
FORM 990, PART VI, SECTION A, LINE 7AFOR THE NEXT THREE YEARS, EACH CLASS MEMBER B MAY APPOINT ONE DIRECTOR AND THE CLASS MEMBER A MAY APPOINT AT LEAST SIX DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AND THEN PROVIDED TO THE FULL BOARD PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CIN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND/OR MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. ALL AFFECTED PERSONS SHALL COMPLETE THE ANNUAL AFFIRMATION AND DISCLOSURE STATEMENT ON AN ANNUAL BASIS AND SUBMIT SUCH COMPLETED ANNUAL DISCLOSURE STATEMENTS TO THE SECRETARY OF THE BOARD OF DIRECTORS. THE SECRETARY SHALL BE RESPONSIBLE FOR FILING ALL COPIES OF THE ANNUAL AFFIRMATION AND DISCLOSURE STATEMENTS WITH THE OFFICIAL CORPORATE RECORDS OF THE ORGANIZATION AND SHALL BRING ANY POTENTIAL CONFLICTS OF INTEREST DISCLOSED IN THE ANNUAL AFFIRMATION AND DISCLOSURE STATEMENTS TO THE ATTENTION OF THE BOARD OF DIRECTORS AT THE NEXT MEETING OF THE BOARD DIRECTORS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING/ORGANIZING DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2CTHE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1OCHIN INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11881 SW NAITO PARKWAYAddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97201ZIPCd
FieldValueIRS element (for citing)
EIN200195556EIN
Primary ActivitiesSUPPORT AND IMPROVE INFORMATION TECHNOLOGY FOR COMMUNITY HEALTH CLINICSPrimaryActivitiesTxt
Legal Domicile StateORLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 7PublicCharityStatusTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
OCHIN INC
R$1,218,625FAIR MARKET VALUE
OCHIN INC
O$471,574ACTUAL AMOUNT

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