2020-07-14T17:27:52-05:00 2019-12-31 910189318 MOSS ADAMS LLP PO BOX 22650 YAKIMA WA 989072650 990 2019-01-01 911022358 THE MEMORIAL FOUNDATION MEMO 5095765794 2701 TIETON DRIVE YAKIMA WA 98902 ERIN BLACK CHIEF EXECUTIVE OFFICER 5095765794 2020-07-14 1 EMINA O CRESSWELL CPA P01217304 5092487750 2020-07-14 73.59.64.75 2020-07-14 11:37:06 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 C6DE56114614F097EFEFA27A1F452A96C82E7D93 2019 2020-09-22 18:59:49Z ERIN BLACK 2701 TIETON DRIVE YAKIMA WA 98902 3346382 0 X WWW.MEMFOUND.ORG X 1978 WA ADVANCE AND TRANSFORM HEALTHCARE IN YAKIMA. 22 22 0 60 0 0 2784963 2792668 0 0 349851 451598 28014 -31414 3162828 3212852 2218241 2446403 0 0 522301 485444 0 0 207220 133579 265048 2874121 3196895 288707 15957 11794286 13061655 414548 447084 11379738 12614571 X ADVANCE AND TRANSFORM HEALTHCARE IN YAKIMA. 0 0 367320 367320 HOSPICE HOME HEALTH CARE - SUPPORTING HOSPICE/HOME HEALTH SERVICES INCLUDING END OF LIFE SERVICES TO PATIENTS AT HOME AND IN AN IN-PATIENT SETTING (INCLUDING PALLIATIVE CARE/TRANSITIONS). 236222 236222 NORTH STAR LODGE - SUPPORTING A FULL-SERVICE OUTPATIENT CANCER TREATMENT FACILITY. 189764 189764 CHILDREN'S VILLAGE - SUPPORTING SERVICES FOR CHILDREN WITH SPECIAL HEALTHCARE NEEDS. 1703443 1653097 SUPPORT NUMEROUS HEALTHCARE/HEALTHCARE RELATED PROGRAMS. 1703443 1653097 2496749 1 1 0 0 0 1 0 0 0 1 0 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 X 22 22 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X ANNE BEAUVAIS 5092495102 2701 TIETON DRIVE YAKIMA WA 98902 LEANNE ANTONIO TRUSTEE 1.00 X 0 0 0 WEST H CAMPBELL TRUSTEE 1.00 X 0 0 0 DOLORES DESSERAULT TRUSTEE 1.00 X 0 0 0 BILL DOLSEN TRUSTEE 1.00 X 0 0 0 DR DANIEL DOORNINK TRUSTEE 1.00 X 0 0 0 JENNIFER HUNTER TRUSTEE 1.00 X 0 0 0 CAROLINE SUNDQUIST TRUSTEE 1.00 X 0 0 0 DR JAMES HAVEN TRUSTEE 1.00 X 0 0 0 RICK LINNEWEH TRUSTEE 1.00 X 0 0 0 CAROL M LOUDON TRUSTEE 1.00 X 0 0 0 DR TIMOTHY MELHORN TRUSTEE 1.00 X 0 0 0 MICHAEL MOEN TRUSTEE 1.00 X 0 0 0 JOCELYN PEDROSA TRUSTEE 1.00 X 0 0 0 CHERYL SMITH TRUSTEE 1.00 X 0 0 0 DR ROBERT WILLIAMS TRUSTEE 1.00 X 0 0 0 MARIE HALVERSON EXECUTIVE COMMITTEE MEMBER 1.00 X 0 0 0 TOM STOKES EXECUTIVE COMMITTEE MEMBER 1.00 X 0 0 0 BILL WHEELER EXECUTIVE COMMITTEE MEMBER 1.00 X 0 0 0 ROBERT G PRICE BOARD CHAIRMAN 2.00 X X 0 0 0 DOUG ELLISON VICE CHAIRMAN 2.00 X X 0 0 0 B JEAN PRYOR SECRETARY/TREASURER 2.00 X X 0 0 0 BRUCE HEISER IMMEDIATE PAST CHAIRMAN 1.00 X X 0 0 0 ERIN BLACK CEO 40.00 X 142762 0 23972 142762 0 23972 1 0 1 1 0 324998 2467670 16957 2792668 398075 398075 146139 92616 53523 53523 53523 9500 324998 40914 -31414 -31414 3212852 0 0 420184 2431403 2431403 15000 15000 166734 166734 318710 41290 161451 115969 47349 47349 93385 15847 77538 14405 12928 1477 6195 6195 4570 107 4463 SUPPLIES 65239 53013 12226 DUES 24956 24946 10 NET ANNUITY 8949 8949 3196895 2496749 492926 207220 3049677 3113509 783978 386057 7960631 9562089 11794286 13061655 414548 447084 414548 447084 X 1981545 3259811 9398193 9354760 11379738 12614571 11794286 13061655 15957 1218875 0 X 0 1 X 1 0 X 1427546 4021050 4476264 2784963 2792668 15502491 1427546 4021050 4476264 2784963 2792668 15502491 3593202 11909289 78576 156472 256005 317469 398075 1206597 16709088 155297 0.71270 0.73950 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 810 13349 133108 1 1 611032 57867 1144 667755 633913 -21302 1579 611032 589212 46053 1352 633913 558895 31613 1296 589212 567685 -8479 311 558895 0.00000 0.46830 0.53170 0 0 0 DUE TO VMM 309761 DEFERRED LIABILITIES 68609 DUE TO EPIC 34357 DUE TO NURSING HOME 34357 447084 X 4472640 1218874 40913 1259787 3212853 0 3212853 3237808 40913 40913 3196895 0 3196895 PART V, LINE 4: THE INTENDED USE FOR THE ENDOWMENT FUNDS ARE CHILDREN'S HEALTHCARE NEEDS AND CANCER PATIENTS. PART X, LINE 2: THE FOUNDATION IS A TAX-EXEMPT ORGANIZATION QUALIFYING UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE FOUNDATION'S TAXEXEMPT PURPOSE WOULD BE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THE FOUNDATION DID NOT ENGAGE IN AN ACTIVITY UNRELATED TO ITS TAX-EXEMPT PURPOSE; ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. IN ACCORDANCE WITH REQUIREMENTS RELATED TO ACCOUNTING FOR UNCERTAINTIES IN INCOME TAXES, THE FOUNDATION HAS DETERMINED THEY HAVE NO UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2019 AND 2018. IN ADDITION, THE FOUNDATION QUALIFIED FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170((B)(1)(A)AND HAS BEEN CLASSIFIED AS OTHER THAN A PRIVATE FOUNDATION UNDER SECTION 509(A)(1). PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 40,913. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 40,913. PASSION FOR THE VILLAGE 334498 324998 9500 12424 24571 3919 334498 324998 9500 12424 24571 3919 40914 -31414 1 VIRGINIA MASON MEMORIAL 2811 TIETON DR YAKIMA WA 98902 910567263 501(C)(3) 2411403 TO PROVIDE SUPPORT TO THE VIRGINA MASON MEMORIAL IN THEIR PURSUIT OF HEALTH IMPROVEMENT, EDUCATION, AND IMPROVING OUR COMMUNITY. YAKIMA VALLEY SKILLS CENTER FOUNDATION 1120 S 18TH STREET YAKIMA WA 98901 943121966 501(C)(3) 20000 TO PROVIDE SUPPORT TO THE YAKIMA VALLEY TECHNICAL SKILLS CENTER 2 HEALTHCARE SCHOLARSHIPS 12 15000 PART I, LINE 2: GRANTS (ALLOCATIONS) APPLICATIONS ARE SUBMITTED TO THE FOUNDATION ANNUALLY AND ARE REVIEWED BY THE MEMORIAL FOUNDATION ALLOCATION COMMITTEE, A SUB-COMMITTEE OF THE MEMORIAL FOUNDATION BOARD OF TRUSTEES. THE ROLE OF THE MEMORIAL FOUNDATION ALLOCATION COMMITTEE IS TO: ANNUALLY REVIEW GRANT APPLICATIONS FROM VIRGINIA MASON MEMORIAL PROGRAMS FOR FOUNDATION FUNDING FOR THE NEXT CALENDAR YEAR; RECOMMEND ALLOCATION FUNDING TO THE FOUNDATION EXECUTIVE COMMITTEE FOR THEIR REVIEW AND FOR APPROVAL BY THE MEMORIAL FOUNDATION BOARD OF TRUSTEES. THE CEO REVIEWS BUDGETS AND PROFIT/LOSS STATEMENTS OF THE PROGRAMS RECEIVING ALLOCATION AWARDS ON, AT LEAST, AN ANNUAL BASIS. THE COMMITTEE ALSO ENSURES THAT THE FUNDS ARE ONLY USED IN THE UNITED STATES OF AMERICA. X X X 0 0 0 0 0 0 0 0 0 ERIN BLACK CEO 142762 0 0 0 0 0 913 0 23059 0 166734 0 0 0 PART I, LINE 3 VIRGINIA MASON MEMORIAL DETERMINES COMPENSATION THROUGH COMPENSATION COMMITTEES, SURVEYS, AND APPROVAL BY THE BOARD AND COMPENSATION COMMITTEE. A PORTION OF CERTAIN MEMORIAL FOUNDATION EMPLOYEE SALARIES, INCLUDING THE CEO, ARE PAID VIA A CONTRIBUTION SPECIFICALLY ASSIGNED FOR SAID SALARIES. FORM 990, PART VI, SECTION B, LINE 11B THE REVIEW AND APPROVAL OF THE FORM 990 IS DELEGATED TO THE EXECUTIVE COMMITTEE OF THE BOARD. THE FORM 990 IS THEN SUBMITTED TO THE FULL VOTING BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES TO SIGN NEW CONFLICT OF INTEREST STATEMENTS. THE BODY OF THE STATEMENT STATES THAT THE DISCLOSURE IS MADE BECAUSE THE SAID FOUNDATION HAS, OR MIGHT REASONABLY BE EXPECTED IN THE FUTURE TO HAVE A RELATIONSHIP, TRANSACTION OR BUSINESS DEALING WITH THE SAID ORGANIZATION WHICH MIGHT IN SOME WAY CONSTITUTE A CONFLICT OF INTEREST WITH RESPECT TO THE UNDERSIGNED BECAUSE OF HIS/HER MEMBERSHIP ON THE BOARD OF TRUSTEES AND HIS/HER ASSOCIATION WITH THE ABOVE-LISTED BUSINESS OR ORGANIZATION. THE UNDERSIGNED AGREES THAT, IF AT ANY TIME ANY MATTER SHOULD COME BEFORE THE BOARD OF TRUSTEES CONCERNING THE ABOVE-LISTED ORGANIZATION OR BUSINESS, THE UNDERSIGNED SHALL MAKE KNOWN THE POTENTIAL CONFLICT AND WITHDRAW FROM THE MEETING SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION AND SHALL NOT EITHER VOTE ON THE MATTER UNDER DISCUSSION OR ATTEMPT TO INFLUENCE A DECISION OF THE BOARD OF TRUSTEES WITH RESPECT TO SUCH MATTERS. THE UNDERSIGNED FURTHER AGREES THAT, IN THE EVENT HIS/HER RELATIONSHIP WITH THE ABOVE-LISTED BUSINESS OR ORGANIZATION SHOULD CHANGE, OR SHOULD OTHER RELATIONSHIPS WITH OTHER BUSINESSES OR ORGANIZATIONS BE ESTABLISHED WHICH WOULD GIVE RISE TO A POTENTIAL CONFLICT OF INTEREST, HE/SHE SHALL INFORM THE BOARD OF TRUSTEES AND WITHDRAW FROM PARTICIPATION IN ANY DECISIONS AFFECTING SUCH BUSINESS OR ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 SALARIES FOR TOP MANAGEMENT ARE DETERMINED AND REVIEWED BY VIRGINIA MASON MEMORIAL'S BOARD OF DIRECTORS AND COMPENSATION COMMITTEE. THE FOUNDATION DOES NOT PAY WAGES, IT REIMBURSES THE HOSPITAL FOR APPLICABLE EMPLOYEE COSTS. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE UPON REQUEST DURING BUSINESS HOURS, MONDAY THROUGH FRIDAY, 8:00 AM - 5:00 PM. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST DURING BUSINESS HOURS, MONDAY THROUGH FRIDAY, 8:00 AM - 5:00 PM.