2020-10-26T08:09:36-05:00 2019-12-31 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2019-01-01 930854433 MID-COLUMBIA HEALTH FOUNDATION MID- 5412967275 PO BOX 1580 THE DALLES OR 97058 KRISTI TIMMONS CHAIR 5412967275 2020-10-12 1 TERRI REXRODE CPA MST P00096513 9206620016 2020-10-08 184.100.239.163 2020-10-12 11:30:25 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 7D2FE2EA17AC540A2D29D4112E82844D375299C1 2019 2021-01-29 14:40:06Z CELESTE HILL-THOMAS PO BOX 1580 THE DALLES OR 97058 2081785 0 X WWW.MCMC.NET/FOUNDATION X 1983 OR WORK TOGETHER WITH AND PROVIDE FINANCIAL SUPPORT TO MID-COLUMBIA MEDICAL CENTER IN ORDER TO PROVIDE ACCESS TO QUALITY HEALTHCARE FOR OUR COMMUNITY. 14 10 0 114 0 0 1470080 1170484 42742 57669 95143 756481 12274 61312 1620239 2045946 478676 359277 0 0 413096 430319 0 0 0 221887 208104 1113659 997700 506580 1048246 5750027 6741109 250223 212317 5499804 6528792 WORK TOGETHER WITH AND PROVIDE FINANCIAL SUPPORT TO MID-COLUMBIA MEDICAL CENTER IN ORDER TO PROVIDE ACCESS TO QUALITY HEALTHCARE FOR OUR COMMUNITY. 0 0 402876 359277 2045946 THE PRIMARY PURPOSE OF THE FOUNDATION IS TO PROVIDE FUNDRAISING FOR THE MID-COLUMBIA MEDICAL CENTER (ID# 93-0386936) AS WELL AS GRANTS/SCHOLARSHIPS TO THE GENERAL PUBLIC. 402876 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 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 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 14 10 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X X WENDY APLAND 5415065928 323 E 2ND ST THE DALLES OR 97058 DENNIS KNOX DIRECTOR 1.00 40.00 X 0 635212 29891 ERIC HOLEMAN VICE CHAIR 1.00 40.00 X X 0 169376 30924 CELESTE HILL-THOMAS EXECUTIVE DIRECTOR 40.00 X 0 121989 23588 AMY SUGG SECRETARY 1.00 X X 0 80632 23885 KRISTI TIMMONS CHAIR 1.00 X X 0 0 0 DR FRANK TODA TREASURER 1.00 X X 0 0 0 DR PAULA LEE-VALKOV DIRECTOR 1.00 40.00 X 0 0 0 ROB CARNAHAN DIRECTOR 1.00 X 0 0 0 JASON COREY DIRECTOR 1.00 X 0 0 0 ROBERT BAILEY DIRECTOR 1.00 X 0 0 0 PAT ASHMORE DIRECTOR 1.00 X 0 0 0 MARILYN NIELSEN DIRECTOR 1.00 X 0 0 0 DEAN DOLLARHIDE DIRECTOR 1.00 X 0 0 0 LORI ROSEBRAUGH DIRECTOR 1.00 X 0 0 0 KARA SIMPSON DIRECTOR 1.00 X 0 0 0 0 1007209 108288 0 0 1 0 0 4186 614974 551324 1170484 COFFEE CART FUND 722210 57669 57669 57669 756481 756481 97151 4186 35839 61312 61312 2045946 0 0 875462 236172 236172 123105 123105 145577 145577 224401 30869 193532 10789 1232 9557 23679 20 23659 25873 2058 23815 1245 1245 16252 16252 98141 98141 16899 16899 24598 2823 21775 26114 26114 15121 15121 828 334 494 205 205 565 565 REPAIRS AND MAINTENANCE 4511 4511 SUPPLIES 1873 1873 DUES AND SUBSCRIPTIONS 275 275 1477 1477 997700 402876 594824 0 459692 570915 1864789 1669131 271097 260348 1484 3911 39581 38231 1350 1350 3151615 3414789 0 820665 5750027 6741109 21172 16797 229051 195520 250223 212317 X 2702158 3421120 2797646 3107672 5499804 6528792 5750027 6741109 X 1048246 -19258 X X 0 1 X 1 0 X 528364 717716 517245 1470080 1170484 4403889 528364 717716 517245 1470080 1170484 4403889 2377325 2026564 61065 68889 75018 91712 756481 1053165 5457054 660281 0.37140 0.60110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2044538 52326 59362 20250 2135976 1644624 403368 10096 13550 2044538 1387747 209917 60960 14000 1644624 1429254 102815 51758 196080 1387747 1389999 11182 51092 23019 1429254 0.74110 0.18270 0.07620 0 0 39581 38231 1350 1350 DUE FROM RELATED PARTIES 820665 820665 CRUT LIABILITY 183336 OTHER LIABILITIES 12184 195520 X 888530 0 888530 1157416 1157416 2045946 1033539 35839 35839 997700 0 997700 PART V, LINE 4: THE FOUNDATION'S ENDOWMENT FUND IS A QUASI-ENDOWMENT THAT FUNDS THE MID-COLUMBIA HEALTH FOUNDATION OPERATING EXPENSES - ENDING BALANCE $1,582,880 THE REMAINING ENDOWMENT FUNDS SUPPORT SEVERAL SCHOLARSHIPS AND OTHER FUNDS EXPLAINED BELOW: TEMPORARY AND PERMANENTLY RESTRICTED FUNDS: -EVELYN KASER SCHOLARSHIP FUND: TO ASSIST INDIVIDUALS WHO ASPIRE TO BECOME REGISTERED NURSES AND INTEND TO PRACTICE THEIR PROFESSION IN THE MID-COLUMBIA REGION. -LORNA & JOSEPH HALLIDAY FAMILY NURSING SCHOLARSHIP FUND: TO ASSIST INDIVIDUALS ASPIRING TO BECOME REGISTERED NURSES WHO GREW UP IN THE MID-COLUMBIA REGION. -MCMC BOARD OF TRUSTEES MEDICAL PROFESSIONALS SCHOLARSHIP: TO HELP DEFRAY SOME COLLEGE EXPENSES FOR GRADUATING SENIORS FROM THE DALLES HIGH SCHOOL. -MASONS LODGE SCHOLARSHIP FUND: TO ASSIST INDIVIDUALS FROM THE LOCAL COMMUNITIES OF SHERMAN, DUFUR, AND THE DALLES HIGH SCHOOLS TO ATTEND COLLEGE. -PERMANENT SCHOLARSHIP FUND: EARNS INTEREST THAT IS ANNUALLY TRANSFERRED TO THE MID-COLUMBIA MEDICAL CENTER SCHOLARSHIP FUND. PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSISTIONS, THE MEDICAL CENTER DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSISTION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE -35,839. RESTRICTED CONTRIBUTIONS 499,132. RESTRICTED INVESTMENT INCOME 79,149. CONTRIBUTIONS FROM MCMC 614,974. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 35,839. FESTIVAL OF TREES 52881 3090 49791 4490 3549 550 5894 GOLF 37675 946 36729 650 5302 150 9292 2 4520 150 4370 1618 25 75 4245 95076 4186 90890 6758 8876 775 19431 35840 55050 1 THE NEXT DOOR INC 1113 KELLY AVE THE DALLES OR 97058 930600421 501(C)(3) 5000 AREA OF GREATEST NEED GRANT WHITE SALMON VALLEY EDUCATION PO BOX 2231 WHITE SALMON WA 98672 760817766 501(C)(3) 4950 AREA OF GREATEST NEED GRANT YOUTH EMPOWERMENT SHELTER 514 E 9TH ST THE DALLES OR 97058 464777480 501(C)(3) 10000 WOMENS GIVING CIRCLE DONATIONS 3 0 WASCO LODGE MASONIC SCHOLARSHIP 2 4000 RANDY ROOD MEMORIAL SCHOLARSHIP 40 97499 MCMC EMPLOYEE SCHOLARSHIP 3 2990 MCMC EMPLOYEE DEPENDENT SCHOLARSHIP 10 6866 NON-TRADITIONAL NURSING STUDENT SCHOLARSHIP 3 3500 EVELYN KASER NURSING SCHOLARSHIP 7 4500 LORNA & JOSEPH HALLIDAY NURSING SCHOLARSHIP 3 1750 MCMC BOARD OF TRUSTEES FUTURE HEALTHCARE PROFESSIONALS 1 2000 PART I, LINE 2: FUNDING IS TRACKED THROUGH OUR JOUNAL SHEETS OF ALL THE DIFFERENT FUNDS WE HAVE. THE GRANTEES ARE REQUIRED TO PROVIDE A END OF YEAR REPORT ON HOW FUNDS WERE USED. X X X X X 0 0 0 0 0 0 0 0 0 DENNIS KNOX DIRECTOR 0 481682 0 150562 0 2968 0 14000 0 15891 0 665103 0 0 ERIC HOLEMAN VICE CHAIR 0 166980 0 0 0 2396 0 8806 0 22118 0 200300 0 0 FORM 990, PART VI, SECTION A, LINE 6 HEALTHCARE FOR THE MID-COLUMBIA REGION IS THE SOLE MEMBER. ON APRIL 4, 2019, THE OPERATIONS AND RELATED ASSETS AND LIABILITIES OF HEALTH CARE FOR THE MID-COLUMBIA REGION WERE MERGED INTO MID-COLUMBIA MEDICAL CENTER. AS A RESULT, MID-COLUMBIA MEDICAL CENTER WILL EXIST AS THE PARENT OVER THE AFFILIATES OF THE FOUNDATION AND DRY HOLLOW. NO CHANGE TO THE OVERALL SCOPE OF OPERATIONS OCCURRED AS A RESULT OF THIS EVENT. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE RETURN IS SUBMITTED TO THE BOARD OF TRUSTEES FOR REVIEW. UPDATES ARE MADE AS NECESSARY BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C WE ANNUALLY REQUIRE DIRECTORS, OFFICERS AND EXECUTIVE MANAGEMENT TEAM TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT, THEY WOULD BE SUBJECT TO CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION FOR VIOLATION OF OUR POLICY. IF THEY SELF-DISCLOSED A POTENTIAL CONFLICT OF INTEREST ON THE FORM, WE WOULD GATHER INFORMATION ON THE ISSUE AND MAKE A DETERMINATION ON HOW SEVERE THE CONFLICT IS AND WHETHER OR NOT THE EMPLOYEE OR DIRECTOR COULD REMAIN AN OFFICER, DIRECTOR OR EMPLOYEE. THE CONFLICT OF INTEREST POLICY IS REVEIWED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION COMMITTEE WAS DESIGNED TO INCLUDED MEMBERS OF THE BOARD OF TRUSTEES, HR DIRECTOR AND COMPENSATION SPECIALIST. COMPENSATION COMMITTEE AGED AND/OR UPDATED PREVIOUSLY SUPPLIED COMPENSATION DATA FROM OUTSIDE FIRM BASED ON COMMERCIALLY AVAILABLE SALARY SURVEYS. THE CEO THEN NEGOTIATES WITH THE BOARD, WHICH COMPARES THE COMPENSATION DISCUSSED WITH THE ANALYSIS PREVIOUSLY DESCRIBED AND VOTES ON AND APPROVES A NEW CONTRACT IN EXECUTIVE SESSION WITHOUT CEO PRESENCE OR PARTICIPATION IN THE VOTE. COMPENSATION OF THE ORGANIZATIONS OFFICERS OR KEY EMPLOYEES IS DETERMINED BY A SURVEY OF MARKET RATES FOR SIMILAR POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL INFORMATION AVAILABLE TO THE PUBLIC AT THE CHARIABLE ACTIVITIES DIVISION OF THE OREGON DEPARTMENT OF JUSTICE. FORM 990, PART XI, LINE 9: CHANGE IN CRUT -19,258. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THEIR FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. HEALTH CARE FOR THE MID-COLUMBIA REGION 1700 E 19TH STREET THE DALLES OR 97058 930847905 HEALTH SERVICES OR 501(C)(3) LINE 12C, III-FI 0 MID-COLUMBIA MEDICAL CENTER 1700 E 19TH STREET THE DALLES OR 97058 930386936 ACUTE HOSPITAL OR 501(C)(3) LINE 3 HEALTHCARE FOR THE MID-COLUMBIA REGION 1 LPH&WC HOLDINGS LLC 1524 SHERMAN AVENUE HOOD RIVER OR 97031 811236711 RENTAL ACTIVITY OR N/A DRY HOLLOW PROFESSIONAL CENTER INC PO BOX 1580 THE DALLES OR 97058 930631350 RENTAL BUILDING OR N/A C 0 CHARITABLE REMAINDER TRUST (1) INVESTMENTS OR T 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 MID-COLUMBIA MEDICAL CENTER B 82139 GRANTED TO RELATED PARTY FOUNDATI MID-COLUMBIA MEDICAL CENTER C 614974 ACTUAL REIMBURSED EXPENSES MID-COLUMBIA MEDICAL CENTER L 388892 FUNDRAISER FOR RELATED PARTY FOUN PART II ON APRIL 4, 2019, THE OPERATIONS AND RELATED ASSETS AND LIABILITES OF HEALTH CARE FOR THE MID-COLUMBIA REGION WERE MERGED INTO MID-COLUMBIA MEDICAL CENTER. AS A RESULT, MID-COLUMBIA MEDICAL CENTER WILL EXIST AS THE PARENT OVER THE AFFILIATES OF THE FOUNDATION AND DRY HOLLOW. NO CHANGE TO THE OVERALL SCOPE OF OPERATIONS OCCURRED AS A RESULT OF THIS EVENT.