SPOKANE TEACHING HEALTH CENTER: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
SPOKANE TEACHING HEALTH CENTER (EIN 46-4139065)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-15
IRS object ID
202033209349301358
Schema version
2019v5.1
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)
Return2020-11-15T15:57:13-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110700 NORTHUP WAY SUITE 200AddressLine1Txt
CityBELLEVUECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98004ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN464139065EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SPOKANE TEACHING HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSPOKBusinessNameControlTxt
Phone5093151260PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 244AddressLine1Txt
CitySPOKANECityNm
State AbbreviationWAStateAbbreviationCd
ZIP99210ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID E LUHNPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone5093151260PhoneNum
Signature2020-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKURT BENNION CPAPreparerPersonNm
PTINP01469618PTIN
Phone4252506100PhoneNum
Preparation2020-11-14PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-14IPDt
IP Tm16:17:48IPTm
IP TimezonePSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdD6404CD6BDC62D55699D8FB81E5F5A720539BEA9AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTRACI RICHMONDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 244AddressLine1Txt
CitySPOKANECityNm
State AbbreviationWAStateAbbreviationCd
ZIP99210ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,082,985GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressSPOKANETEACHINGHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2013FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionPROVIDE EDUCATION TO HEALTH CARE PROFESSIONALS THROUGH SPONSORSHIP OF GRADUATE MEDICAL EDUCATION.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee1TotalEmployeeCnt
Total Volunteers8TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,731,857PYContributionsGrantsAmt
CY Contributions Grants$3,837,985CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$245,000CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$3,731,857PYTotalRevenueAmt
CY Total Revenue$4,082,985CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$10,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,748CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,576,690PYOtherExpensesAmt
CY Other Expenses$3,543,601CYOtherExpensesAmt
PY Total Expenses$3,576,690PYTotalExpensesAmt
CY Total Expenses$3,570,349CYTotalExpensesAmt
PY Revenues Less Expenses$155,167PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$512,636CYRevenuesLessExpensesAmt
Total Assets BOY$4,093,561TotalAssetsBOYAmt
Total Assets EOY$3,330,185TotalAssetsEOYAmt
Total Liabilities BOY$2,827,077TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,551,065TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,266,484NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,779,120NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE ENTITY IS ORGANIZED AND OPERATED SPECIFICALLY TO PROMOTE, CONDUCT AND SPONSOR EDUCATIONAL ACTIVITIES RELATED TO GRADUATE MEDICAL EDUCATION, INCLUDING PHYSICIAN RESIDENCY PROGRAMS.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,723,543ExpenseAmt
Grant$10,000GrantAmt
Revenue$0RevenueAmt
DescGRADUATE 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 2019 THE ORGANIZATION MAINTAINED ITS FINANCIAL OBLIGATIONS FOR THE FUNDING OF 18 TOTAL HRSA-FUND RESIDENTS, OF WHICH 6 COMPLETED THEIR TRAINING AND GRADUATED.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$266,826ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescGRADUATE 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 SUSPENDED SUBSEQUENTLY IN 2020.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$10,713ExpenseAmt
Grant$0GrantAmt
Revenue$245,000RevenueAmt
DescMEDICAID 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.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$77,058ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescGRADUATE MEDICAL EDUCATION--DEVELOPMENT OF A PEDIATRICS RESIDENCY:THE ORGANIZATION IS DEVELOPING A NEW PEDIATRICS RESIDENCY PROGRAM IN SPOKANE, WASHINGTON.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$77,058TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$0TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$3,078,140TotalProgramServiceExpensesAmt
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 EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
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 Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1EmployeeCnt
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 Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
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 Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAVID E LUHN CHIEF FINANCIAL OFFICERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5093151260PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11020 W RIVERSIDE AVEAddressLine1Txt
CitySPOKANECityNm
State AbbreviationWAStateAbbreviationCd
ZIP99201ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
ANTONY CHIANG DIRECTOR CLASS
A APPOINTEE) (THROUGH SEP 2019)0.5040.00Yes (X)$0$247,940$37,227
DAVID E LUHN
CHIEF FINANCIAL OFFICER0.5040.00$0$137,336$38,136Yes (X)
VALERI STEIGERWALD
EXECUTIVE DIR. (THROUGH SEP 2019)0.5040.00$0$104,450$21,447Yes (X)
JEFFREY BELL
SECRETARY (CLASS A APPOINTEE)0.5040.00Yes (X)$0$89,717$9,792Yes (X)
SARAH LYMAN DIRECTOR CLASS A
APPOINTEE) (THROUGH MAY 2019)0.5040.00Yes (X)$0$75,328$21,534
TRACI RICHMOND COUTURE
EXECUTIVE DIRECTOR0.5040.00$0$11,712$2,166Yes (X)
RICH HADLEY
PRESIDENT (CLASS B APPOINTEE)0.500.00Yes (X)$0$0$0Yes (X)
JEFFREY COLLINS MD
VICE PRESIDENT (CLASS B APPOINTEE)0.500.00Yes (X)$0$0$0Yes (X)
MICHAEL NOWLING
TREASURER (CLASS A APPOINTEE)0.500.00Yes (X)$0$0$0Yes (X)
FREDERICK CHEN MD DIRECTOR
(CLASS A APPOINTEE) (THRU MAR 2019)0.500.00Yes (X)$0$0$0
DARYLL DEWALD PHD
DIRECTOR (CLASS C APPOINTEE)0.500.00Yes (X)$0$0$0
LINDA GARRELTS MACLEAN
DIRECTOR (CLASS C APPOINTEE)0.500.00Yes (X)$0$0$0
DEB HARPER MD
DIRECTOR (CLASS A APPOINTEE)0.500.00Yes (X)$0$0$0
COURTNEY LAW
DIRECTOR (CLASS A APPOINTEE)0.500.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$666,483TotReportableCompRltdOrgAmt
Total Other Compensation$130,302TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1J O'CONNOR MDO'CONNOR FAMILY MEDICINEBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1309 E FARWELL ROAD 204AddressLine1Txt
CitySPOKANECityNm
State AbbreviationWAStateAbbreviationCd
ZIP99218ZIPCd
FieldValueIRS element (for citing)
ServicesPROGRAM DIRECTOR (GRAD. MEDICAL ED.)ServicesDesc
Compensation$121,646CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Related Organizations$997,037RelatedOrganizationsAmt
Government Grants$2,840,948GovernmentGrantsAmt
Total Contributions$3,837,985TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescMEDICAID WAIVERSDesc
Business621110BusinessCd
Total Revenue Column$245,000TotalRevenueColumnAmt
Related Or Exempt Func Income$245,000RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$245,000TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,082,985TotalRevenueColumnAmt
Related Or Exempt Func Income$245,000RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$10,000TotalAmt
Program Services$10,000ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$12,500TotalAmt
Program Services$12,500ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,382TotalAmt
Program Services$2,382ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,866TotalAmt
Program Services$1,821ProgramServicesAmt
Management And General$45ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$85,477TotalAmt
Management And General$85,477ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$13,150TotalAmt
Management And General$13,150ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$324,254TotalAmt
Program Services$290,434ProgramServicesAmt
Management And General$33,820ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$25,035TotalAmt
Program Services$10,862ProgramServicesAmt
Management And General$14,173ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$10,871TotalAmt
Program Services$31ProgramServicesAmt
Management And General$10,840ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$9,315TotalAmt
Management And General$9,315ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$20,658TotalAmt
Program Services$7,349ProgramServicesAmt
Management And General$13,309ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$23,100TotalAmt
Program Services$13,695ProgramServicesAmt
Management And General$9,405ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$262,033TotalAmt
Program Services$8,333ProgramServicesAmt
Management And General$253,700ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$985TotalAmt
Management And General$985ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$18,080TotalAmt
Management And General$18,080ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
RESIDENCY PROGRAM$2,713,543$2,713,543
DUES, LICENSES, MEMBERS$21,991$7,000$14,991
BAD DEBT$14,919$14,919

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$190TotalAmt
Program Services$190ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,570,349TotalAmt
Program Services$3,078,140ProgramServicesAmt
Management And General$492,209ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,472,749BOYAmt
EOY$2,279,511EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,606,979BOYAmt
EOY$1,037,782EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$12,071BOYAmt
EOY$12,115EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,693LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,916LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,762BOYAmt
EOY$777EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,093,561BOYAmt
EOY$3,330,185EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,091,873BOYAmt
EOY$762,193EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$735,204BOYAmt
EOY$788,872EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,827,077BOYAmt
EOY$1,551,065EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,260,493BOYAmt
EOY$1,736,178EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,991BOYAmt
EOY$42,942EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,266,484BOYAmt
EOY$1,779,120EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,093,561BOYAmt
EOY$3,330,185EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$512,636ReconcilationRevenueExpnssAmt
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)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,566,725CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,717,685CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,208,457CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,731,857CurrentTaxYearMinus1YearAmt
Current Tax Year$3,837,985CurrentTaxYearAmt
Total$14,062,709TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,566,725CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,717,685CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,208,457CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,731,857CurrentTaxYearMinus1YearAmt
Current Tax Year$3,837,985CurrentTaxYearAmt
Total$14,062,709TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$14,062,709PublicSupportTotal170Amt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$23,663CurrentTaxYearMinus4YearsAmt
Total$23,663TotalAmt
FieldValueIRS element (for citing)
Total Support$14,086,372TotalSupportAmt
Gross Receipts Rltd Activities$245,000GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99830PublicSupportCY170Pct
Public Support PY1700.99730PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,693OtherCostOrOtherBasisAmt
Depreciation$2,916DepreciationAmt
Book Value$777BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$777TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescREFUNDABLE GRANT AND ADVANCESDesc
Amt$788,872Amt
FieldValueIRS element (for citing)
Total Liability$788,872TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$4,082,985TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$4,082,985RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$4,082,985TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$3,570,349TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$3,570,349ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$3,570,349TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE 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.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE HEALTH & SERVICES WASHINGTON (DBA PROVIDENCE MEDICAL GROUP)BusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 W 8TH AVENUEAddressLine1Txt
CitySPOKANECityNm
State AbbreviationWAStateAbbreviationCd
ZIP99204ZIPCd
FieldValueIRS element (for citing)
Recipient EIN911216033RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$10,000CashGrantAmt
Purpose Of GrantSUPPORT TO RECRUIT AND RETAIN GME FACULTYPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II LINE 1FormAndLineReferenceDesc
ExplanationIN 2019, THE ORGANIZATION GRANTED TO A RELATED ENTITY WITH WHICH IT HAS A WRITTEN CONTRACT FOR PROGRAM OPERATIONS AND SUPPORT.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
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 (2 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
ANTONY CHIANG DIRECTOR CLASS
A APPOINTEE) (THROUGH SEP 2019)$0$235,349$0$12,300$0$291$0$14,998$0$22,229$0$285,167$0$0
DAVID E LUHN
CHIEF FINANCIAL OFFICER$0$131,115$0$5,778$0$443$0$8,240$0$29,896$0$175,472$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationWRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE IS USED BY A RELATED ORGANIZATION.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2IN 2019, THE ORGANIZATION BEGAN PARTNERING 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.
FORM 990, PART VI, SECTION A, LINE 4THE BYLAWS WERE AMENDED IN JANUARY 2019 TO MODIFY THE CRITERIA TO SERVE AS PRESIDENT OF THE BOARD.
FORM 990, PART VI, SECTION A, LINE 6TWO MEMBER CLASSES: CLASS A (EMPIRE HEALTH FOUNDATION); CLASS B (PROVIDENCE HEALTH AND SERVICES)
FORM 990, PART VI, SECTION A, LINE 7ACLASS 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 11BCORPORATE COUNSEL AND THE EXECUTIVE DIRECTOR WERE PROVIDED WITH A PRE-FILING COPY FOR REVIEW AND COMMENT.
FORM 990, PART VI, SECTION B, LINE 12CWRITTEN POLICY REQUIRES AFFIRMATIVE DISCLOSURE OF ACTUAL OR POTENTIAL CONFLICTS ANNUALLY--REVIEWED BY BOARD AND LEGAL COUNSEL.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST
PART XII, LINE 2CTHE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
EMPIRE HEALTH FOUNDATION
422 W RIVERSIDE AVE STE 1100SPOKANEWA99201263375286PRIVATE FOUNDATIONWA501(C)(3)PFN/A0
PROVIDENCE HEALTH & SERVICES
101 E 8TH AVESPOKANEWA99204911216033HOSPITALWA501(C)(3)LINE 3N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
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 OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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