TAHOE FOREST HEALTH SYSTEM FOUNDATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
TAHOE FOREST HEALTH SYSTEM FOUNDATION (EIN 94-3047869)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-15
IRS object ID
201811359349307051
Schema version
2016v3.0
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)
Return2018-05-15T13:03:59-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN910189318PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Moss Adams LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1101 Second Street Suite 900AddressLine1Txt
CitySan FranciscoCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94105ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN943047869EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Tahoe Forest Health System FoundationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlTAHOBusinessNameControlTxt
Phone5305826329PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O Box 2508AddressLine1Txt
CityTruckeeCityNm
State AbbreviationCAStateAbbreviationCd
ZIP961602508ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMartha SimmonPersonNm
Person TitleExecutive DirectorPersonTitleTxt
Phone5305826329PhoneNum
Signature2018-05-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTracy S PagliaPreparerPersonNm
PTINP00366884PTIN
Phone4159561500PhoneNum
Preparation2018-05-14PreparationDt
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMartha SimmonPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O Box 2508AddressLine1Txt
CityTruckeeCityNm
State AbbreviationCAStateAbbreviationCd
ZIP961602508ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$835,224GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.tfhd.com/tahoeforrestfoundation.aspWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1987FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO CREATE A CULTURE OF COLLABORATION WHICH RESULTs IN EXCELLENCE IN COMMUNITY HEALTH CARE.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers170TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$803,899PYContributionsGrantsAmt
CY Contributions Grants$579,981CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$195,764PYOtherRevenueAmt
CY Other Revenue-$11,773CYOtherRevenueAmt
PY Total Revenue$999,663PYTotalRevenueAmt
CY Total Revenue$568,208CYTotalRevenueAmt
PY Grants And Similar Paid$586,324PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$467,197CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$234,845PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,217CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$1,966CYTotalFundraisingExpenseAmt
PY Other Expenses$142,624PYOtherExpensesAmt
CY Other Expenses$45,217CYOtherExpensesAmt
PY Total Expenses$963,793PYTotalExpensesAmt
CY Total Expenses$519,631CYTotalExpensesAmt
PY Revenues Less Expenses$35,870PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$48,577CYRevenuesLessExpensesAmt
Total Assets BOY$2,103,505TotalAssetsBOYAmt
Total Assets EOY$2,419,315TotalAssetsEOYAmt
Total Liabilities BOY$304,080TotalLiabilitiesBOYAmt
Total Liabilities EOY$408,164TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,799,425NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,011,151NetAssetsOrFundBalancesEOYAmt
MissionTO CREATE A CULTURE OF COLLABORATION WHICH FACILITATES THE EXPLORATION OF CREATIVE OPPORTUNITIES AND SOLUTIONS THAT RESULT IN EXCELLENCE IN COMMUNITY HEALTH CARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$264,144ExpenseAmt
Grant$292,131GrantAmt
Revenue$0RevenueAmt
DescProvided support to the Tahoe Forest Hospital District for the Tahoe Forest Cancer and Cancer research.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$26,305ExpenseAmt
Grant$26,305GrantAmt
Revenue$0RevenueAmt
DescPROVIDED SUPPORT TO THE TAHOE FOREST HOSPITAL DISTRICT'S HOSPICE PROGRAM.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$179,212ExpenseAmt
Grant$148,761GrantAmt
Revenue$0RevenueAmt
DescPROVIDED SUPPORT TO A VARIETY OF SERVICES AND PROGRAMS AT THE TAHOE FOREST HOSPITAL DISTRICT, INCLUDING THE CHILDREN'S CENTER, COMMUNITY WELLNESS, EMERGENCY SERVICES, PHYSICAL THERAPY, HOME HEALTH, AND THE WOMEN & FAMILY CENTER.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$469,661TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
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 ActivitiesYes (1)FundraisingActivitiesInd
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 With Officer Ent0BusinessRlnWithOfficerEntInd
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 Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
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 Policy0ConflictOfInterestPolicyInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Tahoe Forest Hospital District Jaye Chasseur ControllerBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5305823489PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110121 Pine AvenueAddressLine1Txt
CityTruckeeCityNm
State AbbreviationCAStateAbbreviationCd
ZIP96160ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeInd
Mary Brown
President5.00Yes (X)Yes (X)$0$0$0
John McHugh II
Treasurer5.00Yes (X)Yes (X)$0$0$0
Lisa Peltier
Director5.00Yes (X)$0$0$0
Randy Sater
Director5.00Yes (X)$0$0$0
Cheryl Luther
Secretary5.00Yes (X)Yes (X)$0$0$0
Jaime Haddad
Director5.00Yes (X)$0$0$0
Sarah Wolfe
Director5.00Yes (X)$0$0$0
Jon Shanser MD
Director5.00Yes (X)$0$0$0
Pamela Hobday thru 1016
Director5.00Yes (X)$0$0$0
Trinkie Watson thru 1016
Director5.00Yes (X)$0$0$0
Besty Cole thru 1016
Director5.00Yes (X)$0$0$0
Chris Ryman thru 1016
Director5.00Yes (X)$0$0$0
Warren Kocmond thru 1016
President5.00Yes (X)Yes (X)$0$0$0
Dale Chamblin thru 1016
Director5.00Yes (X)$0$0$0
Stuart Yount thru 1016
Treasurer5.00Yes (X)$0$0$0
Sarah Jackson thru 1016
Secretary5.00Yes (X)Yes (X)$0$0$0
Tom Hobday thru 1016
director5.00Yes (X)$0$0$0
Harry Weis
TFHD, CEO5.00Yes (X)$0$444,093$55,01440.00
Martha Simon
TFHSF Executive Director5.00Yes (X)$0$147,500$32,64940.00
Ted Owens
TFHD, Executive Director Governance and Business D5.00Yes (X)$0$179,170$12,95540.00
Crystal Betts
TFHD, CFO5.00Yes (X)$0$289,083$49,48940.00
Jaye Chasseur
TFHD, Controller5.00$0$176,259$23,26140.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,236,105TotReportableCompRltdOrgAmt
Total Other Compensation$173,368TotalOtherCompensationAmt
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
Fundraising$419,904FundraisingAmt
Government Grants$10,402GovernmentGrantsAmt
All Other Contributions$149,675AllOtherContributionsAmt
Noncash Contributions$10,010NoncashContributionsAmt
Total Contributions$579,981TotalContributionsAmt
Fundraising Gross Income$227,643FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$419,904ContriRptFundraisingEventAmt
Fundraising Direct Expenses$267,016FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$39,373TotalRevenueColumnAmt
Exclusion-$39,373ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$27,600GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,600TotalRevenueColumnAmt
Exclusion$27,600ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$568,208TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$11,773ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$467,197TotalAmt
Program Services$467,197ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,778TotalAmt
Program Services$1,290ProgramServicesAmt
Management And General$1,459ManagementAndGeneralAmt
Fundraising$1,029FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,439TotalAmt
Program Services$1,174ProgramServicesAmt
Management And General$1,328ManagementAndGeneralAmt
Fundraising$937FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,935TotalAmt
Management And General$3,935ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$35,860TotalAmt
Management And General$35,860ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,942TotalAmt
Management And General$3,942ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,480TotalAmt
Management And General$1,480ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$519,631TotalAmt
Program Services$469,661ProgramServicesAmt
Management And General$48,004ManagementAndGeneralAmt
Fundraising$1,966FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$694,552BOYAmt
EOY$842,341EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$16,622BOYAmt
EOY$8,185EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$36,282BOYAmt
EOY$40,745EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,356,049BOYAmt
EOY$1,528,044EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,103,505BOYAmt
EOY$2,419,315EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$202,765BOYAmt
EOY$360,828EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$101,315BOYAmt
EOY$47,336EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$304,080BOYAmt
EOY$408,164EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$39,625BOYAmt
EOY$11,277EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,759,800BOYAmt
EOY$1,999,874EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,799,425BOYAmt
EOY$2,011,151EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,103,505BOYAmt
EOY$2,419,315EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$48,577ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$163,149OtherChangesInNetAssetsAmt
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)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Tahoe Forest Hospital DistrictBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN946004062EIN
Organization Type6OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$467,197SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$467,197SupportSumAmt
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 Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,356,049BeginningYearBalanceAmt
Contributions$8,846ContributionsAmt
Investment Earnings Or Losses$163,149InvestmentEarningsOrLossesAmt
End Year Balance$1,528,044EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,274,977BeginningYearBalanceAmt
Contributions$87,950ContributionsAmt
Investment Earnings Or Losses$6,232InvestmentEarningsOrLossesAmt
Administrative Expenses$13,110AdministrativeExpensesAmt
End Year Balance$1,356,049EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,205,961BeginningYearBalanceAmt
Contributions$82,175ContributionsAmt
Investment Earnings Or Losses-$699InvestmentEarningsOrLossesAmt
Administrative Expenses$12,460AdministrativeExpensesAmt
End Year Balance$1,274,977EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$937,938BeginningYearBalanceAmt
Contributions$113,410ContributionsAmt
Investment Earnings Or Losses$162,638InvestmentEarningsOrLossesAmt
Administrative Expenses$8,025AdministrativeExpensesAmt
End Year Balance$1,205,961EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$645,885BeginningYearBalanceAmt
Contributions$192,238ContributionsAmt
Investment Earnings Or Losses$102,497InvestmentEarningsOrLossesAmt
Administrative Expenses$2,682AdministrativeExpensesAmt
End Year Balance$937,938EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescBeneficial Interest in Community for Cancer Care EndowmentDesc
Book Value$1,528,044BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,528,044TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Due to Tahoe Forest Hospital District$42,519
Held in Trust for Others$4,817
FieldValueIRS element (for citing)
Total Liability$47,336TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$1,443,111TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$444,738DonatedServicesAndUseFcltsAmt
Other Revenue$430,165OtherRevenueAmt
Revenue Not Reported$874,903RevenueNotReportedAmt
Revenue Subtotal$568,208RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$568,208TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,231,385TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$444,738DonatedServicesUseFcltsAmt
Other Expenses Included$267,016OtherExpensesIncludedAmt
Expenses Not Reported$711,754ExpensesNotReportedAmt
Expenses Subtotal$519,631ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$519,631TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:THE ENDOWMENT FUND IS INTENDED TO SUPPORT THE CANCER CENTER IN THE TREATMENT, SUPPORT, AND PREVENTION OF CANCER.
Part XI, Line 2d - Other Adjustments:Fundraising Expenses Netted Against Fundraising Revenue 267,016. Change in beneficial interest in trust 163,149.
Part XII, Line 2d - Other Adjustments:Fundraising Expenses Netted Against Fundraising Revenue 267,016.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Gene Upshaw Memorial Golf ClassicEvent1Nm
Gross Receipts Event1$177,757GrossReceiptsEvent1Amt
Charitable Contri Event1$119,654CharitableContriEvent1Amt
Gross Revenue Event1$58,103GrossRevenueEvent1Amt
Other Direct Expenses Event1$216,126OtherDirectExpensesEvent1Amt
Event2Best of Tahoe ChefsEvent2Nm
Gross Receipts Event2$469,790GrossReceiptsEvent2Amt
Charitable Contri Event2$300,250CharitableContriEvent2Amt
Gross Revenue Event2$169,540GrossRevenueEvent2Amt
Other Direct Expenses Event2$50,890OtherDirectExpensesEvent2Amt
Gross Receipts Total$647,547GrossReceiptsTotalAmt
Charitable Contributions Tot$419,904CharitableContributionsTotAmt
Gross Revenue Total Events$227,643GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$267,016OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$267,016DirectExpenseSummaryEventsAmt
Net Income Summary-$39,373NetIncomeSummaryAmt

Gaming Information GamingInformationGrp

FieldValueIRS element (for citing)
Gross Revenue Other Gaming$27,600GrossRevenueOtherGamingAmt
Volunteer Labor Other Gaming0VolunteerLaborOtherGamingInd
Gross Revenue Total Gaming$27,600GrossRevenueTotalGamingAmt
Net Gaming Income Summary$27,600NetGamingIncomeSummaryAmt
FieldValueIRS element (for citing)
Licensed0LicensedInd
License Suspended Etc0LicenseSuspendedEtcInd
Gaming With Nonmembers0GamingWithNonmembersInd
Member Of Other Entity0MemberOfOtherEntityInd
Cntrct With3rd Prty For Game Rev0CntrctWith3rdPrtyForGameRevInd
Charitable Distribution Rqr0CharitableDistributionRqrInd

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Tahoe Forest Hospital DistrictBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line110121 Pine AvenueAddressLine1Txt
CityTruckeeCityNm
State AbbreviationCAStateAbbreviationCd
ZIP96160ZIPCd
FieldValueIRS element (for citing)
Recipient EIN946004062RecipientEIN
IRC Section115(1)IRCSectionDesc
Cash Grant$467,197CashGrantAmt
Purpose Of GrantTo support and enhance healthcare in the district's service areaPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationTHE FOUNDATION EXISTS TO SUPPORT AND ENHANCE HEALTHCARE IN THE TAHOE FOREST HOSPITAL DISTRICT'S (THE DISTRICT) SERVICE AREA. ACCORDINGLY, THE FOUNDATION'S ASSISTANCE REPRESENTS PAYMENTS DIRECTLY MADE TO THE DISTRICT IN FURTHERANCE OF THESE PURPOSES THE BOARD OF DIRECTORS FROM THE FOUNDATION AND THE DISTRICT PERFORM MONITORING PROCEDURES TO ENSURE THAT THE ASSISTANCE PROVIDED BY THE FOUNDATION IS USED TO SUPPORT AND ENHANCE HEALTHCARE IN THE DISTRICT'S SERVICE AREA.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 (5 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
Harry Weis
TFHD, CEO$0$388,832$0$39,039$0$16,222$0$33,744$0$21,270$0$499,107$0$0
Martha Simon
TFHSF Executive Director$0$129,508$0$16,886$0$1,106$0$11,929$0$20,720$0$180,149$0$0
Ted Owens
TFHD, Executive Director Governance$0$157,154$0$19,784$0$2,232$0$12,391$0$564$0$192,125$0$0
Crystal Betts
TFHD, CFO$0$246,520$0$34,314$0$8,249$0$26,493$0$22,996$0$338,572$0$0
Jaye Chasseur
TFHD, Controller$0$155,738$0$19,793$0$728$0$12,669$0$10,592$0$199,520$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 3FormAndLineReferenceDesc
ExplanationThe organization relied on a related organization that used one or more of the methods to establish the top management's compensation.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2board member tom and pam hobday have a family relationship.
Form 990, Part VI, Section B, line 11bThe board places the Form 990 on its agenda for its review and approval. Management reviews the final Form 990 as prepared by its tax firm.
Form 990, Part VI, Section B, line 15Annual California Hospital Association survey is used to determine appropriate salary ranges on our geographical area based on job. Reviewed by the Human Resources Department annually.
Form 990, Part VI, Section C, line 19The Foundation makes its governing documents and financial statements available to the public upon request.
Form 990, Part XI, line 9:Change in beneficial interest in trust 163,149.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtControlled OrganizationControlledOrganizationIndPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Tahoe Forest Hospital District
10121 Pine AvenueTruckeeCA96160946004062HealthcareCA115(1)0
Incline Village Community Hospital Foundation
880 Alder AvenueIncline VillageNV89451200752156HealthcareNV501(c)(3)Yes (1)Line 12a, ITahoe Forest Hospital District
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 Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.