2018-05-15T13:03:59-05:00 2017-06-30 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2016-07-01 943047869 Tahoe Forest Health System Foundation TAHO 5305826329 P O Box 2508 Truckee CA 961602508 Martha Simmon Executive Director 5305826329 2018-05-14 1 Tracy S Paglia P00366884 4159561500 2018-05-14 2016 2022-09-23 18:48:47Z Martha Simmon P O Box 2508 Truckee CA 961602508 835224 0 X www.tfhd.com/tahoeforrestfoundation.asp X 1987 CA TO CREATE A CULTURE OF COLLABORATION WHICH RESULTs IN EXCELLENCE IN COMMUNITY HEALTH CARE. 8 8 0 170 0 0 803899 579981 0 0 0 0 195764 -11773 999663 568208 586324 467197 0 0 234845 7217 0 0 1966 142624 45217 963793 519631 35870 48577 2103505 2419315 304080 408164 1799425 2011151 TO CREATE A CULTURE OF COLLABORATION WHICH FACILITATES THE EXPLORATION OF CREATIVE OPPORTUNITIES AND SOLUTIONS THAT RESULT IN EXCELLENCE IN COMMUNITY HEALTH CARE. 0 0 264144 292131 0 Provided support to the Tahoe Forest Hospital District for the Tahoe Forest Cancer and Cancer research. 26305 26305 0 PROVIDED SUPPORT TO THE TAHOE FOREST HOSPITAL DISTRICT'S HOSPICE PROGRAM. 179212 148761 0 PROVIDED 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. 469661 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 1 0 0 1 0 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 0 0 0 0 0 X 8 8 1 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 CA X Tahoe Forest Hospital District Jaye Chasseur Controller 5305823489 10121 Pine Avenue Truckee CA 96160 Mary Brown President 5.00 X X 0 0 0 John McHugh II Treasurer 5.00 X X 0 0 0 Lisa Peltier Director 5.00 X 0 0 0 Randy Sater Director 5.00 X 0 0 0 Cheryl Luther Secretary 5.00 X X 0 0 0 Jaime Haddad Director 5.00 X 0 0 0 Sarah Wolfe Director 5.00 X 0 0 0 Jon Shanser MD Director 5.00 X 0 0 0 Pamela Hobday thru 1016 Director 5.00 X 0 0 0 Trinkie Watson thru 1016 Director 5.00 X 0 0 0 Besty Cole thru 1016 Director 5.00 X 0 0 0 Chris Ryman thru 1016 Director 5.00 X 0 0 0 Warren Kocmond thru 1016 President 5.00 X X 0 0 0 Dale Chamblin thru 1016 Director 5.00 X 0 0 0 Stuart Yount thru 1016 Treasurer 5.00 X 0 0 0 Sarah Jackson thru 1016 Secretary 5.00 X X 0 0 0 Tom Hobday thru 1016 director 5.00 X 0 0 0 Harry Weis TFHD, CEO 5.00 40.00 X 0 444093 55014 Martha Simon TFHSF Executive Director 5.00 40.00 X 0 147500 32649 Ted Owens TFHD, Executive Director Governance and Business D 5.00 40.00 X 0 179170 12955 Crystal Betts TFHD, CFO 5.00 40.00 X 0 289083 49489 Jaye Chasseur TFHD, Controller 5.00 40.00 X 0 176259 23261 0 1236105 173368 0 0 1 0 0 419904 10402 149675 10010 579981 227643 419904 267016 -39373 -39373 27600 0 27600 27600 568208 0 0 -11773 467197 467197 3778 1290 1459 1029 3439 1174 1328 937 3935 3935 35860 35860 3942 3942 1480 1480 519631 469661 48004 1966 694552 842341 16622 8185 36282 40745 0 0 0 0 1356049 1528044 2103505 2419315 202765 360828 101315 47336 304080 408164 X 39625 11277 1759800 1999874 1799425 2011151 2103505 2419315 X 48577 163149 X 0 1 X 1 0 X X 1 Tahoe Forest Hospital District 946004062 6 1 467197 0 1 467197 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1356049 8846 163149 1528044 1274977 87950 6232 13110 1356049 1205961 82175 -699 12460 1274977 937938 113410 162638 8025 1205961 645885 192238 102497 2682 937938 0.00000 0.00000 1.00000 1 0 0 Beneficial Interest in Community for Cancer Care Endowment 1528044 1528044 Due to Tahoe Forest Hospital District 42519 Held in Trust for Others 4817 47336 1443111 444738 430165 874903 568208 0 568208 1231385 444738 267016 711754 519631 0 519631 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. Gene Upshaw Memorial Golf Classic 177757 119654 58103 216126 Best of Tahoe Chefs 469790 300250 169540 50890 647547 419904 227643 267016 267016 -39373 27600 0 27600 27600 0 0 0 0 0 0 0 Tahoe Forest Hospital District 10121 Pine Avenue Truckee CA 96160 946004062 115(1) 467197 To support and enhance healthcare in the district's service area 1 0 Part I, Line 2: THE 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. 0 0 0 0 0 0 0 0 0 Harry Weis TFHD, CEO 0 388832 0 39039 0 16222 0 33744 0 21270 0 499107 0 0 Martha Simon TFHSF Executive Director 0 129508 0 16886 0 1106 0 11929 0 20720 0 180149 0 0 Ted Owens TFHD, Executive Director Governance 0 157154 0 19784 0 2232 0 12391 0 564 0 192125 0 0 Crystal Betts TFHD, CFO 0 246520 0 34314 0 8249 0 26493 0 22996 0 338572 0 0 Jaye Chasseur TFHD, Controller 0 155738 0 19793 0 728 0 12669 0 10592 0 199520 0 0 Part I, Line 3 The organization relied on a related organization that used one or more of the methods to establish the top management's compensation. Form 990, Part VI, Section A, line 2 board member tom and pam hobday have a family relationship. Form 990, Part VI, Section B, line 11b The 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 15 Annual 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 19 The 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. Tahoe Forest Hospital District 10121 Pine Avenue Truckee CA 96160 946004062 Healthcare CA 115(1) 0 Incline Village Community Hospital Foundation 880 Alder Avenue Incline Village NV 89451 200752156 Healthcare NV 501(c)(3) Line 12a, I Tahoe Forest Hospital District 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0