2018-05-15T13:07:13-05:00 2017-06-30 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2016-07-01 200752156 Incline Village Community Hospital Foundation INCL 7758334100 880 Alder Avenue Incline Village NV 89451 Karli Epstein Executive Director 7758334100 2018-05-14 1 Tracy S Paglia P00366884 4159561500 2018-05-14 2016 2022-09-23 18:48:47Z Karli Epstein 880 Alder Avenue Incline Village NV 89451 365458 0 X www.tfhd.com/ivchfoundation.asp X 2004 NV TO ASSIST THE INCLINE VILLAGE COMMUNITY HOSPITAL IN DELIVERING OPTIMAL HEALTH CARE SERVICES. 21 21 0 23 0 0 537606 365458 0 0 0 0 0 0 537606 365458 603342 379347 0 0 96400 0 0 0 0 115794 10091 815536 389438 -277930 -23980 848066 449594 559445 182000 288621 267594 X to assist the Incline Village Community Hospital in delivering the highest quality emergency and primary health care services by procuring financial resources, improving community awareness and involving community residents and visitors in developing a long-term vision for comprehensive health care in the communities of the north shore of Lake Tahoe, including Kings Beach, Crystal Bay and Incline Village. 0 0 379347 379347 0 The foundation provides support for various other expenses to assist the incline village community hospital in delivering optimal health care services in north lake Tahoe. 379347 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 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 21 21 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 NV CA X Incline Village Community Hospital 7758334100 990 Alder Avenue Incline Village NV 894518215 Gerry Eick President 0.50 X X 0 0 0 Warren Kocmond Past President 0.50 X X 0 0 0 Jonathan Smith OD Vice President 0.50 X X 0 0 0 Mary Ansari Secretary 0.50 X X 0 0 0 Kevin Hanna Treasurer 0.50 X X 0 0 0 Walter Binder Director 0.50 X 0 0 0 David Collins Director 0.50 X 0 0 0 Gary Finch Director 0.50 X 0 0 0 Lindsay Hardie Director 0.50 X 0 0 0 Nan Healy Director 0.50 X 0 0 0 Robert Heynen Director 0.50 X 0 0 0 Shane Johnson Director 0.50 X 0 0 0 Roger Kahn Director 0.50 X 0 0 0 Robert Kennedy Director 0.50 X 0 0 0 Susanna Kintz Director 0.50 X 0 0 0 Ralph Kuhn MD Director 0.50 X 0 0 0 Mike Lacey Director 0.50 X 0 0 0 Margo Lalchandani Director 0.50 X 0 0 0 Donald Mason MD Director 0.50 X 0 0 0 Sean O'Neal Director 0.50 X 0 0 0 Charles Zipkin Board Liason TFHD 0.50 X 0 0 0 Stuart Jed Director (Thru 12/16) 0.50 X 0 0 0 William Guerra Director (thru 07/16) 0.50 X 0 0 0 Betsy Kinsley Director (Thru 12/16) 0.50 X 0 0 0 Harry Weis Director & CEO TFHD 0.50 40.00 X 0 444093 55014 Judy Newland Administrator IVCH 0.50 40.00 X 0 279082 55923 Karli Epstein Executive Director 40.00 X 0 104896 16939 Crystal Betts CFO, TFHD 40.00 X 0 289083 49489 Jaye Chasseur Controller, TFHD 40.00 X 0 176259 23261 0 1293413 200626 0 0 1 0 0 365458 365458 365458 0 0 0 379347 379347 10091 10091 389438 379347 10091 0 525259 108198 302307 302484 20500 6750 0 32162 848066 449594 559445 182000 559445 182000 X 281425 201965 7196 36420 29209 288621 267594 848066 449594 X -23980 2953 X 0 1 X 1 0 X X 1 Tahoe Forest Hospital District 946004062 6 1 379347 0 1 379347 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 29209 2953 32162 0.00000 1.00000 0.00000 1 0 0 Endowment Fund 32162 32162 596242 227831 2953 230784 365458 0 365458 617269 227831 227831 389438 0 389438 Part V, Line 4: The purpose of the endowment and improvement funds is to provide support to or for the benefit of the Foundation and its activities in pursuit of its mission to deliver optimal health care services in the communities served by Incline Village Community Hospital. Part XI, Line 2d - Other Adjustments: Change in beneficial interest in trust 2,953. 1 Tahoe Forest Hospital District PO Box 759 Truckee CA 96160 946004062 115(1) 379347 To support and enhance healthcare in the district's service area 1 0 Part I, Line 2: The Incline Village Community Hospital Foundation selects various activities of the Tahoe Forest Hospital District to support therefore, monitoring is not required. 0 0 0 0 0 0 0 0 0 Harry Weis Director & CEO TFHD 0 388832 0 39039 0 16222 0 33744 0 21270 0 499107 0 0 Judy Newland Administrator IVCH 0 225906 0 42616 0 10560 0 29289 0 26634 0 335005 0 0 Crystal Betts CFO, TFHD 0 246520 0 34314 0 8249 0 26493 0 22996 0 338572 0 0 Jaye Chasseur Controller, TFHD 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 B, line 11b The Form 990 is prepared by an external CPA firm and reviewed by treasurer for approval before filing. Form 990, Part VI, Section C, line 19 Any interested parties who desire to obtain a copy of any of the governing documents and financial statements can contact the office and request a paper copy. Any documents requested are printed and handed to the interested party at the office. Form 990, Part XI, line 9: Change in beneficial interest in trust 2,953. Tahoe Forest Hospital District PO Box 759 Truckee CA 96160 946004062 Healthcare CA 501(c)(3) Line 3 0 Tahoe Forest Health System Foundation PO Box 2508 Truckee CA 96160 943047869 Healthcare CA Healthcare 501(c)(3) Tahoe Forest Hospital District 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0