2018-09-04T16:06:38-05:00 2017-12-31 204749363 ISLER MEDFORD LLC 839 ALDER CREEK DR MEDFORD OR 97504 990 2017-01-01 930691238 ASHLAND COMMUNITY HOSPITAL FOUNDATION ASHL 5412014014 280 MAPLE STREET ASHLAND OR 97520 ED COLSON TREASURER 5412014014 2018-08-30 1 CAROLYN M RYDER P00033827 5417797641 2017 2022-09-23 18:48:47Z JANET TROY 280 MAPLE STREET ASHLAND OR 97520 3028836 0 X WWW.ACHFOUNDATION.ORG X 1977 OR SEE SCHEDULE O - PAGE 36 FOR FOUNDATION MISSION STATEMENT.OUR MISSION IS TO SOLICIT, STEWARD AND GRANT FUNDS TO SUPPORT ASANTE ASHLAND COMMUNITY HOSPITAL.VISION INSPIRING PHILANTHROPY TO ENHANCE ASANTE ASHLAND COMMUNITY HOSPITAL SERVICES.VALUES WE ACHIEVE OUR VISION AND LIVE OUR MISSION BY VALUING:*PASSION FOR ASANTE ASHLAND COMMUNITY HOSPITAL AND COMMUNITY HEALTH;*GENEROSITY WITH CHARITABLE GIFTS, TIME, AND EXPERTISE;*STEWARDSHIP IN THE MANAGEMENT OF ASSETS ENTRUSTED TO OUR CARE;*STRATEGIC PARTNERSHIP WITH ASANTE ASHLAND COMMUNITY HOSPITAL, ASANTE AND COMMUNITY MEMBERS;*ADVOCACY TO RAISE THE PROFILE OF ASANTE ASHLAND COMMUNITY HOSPITAL AS AN HONORED INSTITUTION IN THE COMMUNITY; *INDEPENDENCE FOR ASHLAND COMMUNITY HOSPITAL FOUNDATION 12 12 0 0 178500 0 393209 426433 31963 33084 164886 236467 181113 178772 771171 874756 313617 300795 0 0 0 0 0 0 0 247859 229783 561476 530578 209695 344178 6822976 7664567 154089 137445 6668887 7527122 X OUR MISSION IS TO SOLICIT, STEWARD AND GRANT FUNDS TO SUPPORT ASANTE ASHLAND COMMUNITY HOSPITAL. 0 0 300795 300795 SEE SCHEDULE O - REPORTED NET OF UNUSED GRANTS. 5582 33084 THROUGH EFFORTS OF ASHLAND COMMUNTIY HOSPITAL FOUNDATION, THE COMMUNITY OF TALENT, OREGON CONTINUES TO RECEIVE QUALITY HEALTHCARE. IN 1994, THE FOUNDATION CONSTRUCTED A PHARMACY IN THAT COMMUNITY, WHICH IS RENTED TO MEDICAP PHARMACY. THIS PROJECT HELPED GUARANTEE ACCESS TO PHARMACEUTICALS IN THE COMMUNITY. 306377 1 1 0 0 0 1 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 7 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 0 0 0 OR X X REID HANNA JOHNSON & COMPANY LLC 5414823711 1101 SISKIYOU BLVD ASHLAND OR 97520 X KAREN AMAROTICO DIRECTOR 2.00 X 0 0 0 LAUREL KIICHLI DIRECTOR 2.00 X 0 0 0 KAREN DRESCHER DIRECTOR 2.00 X 0 0 0 ERIC HERRON DIRECTOR 2.00 X 0 0 0 RICK NAGEL DIRECTOR 2.00 X 0 0 0 SHARON LASKOS DIRECTOR 2.00 X 0 0 0 RAND ROSELLI DIRECTOR 2.00 X 0 0 0 JANE STROMBERG DIRECTOR 2.00 X 0 0 0 TRICIA HAHN DIRECTOR 2.00 X 0 0 0 ED COLSON TREASURER 2.00 X 0 0 0 JOY DOBSON WAY PRESIDENT 2.00 X 0 0 0 MARGIE LININGER SECRETARY 2.00 X 0 0 0 LIZ MURPHY PAST PRESIDENT 2.00 X 0 0 0 0 0 0 0 0 0 0 0 426433 426433 RENT OF MED FACILITIES 531390 33084 33084 33084 197745 197745 178500 0 178500 178500 178500 2192802 2154080 38722 38722 38722 MISCELLANEOUS INCOME 561000 272 272 272 874756 72078 178500 197745 204861 204861 95934 95934 33096 33096 37472 37472 2034 2034 9645 9645 4007 4007 OTHER OPERATING EXPENSE 141954 141954 OTHER RENTAL EXPENSE 1575 1575 530578 306377 224201 0 47597 9486 335894 410305 6888 10187 2831 3520 569243 83980 489270 485263 5940496 6745806 6822976 7664567 28342 4941 125747 132504 154089 137445 X 2242816 2550887 1147575 1587461 3278496 3388774 6668887 7527122 6822976 7664567 X 344178 505375 306604 -297922 X X 0 1 X 1 0 X 2635877 619650 338671 393209 426433 4413840 2635877 619650 338671 393209 426433 4413840 4413840 541244 396797 379418 381511 409601 2108571 1473 1473 6523884 0.67660 0.65030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 95934 2875647 0 0 0 3502232 31616 443049 133652 22191 3821054 3397601 10972 230966 115555 21752 3502232 3209768 263285 53852 21600 3397601 2839646 296350 166889 32833 38256 22028 3209768 713533 2078698 102587 16167 25188 13817 2839646 0 0 411472 411472 157771 83980 73791 485263 MUTUAL FUNDS 6556620 F UNITRUST ASSETS 189186 F 6745806 ANNUITY OBLIGATION 129904 DEPOSITS 2600 132504 X 1693905 505375 306605 7169 819149 874756 0 874756 835670 305092 305092 530578 0 530578 Part V, Line 4: INCOME FROM EVANS SCHOLARSHIP ENDOWMENT FUND IS TO AWARD SCHOLARSHIPS TO STUDENTS WHO ARE PURSUING NURSING DEGREES FROM OREGON HEALTH SCIENCES UNIVERSITY AT SOUTHERN OREGON UNIVERSITY OR ROGUE COMMUNITY COLLEGE. INCOME FROM THE NIXON ENDOWMENT FUND IS GIFTED ANNUALLY TO THE FOUNDATION'S LIGHTS FOR LIFE CAMPAIGN. Part X, Line 2: THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT ON NET INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES GENERATED FROM THE RENTAL OF CERTAIN DEBT-FINANCED PROPERTY. AT DECEMBER 31, 2016, THE ACTIVITY REPORTED OPERATING INCOME OF $0 WHICH DID NOT ADD OR SUBTRACT FROM OPERATING LOSS CARRYFORWARDS. THE UNUSED NET OPERATING LOSS CARRYFORWARDS MAY BE APPLIED AGAINST FUTURE TAXABLE INCOME. THE DEFERRED TAX ASSET HAS NOT BEEN RECORDED IN THE FINANCIAL STATEMENTS DUE TO THE UNDETERMINABLE TIMING OF EVENTS OF WHICH THE FOUNDATION WOULD BE ABLE TO UTILIZE THE CARRYFORWARDS. THE FOUNDATION'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS (FORM 990-T) FOR 2014, 2015, AND 2016 ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR 3 YEARS AFTER THEY WERE FILED. MANAGEMENT BELIEVES IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN. Part XI, Line 2d - Other Adjustments: CHANGE IN SPLIT INTEREST AGREEMENT 7,169. 0 ASANTE ASHLAND COMMUNITY HOSPITAL 280 MAPLE STREET ASHLAND OR 97520 204860 FMV FUNDING PROVIDED TO ASSIST WITH: EQUIPMENT PURCHASES, GENERAL EDUCATION, AND HOSPICE CENTER. NURSING SCHOLARSHIPS AWARDED 32 95934 FMV X OTHER SERVICES/GIFTS 28 0 COMPARABLE SALES X ACH ADMIN/OFFICE SPACE 1 0 FMV 0 1 0 Form 990, Part I, Line 1 ASHLAND COMMUNITY HOSPITAL FOUNDATION IS ORGANIZED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL AND SCIENTIFIC PURPOSES, INCLUDING, FOR SUCH PURPOSES, THE MAKING OF DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986 (AND SIMILAR PROVISIONS OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW). THE FOUNDATION SHALL HAVE THE FOLLOWING POWERS: (1) TO ASSIST, ENCOURAGE, PROMOTE AND ADVANCE THE QUALITY OF CARE, TREATMENT AND REHABILITATION OF THE SICK, AFFLICTED, INFIRM AND INJURED PATIENTS OF ASANTE ASHLAND COMMUNITY HOSPITAL, ASHLAND, OREGON. (2) TO FURTHER THE CHARITABLE, SCIENTIFIC, EDUCATIONAL AND SERVICE ACTIVITIES OF ASANTE ASHLAND COMMUNITY HOSPITAL. (3) TO SUPPORT ASANTE ASHLAND COMMUNITY HOSPITAL, ITS OBJECTIVES AND PROJECTS BY APPROPRIATE REPRESENTATIONS TO THE PUBLIC WITH RESPECT TO THE HOSPITAL'S NEEDS, MISSION AND REQUIREMENTS AND TO SOLICIT FUNDS FOR ITS USE IN PROVIDING THE MEDICAL AND HOSPITAL FACILITIES NEEDED IN THE GENERAL COMMUNITY SERVED BY ASANTE ASHLAND COMMUNITY HOSPITAL. (4) TO ACCEPT DONATIONS, GRANTS, BEQUESTS AND DEVISES FROM ANY SOURCES, AND TO ACCEPT PROPERTY OF ALL KINDS APPROPRIATE TO FOUNDATION PURPOSES. (5) TO FACILITATE, ASSIST, ENCOURAGE, SUPPORT, PROMOTE AND ADVANCE THE PHYSICAL, MENTAL AND EMOTIONAL HEALTH OF PERSONS WITHIN THE GEOGRAPHIC AREA SERVED BY ASANTE ASHLAND COMMUNITY HOSPITAL THROUGH ANY LAWFUL ACTIVITIES, WHICH ARE AUTHORIZED UNDER THE LAWS APPLICABLE TO OREGON NONPROFIT CORPORATIONS WHICH ARE NOT PROHIBITED UNDER ARTICLE III OF THE ARTICLES OF INCORPORATION. (6) TO DO AND PERFORM SUCH OTHER ACTS AS MAY BE NECESSARY OR APPROPRIATE FOR CARRYING OUT THE FOREGOING PURPOSES OF THE CORPORATION AND IN CONNECTION THEREWITH TO ENGAGE IN ANY LAWFUL ACTIVITY AUTHORIZED BY THE OREGON NONPROFIT CORPORATION LAW AND NOT PROHIBITED BY THE ARTICLES OF INCORPORATION OR SECTION 2 OF THIS ARTICLE. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS A. ULTRASOUND SYSTEM - A BEQUEST FROM THE ELMER C. BIEGEL FAMILY FOUNDATION, A GRANT FROM THE GWLADYS AND JOHN ZURLO CHARITABLE FOUNDATION, AND DONOR DESIGNATED GIFTS HELPED PURCHASE A NEW ULTRASOUND SYSTEM TO SERVE PATIENS IN OUR EMERGENCY DEPARTMENT AND FAMILY BIRTH CENTER. THE SYSTEM WILL ENHANCE DIAGNOSES FOR PATIENTS INCLUDING PEDIATRIC, CARDIAC, GYNECOLOGIC, UROLOGY VASCULAR AND CRITICAL CARE NEEDS $47,597 B. CAREGIVER FUND - PROCEEDS FROM LOUIE'S BIG GIVE AND EMPLOYEE GIFTS SUPPORTED EMPLOYEE INITIATIVES TO ENHANCE PATIENT CARE. PROJECTS INCLUDE THE ADDITION OF A HOVER JACK AIR LIFT TO SAFELY MOVE PATIENTS WHO HAVE SUFFERED A FALL, TELEVISIONS FOR PATIENT ROOMS, PUSH CARTS FOR IMPROVED STAFF EFFICIENCY DURING INPATIENT ROUNDING, AND AN INFRARED CAMERA TO DETECT AND PREVENT BUILDING MOISTURE AND WATER DAMAGE, MINIMIZING DISRUPTION IN SERVICE FOR PATIENT CARE $14,503 C. CHAPEL - CONTRIBUTIONS TO THE CREATION OF THE CHAPEL ASSISTED IN PURCHASING CRYSTAL PLAQUES TO REPRESENT THE SEVEN LARGEST FAITH GROUPS IN THE ASHLAND COMMUNITY $515 D. DIAGNOSTIC IMAGING - CONTRIBUTIONS SUPPORTED THE PURCHASE OF MATERIALS FOR THE BREAST CANCER AWARENESS EVENT HOSTED BY THE PADDINGTON JEWEL BOX AS PART OF BREAST CANCER AWARENESS MONTH $98 E. EVANS NURSING SCHOLARSHIPS - DONOR DESIGNATED GIFTS HAVE ENHANCED OUR ENDOWED SCHOLARSHIP FUND FOR NURSING STUDENTS IN THE ROGUE VALLEY. LAST YEAR, SIXTEEN NURSING STUDENTS ENROLLED AT OREGON HEALTH SCIENCE UNIVERSITY (ASHLAND CAMPUS), AND ROGUE COMMUNITY COLLEGE RECEIVED A TOTAL OF $93,000 IN SCHOLARSHIPS THROUGH THE WILLIAM G. AND RUTH T. EVANS ENDOWED NURSING SCHOLARSHIP FUND. AN ADDITIONAL 16 GRADUATES OF THE LICENSED PRACTICAL NURSE PROGRAM AT ROGUE COMMUNITY COLLEGE RECEIVED A SCHOLARSHIP TO COVER THE COST OF THEIR STATE APPLICATION AN EXAM FEES FOR A TOTAL OF $6,936. $99,936 F. FAMILY BIRTH CENTER - DONOR DESIGNATED GIFTS SUPPORTED THE CREATION OF AN EMPLOYEE BREAK ROOM IN THE UNIT $3,250 G. HOME HEALTH - CONTRIBUTIONS FROM DONOR DESIGNATED GIFTS SUPPORTED EDUCATION FOR EMPLOYEES, EQUIPMENT AND PATIENT CARE $7,748 H. HOSPICE - DONOR DESIGNATED GIFTS SUPPORTED THE MINDFUL CAREGIVER EDUCATION SESSION FACILITATED BY ZEN HOSPICE FOR EMPLOYEES AND SPIRITUAL CARE VOLUNTEERS. CONTRIBUTIONS ALSO FUNDED A REGULAR BEREAVEMENT SUPPORT GROUP FOR FAMILIES WHO HAVE SUFFERED A LOSS $9,800 I. INTENSIVE CARE UNIT - DONOR DESIGNATED GIFTS PURCHASED EQUIPMENT, INCLUDING SOFTWARE SUPPORT FOR TELEHEALTH $17,650 J. MEDICAL SURGICAL UNIT - A SPECIAL CONTRIBUTION FROM A DONOR SUPPORTED UPGRADES TO THE DEPARTMENT STAFF BREAKROOM $1,000 K. RADIOLOGY EDUCATION - DONOR DESIGNATED GIFTS ALLOWED AN ASANTE ASHLAND ULTRASOUND TECHNICIAN IN DIAGNOSTIC IMAGING TO ATTEND THE 2017 ANNUAL CONFERENCE FOR THE SOCIETY OF DIAGNOSTIC MEDICAL SONOGRAPHY. IN ADDITION, CONTRIBUTIONS ENABLED TRAINING OF STAFF FOR THE NEW DEXA SCANNER $2,446 L. SCHOOL NURSE PROGRAM - GRANTS FROM THE REED AND CAROLEE WALKER FUND OF THE OREGON COMMUNITY FOUNDATION, AND THE SHARKEY FOUNDATION PROVIDED FUNDING FOR NURSING SERVICES TO OVER 1,700 ELEMENTARY SCHOOL CHILDREN IN THE ASHLAND AND TALENT-PHOENIX SCHOOL DISTRICTS. IN ADDITION, THE ASHLAND FOOD COOP AND ASHLAND SHOP-N-KART SUPPLIED HEALTHY SNACKS TO STUDENTS AS PART OF THE HEALTHY SNACKS: AN ALTERNATIVE TO MEDICATION PROGRAM $65,515 M. STAFF EDUCATION - GRANTS FROM THE OREGON HEALTH & SCIENCE UNIVERSITY OFFICE OF RURAL HEALTH SMALL HOSPITAL IMPROVEMENT PROGRAM PROVIDED FUNDING FOR LEAN TRAINING FOR LEADERS $6,836 N. SURGICAL SERVICES - DONOR DESIGNATED GIFTS HELPED PURCHASE A NEW SURGICAL TABLE TO BENEFIT PATIENTS UNDERGOING GYNECOLOGICAL AND UROLOGY PROCEDURES $27,795 TOTAL PROGRAM SERVICE EXPENSES $304,689 Form 990, Part VI, Section A, line 6 FOUNDATION BOARD MEMBERS SERVE AS VOTING MEMBERS WITH AUTHORITY AND RESPONSIBILITY TO DEVELOP POLICIES, PROCEDURES, AND REGULATIONS NECESSARY TO OPERATE THE FOUNDATION, PARTICIPATE IN FUNDRAISING THROUGH PERSONAL CONTRIBUTIONS, AND PARTICPATE IN THE VARIOUS CAMPAIGNS NECESSARY TO FINANCE THE ONGOING OPERATION OF THE FOUNDATION AND ITS WORK WITH THE HOSPITAL. BOARD MEMBERS SERVE A THREE YEAR TERM (UNLESS ELECTED TO FILL AN UNEXPIRED TERM). Form 990, Part VI, Section A, line 7a THE OFFICERS SHALL BE ELECTED BY, AND SHALL SERVE AT THE PLEASURE OF, THE BOARD, AND SHALL HOLD THEIR RESPECTIVE OFFICES UNTIL THEIR RESIGNATION, REMOVAL, OR OTHER DISQUALIFICATION FROM SERVICE, OR UNTIL THEIR RESPECTIVE SUCCESSORS SHALL BE ELECTED. THE PRESIDENT SHALL BE ELECTED FOR A TWO-YEAR TERM OF OFFICE. VICE-PRESIDENT, SECRETARY AND TREASURER SHALL BE ELECTED ANNUALLY. Form 990, Part VI, Section A, line 7b FOUNDATION BOARD MEMBERS ARE EXPECTED TO ATTEND MONTHLY BOARD MEETINGS, STANDING COMMITTEES (AS ASSIGNED), AD HOC COMMITTEE MEETINGS (AS APPOINTED) AND SPECIAL EVENTS (AS ANNOUNCED). CONTINUITY OF ATTENDANCE AND PARTICIPATION AS A POLICY MAKER AND PLANNER IS IMPERATIVE FOR SERVING AS A VOTING MEMBER. Form 990, Part VI, Section B, line 11b THE ACH FOUNDATION HAS A STANDING ASSET MANAGEMENT COMMITTEE THAT MEETS QUARTERLY TO REVIEW FINANCIAL STATEMENTS, INCLUDING EXPENSES, INCOME, GRANTS, CASH DISBURSEMENTS, BALANCE SHEET, PROFIT AND LOSS, AND ANY AUDIT LETTERS. IN ADDITION, TIME IS ALLOCATED AT EACH QUARTERLY BOARD MEETING TO REVIEW FINANCIAL STATEMENTS AND THE ANNUAL AUDIT IS PRESENTED TO THE FULL FOUNDATION BOARD UPON ITS COMPLETION. BOTH THE ASSET MANAGEMENT COMMITTEE AND THE BOARD MONITOR THE FINANCIAL RESOURCES TO ENSURE THAT FUNDS ARE APPROPRIATELY ACCOUNTED FOR. THE FOUNDATION BOARD TREASURER REVIEWS THE FINANCIAL STATEMENTS ON A MONTHLY BASIS. FINANCIAL STATEMENTS: 1. THE ACH FOUNDATION IS NOT REQUIRED BY LAW TO UNDERGO AN AUDIT BY AN INDEPENDENT AUDITOR. 2. THE ACH FOUNDATION HAS NOT RECEIVED FEDERAL FUNDS THAT REQUIRES ONE OR MORE AUDITS. 3. THE ACH FOUNDATION BOARD HAS AN ESTABLISHED ASSET MANAGEMENT COMMITTEE WHICH MAKES RECOMMENDATIONS ON THE SELECTION OF THE INDEPENDENT AUDITOR TO THE FOUNDATION BOARD. IN ADDITION, THEY OVERSEE THE INDEPENDENT AUDITOR. 4. THE ACH FOUNDATION CURRENTLY HAS FINANCIAL STATEMENTS COMPILED BY AN INDEPENDENT ACCOUNTANT AND AUDITED ANNUALLY BY A QUALIFIED THIRD-PARTY. Form 990, Part VI, Section B, line 12c ALL BOARD MEMBERS ARE EXPECTED TO ACCEPT AND ADHERE TO POLICIES AND HOLD FELLOW BOARD MEMBERS AND STAFF TO THE SAME STANDARDS. MONITORING OF SUCH IS ONGOING. Form 990, Part VI, Section C, line 18 THE FOUNDATION'S DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION MAY BE REQUESTED FOR VIEWING BY CONTACTING THE FOUNDATION'S OFFICE. Form 990, Part VI, Section C, line 19 THE FOUNDATION'S FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AND BY VISITING THE WEBSITE WWW.ACHFOUNDATION.ORG Form 990, Part XI, line 9: CHANGE IN MARKET VALUE OF TRUST ASSETS 7,169. IN-KIND EXPENSES -305,091. FINANCIAL STATEMENT AND AUDIT OVERSIGHT THE OVERSIGHT OR SELECTION PROCESS HAS NOT CHANGED DURING THE YEAR.