ISLAND HOSPITAL HEALTH FOUNDATION: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- ISLAND HOSPITAL HEALTH FOUNDATION (EIN 91-1030686)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-08
- IRS object ID
- 201803129349303250
- Schema version
- 2017v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-08T15:55:11-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10700 NORTHUP WAY SUITE 200 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911030686 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ISLAND HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ISLA | BusinessNameControlTxt |
| Phone | 3602994201 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 24TH STREET | AddressLine1Txt |
| City | ANACORTES | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98221 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DESHA FURIN | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 3602994201 | PhoneNum |
| Signature | 2018-10-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KURT BENNION CPA | PreparerPersonNm |
| PTIN | P01469618 | PTIN |
| Phone | 4252506100 | PhoneNum |
| Preparation | 2018-10-22 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-10-22 | IPDt |
| IP Tm | 11:11:10 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | EB0BBDEF6E86ED143E3AB707D06A90C6F6839315 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 33F877C3ABFBB78B8EF2964D67A95BC3B590144C | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MEREDITH MACHIN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 24TH STREET | AddressLine1Txt |
| City | ANACORTES | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98221 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,558,655 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ISLANDHOSPITALFOUNDATION.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | TO RAISE FUNDS TO SUPPORT ISLAND HOSPITAL AND ITS COMMITMENT TO COMMUNITY HEALTH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 18 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $804,452 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,281,214 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $74,980 | PYInvestmentIncomeAmt |
| CY Investment Income | $142,834 | CYInvestmentIncomeAmt |
| PY Other Revenue | $110,815 | PYOtherRevenueAmt |
| CY Other Revenue | -$75,480 | CYOtherRevenueAmt |
| PY Total Revenue | $990,247 | PYTotalRevenueAmt |
| CY Total Revenue | $1,348,568 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $725,728 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,086,192 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $31,947 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $26,101 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $70,936 | PYOtherExpensesAmt |
| CY Other Expenses | $97,077 | CYOtherExpensesAmt |
| PY Total Expenses | $796,664 | PYTotalExpensesAmt |
| CY Total Expenses | $1,215,216 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $193,583 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $133,352 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,607,084 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,909,989 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $851 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,545 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,606,233 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,907,444 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF THE FOUNDATION IS TO RAISE FUNDS TO SUPPORT ISLAND HOSPITAL AND ITS COMMITMENT TO COMMUNITY HEALTH IN AND AROUND ANACORTES, WASHINGTON. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,142,581 | ExpenseAmt |
| Grant | $1,086,192 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | SINCE 1962, ISLAND HOSPITAL HAS PROVIDED HIGH QUALITY, COMPASSIONATE AND PERSONALIZED HEALTH CARE TO OUR COMMUNITY. ISLAND HOSPITAL MAINTAINS A PROGRESSIVE STAND IN DELIVERING THE BEST HEALTH CARE EXPERIENCES FOR PATIENTS AND THEIR FAMILIES BY PLACING THEIR EMOTIONAL AND MEDICAL NEEDS FIRST AND FOREMOST. ISLAND HOSPITAL FOUNDATION SUPPORTS ISLAND HOSPITAL'S VITAL MISSION BY RAISING MUCH-NEEDED FUNDS FOR THE BENEFIT OF COMMUNITY HEALTH. FOUNDED IN 1978, THE FOUNDATION IS AN INDEPENDENT, NONPROFIT CORPORATION HEADED BY A 21-MEMBER VOLUNTEER BOARD OF DIRECTORS. THESE DEDICATED COMMUNITY AND BUSINESS LEADERS GENEROUSLY DONATE THEIR TIME, TALENTS, AND ENERGY TO DIRECT THE FOUNDATION'S POLICIES, PROVIDE FUDICIARY OVERSIGHT, IMPLEMENT THE ANNUAL FUNDRAISING PLAN AND (CONTINUED IN SCHEDULE O) TO SECURE ITS FINANCIAL FUTURE.THROUGH FUNDRAISING, THE ISLAND HOSPITAL FOUNDATION PROVIDES FUNDING FOR COMMITMENTS TO THE HOSPITAL THAT INCLUDE THE HEALTH RESOURCE CENTER, FREE AND LOW COST COMMUNITY HEALTH SCREENINGS, DIRECT CLINIC SUPPORT, MENTAL HEALTH COUNSELING THROUGH THE MENTAL HEALTH INTERVENTION SCHOOL PROGRAM, THE CHAPLAIN PROGRAM, AND PATIENT PROGRAMS. PATIENT PROGRAMS INCLUDE MEDICAL RELIEF, ONCOLOGY RELIEF AND ONCOLOGY LODGING ASSISTANCE. NEW TECHNOLOGY EQUIPMENT ALONG WITH OTHER NEEDS ARE ALSO PROVIDED FOR AS THEY ARISE THROUGH THE YEAR. ADDITIONALLY, ISLAND HOSPITAL FOUNDATION PROVIDES FUNDING FOR HOSPITAL RENOVATION AND EXPANSION COSTS NOT MET BY TAX REVENUE. THIS INCLUDES THE MEDICAL ARTS PAVILION HOUSING CANCER CARE, PHYSICAL/OCCUPATIONAL/ SPEECH THERAPY AND WOUND CARE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Revenue | $0 | RevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $1,142,581 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 18 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CINDY ANDERSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3602991300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 24TH ST | AddressLine1Txt |
| City | ANACORTES | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98221 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| DESHA FURIN | |||||||
| PRESIDENT | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MEREDITH MACHIN | |||||||
| VICE PRESIDENT | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JAMIE CROMACK | |||||||
| SECRETARY | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JEREMY MCNETT | |||||||
| TREASURER | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| NICOLE COLEMAN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| CHUCK FLAGG | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KATHLEEN GARDE MD | |||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $452,205 | $82,487 | |
| RICH HUMPHREY | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| FRANK JERETZKY | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DIANNE KUHN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TROY KUNZ | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KRISTA OICLES | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KIM ORT | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DON SCHMUDE | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARILYN STADLER | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JAMES TANGARO | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SHIRLEY VACANTI RN BSN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| GINA WALSH | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JEANNETTE PAPADAKIS | |||||||
| EXECUTIVE DIRECTOR | 40.00 | 0.00 | Yes (X) | $0 | $75,373 | $11,426 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $527,578 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $93,913 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $399,069 | FundraisingAmt |
| All Other Contributions | $882,145 | AllOtherContributionsAmt |
| Noncash Contributions | $38,826 | NoncashContributionsAmt |
| Total Contributions | $1,281,214 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $79,684 | TotalRevenueColumnAmt |
| Exclusion | $79,684 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $109,800 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $46,650 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $63,150 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63,150 | TotalRevenueColumnAmt |
| Exclusion | $63,150 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $87,957 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $399,069 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $163,437 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$75,480 | TotalRevenueColumnAmt |
| Exclusion | -$75,480 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,348,568 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $67,354 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,069,365 | TotalAmt |
| Program Services | $1,069,365 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,827 | TotalAmt |
| Program Services | $16,827 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,947 | TotalAmt |
| Program Services | $31,947 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,450 | TotalAmt |
| Management And General | $6,450 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,590 | TotalAmt |
| Management And General | $10,590 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,196 | TotalAmt |
| Program Services | $2,098 | ProgramServicesAmt |
| Management And General | $2,098 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $710 | TotalAmt |
| Management And General | $710 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,767 | TotalAmt |
| Management And General | $4,767 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| EXPENSES PAID BY ISLAND | $68,163 | $22,344 | $19,718 | $26,101 |
| MISCELLANEOUS EXPENSES | $1,676 | $1,676 | ||
| DUES & SUBSCRIPTIONS | $525 | $525 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,215,216 | TotalAmt |
| Program Services | $1,142,581 | ProgramServicesAmt |
| Management And General | $46,534 | ManagementAndGeneralAmt |
| Fundraising | $26,101 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,194 | BOYAmt |
| EOY | $269,611 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,679 | BOYAmt |
| EOY | $16,916 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,000 | BOYAmt |
| EOY | $2,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,675 | BOYAmt |
| EOY | $68,879 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $500 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,255,536 | BOYAmt |
| EOY | $2,552,083 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,607,084 | BOYAmt |
| EOY | $2,909,989 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $851 | BOYAmt |
| EOY | $2,545 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $851 | BOYAmt |
| EOY | $2,545 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,235,146 | BOYAmt |
| EOY | $2,464,517 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,087 | BOYAmt |
| EOY | $241,927 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,000 | BOYAmt |
| EOY | $201,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,606,233 | BOYAmt |
| EOY | $2,907,444 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,607,084 | BOYAmt |
| EOY | $2,909,989 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $133,352 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $167,547 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $312 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | 0 | FSAuditedInd |
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $684,420 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $476,276 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $432,765 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $804,452 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,281,214 | CurrentTaxYearAmt |
| Total | $3,679,127 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $684,420 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $476,276 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $432,765 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $804,452 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,281,214 | CurrentTaxYearAmt |
| Total | $3,679,127 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $234,466 | SubstantialContributorsTotAmt |
| Public Support Total170 | $3,444,661 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $89 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $50,492 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $71,666 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $74,980 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $79,684 | CurrentTaxYearAmt |
| Total | $276,911 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $67,868 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $127,161 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $628,193 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $396,110 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $87,957 | CurrentTaxYearAmt |
| Total | $1,307,289 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $5,263,327 | TotalSupportAmt |
| Public Support CY170 | 0.65450 | PublicSupportCY170Pct |
| Public Support PY170 | 0.63610 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | FUNDRAISING EVENT REVENUES MISCELLANEOUS INCOME | ExplanationTxt |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,255,536 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $304,829 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $8,268 | OtherExpendituresAmt |
| End Year Balance | $2,552,097 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,081,962 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $170,272 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$3,302 | OtherExpendituresAmt |
| End Year Balance | $2,255,536 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,145,881 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$41,099 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $8,220 | OtherExpendituresAmt |
| Administrative Expenses | $14,600 | AdministrativeExpensesAmt |
| End Year Balance | $2,081,962 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,714,403 | BeginningYearBalanceAmt |
| Contributions | $384,090 | ContributionsAmt |
| Investment Earnings Or Losses | $87,727 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $40,339 | OtherExpendituresAmt |
| End Year Balance | $2,145,881 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,503,114 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $252,194 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $40,904 | OtherExpendituresAmt |
| End Year Balance | $1,714,404 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.89600 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.07880 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.02520 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,697,075 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $167,547 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $17,523 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $163,437 | OtherRevenueAmt |
| Revenue Not Reported | $348,507 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,348,568 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,348,568 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,396,176 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $17,523 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $163,437 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $180,960 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,215,216 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,215,216 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE INCOME FROM THE ENDOWMENTS IS TO BE USED FOR TWO PURPOSES: 1. HOSPITAL-IDENTIFIED COMMUNITY HEALTH NEEDS 2. PROVIDE FUNDS FOR THE BENEFIT OF THE OBSTETRICS DEPARTMENT |
| PART X, LINE 2: | AS A CHARITABLE FOUNDATION, ISLAND HOSPITAL FOUNDATION IS A NONPROFIT CORPORATION AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A). THE FOUNDATION HAS ACCOUNTED FOR UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND WAS REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2017 AND 2016, THE FOUNDATION HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL OR DISCLOSURE. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 163,437. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 163,437. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA | Event1Nm |
| Gross Receipts Event1 | $363,987 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $289,574 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $74,413 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $918 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $1,500 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $25,593 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $10,083 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $60,366 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF TOURNAMENT | Event2Nm |
| Gross Receipts Event2 | $123,039 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $109,495 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $13,544 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $3,189 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $11,641 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $16,157 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $205 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $33,785 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $487,026 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $399,069 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $87,957 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $4,107 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $13,141 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $41,750 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $10,288 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $94,151 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $163,437 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$75,480 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| SKAGIT COUNTY PUBLIC HOSPITAL DISTRICT NO 2 (DBA ISLAND HOSPITAL) | ||||||||||
| 1211 24TH STREET | ANACORTES | WA | 98221 | 910729255 | ISLAND HOSPITAL | $967,383 | $1,982 | FMV | MISCELLANEOUS NON-CASH ITEMS | SUPPORT OF HEALTH PROGRAMS AT HOSPITAL |
| ANACORTES SCHOOL DISTRICT | ||||||||||
| 2202 M AVENUE | ANACORTES | WA | 98221 | 916016222 | ANACORTES SCHOOL DIS | $100,000 | MENTAL HEALTH PROGRAMS | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| ONCOLOGY GRANTS | 115 | $13,827 |
| SCHOLARSHIPS | 2 | $3,000 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | COMMON EXECUTIVE MANAGEMENT ENSURE THAT ALL FUNDS TRANSFERRED TO ISLAND HOSPITAL ARE USED FOR INTENDED PURPOSES. FOUNDATION AND HOSPITAL LEADERS MET REGULARLY WITH THE ANACORTES SCHOOL DISTRICT TO DISCUSS PROGRESS IN THEIR MENTAL HEALTH PROGRAMS, DURING WHICH THE FOUNDATION ENSURED THAT THE FUNDS WERE USED FOR APPROPRIATE PURPOSES. INDIVIDUALS RECEIVING ONCOLOGY GRANTS PROVIDE RECEIPTS SHOWING QUALIFIED EXPENSES AND ARE REIMBURSED. SCHOLARSHIP FUNDS ARE GIVEN DIRECTLY TO THE INDIVIDUAL'S SCHOOL. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KATHLEEN GARDE MD | PersonNm |
| Title | DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $438,156 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $14,049 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $64,575 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $17,912 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $534,692 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY ISLAND HOSPITAL. THE FOLLOWING WERE USED BY ISLAND HOSPITAL IN SETTING THE EXECUTIVE DIRECTOR'S COMPENSATION: 1. FORM 990 OF OTHER ORGANIZATIONS 2. WRITTEN EMPLOYMENT CONTRACT 3. COMPENSATION SURVEY OR STUDY | ExplanationTxt |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $3,509 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | DONOR DETERMINED | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $5,679 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | DONOR DETERMINED | MethodOfDeterminingRevenuesTxt |
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 27 | ContributionCnt |
| Noncash Contributions Rpt F990 | $9,005 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | DONOR DETERMINED | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (3 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | TRAVEL | 12 | $11,630 | DONOR DETERMINED |
| Yes (X) | EVENT TICKETS | 20 | $4,841 | FACE VALUE |
| Yes (X) | GIFT CERTIFICATES | 32 | $4,162 | FACE VALUE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | ALL DAY-TO-DAY MANAGEMENT AND ADMINISTRATIVE SERVICES ARE PROVIDED BY EMPLOYEES OF ISLAND HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE BYLAWS WERE AMENDED IN JANUARY 2017 TO INCREASE THE MINIMUM NUMBER OF BOARD MEETINGS FROM SIX PER YEAR TO EIGHT PER YEAR. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE EXECUTIVE BOARD REVIEWED THE FULL FORM 990, INCLUDING DISCLOSURES. A PUBLIC DISCLOSURE COPY OF THE FORM 990 WAS PROVIDED TO THE ENTIRE BOARD FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF THE COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFILCT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS IHF IS A CHARITABLE ORGANIZATION AND IN ORDER TO MAINTAIN ITS FEDERAL TAX-EXEMPT STATUS MUST ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. EACH VOTING MEMBER OF THE BOARD SHALL ANNUALLY SIGN A STATEMENT WHICH DECLARES WHETHER SUCH PERSON IS AN INDEPENDENT DIRECTOR. IF AT ANY TIME DURING THE YEAR, THE INFORMATION IN THE ANNUAL STATEMENT CHANGES MATERIALLY, THE DIRECTOR SHALL DISCLOSE SUCH CHANGES AND REVISE THE ANNUAL DISCLOSURE FORM. THE EXECUTIVE COMMITTEE SHALL REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THIS POLICY BY REVIEWING ANNUAL STATEMENTS AND TAKING SUCH OTHER ACTIONS AS ARE NECESSARY FOR EFFECTIVE OVERSIGHT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE FOUNDATION HAS NO COMPENSATED EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SKAGIT COUNTY PUBLIC HOSPITAL DIST #2 (DBA ISLAND HOSPITAL) | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 24TH STREET | AddressLine1Txt |
| City | ANACORTES | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98221 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910729255 | EIN |
| Primary Activities | HEALTH CARE | PrimaryActivitiesTxt |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Exempt Code Section | 115(1) | ExemptCodeSectionTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments