COMMUNITY HEALTH CARE: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH CARE (EIN 91-1349657)
- Tax period
- 2016-06-01 to 2017-05-31
- Filed
- 2018-02-07
- IRS object ID
- 201840389349300739
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-02-07T18:55:07-06:00 | ReturnTs |
| Tax Period End | 2017-05-31 | 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 | 2016-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911349657 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 2535974550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1148 BROADWAY NO 100 | AddressLine1Txt |
| City | TACOMA | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98402 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID FLENTGE | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2537221502 | PhoneNum |
| Signature | 2018-02-01 | 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 |
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 | 2018-02-01 | IPDt |
| IP Tm | 13:39:07 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | E49AB45AF12B1BB25434C7612008407C4465D4D7 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 7B720C417D09A2A0A49D149EB40D603FC32411E4 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | DAVID FLENTGE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1148 BROADWAY NO 100 | AddressLine1Txt |
| City | TACOMA | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $50,818,981 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COMMHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE THE HIGHEST QUALITY HEALTH CARE WITH COMPASSIONATE AND ACCESSIBLE SERVICE FOR ALL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 539 | TotalEmployeeCnt |
| Total Volunteers | 26 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,040,011 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,685,597 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $36,819,697 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $41,764,716 | CYProgramServiceRevenueAmt |
| PY Investment Income | $199,650 | PYInvestmentIncomeAmt |
| CY Investment Income | $202,159 | CYInvestmentIncomeAmt |
| PY Other Revenue | $93,221 | PYOtherRevenueAmt |
| CY Other Revenue | $123,086 | CYOtherRevenueAmt |
| PY Total Revenue | $43,152,579 | PYTotalRevenueAmt |
| CY Total Revenue | $50,775,558 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $22,780 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $29,264,359 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $33,512,995 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $45,966 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $61,050 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $79,902 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,075,599 | PYOtherExpensesAmt |
| CY Other Expenses | $16,358,373 | CYOtherExpensesAmt |
| PY Total Expenses | $42,385,924 | PYTotalExpensesAmt |
| CY Total Expenses | $49,955,198 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $766,655 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $820,360 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $49,257,892 | TotalAssetsBOYAmt |
| Total Assets EOY | $52,990,893 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,898,013 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,810,654 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $36,359,879 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $37,180,239 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | COMMUNITY HEALTH CARE PROVIDES COMPREHENSIVE PRIMARY MEDICAL AND DENTAL CARE THROUGH A CLINIC SYSTEM THAT INCLUDES SEVEN MEDICAL AND THREE DENTAL CLINICS. IN ADDITION, CARE IS ALSO PROVIDED THROUGH A WOMEN'S HEALTH CLINIC. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $24,689,334 | ExpenseAmt |
| Grant | $22,780 | GrantAmt |
| Revenue | $19,289,182 | RevenueAmt |
| Desc | COMMUNITY HEALTH CARE (CHC) MEDICAL CLINICS OFFER MEDICAL SERVICES AND URGENT CARE CENTER SERVICES IN VARIOUS LOCATIONS IN PIERCE COUNTY ACCORDING TO A SLIDING FEE SCALE BASED ON INCOME AND FAMILY SIZE. CHC CONTINUES TO SUPPORT TWO RESIDENCY PROGRAMS: 1. A FAMILY PHYSICIAN RESIDENCY PROGRAM THAT ACCEPTS 6 RESIDENTS EACH YEAR FOR A TOTAL OF 18 RESIDENTS DURING A 3 YEAR PROGRAM; AND 2. A FAMILY ADVANCED REGISTERED NURSE PRACTIONER RESIDENCY PROGRAM. DURING THE FISCAL YEAR ENDED 5/31/17, CHC PROVIDED 32,228 PATIENTS WITH MEDICAL CARE FROM 116,123 PATIENT VISITS AT 5 MEDICAL CLINICS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $9,422,902 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $8,564,775 | RevenueAmt |
| Desc | COMMUNITY HEALTH CARE (CHC) DENTAL CLINICS OFFER PRIMARY CARE DENTAL SERVICES IN VARIOUS PIERCE COUNTY LOCATIONS ACCORDING TO THE SAME FEE STRUCTURE. CHC DENTAL CLINICS INCLUDE A DENTAL RESIDENCY PROGRAM THAT LAUNCHED IN JULY 2013. DURING THE FISCAL YEAR ENDED 5/31/17, CHC PROVIDED 21,674 PATIENTS WITH DENTAL CARE FROM 60,454 DENTAL VISITS PATIENTS AT 3 DENTAL CLINICS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,435,111 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $12,796,052 | RevenueAmt |
| Desc | COMMUNITY HEALTH CARE (CHC) PHARMACIES OFFER PHARMACEUTICAL SERVICES TO PATIENTS IN VARIOUS LOCATIONS IN PIERCE COUNTY ACCORDING TO THE SAME FEE STRUCTURE NOTED ABOVE. DURING THE FISCAL YEAR ENDED 5/31/17, CHC'S PHARMACIES SERVED 15,477 PATIENTS THROUGH 147,314 MEDICATION FILLS AT 4 CLINICS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,504,731 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,114,707 | RevenueAmt |
| Desc | COMMUNITY HEALTH CARE (CHC) OFFERS NUTRITION, VISION, MATERNITY, AND BEHAVIORAL HEALTH SERVICES THROUGH THE CHC CLINICS IN PIERCE COUNTY. DURING THE FISCAL YEAR ENDED 5/31/2017, CHC PROVIDED 4,362 PATIENTS WITH 13,968 VISITS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,504,731 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $1,114,707 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $43,052,078 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 539 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | 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 | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TONIA CAMPBELL | PersonNm |
| Phone | 2535691510 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1148 BROADWAY NO 100 | AddressLine1Txt |
| City | TACOMA | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98402 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| GARY WALMER | |||||||||
| CHAIR | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RICHARD BOWE | |||||||||
| VICE CHAIR | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAN SLOAN | |||||||||
| SECRETARY | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LES CATHERSAL | |||||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LINDA BOWMAN | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LADEDRIA GRIFFIN-STALLWORTH | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| PAUL HANSEN | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| RIA JOHNSON | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CHAD MCMILLAN | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KEN REPP | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ANDY SMART | |||||||||
| BOARD MEMBER (THROUGH NOV 2016) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DOUG SWANBERG | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| LINDA TIEMAN | |||||||||
| BOARD MEMBER (THROUGH AUG 2016) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ANTHONY VELEZ | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MARCO VINIEGRA | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SHELLY WEISS | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DEBRA YOUNG | |||||||||
| BOARD MEMBER (THROUGH DEC 2016) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID FLENTGE | |||||||||
| CEO | 40.00 | 2.00 | Yes (X) | $196,639 | $0 | $20,062 | |||
| TONIA CAMPBELL | |||||||||
| CFO | 40.00 | 2.00 | Yes (X) | $140,728 | $0 | $28,633 | |||
| JEFFREY SMITH | |||||||||
| RESIDENCY DIRECTOR | 40.00 | 0.00 | $316,229 | $0 | $31,482 | Yes (X) | |||
| GARY REICHARD | |||||||||
| MD/DO & ASSISTANT RESIDENCY DIRECTOR | 40.00 | 0.00 | $221,553 | $0 | $29,586 | Yes (X) | |||
| ELIZABETH FRIESEMA | |||||||||
| MEDICAL DIRECTOR | 40.00 | 0.00 | $246,016 | $0 | $15,585 | Yes (X) | |||
| DANIEL KREBS | |||||||||
| ASSISTANT MEDICAL DIRECTOR | 40.00 | 0.00 | $248,233 | $0 | $22,304 | Yes (X) | |||
| JEFF REYNOLDS | |||||||||
| DENTAL DIRECTOR | 40.00 | 0.00 | $151,952 | $0 | $22,879 | Yes (X) | |||
| ALBERT KIM | |||||||||
| MD FP W/OB | 40.00 | 0.00 | $314,493 | $0 | $36,468 | Yes (X) | |||
| JOHNNY ERKINS | |||||||||
| MD OBGYN | 40.00 | 0.00 | $298,745 | $0 | $23,540 | Yes (X) | |||
| JAMES LENHART | |||||||||
| MD FP W/OB | 40.00 | 0.00 | $255,478 | $0 | $28,702 | Yes (X) | |||
| SANDRA WERNER | |||||||||
| MD FP W/OB | 40.00 | 0.00 | $250,522 | $0 | $21,496 | Yes (X) | |||
| CONSTANCE CAMPBELL | |||||||||
| MD FP W/OB | 40.00 | 0.00 | $216,939 | $0 | $16,057 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,857,527 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $296,794 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 55 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| JR ABBOTT CONSTRUCTION INC | |||||
| 3408 1ST AVE S STE 101 | SEATTLE | WA | 98134 | CONSTRUCTION | $1,668,321 |
| SCRIBE-X NORTHWEST LLC | |||||
| 931 SW KING AVENUE | PORTLAND | OR | 97205 | MEDICAL SCRIBES | $298,515 |
| ABM JANITORIAL SERVICES | |||||
| PO BOX 742049 | LOS ANGELES | CA | 90074 | JANITORIAL | $282,352 |
| NUWEST GROUP HOLDINGS LLC | |||||
| PO BOX 40285 | BELLEVUE | WA | 98015 | TEMP STAFFING | $255,976 |
| DR TAREK BAGHDADI OBGYN | |||||
| 1802 S YAKIMA 300 | TACOMA | WA | 98405 | AFTER-HOUR INFANT DELIVERY | $225,831 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $8,167 | FederatedCampaignsAmt |
| Fundraising | $55,360 | FundraisingAmt |
| Government Grants | $8,248,002 | GovernmentGrantsAmt |
| All Other Contributions | $374,068 | AllOtherContributionsAmt |
| Noncash Contributions | $476,705 | NoncashContributionsAmt |
| Total Contributions | $8,685,597 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT FEES | 621400 | $28,421,660 | $28,421,660 |
| PHARMACY REVENUE | 621300 | $11,975,820 | $11,975,820 |
| MANAGED CARE POOL | 621300 | $835,986 | $835,986 |
| MEANINGFUL USE REVENUE | 621300 | $531,250 | $531,250 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $41,764,716 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $202,159 | TotalRevenueColumnAmt |
| Exclusion | $202,159 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $35,634 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $35,634 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,634 | TotalRevenueColumnAmt |
| Exclusion | $35,634 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $53,480 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $55,360 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $43,423 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,057 | TotalRevenueColumnAmt |
| Exclusion | $10,057 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $77,395 | TotalRevenueColumnAmt |
| Exclusion | $77,395 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $77,395 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $50,775,558 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $41,764,716 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $325,245 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,780 | TotalAmt |
| Program Services | $22,780 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,430,802 | TotalAmt |
| Management And General | $2,430,802 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,695,684 | TotalAmt |
| Program Services | $23,121,836 | ProgramServicesAmt |
| Management And General | $1,567,849 | ManagementAndGeneralAmt |
| Fundraising | $5,999 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $968,317 | TotalAmt |
| Program Services | $822,669 | ProgramServicesAmt |
| Management And General | $145,429 | ManagementAndGeneralAmt |
| Fundraising | $219 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,581,543 | TotalAmt |
| Program Services | $3,226,887 | ProgramServicesAmt |
| Management And General | $353,796 | ManagementAndGeneralAmt |
| Fundraising | $860 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,836,649 | TotalAmt |
| Program Services | $1,560,392 | ProgramServicesAmt |
| Management And General | $275,841 | ManagementAndGeneralAmt |
| Fundraising | $416 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,511 | TotalAmt |
| Program Services | $12,478 | ProgramServicesAmt |
| Management And General | $52,990 | ManagementAndGeneralAmt |
| Fundraising | $43 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,733 | TotalAmt |
| Program Services | $4,330 | ProgramServicesAmt |
| Management And General | $18,388 | ManagementAndGeneralAmt |
| Fundraising | $15 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,050 | TotalAmt |
| Fundraising | $61,050 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,464,612 | TotalAmt |
| Program Services | $2,156,670 | ProgramServicesAmt |
| Management And General | $301,239 | ManagementAndGeneralAmt |
| Fundraising | $6,703 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,014 | TotalAmt |
| Program Services | $104,336 | ProgramServicesAmt |
| Management And General | $88,334 | ManagementAndGeneralAmt |
| Fundraising | $344 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $961,858 | TotalAmt |
| Program Services | $605,669 | ProgramServicesAmt |
| Management And General | $355,644 | ManagementAndGeneralAmt |
| Fundraising | $545 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $871,713 | TotalAmt |
| Program Services | $741,829 | ProgramServicesAmt |
| Management And General | $127,484 | ManagementAndGeneralAmt |
| Fundraising | $2,400 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,045,596 | TotalAmt |
| Program Services | $613,833 | ProgramServicesAmt |
| Management And General | $430,971 | ManagementAndGeneralAmt |
| Fundraising | $792 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,181 | TotalAmt |
| Program Services | $257,534 | ProgramServicesAmt |
| Management And General | $101,407 | ManagementAndGeneralAmt |
| Fundraising | $240 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $403,265 | TotalAmt |
| Program Services | $251,147 | ProgramServicesAmt |
| Management And General | $152,116 | ManagementAndGeneralAmt |
| Fundraising | $2 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $969,975 | TotalAmt |
| Program Services | $853,813 | ProgramServicesAmt |
| Management And General | $115,996 | ManagementAndGeneralAmt |
| Fundraising | $166 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,367 | TotalAmt |
| Program Services | $92,337 | ProgramServicesAmt |
| Management And General | $47,022 | ManagementAndGeneralAmt |
| Fundraising | $8 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL AND DENTAL SUPP | $6,776,424 | $6,766,076 | $10,348 | |
| BAD DEBT | $887,161 | $887,161 | ||
| MISCELLANEOUS | $626,907 | $468,485 | $158,329 | $93 |
| REPAIRS AND MAINTENANCE | $299,259 | $258,304 | $40,948 | $7 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,797 | TotalAmt |
| Program Services | $223,512 | ProgramServicesAmt |
| Management And General | $48,285 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,955,198 | TotalAmt |
| Program Services | $43,052,078 | ProgramServicesAmt |
| Management And General | $6,823,218 | ManagementAndGeneralAmt |
| Fundraising | $79,902 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,694,373 | BOYAmt |
| EOY | $4,009,064 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,943,375 | BOYAmt |
| EOY | $2,850,685 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $438,948 | BOYAmt |
| EOY | $783,679 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,649,333 | BOYAmt |
| EOY | $4,696,863 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $206,582 | BOYAmt |
| EOY | $187,585 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $963,168 | BOYAmt |
| EOY | $2,469,002 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $33,888,650 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $15,071,184 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,000,564 | BOYAmt |
| EOY | $18,817,466 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,361,549 | BOYAmt |
| EOY | $19,176,549 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,257,892 | BOYAmt |
| EOY | $52,990,893 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,706,265 | BOYAmt |
| EOY | $7,920,623 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,658 | BOYAmt |
| EOY | $95,791 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,020,813 | BOYAmt |
| EOY | $3,148,540 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,072,277 | BOYAmt |
| EOY | $4,645,700 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,898,013 | BOYAmt |
| EOY | $15,810,654 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,359,879 | BOYAmt |
| EOY | $37,180,239 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,359,879 | BOYAmt |
| EOY | $37,180,239 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,257,892 | BOYAmt |
| EOY | $52,990,893 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $820,360 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 | $14,867,928 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,267,521 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,976,893 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,040,011 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,685,597 | CurrentTaxYearAmt |
| Total | $41,837,950 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,867,928 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,267,521 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,976,893 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,040,011 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,685,597 | CurrentTaxYearAmt |
| Total | $41,837,950 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $41,837,950 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $90,758 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $212,177 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $244,377 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $234,721 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $237,793 | CurrentTaxYearAmt |
| Total | $1,019,826 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $48,197 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $100,948 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $30,053 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $96,865 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $130,875 | CurrentTaxYearAmt |
| Total | $406,938 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $43,264,714 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $165,012,270 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.96700 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97640 | 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 | MISCELLANEOUS REVENUE SPECIAL FUNDRAISING EVENT REVENUES | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | Yes (1) | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $1,302 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $1,302 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S EMPLOYEES, INCLUDING THE CEO AND HUMAN RESOURCES DIRECTOR, SPENT APPROXIMATELY 16 HOURS LOBBYING. TWO OF THE ORGANIZATION'S BOARD MEMBERS SPENT APPROXIMATELY 16 HOURS LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,642,530 | OtherCostOrOtherBasisAmt |
| Book Value | $3,642,530 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,370,155 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,821,483 | DepreciationAmt |
| Book Value | $11,548,672 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,311,127 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,513,302 | DepreciationAmt |
| Book Value | $797,825 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,066,082 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,736,399 | DepreciationAmt |
| Book Value | $2,329,683 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $498,756 | OtherCostOrOtherBasisAmt |
| Book Value | $498,756 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,817,466 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RECEIVABLE FROM HILLTOP CHC INVESTMENT FUND, LLC | Desc |
| Book Value | $19,176,549 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $19,176,549 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $48,010,753 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $55,003 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $43,423 | OtherRevenueAmt |
| Revenue Not Reported | $98,426 | RevenueNotReportedAmt |
| Revenue Subtotal | $47,912,327 | RevenueSubtotalAmt |
| Other Revenues Not Included | $2,863,231 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,863,231 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $50,775,558 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $49,166,463 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $55,003 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $43,423 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $98,426 | ExpensesNotReportedAmt |
| Expenses Subtotal | $49,068,037 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $887,161 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $887,161 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $49,955,198 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS BECAUSE THE ORGANIZATION IS A NONPROFIT ORGANIZATION, EXEMPT FROM INCOME TAXES UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION (ASC). |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 43,423. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | MANAGED CARE POOL SAVINGS 835,986. CAPITAL GRANT 498,757. OTHER INCOME 237,796. CAPITAL CAMPAIGN CONTRIBUTIONS 403,531. BAD DEBT EXPENSE 887,161. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 43,423. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 887,161. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RICHARD OLDENBURG | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6825 RAINIER AVE | AddressLine1Txt |
| City | GIG HARBOR | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98335 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | MAJOR & PLANNED GIFT CONSULTING | ActivityTxt |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFundsInd |
| Gross Receipts | $464,009 | GrossReceiptsAmt |
| Retained By Contractor | $61,050 | RetainedByContractorAmt |
| Net To Organization | $402,959 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $464,009 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $61,050 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $402,959 | TotalNetToOrganizationAmt |
| Licensed States | WA | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | ANNUAL LUNCHEON | Event1Nm |
| Gross Receipts Event1 | $108,840 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $55,360 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $53,480 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $17,555 | RentFacilityCostsEvent1Amt |
| Entertainment Event1 | $2,000 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $23,868 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $108,840 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $55,360 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $53,480 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $17,555 | RentFcltyCostsTotalEventsAmt |
| Entertainment Total Events | $2,000 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $23,868 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $43,423 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $10,057 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7501 WISCONSIN AVENUE 1100W | AddressLine1Txt |
| City | BETHESDA | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20814 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 520939952 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $15,000 | CashGrantAmt |
| Purpose Of Grant | SUPPORT THE "SECURE OUR FUTURE" CAMPAIGN | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 | Yes (1) | 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 (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID FLENTGE | ||||||||||||||
| CEO | $185,764 | $0 | $7,875 | $0 | $3,000 | $0 | $9,748 | $0 | $10,314 | $0 | $216,701 | $0 | $0 | $0 |
| TONIA CAMPBELL | ||||||||||||||
| CFO | $135,259 | $0 | $3,938 | $0 | $1,531 | $0 | $6,803 | $0 | $21,830 | $0 | $169,361 | $0 | $0 | $0 |
| JEFFREY SMITH | ||||||||||||||
| RESIDENCY DIRECTOR | $281,737 | $0 | $33,529 | $0 | $963 | $0 | $12,837 | $0 | $18,645 | $0 | $347,711 | $0 | $0 | $0 |
| GARY REICHARD | ||||||||||||||
| MD/DO & ASSISTANT RESIDENCY DIRECTOR | $221,478 | $0 | $75 | $0 | $0 | $0 | $11,439 | $0 | $18,147 | $0 | $251,139 | $0 | $0 | $0 |
| ELIZABETH FRIESEMA | ||||||||||||||
| MEDICAL DIRECTOR | $212,550 | $0 | $32,824 | $0 | $642 | $0 | $12,566 | $0 | $3,019 | $0 | $261,601 | $0 | $0 | $0 |
| DANIEL KREBS | ||||||||||||||
| ASSISTANT MEDICAL DIRECTOR | $204,772 | $0 | $42,101 | $0 | $1,360 | $0 | $11,963 | $0 | $10,341 | $0 | $270,537 | $0 | $0 | $0 |
| JEFF REYNOLDS | ||||||||||||||
| DENTAL DIRECTOR | $149,983 | $0 | $1,969 | $0 | $0 | $0 | $6,329 | $0 | $16,550 | $0 | $174,831 | $0 | $0 | $0 |
| ALBERT KIM | ||||||||||||||
| MD FP W/OB | $267,720 | $0 | $46,889 | $0 | -$116 | $0 | $15,707 | $0 | $20,761 | $0 | $350,961 | $0 | $0 | $0 |
| JOHNNY ERKINS | ||||||||||||||
| MD OBGYN | $246,484 | $0 | $50,865 | $0 | $1,396 | $0 | $12,182 | $0 | $11,358 | $0 | $322,285 | $0 | $0 | $0 |
| JAMES LENHART | ||||||||||||||
| MD FP W/OB | $228,616 | $0 | $26,669 | $0 | $193 | $0 | $12,821 | $0 | $15,881 | $0 | $284,180 | $0 | $0 | $0 |
| SANDRA WERNER | ||||||||||||||
| MD FP W/OB | $238,776 | $0 | $11,746 | $0 | $0 | $0 | $11,684 | $0 | $9,812 | $0 | $272,018 | $0 | $0 | $0 |
| CONSTANCE CAMPBELL | ||||||||||||||
| MD FP W/OB | $178,704 | $0 | $37,667 | $0 | $568 | $0 | $7,079 | $0 | $8,978 | $0 | $232,996 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 6 | FormAndLineReferenceDesc |
| Explanation | THE EXECUTIVE MANAGEMENT TEAM RECEIVES A BONUS THAT IS PRIMARILY BASED ON ACHIEVING BOARD-APPROVED OPERATING SURPLUS/DEFICIT GOALS, AS WELL AS FOUR OTHER STRATEGIC GOALS SUCH AS PATIENT SATISFACTION AND NUMBER OF PATIENTS SERVED. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WASHINGTON HEALTH CARE FACILITIES AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 911108929 | BondIssuerEIN |
| Bond Issued | 2016-08-19 | BondIssuedDt |
| Issue Price | $3,285,000 | IssuePriceAmt |
| Purpose | TO FUND A FACILITY RENOVATION AND REFUND SERIES 2003 BONDS | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $79,551 | RetiredAmt |
| Total Proceeds | $3,285,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $46,000 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $2,311,710 | CapitalExpendituresAmt |
| Other Spent Proceeds | $927,290 | OtherSpentProceedsAmt |
| Substantial Completion | 2017 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 18 | ContributionCnt |
| Noncash Contributions Rpt F990 | $458,705 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | CDC PRICING | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | EQUIP MAINTENANCE | Desc |
| Contribution | 12 | ContributionCnt |
| Noncash Contributions Rpt F990 | $18,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | INVOICE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | 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 1 | THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF BOARD (CHAIR OR CO-CHAIRS, VICE CHAIR, SECRETARY AND TREASURER) AND THE CHAIRS OF EACH STANDING COMMITTEE. THE EXECUTIVE COMMITTEE HAS THE POWERS AND AUTHORITY OF THE BOARD TO MAKE DECISIONS WHEN THE BOARD IS NOT IN SESSION. THE EXECUTIVE COMMITTEE ALSO OVERSEES THE RECRUITMENT AND HIRING OF THE CEO. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE BYLAWS WERE AMENDED IN JULY 2016. AMONG THE AMENDMENTS WERE THE FOLLOWING SIGNIFICANT CHANGES: (A) THE CEO WAS ADDED AS AN EX-OFFICIO NON-VOTING MEMBER OF THE BOARD OF DIRECTORS; AND (B) THE CONFLICT OF INTEREST REQUIREMENTS FOR THE ORGANIZATION WERE STRENGTHENED. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PROVIDED TO THE BOARD PRIOR TO FILING. THE BOARD WAS GIVEN THE OPPORTUNITY TO FORWARD QUESTIONS AND/OR CONCERNS TO THE FINANCE COMMITTEE SO THEY COULD BE ADDRESSED. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS AND MANAGEMENT TEAM MEMBERS ARE ASKED TO SIGN A CONFLICT OF INTEREST STATEMENT AT INITIAL ORIENTATION AND AGAIN ANNUALLY. RECORDS ARE MAINTAINED BY EITHER THE HUMAN RESOURCES DIRECTOR OR THE ASSISTANT TO THE CEO. REPORTED OR POTENTIAL CONFLICTS ARE REVIEWED BY EITHER THE HUMAN RESOURCES DIRECTOR OR THE CEO. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER OR MANAGEMENT TEAM MEMBER MUST EXCUSE THEMSELVES FROM THE DISCUSSION OR VOTING. IF A CONFLICT IS PERVASIVE WITH A BOARD MEMBER THEN THE CO-CHAIRS CAN PROCEED TO REMOVE THE BOARD MEMBER. IF A CONFLICT IS PERVASIVE WITH A MANAGEMENT TEAM MEMBER THEN THEY MAY BE TERMINATED. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMMUNITY HEALTH CARE USES NORTHWEST REGIONAL PRIMARY CARE ASSOCIATION, NATIONAL ASSOCIATION FOR COMMUNITY HEALTH CENTERS, AND MILLIMAN SALARY SURVEYS AND DATA FROM THE PACIFIC NORTHWEST REGION AS COMPARATIVE DATA. AN OUTSOURCED INDEPENDENT CONSULTANT IS ALSO USED TO DETERMINE SALARY EXPECTATION. THE BOARD REVIEWS THE CEO'S COMPENSATION AND APPROVES. THIS PROCESS WAS LAST COMPLETED IN 2015. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS REVIEWED BY THE CEO AND THEN THE BOARD OF DIRECTORS FOR FINAL APPROVAL. THIS PROCESS WAS LAST COMPLETED IN 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HILLTOP REGIONAL HEALTH CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1148 BROADWAY SUITE 100 | AddressLine1Txt |
| City | TACOMA | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 455494488 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12D, III-O | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HILLTOP REGIONAL HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionTypeTxt |
| Involved | $231,001 | InvolvedAmt |
| Method Of Amount Determination | FMV BASED ON LOW-COST FINANCING | MethodOfAmountDeterminationTxt |
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