2018-02-07T18:55:07-06:00 2017-05-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2016-06-01 911349657 COMMUNITY HEALTH CARE COMM 2535974550 1148 BROADWAY NO 100 TACOMA WA 98402 DAVID FLENTGE CEO 2537221502 2018-02-01 1 KURT BENNION CPA P01469618 4252506100 67.137.57.251 2018-02-01 13:39:07 PS P E49AB45AF12B1BB25434C7612008407C4465D4D7 7B720C417D09A2A0A49D149EB40D603FC32411E4 2016 2021-01-29 14:40:06Z X DAVID FLENTGE 1148 BROADWAY NO 100 TACOMA WA 98402 50818981 0 X WWW.COMMHEALTH.ORG X 1987 WA TO PROVIDE THE HIGHEST QUALITY HEALTH CARE WITH COMPASSIONATE AND ACCESSIBLE SERVICE FOR ALL. 14 14 539 26 0 0 6040011 8685597 36819697 41764716 199650 202159 93221 123086 43152579 50775558 0 22780 0 0 29264359 33512995 45966 61050 79902 13075599 16358373 42385924 49955198 766655 820360 49257892 52990893 12898013 15810654 36359879 37180239 X 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. 0 0 24689334 22780 19289182 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. 9422902 0 8564775 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. 7435111 0 12796052 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. 1504731 0 1114707 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. 1504731 0 1114707 43052078 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 32 0 539 1 0 0 0 0 0 1 1 0 0 0 0 X 14 14 0 0 1 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X TONIA CAMPBELL 2535691510 1148 BROADWAY NO 100 TACOMA WA 98402 GARY WALMER CHAIR 2.00 2.00 X X 0 0 0 RICHARD BOWE VICE CHAIR 2.00 0.00 X X 0 0 0 DAN SLOAN SECRETARY 2.00 2.00 X X 0 0 0 LES CATHERSAL TREASURER 2.00 0.00 X X 0 0 0 LINDA BOWMAN BOARD MEMBER 2.00 0.00 X 0 0 0 LADEDRIA GRIFFIN-STALLWORTH BOARD MEMBER 2.00 0.00 X 0 0 0 PAUL HANSEN BOARD MEMBER 2.00 0.00 X 0 0 0 RIA JOHNSON BOARD MEMBER 2.00 0.00 X 0 0 0 CHAD MCMILLAN BOARD MEMBER 2.00 0.00 X 0 0 0 KEN REPP BOARD MEMBER 2.00 0.00 X 0 0 0 ANDY SMART BOARD MEMBER (THROUGH NOV 2016) 2.00 0.00 X 0 0 0 DOUG SWANBERG BOARD MEMBER 2.00 2.00 X 0 0 0 LINDA TIEMAN BOARD MEMBER (THROUGH AUG 2016) 2.00 0.00 X 0 0 0 ANTHONY VELEZ BOARD MEMBER 2.00 0.00 X 0 0 0 MARCO VINIEGRA BOARD MEMBER 2.00 0.00 X 0 0 0 SHELLY WEISS BOARD MEMBER 2.00 0.00 X 0 0 0 DEBRA YOUNG BOARD MEMBER (THROUGH DEC 2016) 2.00 0.00 X 0 0 0 DAVID FLENTGE CEO 40.00 2.00 X 196639 0 20062 TONIA CAMPBELL CFO 40.00 2.00 X 140728 0 28633 JEFFREY SMITH RESIDENCY DIRECTOR 40.00 0.00 X 316229 0 31482 GARY REICHARD MD/DO & ASSISTANT RESIDENCY DIRECTOR 40.00 0.00 X 221553 0 29586 ELIZABETH FRIESEMA MEDICAL DIRECTOR 40.00 0.00 X 246016 0 15585 DANIEL KREBS ASSISTANT MEDICAL DIRECTOR 40.00 0.00 X 248233 0 22304 JEFF REYNOLDS DENTAL DIRECTOR 40.00 0.00 X 151952 0 22879 ALBERT KIM MD FP W/OB 40.00 0.00 X 314493 0 36468 JOHNNY ERKINS MD OBGYN 40.00 0.00 X 298745 0 23540 JAMES LENHART MD FP W/OB 40.00 0.00 X 255478 0 28702 SANDRA WERNER MD FP W/OB 40.00 0.00 X 250522 0 21496 CONSTANCE CAMPBELL MD FP W/OB 40.00 0.00 X 216939 0 16057 2857527 0 296794 55 0 1 0 JR ABBOTT CONSTRUCTION INC 3408 1ST AVE S STE 101 SEATTLE WA 98134 CONSTRUCTION 1668321 SCRIBE-X NORTHWEST LLC 931 SW KING AVENUE PORTLAND OR 97205 MEDICAL SCRIBES 298515 ABM JANITORIAL SERVICES PO BOX 742049 LOS ANGELES CA 90074 JANITORIAL 282352 NUWEST GROUP HOLDINGS LLC PO BOX 40285 BELLEVUE WA 98015 TEMP STAFFING 255976 DR TAREK BAGHDADI OBGYN 1802 S YAKIMA 300 TACOMA WA 98405 AFTER-HOUR INFANT DELIVERY 225831 9 8167 55360 8248002 374068 476705 8685597 PATIENT FEES 621400 28421660 28421660 PHARMACY REVENUE 621300 11975820 11975820 MANAGED CARE POOL 621300 835986 835986 MEANINGFUL USE REVENUE 621300 531250 531250 41764716 202159 202159 35634 0 35634 35634 35634 53480 55360 43423 10057 10057 MISCELLANEOUS REVENUE 900099 77395 77395 77395 50775558 41764716 0 325245 22780 22780 2430802 2430802 24695684 23121836 1567849 5999 968317 822669 145429 219 3581543 3226887 353796 860 1836649 1560392 275841 416 65511 12478 52990 43 22733 4330 18388 15 61050 61050 2464612 2156670 301239 6703 193014 104336 88334 344 961858 605669 355644 545 871713 741829 127484 2400 1045596 613833 430971 792 359181 257534 101407 240 403265 251147 152116 2 969975 853813 115996 166 139367 92337 47022 8 MEDICAL AND DENTAL SUPP 6776424 6766076 10348 BAD DEBT 887161 887161 MISCELLANEOUS 626907 468485 158329 93 REPAIRS AND MAINTENANCE 299259 258304 40948 7 271797 223512 48285 49955198 43052078 6823218 79902 5694373 4009064 1943375 2850685 438948 783679 3649333 4696863 206582 187585 963168 2469002 33888650 15071184 17000564 18817466 19361549 19176549 49257892 52990893 6706265 7920623 98658 95791 1020813 3148540 5072277 4645700 12898013 15810654 X 36359879 37180239 36359879 37180239 49257892 52990893 820360 0 X 0 1 X 1 1 1 X 14867928 7267521 4976893 6040011 8685597 41837950 14867928 7267521 4976893 6040011 8685597 41837950 41837950 90758 212177 244377 234721 237793 1019826 48197 100948 30053 96865 130875 406938 43264714 165012270 0.96700 0.97640 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE SPECIAL FUNDRAISING EVENT REVENUES RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 1302 0 0 1302 0 PART II-B, LINE 1: 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. 3642530 3642530 16370155 4821483 11548672 2311127 1513302 797825 11066082 8736399 2329683 498756 498756 18817466 RECEIVABLE FROM HILLTOP CHC INVESTMENT FUND, LLC 19176549 19176549 X 48010753 55003 43423 98426 47912327 2863231 2863231 50775558 49166463 55003 43423 98426 49068037 887161 887161 49955198 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. X X X X X X X 1 RICHARD OLDENBURG 6825 RAINIER AVE GIG HARBOR WA 98335 MAJOR & PLANNED GIFT CONSULTING 0 464009 61050 402959 464009 61050 402959 WA ANNUAL LUNCHEON 108840 55360 53480 17555 2000 23868 108840 55360 53480 17555 2000 23868 43423 10057 1 NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS 7501 WISCONSIN AVENUE 1100W BETHESDA MD 20814 520939952 501(C)(3) 15000 SUPPORT THE "SECURE OUR FUTURE" CAMPAIGN 1 0 X X X X X 0 0 0 0 0 1 0 0 0 DAVID FLENTGE CEO 185764 0 7875 0 3000 0 9748 0 10314 0 216701 0 0 0 TONIA CAMPBELL CFO 135259 0 3938 0 1531 0 6803 0 21830 0 169361 0 0 0 JEFFREY SMITH RESIDENCY DIRECTOR 281737 0 33529 0 963 0 12837 0 18645 0 347711 0 0 0 GARY REICHARD MD/DO & ASSISTANT RESIDENCY DIRECTOR 221478 0 75 0 0 0 11439 0 18147 0 251139 0 0 0 ELIZABETH FRIESEMA MEDICAL DIRECTOR 212550 0 32824 0 642 0 12566 0 3019 0 261601 0 0 0 DANIEL KREBS ASSISTANT MEDICAL DIRECTOR 204772 0 42101 0 1360 0 11963 0 10341 0 270537 0 0 0 JEFF REYNOLDS DENTAL DIRECTOR 149983 0 1969 0 0 0 6329 0 16550 0 174831 0 0 0 ALBERT KIM MD FP W/OB 267720 0 46889 0 -116 0 15707 0 20761 0 350961 0 0 0 JOHNNY ERKINS MD OBGYN 246484 0 50865 0 1396 0 12182 0 11358 0 322285 0 0 0 JAMES LENHART MD FP W/OB 228616 0 26669 0 193 0 12821 0 15881 0 284180 0 0 0 SANDRA WERNER MD FP W/OB 238776 0 11746 0 0 0 11684 0 9812 0 272018 0 0 0 CONSTANCE CAMPBELL MD FP W/OB 178704 0 37667 0 568 0 7079 0 8978 0 232996 0 0 0 PART I, LINE 6 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. A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 2016-08-19 3285000 TO FUND A FACILITY RENOVATION AND REFUND SERIES 2003 BONDS 0 0 0 A 79551 3285000 46000 2311710 927290 2017 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 X 18 458705 CDC PRICING X EQUIP MAINTENANCE 12 18000 INVOICE 0 0 1 0 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. HILLTOP REGIONAL HEALTH CENTER 1148 BROADWAY SUITE 100 TACOMA WA 98402 455494488 HEALTHCARE WA 501(C)(3) LINE 12D, III-O COMMUNITY HEALTH CARE 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 HILLTOP REGIONAL HEALTH CENTER K 231001 FMV BASED ON LOW-COST FINANCING