2017-12-01T14:56:49-06:00 2017-06-30 930623286 ALDRICH CPAS AND ADVISORS LLP 680 HAWTHORNE AVE SE 140 SALEM OR 97301 990 2016-07-01 721545902 PEACEHEALTH ST JOSEPH MEDICAL CENTER FOUNDATION PEAC 3607886866 2901 SQUALICUM PARKWAY BELLINGHAM WA 98225 KATIE JANSEN TREASURER 3607886866 2017-11-15 1 DEBRA D SMITH P00646873 5035857774 2017-11-15 69.30.50.66 2017-11-15 09:00:29 PS P 4343CEBA1BC2C9EDFF09D7BB5D74F2F89CFC3EB8 D3249599D98CC77547F97D51830FE9C3647E5717 2016 2017-02-10 21:41:12Z KATIE JANSEN 2901 SQUALICUM PARKWAY BELLINGHAM WA 98225 1567814 0 X WWW.PEACEHEALTH.ORG/FOUNDATION/ST-JOSEPH X 2003 WA RAISE CONTRIBUTIONS & ESTABLISH ENDOWMENTS TO SUPPORT PEACEHEALTH ST.JOSEPH MEDICAL CENTER. 23 20 0 39 0 0 4227893 1349945 0 0 73485 135265 -49334 0 4252044 1485210 230223 1240234 0 0 0 0 0 0 0 13772 29716 243995 1269950 4008049 215260 10369353 10695501 159298 25000 10210055 10670501 THE MISSION OF THE FOUNDATION IS TO SUPPORT PEACEHEALTH ST. JOSEPH MEDICAL CENTER, LOCATED IN BELLINGHAM, WASHINGTON, BY SOLICITING, RECEIVING, MANAGING, ADMINISTERING AND DISTRIBUTING FUNDS OR OTHER GIFTS TO OR FOR THE BENEFIT OF PEACEHEALTH ST. JOSEPH MEDICAL CENTER. 0 0 1240234 1240234 THE FOUNDATION PROVIDES SUPPORT TO PEACEHEALTH ST. JOSEPH MEDICAL CENTER. 1240234 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 0 0 X 23 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WA X SACRED HEART MEDICAL CENTER FOUNDATION 5413352597 123 INTERNATIONAL WAY SPRINGFIELD OR 97477 X SHAUN SULLIVAN MD PRESIDENT & VICE PRESIDENT 1.00 X X 0 0 0 CHRISTINE THOMPSON SECRETARY 1.00 X X 0 0 0 KATIE JANSEN TREASURER 1.00 X X 0 0 0 JOHN HUNTLEY PAST PRESIDENT 1.00 X X 0 0 0 CHARLES ARIZ MD DIRECTOR 1.00 X 0 0 0 BRAD BEARDEN OD DIRECTOR 1.00 X 0 0 0 BRAD DEHAAN DIRECTOR 1.00 X 0 0 0 AMY ESARY DIRECTOR 1.00 X 0 0 0 WILLIAM HALL MD DIRECTOR 1.00 X 0 0 0 FRANK IMHOF DIRECTOR 1.00 X 0 0 0 DONNA INGLIS DIRECTOR 1.00 X 0 0 0 LYNETTE JENSEN DIRECTOR 1.00 X 0 0 0 CHET KENOYER DIRECTOR 1.00 X 0 0 0 MIKE PERRY DIRECTOR 1.00 X 0 0 0 MARCUS SCHUMACHER DIRECTOR 1.00 X 0 0 0 JON SITKIN DIRECTOR 1.00 X 0 0 0 HOLLY STUDLEY DIRECTOR 1.00 X 0 0 0 ROBERT TULL DIRECTOR 1.00 X 0 0 0 CHERYL WEG DIRECTOR 1.00 X 0 0 0 DOUGLAS WIGHT DIRECTOR 1.00 X 0 0 0 ANNA WILLIAMS DIRECTOR 1.00 X 0 0 0 DALE ZENDER DIRECTOR 1.00 40.00 X 0 446849 37821 SCOTT WHITMAN DIRECTOR 1.00 X 0 0 0 ANNE RASMUSSEN CHIEF DEVELOPMENT OFFICER 20.00 20.00 X 0 128607 11517 0 575456 49338 0 0 1 0 0 5000 1344945 47389 1349945 62217 62217 155652 82604 73048 73048 73048 1485210 0 0 135265 1240234 1240234 NON-CASH DONATED MATERI 17364 0 17364 0 BANK FEES 9035 0 9035 0 BAD DEBT EXPENSE 3317 0 3317 0 1269950 1240234 29716 0 6458471 6470092 1030562 971236 2644815 3017081 222467 225488 13038 11604 10369353 10695501 1049 0 0 25000 35117 0 123132 0 159298 25000 X 4861583 5845876 4576952 4053605 771520 771020 10210055 10670501 10369353 10695501 X 215260 216991 28195 X 0 1 X 1 0 X 2549089 1716957 2330547 4227893 1349945 12174431 2549089 1716957 2330547 4227893 1349945 12174431 1919908 10254523 71020 63868 42237 143218 62217 382560 2382 2382 12559373 0.81650 0.85740 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2730733 338370 357027 18668 2693408 2012944 701244 26194 9649 2730733 1643493 321263 51711 3523 2012944 1386904 54250 204559 2220 1643493 1273160 113744 1386904 0.57790 0.13580 0.28630 0 0 0 X 2409790 216991 679394 28195 924580 1485210 0 1485210 1949344 679394 679394 1269950 0 1269950 PART V, LINE 4: THE ENDOWMENT FUNDS ARE TO FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. PART X, LINE 2: FOR THE YEARS ENDED JUNE 30, 2017 AND 2016, MANAGEMENT OF THE FOUNDATION BELIEVES THAT THERE HAS BEEN NO ACTIVITY THAT WOULD JEOPARDIZE THE TAX POSITION, BEING A TAX EXEMPT ORGANIZATION, AND THAT IT IS MORE LIKELY THAN NOT, BASED ON THE TECHNICAL MERITS, THAT THIS POSITION WOULD BE SUSTAINED UPON EXAMINATION. THE FOUNDATION RECOGNIZES INTEREST AND PENALTIES, IF ANY, RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE. THERE WERE NONE FOR THE YEARS ENDED JUNE 30, 2017 AND 2016. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF ASSETS HELD IN TRUST 28,195. 1 PEACEHEALTH 1115 SE 164TH AVE SUITE 332 VANCOUVER WA 98683 910939479 501(C)(3) 1240234 PATIENT SERVICES 1 0 0 0 0 0 0 0 0 0 DALE ZENDER DIRECTOR 0 440196 0 0 0 6653 0 32913 0 4908 0 484670 0 0 PART I, LINE 3 THE ORGANIZATION DOES NOT HAVE ANY PAID EMPLOYEES. EMPLOYEES ARE COMPENSATED BY PEACEHEALTH (A RELATED ORGANIZATION) WHICH USES A MARKET BASED COMPENSATION PROGRAM UTILIZING SEVERAL INDEPENDENT THIRD PARTY COMPENSATION MARKET SURVEYS TO ESTABLISH PAY RANGES FOR THE POSITION. PEACEHEALTH ESTABLISHES THE INDIVIDUAL RATE OF PAY WITHIN THE PAY RANGE BASED ON RELEVANT EXPERIENCE/SKILLS/COMPETENCE TO DO THE JOB. THE RANGES OF PAY RATES ARE REVIEWED ON AN ANNUAL BASIS. X 17200 FMV X 1 30025 FMV X GIFT CARDS & OTHER 1 164 FMV 0 1 0 FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY AN INDEPENDENT CPA FIRM AND IS PRESENTED TO THE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS, OFFICERS, AGENTS AND EMPLOYEES ARE REQUIRED TO SIGN ANNUALLY, OUR IN-DEPTH CONFLICT OF INTEREST DISCLOSURE POLICY WHICH AFFIRMS THEY HAVE READ, UNDERSTOOD AND AGREED WITH THE CONFLICT OF INTEREST POLICY AND HAVE ANSWERED ALL QUESTIONS ON THE DISCLOSURE FULLY AND HONESTLY. THE OFFICERS, DIRECTORS, AGENTS AND EMPLOYEES ARE COVERED UNDER THIS POLICY. EACH BOARD MEMBER IS REQUIRED TO SIGN A COPY WHICH IS REVIEWED BY THE EXECUTIVE DIRECTOR. IT MUST BE SIGNED BEFORE THEY ATTEND ANY BOARD OR COMMITTEE MEETINGS. BEFORE AN ITEM IS PUT ON AN AGENDA, THE BOARD/COMMITTEE WILL REVIEW AND ASCERTAIN IF THERE WILL BE ANY CONFLICTS ON THE BOARD AND IF SO, THE BOARD MEMBER IS CONTACTED AND TOLD ABOUT THE SUBJECT OF DISCUSSION. THE BOARD/COMMITTEE DECIDES IF IT IS IN FACT A CONFLICT AND IF SO, THE BOARD MEMBER IS ASKED TO EXCUSE THEMSELVES FROM THE ROOM DURING DISCUSSION AND VOTING BY THE EXECUTIVE DIRECTOR OR COMMITTEE CHAIR. FORM 990, PART VI, SECTION B, LINE 15A THE FOUNDATION'S EXECUTIVE DIRECTOR IS COMPENSATED BY PEACEHEALTH (A RELATED ORGANIZATION) WHICH USES A MARKET BASED COMPENSATION PROGRAM UTILIZING SEVERAL INDEPENDENT THIRD PARTY COMPENSATION MARKET SURVEYS TO ESTABLISH PAY RANGES FOR THE POSITION. PEACEHEALTH THEN ESTABLISHES THE INDIVIDUAL RATE OF PAY WITHIN THE PAY RANGE BASED ON RELEVANT EXPERIENCE/SKILLS/COMPETENCE TO DO THE JOB. THIS RATE OFFERED TO THE EXECUTIVE DIRECTOR AT TIME OF HIRE WAS DETERMINED THROUGH A DISCUSSION BETWEEN THE REGIONAL DIRECTOR OF HUMAN RESOURCES AND THE ADMINISTRATIVE DIRECTOR OF HUMAN RESOURCES. THE RANGES AND RATE OF PAY ARE REVIEWED ON AN ANNUAL BASIS. COMPENSATION WAS LAST REVIEWED ON JUNE 30, 2017. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE IN THE FOUNDATION OFFICE UPON REQUEST. FORM 990 PART VII, LINE 24 ANNE RASMUSSEN, EXECUTIVE FIRECTOR: HER COMPENSATION IS PAID BY THE RELATED ORGANIZATION FOR SERVICES TO THE FILING ORGANIZATION. HER REPORTABLE COMPENSATION IS ZERO FOR THE FILING ORGANIZATION BUT HER AVERAGE HOURS PER WEEK IS 20 AS SHE SPENDS PART OF HER TIME WORKING AT THE FILING ORGANIZATION AND AT WHATCOM HOSPICE FOUNDATION (A RELATED ORGANIZATION TO PEACEHEALTH). FORM 990, PART XI, LINE 9: CHANGE IN GIFT ANNUITY OBLIGATIONS 28,195. PEACEHEALTH 1115 SE 164TH AVE SUITE 332 VANCOUVER WA 98683 910939479 HEALTHCARE WA 501(C)(3) LINE 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0