MID-COLUMBIA HEALTH FOUNDATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MID-COLUMBIA HEALTH FOUNDATION (EIN 93-0854433)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201743199349318164
- 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 D
- Schedule G
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-15T18:23:55-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 930418710 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELAP LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5885 MEADOWS ROAD NO 200 | AddressLine1Txt |
| City | LAKE OSWEGO | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97035 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930854433 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA HEALTH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MID- | BusinessNameControlTxt |
| Phone | 5412967275 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1580 | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EDWIN BODE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5412967275 | PhoneNum |
| Signature | 2017-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARK E EKLUND CPA | PreparerPersonNm |
| PTIN | P00156145 | PTIN |
| Phone | 5036974118 | PhoneNum |
| Preparation | 2017-11-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 76.14.192.226 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-13 | IPDt |
| IP Tm | 15:52:42 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 6EE4B5945FCD93E65398A6249415A829E8D03AFF | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A037F773A43E5D098BFBF49CACF0A7B31F1836C7 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | EDWIN BODE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1580 | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,760,849 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MCMC.NET/FOUNDATION | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1983 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | WORK TOGETHER WITH AND PROVIDE FINANCIAL SUPPORT TO MID-COLUMBIA MEDICAL CENTER IN ORDER TO PROVIDE ACCESS TO QUALITY HEALTHCARE FOR OUR COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 10 | TotalEmployeeCnt |
| Total Volunteers | 61 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $528,364 | PYContributionsGrantsAmt |
| CY Contributions Grants | $717,716 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $66,345 | PYInvestmentIncomeAmt |
| CY Investment Income | $184,106 | CYInvestmentIncomeAmt |
| PY Other Revenue | $116,080 | PYOtherRevenueAmt |
| CY Other Revenue | $116,954 | CYOtherRevenueAmt |
| PY Total Revenue | $710,789 | PYTotalRevenueAmt |
| CY Total Revenue | $1,018,776 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $654,558 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $400,961 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $25,592 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $26,557 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $24,370 | PYOtherExpensesAmt |
| CY Other Expenses | $24,846 | CYOtherExpensesAmt |
| PY Total Expenses | $704,520 | PYTotalExpensesAmt |
| CY Total Expenses | $452,364 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,269 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $566,412 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,785,360 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,118,305 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $493,104 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $199,196 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,292,256 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,919,109 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WORK TOGETHER WITH AND PROVIDE FINANCIAL SUPPORT TO MID-COLUMBIA MEDICAL CENTER IN ORDER TO PROVIDE ACCESS TO QUALITY HEALTHCARE FOR OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $452,364 | ExpenseAmt |
| Grant | $400,961 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | THE PRIMARY PURPOSE OF THE FOUNDATION IS TO PROVIDE FUNDRAISING FOR THE MID-COLUMBIA MEDICAL CENTER (ID# 93-0386936) AS WELL AS GRANTS / SCHOLARSHIPS TO THE GENERAL PUBLIC. | Desc |
| Total Program Service Expenses | $452,364 | 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 | Yes (1) | 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 | 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 | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | 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 | Yes (1) | 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 | 10 | 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 | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | 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 | 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 |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5412961111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1580 | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DIANNE STORBY | ||||||||
| EX-OFFICIO DIRECTOR | 1.00 | 50.00 | Yes (X) | $0 | $323,043 | $34,542 | ||
| DUANE FRANCIS | ||||||||
| EX-OFFICIO DIRECTOR | 1.00 | 50.00 | Yes (X) | $0 | $636,086 | $770,222 | ||
| ROB CARNAHAN | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| BRIAN LAUTERBACH | ||||||||
| VICE-CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| DR FRANK TODA | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DR PAULA LEE-VALKOV | ||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $18,296 | $0 | ||
| SHAWN CARROLL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KRISTI TIMMONS | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CYNTHIA KORTGE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JASON COREY | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT BAILEY | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PHIL KASER | ||||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ERIC HOLEMAN | ||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $160,115 | $27,650 | ||
| VESTA SMITH | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CELESTE HILL-THOMAS | ||||||||
| EXECUTIVE DIRECTOR | 50.00 | $89,344 | $89,344 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $89,344 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,226,884 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $832,414 | 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 |
| All Other Contributions | $717,716 | AllOtherContributionsAmt |
| Noncash Contributions | $70,300 | NoncashContributionsAmt |
| Total Contributions | $717,716 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,889 | TotalRevenueColumnAmt |
| Exclusion | $68,889 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $826,428 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $711,211 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $115,217 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $115,217 | TotalRevenueColumnAmt |
| Exclusion | $115,217 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $101,242 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $30,862 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $70,380 | TotalRevenueColumnAmt |
| Exclusion | $70,380 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | COFFEE CART FUND | Desc |
| Business | 722210 | BusinessCd |
| Total Revenue Column | $46,574 | TotalRevenueColumnAmt |
| Exclusion | $46,574 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $46,574 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,018,776 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $301,060 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $268,904 | TotalAmt |
| Program Services | $268,904 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,057 | TotalAmt |
| Program Services | $132,057 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,202 | TotalAmt |
| Program Services | $24,202 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500 | TotalAmt |
| Program Services | $500 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,855 | TotalAmt |
| Program Services | $1,855 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,673 | TotalAmt |
| Program Services | $5,673 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| FOOD PURCHASES | $18,374 | $18,374 |
| SUPPLIES | $799 | $799 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $452,364 | TotalAmt |
| Program Services | $452,364 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $381,901 | BOYAmt |
| EOY | $609,008 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,884,910 | BOYAmt |
| EOY | $1,971,723 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,836 | BOYAmt |
| EOY | $38,334 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,760 | BOYAmt |
| EOY | $31,088 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,313 | BOYAmt |
| EOY | $3,545 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,696 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $37,838 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,601 | BOYAmt |
| EOY | $1,858 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,434,039 | BOYAmt |
| EOY | $2,462,749 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,785,360 | BOYAmt |
| EOY | $5,118,305 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,492 | BOYAmt |
| EOY | $16,078 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $172,612 | BOYAmt |
| EOY | $183,118 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $493,104 | BOYAmt |
| EOY | $199,196 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,288,373 | BOYAmt |
| EOY | $2,545,916 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,625,748 | BOYAmt |
| EOY | $1,992,243 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $378,135 | BOYAmt |
| EOY | $380,950 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,292,256 | BOYAmt |
| EOY | $4,919,109 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,785,360 | BOYAmt |
| EOY | $5,118,305 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $566,412 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $60,441 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 | 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 | $300,662 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $335,624 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $254,481 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $528,364 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $717,716 | CurrentTaxYearAmt |
| Total | $2,136,847 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $300,662 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $335,624 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $254,481 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $528,364 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $717,716 | CurrentTaxYearAmt |
| Total | $2,136,847 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $650,337 | SubstantialContributorsTotAmt |
| Public Support Total170 | $1,486,510 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | -$18,002 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,024 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $53,775 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $61,065 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $68,889 | CurrentTaxYearAmt |
| Total | $213,751 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $2,350,598 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $459,109 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.63240 | PublicSupportCY170Pct |
| Public Support PY170 | 0.65700 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,429,254 | BeginningYearBalanceAmt |
| Contributions | $102,815 | ContributionsAmt |
| Investment Earnings Or Losses | $51,758 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $196,080 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,387,747 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,389,999 | BeginningYearBalanceAmt |
| Contributions | $11,182 | ContributionsAmt |
| Investment Earnings Or Losses | $51,092 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $23,019 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,429,254 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,345,021 | BeginningYearBalanceAmt |
| Contributions | $8,511 | ContributionsAmt |
| Investment Earnings Or Losses | $48,321 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $11,854 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,389,999 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,310,867 | BeginningYearBalanceAmt |
| Contributions | $12,621 | ContributionsAmt |
| Investment Earnings Or Losses | $27,470 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $5,937 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,345,021 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,287,095 | BeginningYearBalanceAmt |
| Contributions | $6,237 | ContributionsAmt |
| Investment Earnings Or Losses | $23,245 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $5,710 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,310,867 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.62400 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.27450 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.10150 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $39,578 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,838 | DepreciationAmt |
| Book Value | $1,740 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $118 | OtherCostOrOtherBasisAmt |
| Book Value | $118 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,858 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE FOUNDATION'S ENDOWMENT FUND IS A QUASI-ENDOWMENT THAT FUNDS THE MID-COLUMBIA HEALTH FOUNDATION OPERATING EXPENSES - ENDING BALANCE $865,975. THE REMAINING ENDOWMENT FUNDS SUPPORT SEVERAL SCHOLARSHIPS AND OTHER FUNDS EXPLAINED BELOW: TEMPORARY AND PERMANENTLY RESTRICTED FUNDS: - EVELYN KASER SCHOLARSHIP FUND: TO ASSIST INDIVIDUALS WHO ASPIRE TO BECOME REGISTERED NURSES AND INTEND TO PRACTICE THEIR PROFESSION IN THE MID-COLUMBIA REGION. - LORNA & JOSEPH HALLIDAY FAMILY NURSING SCHOLARSHIP FUND: TO ASSIST INDIVIDUALS ASPIRING TO BECOME REGISTERED NURSES WHO GREW UP IN THE MID-COLUMBIA REGION. - MCMC BOARD OF TRUSTEES MEDICAL PROFESSIONALS SCHOLARSHIP: TO HELP DEFRAY SOME COLLEGE EXPENSES FOR GRADUATING SENIORS FROM THE DALLES HIGH SCHOOL. - MASONS LODGE SCHOLARSHIP FUND: TO ASSIST INDIVIDUALS FROM THE LOCAL COMMUNITIES OF SHERMAN, DUFUR AND THE DALLES HIGH SCHOOLS TO ATTEND COLLEGE. - PERMANENT SCHOLARSHIP FUND: EARNS INTEREST THAT IS ANNUALLY TRANSFERRED TO THE MID-COLUMBIA MEDICAL CENTER SCHOLARSHIP FUND. |
| PART X, LINE 2: | INCOME TAX POSITIONS THAT MEET A "MORE-LIKELY-THAN-NOT" RECOGNITION THRESHOLD ARE MEASURED AT THE LARGEST AMOUNT OF INCOME TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH INCOME TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED INCOME TAX BENEFITS IN THE REGION'S COMBINED BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS WOULD BE CLASSIFIED AS INCOME TAXES IN THE STATEMENTS OF OPERATIONS. THERE WERE NO UNRECOGNIZED INCOME TAX BENEFITS, NOR ANY INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS, ACCRUED OR EXPENSED AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2016 AND 2015. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | FESTIVAL OF TREES | Event1Nm |
| Gross Receipts Event1 | $49,809 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $49,809 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $1,948 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $7,477 | OtherDirectExpensesEvent1Amt |
| Event2 | TOURNAMENT OF TRADTION GOLF BENEFIT | Event2Nm |
| Gross Receipts Event2 | $41,066 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $41,066 | GrossRevenueEvent2Amt |
| Food And Beverage Event2 | $5,514 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $9,980 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 5 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $10,367 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $10,367 | GrossRevenueOtherEventsAmt |
| Food And Beverage Other Events | $1,507 | FoodAndBeverageOtherEventsAmt |
| Oth Direct Expnss Other Events | $4,436 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $101,242 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $101,242 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $8,969 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $21,893 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $30,862 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $70,380 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (7 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| EVELYN KASER NURSING SCHOLARSHIP | 5 | $5,000 |
| LORNA & JOSEPH HALLIDAY FAMILY NURSING SCHOLARSHIP | 2 | $1,200 |
| MCMC BOARD OF TRUSTEES FUTURE HEALTH PROFESSIONALS | 3 | $6,000 |
| NON-TRADITIONAL NURSING SCHOLARSHIP | 7 | $6,800 |
| MCMC DEPENDENT SCHOLARSHIP | 8 | $8,512 |
| MCMC EMPLOYEE SCHOLARSHIP | 3 | $4,962 |
| RANDY ROOD MEMORIAL SCHOLARSHIP | 45 | $99,583 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AN INTERNAL GRANT MANAGER TRACKS ALL EXPENSES RELATED TO THE GRANT AND REPORTS THEM PERIODICALLY IN A WRITTEN REPORT TO THE GRANTOR. SOME GRANTS CONTAIN LINE-ITEM BUDGETS WHICH ALSO MUST BE MET AND ARE SUBJECT TO AUDIT BY THE GRANTOR. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| 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 | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DIANNE STORBY | ||||||||||||||
| EX-OFFICIO DIRECTOR | $0 | $323,018 | $0 | $25 | $0 | $0 | $0 | $13,250 | $0 | $21,292 | $0 | $357,585 | $0 | $0 |
| DUANE FRANCIS | ||||||||||||||
| EX-OFFICIO DIRECTOR | $0 | $611,061 | $0 | $25,025 | $0 | $0 | $0 | $752,875 | $0 | $17,347 | $0 | $1,406,308 | $0 | $0 |
| ERIC HOLEMAN | ||||||||||||||
| DIRECTOR | $0 | $160,090 | $0 | $25 | $0 | $0 | $0 | $8,298 | $0 | $19,352 | $0 | $187,765 | $0 | $0 |
| CELESTE HILL-THOMAS | ||||||||||||||
| EXECUTIVE DIRECTOR | $89,344 | $89,344 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $89,344 | $89,344 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINES 4A-B | FormAndLineReferenceDesc |
| Explanation | DUANE FRANCIS: - SEVERENCE COMPENSATION FROM HEALTH CARE FOR THE MID-COLUMBIA REGION TO BE PAID OUT IN 2017: $621,190 - NONQUALIFIED DEFERRED COMPENSATION FROM MID-COLUMBIA MEDICAL CENTER: $101,088. PAYMENT OF THE DEFERRED COMPENSATION WHICH HAS BEEN ACCRUING SINCE 2003 WILL BE MADE IN TEN ANNUAL INSTALLMENTS OF $160,348 BEGINNING 1/1/17. | ExplanationTxt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship With Org | RELATED TO MID-COLUMBIA MEDICAL CENTER BY COMMON PARENT ORGANIZATION. | RelationshipWithOrgTxt |
| Loan Purpose | OPERATING EXPENSES | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Balance Due | $31,088 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | 0 | BoardOrCommitteeApprovalInd |
| Written Agreement | 0 | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $31,088 | TotalBalanceDueAmt |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $70,300 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV - PUBLICLY-TRADED | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 6 | HEALTHCARE FOR THE MID-COLUMBIA REGION IS THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11B | BOARD MEMBERS WERE PROVIDED ACCESS TO THE DRAFT TO REVIEW AT THE BOARD MEETING PRECEDING FILING OF THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | WE ANNUALLY REQUIRE DIRECTORS, OFFICERS AND EXECUTIVE MANAGEMENT TEAM TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. IF A CONFLICT WAS DISCOVERED FOR A PERSON WITH A SIGNED DISCLOSURE STATEMENT, THEY WOULD BE SUBJECT TO CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION FOR VIOLATION OF OUR POLICY. IF THEY SELF-DISCLOSED A POTENTIAL CONFLICT OF INTEREST ON THE FORM, WE WOULD GATHER INFORMATION ON THE ISSUE AND MAKE A DETERMINATION ON HOW SEVERE THE CONFLICT IS AND WHETHER OR NOT THE EMPLOYEE OR DIRECTOR COULD REMAIN AN EMPLOYEE. THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO IS COMPENSATED BY HEALTH CARE FOR THE MID-COLUMBIA REGION, A RELATED ORGANIZATION. THE BOARD OF HEALTH CARE FOR THE MID-COLUMBIA REGION ENGAGES A PROFESSIONAL FIRM TO DO A REGIONAL AND NATIONAL SURVEY, ALONG WITH A COMPARISON OF ORGANIZATION COMPLEXITY AND STRUCTURE, AND THEN RECOMMENDS A SALARY AND BENEFITS RANGE TO THE BOARD. THIS IS ALL DONE CONFIDENTIALLY WITHOUT CEO PARTICIPATION. THE CEO THEN NEGOTIATES WITH THE BOARD, WHICH COMPARES THE COMPENSATION DISCUSSED WITH THE ANALYSIS PREVIOUSLY DESCRIBED AND VOTES ON AND APPROVES A NEW CONTRACT IN EXECUTIVE SESSION WITHOUT CEO PRESENCE OR PARTICIPATION IN THE VOTE. COMPENSATION OF THE ORGANIZATIONS OFFICERS OR KEY EMPLOYEES IS DETERMINED BY A SURVEY OF MARKET RATES FOR SIMILAR POSITIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL INFORMATION AVAILABLE TO THE PUBLIC AT THE CHARITABLE ACTIVITES DIVISION OF THE OREGON DEPARTMENT OF JUSTICE. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THEIR FINANCIAL STATEMENTS & SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HEALTH CARE FOR THE MID-COLUMBIA REGION | ||||||||||
| 1700 E 19TH STREET | THE DALLES | OR | 97058 | 930847905 | HEALTH SERVICES | OR | 501(C)(3) | LINE 12C, III-FI | HEALTHCARE FOR THE MID-COLUMBIA REGION | 0 |
| MID-COLUMBIA MEDICAL CENTER | ||||||||||
| 1700 E 19TH STREET | THE DALLES | OR | 97058 | 930386936 | ACUTE HOSPITAL CARE | OR | 501(C)(3) | LINE 3 | HEALTHCARE FOR THE MID-COLUMBIA REGION | Yes (1) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LPH&WC HOLDINGS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1524 SHERMAN AVENUE | AddressLine1Txt |
| City | HOOD RIVER | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97031 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 811236711 | EIN |
| Primary Activities | RENTAL ACTIVITY | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| DRY HOLLOW INC | |||||||||
| 1700 E 19TH STREET | THE DALLES | OR | 97058 | 930631350 | RENTAL BUILDING | OR | N/A | C | 0 |
| CHARITABLE REMAINDER TRUST (1) | |||||||||
| INVESTMENTS | OR | N/A | T | 0 | |||||
| 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 | Yes (1) | 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 | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MID-COLUMBIA MEDICAL CENTER | ||
| D | $31,088 | LOANS TO RELATED PARTY |
| MID-COLUMBIA MEDICAL CENTER | ||
| Q | $584,920 | ACTUAL REIMBUSED EXPENSES |