SPOKANE TEACHING HEALTH CENTER: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- SPOKANE TEACHING HEALTH CENTER (EIN 46-4139065)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-01
- IRS object ID
- 201733059349301613
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-01T12:30:33-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 WEST RIVERSIDE SUITE 700 | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 992010622 | 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 | 464139065 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPOKANE TEACHING HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SPOK | BusinessNameControlTxt |
| Phone | 5093151260 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 244 | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99210 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID E LUHN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5093151260 | PhoneNum |
| Signature | 2017-10-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BARBARA L EARNHEART | PreparerPersonNm |
| PTIN | P00240388 | PTIN |
| Phone | 5093636300 | PhoneNum |
| Preparation | 2017-10-23 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-10-31 | IPDt |
| IP Tm | 10:02:50 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 3A69748B60C5562FF1572AE4C29EA0C331661B82 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 757A344A9F492B99F4DBC36D20E5EEF65915C547 | 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) |
|---|---|---|
| Principal Officer | NANCY VORHEES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 244 | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99210 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,173,506 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | SPOKANETEACHINGHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | SPOKANE TEACHING HEALTH CENTER IS ORGANIZED AND OPERATED SPECIFICALLY TO PROMOTE, CONDUCT AND SPONSOR EDUCATIONAL ACTIVITIES RELATED TO GRADUATE MEDICAL EDUCATION, INCLUDING RESIDENCY PROGRAMS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 1 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,566,725 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,173,506 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $23,663 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,590,388 | PYTotalRevenueAmt |
| CY Total Revenue | $2,173,506 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $123,999 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $55,738 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,101,749 | PYOtherExpensesAmt |
| CY Other Expenses | $1,700,748 | CYOtherExpensesAmt |
| PY Total Expenses | $1,225,748 | PYTotalExpensesAmt |
| CY Total Expenses | $1,756,486 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $364,640 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $417,020 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,125,374 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,791,105 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $369,056 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $617,767 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $756,318 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,173,338 | NetAssetsOrFundBalancesEOYAmt |
| Mission | POKANE TEACHING HEALTH CENTER IS ORGANIZED AND OPERATED SPECIFICALLY TO PROMOTE, CONDUCT AND SPONSOR EDUCATIONAL ACTIVITIES RELATED TO GRADUATE SMEDICAL EDUCATION, INCLUDING RESIDENCY PROGRAMS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,549,036 | ExpenseAmt |
| Desc | GRADUATE MEDICAL EDUCATION (GME)--INTERNAL MEDICINE AND FAMILY MEDICINE RESIDENCY PROGRAMSACGME--ACCREDITED SPONSORSHIP AND OPERATIONS OF EXPANDED FAMILY AND INTERNAL MEDICINE RESIDENCY PROGRAMS, HRSA-FUNDED, IN A TEACHING HEALTH CENTER SETTING IN SPOKANE, WA. IN 2016, STHC EXPANDED THESE RESIDENCY PROGRAMS IN SPOKANE BY SPONSORING AN ADDITIONAL 6 NEW RESIDENTS (A TOTAL EXPANSION OF 18, OR 40%, SINCE 2014). | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $29,550 | ExpenseAmt |
| Desc | GRADUATE MEDICAL EDUCATION (GME)--DEVELOPMENT OF NEW RESIDENCY PROGRAMS AT AREA HOSPITALSIN 2016, THE ORGANIZATION RECEIVED $490,000 OF GRANTS MADE AVAILABLE BY THE STATE OF WASHINGTON LEGISLATURE (HB 2151) AND ADMINISTERED BY THE UNIVERSITY OF WASHINGTON TO DEVELOP NEW GME RESIDENCY PROGRAMS AT HOLY FAMILY HOSPITAL (SPOKANE, WA) AND PULLMAN REGIONAL HOSPITAL (PULLMAN, WA). THESE HOSPITALS HAVE NO SUCH CURRENT RESIDENCY PROGRAMS. THE FUNDS WILL BE USED TO DEVELOP PROGRAMS AT THOSE FACILITIES OVER A 2 TO 3 YEAR PERIOD. THIS EFFORT IS IN ACCORDANCE WITH THE ORGANIZATION'S MISSION ELEMENT TO EVALUATE AND PROVIDE FOR GROWTH IN ACADEMIC MEDICINE TRAINING IN THE GREATER SPOKANE COMMUNITY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $1,578,586 | 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 | 0 | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | 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 | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1 | 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 |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | 0 | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | 0 | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EMPIRE HEALTH FOUNDATION CO DAVE LUHN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5093151260 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1020 W RIVERSIDE AVE | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99201 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 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 |
|---|---|---|---|---|---|---|---|
| ANTONY CHIANG | |||||||
| CHAIR (CLASS A APPOINTEE) | 0.50 | 40.00 | Yes (X) | Yes (X) | $0 | $248,800 | $35,189 |
| FREDERICK CHEN MD MPH | |||||||
| DIRECTOR (CLASS A APPOINTEE) | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL NOWLING | |||||||
| DIRECTOR (CLASS A APPOINTEE) | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JEFFREY BELL | |||||||
| DIRECTOR (CLASS A APPOINTEE) | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DEB HARPER MD | |||||||
| DIRECTOR (CLASS A APPOINTEE) | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JEFF COLLINS MD | |||||||
| DIRECTOR (CLASS B APPOINTEE) | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| RICH HADLEY | |||||||
| DIRECTOR (CLASS B APPOINTEE) | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| LISA BROWN PHD | |||||||
| SECRETARY (CLASS C APPOINTEE) | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KENNETH ROBERTS PHD | |||||||
| DIRECTOR (CLASS C APPOINTEE) | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| GARMAN LUTZ | |||||||
| DIRECTOR (CLASS A APPOINTEE) | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JOHN ROLL PHD | |||||||
| DIRECTOR (CLASS C APPOINTEE) | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL WILSON | |||||||
| CONSULTING EXECUTIVE DIRECTOR | 2.00 | Yes (X) | $11,875 | $0 | $0 | ||
| DAVID E LUHN | |||||||
| CHIEF FINANCIAL OFFICER (ACTING) | 0.50 | 40.00 | Yes (X) | $0 | $124,824 | $22,880 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $11,875 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $373,624 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $58,069 | 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 |
| Related Organizations | $657,506 | RelatedOrganizationsAmt |
| Government Grants | $1,516,000 | GovernmentGrantsAmt |
| Total Contributions | $2,173,506 | TotalContributionsAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,173,506 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,875 | TotalAmt |
| Management And General | $11,875 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,000 | TotalAmt |
| Management And General | $34,000 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,835 | TotalAmt |
| Management And General | $5,835 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,028 | TotalAmt |
| Management And General | $4,028 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,389 | TotalAmt |
| Management And General | $58,389 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,250 | TotalAmt |
| Management And General | $15,250 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240 | TotalAmt |
| Management And General | $240 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,760 | TotalAmt |
| Management And General | $7,760 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $439 | TotalAmt |
| Management And General | $439 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159 | TotalAmt |
| Management And General | $159 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,212 | TotalAmt |
| Management And General | $12,212 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,413 | TotalAmt |
| Management And General | $2,413 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195 | TotalAmt |
| Management And General | $195 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,714 | TotalAmt |
| Management And General | $17,714 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| RESIDENCY PROGRAM INCRE | $3,169,165 | $3,169,165 | |
| NEW RESIDENCY PROGRAM D | $29,550 | $29,550 | |
| WASHINGTON STATE EXCISE | $7,391 | $7,391 | |
| CONTRACTUAL OFFSETS AND | -$1,620,129 | -$1,620,129 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,756,486 | TotalAmt |
| Program Services | $1,578,586 | ProgramServicesAmt |
| Management And General | $177,900 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $789,262 | BOYAmt |
| EOY | $790,202 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $325,813 | BOYAmt |
| EOY | $990,943 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,338 | BOYAmt |
| EOY | $9,194 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $977 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $211 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $961 | BOYAmt |
| EOY | $766 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,125,374 | BOYAmt |
| EOY | $1,791,105 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $369,056 | BOYAmt |
| EOY | $617,767 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $369,056 | BOYAmt |
| EOY | $617,767 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $756,318 | BOYAmt |
| EOY | $645,238 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $528,100 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $756,318 | BOYAmt |
| EOY | $1,173,338 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,125,374 | BOYAmt |
| EOY | $1,791,105 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $417,020 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 Minus2 Years | $1,013,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,566,725 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,173,506 | CurrentTaxYearAmt |
| Total | $4,753,231 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $1,013,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,566,725 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,173,506 | CurrentTaxYearAmt |
| Total | $4,753,231 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $92,316 | SubstantialContributorsTotAmt |
| Public Support Total170 | $4,660,915 | PublicSupportTotal170Amt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $7,319 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,663 | CurrentTaxYearMinus1YearAmt |
| Total | $30,982 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,784,213 | TotalSupportAmt |
| First5 Years170 | Yes (X) | First5Years170Ind |
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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $977 | OtherCostOrOtherBasisAmt |
| Depreciation | $211 | DepreciationAmt |
| Book Value | $766 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $766 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $2,173,506 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $2,173,506 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $2,173,506 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,756,486 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,756,486 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,756,486 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE CODE. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANTONY CHIANG | PersonNm |
| Title | CHAIR (CLASS A APPOINTEE) | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $222,092 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $11,600 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $15,108 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $35,189 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $283,989 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE IS USED BY A RELATED ORGANIZATION. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ELAINE COUTURE | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | A FORMER DIRECTOR OF THE ORGANIZATION | RelationshipDescriptionTxt |
| Transaction | $34,000 | TransactionAmt |
| Transaction | GROSS WAGE COMPENSATION PAID BY THE ORGANIZATION TO TRACI COUTURE (RESIGNED EFFECTIVE 6/30/2016), THE DAUGHTER OF THE INTERESTED PERSON. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | MR. MICHAEL WILSON, OF WILSON CONSULTING LLC, WAS ENGAGED AS A CONSULTING EXECUTIVE DIRECTOR THROUGH JUNE 30, 2016 AND GRANTED DAY-TO-DAY DECISION-MAKING RESPONSIBILITY FOR THE ORGANIZATION. MR. WILSON WAS PAID CASH COMPENSATION OF $11,875 IN PERFORMANCE OF THESE DUTIES. |
| FORM 990, PART VI, SECTION A, LINE 6 | TWO MEMBERS: EMPIRE HEALTH FOUNDATION (CLASS A) AND PROVIDENCE HEALTH AND SERVICES (CLASS B) |
| FORM 990, PART VI, SECTION A, LINE 7A | EMPIRE HEALTH FOUNDATION APPOINTS 5 CLASS "A" BOARD MEMBERS. PROVIDENCE HEALTH & SERVICES APPOINTS 2 CLASS "B" BOARD MEMBERS. A NON-MEMBER ORGANIZATION, WASHINGTON STATE UNIVERSITY, APPOINTS 2 CLASS "C" BOARD MEMBERS. ALL CLASSES OF BOARD MEMBERS HAVE THE SAME VOTING RIGHTS. HOWEVER, VOTING ACTIONS OF THE BOARD REQUIRE THE AFFIRMATIVE VOTE OF AT LEAST ONE DIRECTOR FROM EACH CLASS--CONSEQUENTLY, NO CLASS OF BOARD MEMBERS CONTROLS 50% OR MORE OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE WERE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | CORPORATE COUNSEL AND EXECUTIVE MANAGEMENT WILL REVIEW A PRE-FILING DRAFT AND MAY SUBMIT IT TO THE BOARD FOR CONSIDERATION POST-FILING. |
| FORM 990, PART VI, SECTION B, LINE 12 | THE BOARD IN 2017 HAS DEFINED THE PROCESS FOR ANNUALLY DISCLOSING ACTUAL OR POTENTIAL CONFLICTS OF INTERESTS AND WILL BE CONSISTENTLY MONITORING AND ENFORCING COMPLIANCE WITH THE ALREADY EXISTING CONFLICT OF INTEREST POLICY MOVING FORWARD. HOWEVER, THE ORGANIZATION IS NOT AWARE OF ANY VIOLATIONS OF THE EXISTING POLICY THROUGH DECEMBER 31, 2016. |
| FORM 990, PART VI, SECTION B, LINE 15 | ANNUAL REVIEW BY THE BOARD, INCLUDING COMPARISONS FOR SIMILAR POSITIONS IN OTHER NON-PROFITS. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| EMPIRE HEALTH FOUNDATION | |||||||||
| 422 W RIVERSIDE AVE STE 1100 | SPOKANE | WA | 99201 | 263375286 | PRIVATE FOUNDATION | WA | 501(C)(3) | PF | 0 |
| RIVERPOINT CLINIC PC | |||||||||
| PO BOX 422 | SPOKANE | WA | 99210 | 464190402 | PUBLIC CHARITY | WA | 501(C)(3) | 0 | |
| PROVIDENCE HEALTH & SERVICES | |||||||||
| 101 E 8TH AVE | SPOKANE | WA | 99204 | 911216033 | HOSPITAL | WA | 501(C)(3) | LINE 3 | 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | 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 (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PROVIDENCE HEALTH & SERVICES | ||
| C | $582,506 | CASH VALUE |
| EMPIRE HEALTH FOUNDATION | ||
| C | $75,000 | CASH VALUE |
| PROVIDENCE HEALTH & SERVICES | ||
| P | $1,549,036 | FAIR MARKET VALUE |
Comments