2017-09-05T17:38:02-05:00 2016-12-31 204749363 ISLER MEDFORD LLC 839 ALDER CREEK DR MEDFORD OR 97504 990 2016-01-01 930691238 ASHLAND COMMUNITY HOSPITAL FOUNDATION ASHL 5412014014 280 MAPLE STREET ASHLAND OR 97520 ED COLSON TREASURER 5412014014 2017-08-17 1 CAROLYN M RYDER P00033827 5417797641 68.185.29.106 2017-08-17 16:27:19 PD P ABFC45A53C905F08A556386F37BC78E18B9B8F61 ABFC45A53C905F08A556386F37BC78E18B9B8F61 2016 2021-01-29 14:40:06Z JANET TROY 280 MAPLE STREET ASHLAND OR 97520 4195108 0 X WWW.ACHFOUNDATION.ORG X 1977 OR SEE SCHEDULE O - PAGE 36 FOR FOUNDATION MISSION STATEMENT.OUR MISSION IS TO SOLICIT, STEWARD AND GRANT FUNDS TO SUPPORT ASANTE ASHLAND COMMUNITY HOSPITAL.VISION INSPIRING PHILANTHROPY TO ENHANCE ASANTE ASHLAND COMMUNITY HOSPITAL SERVICES.VALUES WE ACHIEVE OUR VISION AND LIVE OUR MISSION BY VALUING:*PASSION FOR ASANTE ASHLAND COMMUNITY HOSPITAL AND COMMUNITY HEALTH;*GENEROSITY WITH CHARITABLE GIFTS, TIME, AND EXPERTISE;*STEWARDSHIP IN THE MANAGEMENT OF ASSETS ENTRUSTED TO OUR CARE;*STRATEGIC PARTNERSHIP WITH ASANTE ASHLAND COMMUNITY HOSPITAL, ASANTE AND COMMUNITY MEMBERS;*ADVOCACY TO RAISE THE PROFILE OF ASANTE ASHLAND COMMUNITY HOSPITAL AS AN HONORED INSTITUTION IN THE COMMUNITY; *INDEPENDENCE FOR ASHLAND COMMUNITY HOSPITAL FOUNDATION 12 12 0 0 178500 0 338671 393209 31185 31963 287222 164886 178640 181113 835718 771171 450382 313617 0 0 0 0 0 0 0 225096 247859 675478 561476 160240 209695 6388945 6822976 136328 154089 6252617 6668887 X OUR MISSION IS TO SOLICIT, STEWARD AND GRANT FUNDS TO SUPPORT ASANTE ASHLAND COMMUNITY HOSPITAL. 0 0 313617 313617 -936 SEE SCHEDULE O - REPORTED NET OF UNUSED GRANTS. 5598 31963 THROUGH EFFORTS OF ASHLAND COMMUNTIY HOSPITAL FOUNDATION, THE COMMUNITY OF TALENT, OREGON CONTINUES TO RECEIVE QUALITY HEALTHCARE. IN 1994, THE FOUNDATION CONSTRUCTED A PHARMACY IN THAT COMMUNITY, WHICH IS RENTED TO MEDICAP PHARMACY. THIS PROJECT HELPED GUARANTEE ACCESS TO PHARMACEUTICALS IN THE COMMUNITY. 319215 1 1 0 0 0 1 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 0 0 0 OR X X REID HANNA JOHNSON & COMPANY LLC 5414823711 1101 SISKIYOU BLVD ASHLAND OR 97520 X KAREN AMAROTICO DIRECTOR 2.00 X 0 0 0 ERIC HERRON DIRECTOR 2.00 X 0 0 0 SHARON LASKOS DIRECTOR 2.00 X 0 0 0 MEIWEN RICHARDS DIRECTOR 2.00 X 0 0 0 JOHN MAURER DIRECTOR 2.00 X 0 0 0 RICK NAGEL DIRECTOR 2.00 X 0 0 0 TRICIA HAHN DIRECTOR 2.00 X 0 0 0 MARGIE LININGER DIRECTOR 2.00 X 0 0 0 ELIZABETH A MURPHY PRESIDENT 2.00 X 0 0 0 KAREN DRESCHER VICE-PRESIDENT 2.00 X 0 0 0 BRANDT CULLEN TREASURER 2.00 X 0 0 0 JOY DOBSON WAY SECRETARY 2.00 X 0 0 0 0 0 0 0 0 0 0 0 393209 393209 RENT OF MED FACILITIES 531390 31963 31963 31963 168435 168435 178500 0 178500 178500 178500 3420388 3423937 -3549 -3549 -3549 MISCELLANEOUS INCOME 561000 2613 2613 2613 771171 31027 178500 168435 236158 236158 77459 77459 33314 33314 35164 35164 3035 3035 422 422 9005 9005 4007 4007 OTHER OPERATING EXPENSE 161321 161321 OTHER RENTAL EXPENSE 1591 1591 561476 319215 242261 0 6457 47597 301138 335894 17035 6888 2896 2831 569243 79973 493277 489270 5568142 5940496 6388945 6822976 8738 28342 127590 125747 136328 154089 X 2116680 2242816 738336 1147575 3397601 3278496 6252617 6668887 6388945 6822976 X 209695 203185 298604 -295214 X X 0 1 X 1 0 X 257954 2635877 619650 338671 393209 4245361 257954 2635877 619650 338671 393209 4245361 4245361 571982 541244 396797 379418 381511 2270952 10708 1473 12181 6528494 0.65030 0.63100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 77459 2626637 0 0 0 3397601 10972 230966 115555 21752 3502232 3209768 263285 53852 21600 3397601 2839646 296350 166889 32833 38256 22028 3209768 713533 2078698 102587 16167 25188 13817 2839646 695384 50 48141 12000 12822 5220 713533 0 0 411472 411472 157771 79973 77798 489270 MUTUAL FUNDS 5764936 F UNITRUST ASSETS 175560 F 5940496 ANNUITY OBLIGATION 123147 DEPOSITS 2600 125747 X 1275929 203185 298604 2969 504758 771171 0 771171 859659 298183 298183 561476 0 561476 Part V, Line 4: INCOME FROM EVANS SCHOLARSHIP ENDOWMENT FUND IS TO AWARD SCHOLARSHIPS TO STUDENTS WHO ARE PURSUING NURSING DEGREES FROM OREGON HEALTH SCIENCES UNIVERSITY AT SOUTHERN OREGON UNIVERSITY OR ROGUE COMMUNITY COLLEGE. INCOME FROM THE NIXON ENDOWMENT FUND IS GIFTED ANNUALLY TO THE FOUNDATION'S LIGHTS FOR LIFE CAMPAIGN. Part X, Line 2: THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT ON NET INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES GENERATED FROM THE RENTAL OF CERTAIN DEBT-FINANCED PROPERTY. AT DECEMBER 31, 2016, THE ACTIVITY REPORTED OPERATING INCOME OF $0 WHICH DID NOT ADD OR SUBTRACT FROM OPERATING LOSS CARRYFORWARDS. THE UNUSED NET OPERATING LOSS CARRYFORWARDS MAY BE APPLIED AGAINST FUTURE TAXABLE INCOME. THE DEFERRED TAX ASSET HAS NOT BEEN RECORDED IN THE FINANCIAL STATEMENTS DUE TO THE UNDETERMINABLE TIMING OF EVENTS OF WHICH THE FOUNDATION WOULD BE ABLE TO UTILIZE THE CARRYFORWARDS. THE FOUNDATION'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS (FORM 990-T) FOR 2013, 2014, AND 2015 ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR 3 YEARS AFTER THEY WERE FILED. MANAGEMENT BELIEVES IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN. Part XI, Line 2d - Other Adjustments: CHANGE IN SPLIT INTEREST AGREEMENT 2,969. 0 ASANTE ASHLAND COMMUNITY HOSPITAL 280 MAPLE STREET ASHLAND OR 97520 236158 FMV FUNDING PROVIDED TO ASSIST WITH: EQUIPMENT PURCHASES, GENERAL EDUCATION, AND HOSPICE CENTER. NURSING SCHOLARSHIPS AWARDED 29 77459 FMV X ACH ADMIN/OFFICE SPACE 1 276290 FMV X OTHER SERVICES/GIFTS 28 22314 COMPARABLE SALES 0 1 0 Form 990, Part I, Line 1 ASHLAND COMMUNITY HOSPITAL FOUNDATION IS ORGANIZED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL AND SCIENTIFIC PURPOSES, INCLUDING, FOR SUCH PURPOSES, THE MAKING OF DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986 (AND SIMILAR PROVISIONS OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW). THE FOUNDATION SHALL HAVE THE FOLLOWING POWERS: (1) TO ASSIST, ENCOURAGE, PROMOTE AND ADVANCE THE QUALITY OF CARE, TREATMENT AND REHABILITATION OF THE SICK, AFFLICTED, INFIRM AND INJURED PATIENTS OF ASANTE ASHLAND COMMUNITY HOSPITAL, ASHLAND, OREGON. (2) TO FURTHER THE CHARITABLE, SCIENTIFIC, EDUCATIONAL AND SERVICE ACTIVITIES OF ASANTE ASHLAND COMMUNITY HOSPITAL. (3) TO SUPPORT ASANTE ASHLAND COMMUNITY HOSPITAL, ITS OBJECTIVES AND PROJECTS BY APPROPRIATE REPRESENTATIONS TO THE PUBLIC WITH RESPECT TO THE HOSPITAL'S NEEDS, MISSION AND REQUIREMENTS AND TO SOLICIT FUNDS FOR ITS USE IN PROVIDING THE MEDICAL AND HOSPITAL FACILITIES NEEDED IN THE GENERAL COMMUNITY SERVED BY ASANTE ASHLAND COMMUNITY HOSPITAL. (4) TO ACCEPT DONATIONS, GRANTS, BEQUESTS AND DEVISES FROM ANY SOURCES, AND TO ACCEPT PROPERTY OF ALL KINDS APPROPRIATE TO FOUNDATION PURPOSES. (5) TO FACILITATE, ASSIST, ENCOURAGE, SUPPORT, PROMOTE AND ADVANCE THE PHYSICAL, MENTAL AND EMOTIONAL HEALTH OF PERSONS WITHIN THE GEOGRAPHIC AREA SERVED BY ASANTE ASHLAND COMMUNITY HOSPITAL THROUGH ANY LAWFUL ACTIVITIES, WHICH ARE AUTHORIZED UNDER THE LAWS APPLICABLE TO OREGON NONPROFIT CORPORATIONS WHICH ARE NOT PROHIBITED UNDER ARTICLE III OF THE ARTICLES OF INCORPORATION. (6) TO DO AND PERFORM SUCH OTHER ACTS AS MAY BE NECESSARY OR APPROPRIATE FOR CARRYING OUT THE FOREGOING PURPOSES OF THE CORPORATION AND IN CONNECTION THEREWITH TO ENGAGE IN ANY LAWFUL ACTIVITY AUTHORIZED BY THE OREGON NONPROFIT CORPORATION LAW AND NOT PROHIBITED BY THE ARTICLES OF INCORPORATION OR SECTION 2 OF THIS ARTICLE. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS A. CARDIAC AND CANCER CARE - DONOR DESIGNATED GIFTS AND A BEQUEST FROM THE ELMER C. BIEGEL FAMILY MEMORIAL FOUNDATION PURCHASE A BRONCHOSCOPE AND ENDOSCOPE FOR MINIMALLY INVASIVE EXAMINATION OF THE LUNGS, ESOPHAGUS AND STOMACH FOR EARLY IDENTIFICATION AND TREATMENT OF CANCER. ADDITIONALLY, A PORTABLE ULTRASOUND WAS ALSO PURCHASED TO ASSIST EMERGENCY DEPARTMENT PHYSICIANS AND GENERAL SURGEONS IN DIAGNOSING CARDIAC CONDITIONS $39,147 B. CHAPEL - DONOR DESIGNATED GIFTS WERE USED TO PURCHASE SPIRITUAL CARE SUPPLIES FOR THE NEWLY CREATED CHAPEL, INCLUDING AN ALTAR CLOTH, COMMUNION GLASSES, AND PRAYER BOOKS $308 C. CHARITY CARE PROGRAM - DONOR DESIGNATED GIFTS WERE USED TO HELP ASANTE ASHLAND COMMUNITY HOSPITAL PROVIDE CARE TO UNINSURED PATIENTS $341 D. EVANS NURSING SCHOLARSHIPS - THIRTEEN NURSING STUDENTS ENROLLED AT OREGON HEALTH SCIENCE UNIVERSITY (ASHLAND CAMPUS) RECEIVED A TOTAL OF $81,000 IN SCHOLARSHIPS THROUGH THE WILLIAM G. AND RUTH T. EVANS ENDOWED NURSING SCHOLARSHIP FUND. AN ADDITIONAL 16 GRADUATES OF THE LICENSED PRACTICAL NURSE PROGRAM AT ROGUE COMMUNITY COLLEGE RECEIVED A SCHOLARSHIP TO COVER THE COST OF THEIR STATE APPLICATION AND EXAM FEES IN THE AMOUNT OF $6,792 $87,792 E. HOME HEALTH - DONOR DESIGNATED GIFTS HELPED SUPPORT HOME HEALTH SERVICES FOR THOSE PATIENTS IN NEED OF SKILLED NURSING CARE IN THEIR HOME $6,025 F. HOSPICE - DONOR DESIGNATED GIFTS HELPED SUPPORT THE HOSPICE SERVICES FOR PATIENTS IN NEED OF END OF LIFE CARE $8,163 G. FAMILY BIRTH CENTER - A GRANT FROM THE GWLADYS AND JOHN ZURLO FOUNDATION AND DONOR DESIGNATED GIFTS HELPED PURCHASE RESPIRATORY THERAPY EQUIPMENT TO HELP OUR NEWBORNS BREATHE ON THEIR OWN. DONOR SUPPORT ALSO HELPED PURCHASE A FETAL MONITOR AND NEW ARTWORK AS PART OF THE RENOVATION OF OUR FAMILY BIRTH CENTER $36,462 H. LABORATORY - DONOR DESIGNATED GIFT HELPED PURCAHSE A COAGULATION ANALYZER $3,141 I. MEDICAL/SURGICAL UNIT - DONOR DESIGNATED GIFTS PROVIDED HEALTHY SNACKS IN THE FAMILY COMFORT ZONE ON OUR MEDICAL SURGICAL UNIT $100 J. SCHOOL NURSE PROGRAM - GRANTS FROM THE REED AND CAROLEE WALKER FUND OF THE OREGON COMMUNITY FOUNDATION, AND THE SHARKEY FOUNDATION PROVIDED FUNDING FOR NURSING SERVICES TO OVER 1,700 ELEMENTARY SCHOOL CHILDREN IN THE ASHLAND AND TALENT-PHOENIX SCHOOL DISTRICTS. IN ADDITION, THE ASHLAND FOOD COOP AND ASHLAND SHOP-N-KART CONTRIBUTED $2,500 OF IN-KIND SUPPORT TO SUPPLY HEALTHY SNACKS TO STUDENTS AS PART OF THE HEALTHY SNACKS: AN ALTERNATIVE TO MEDICATION PROGRAM $32,500 K. PATIENT ARE INITIATIVES - PROCEEDS FROM LOUIE'S BIG GIVE AND EMPLOYEE GIFTS SUPPORTED EMPLOYEE INITIATIVES TO ENHANCE PATIENT CARE THROUGH THE CAREGIVER FUND. COMPLETED PROJECTS INCLUDE SIT-TO-STAND EQUIPMENT USED TO SAFELY TRANSFER HIGH-FALL RISK PATIENTS IN AND OUT OF THEIR BED; A BLADDER SCANNER FOR PATIENTS IN OUR EMERGENCY DEPARTMENT; AND THE PURCHASE AND INSTALLATION OF THIRTEEN TELEVISIONS FOR PATIENTS IN SAME DAY SURGERY AND THE MEDICAL SURGICAL UNIT $22,319 L. STAFF EDUCATION AND TRAINING - THROUGH DONOR DESIGNATED GIFTS A RADIOLOGY TECHNICIAN WAS ABLE TO ATTEND A TRAINING ON BONE DENSITOMETRY AND A BONE HEALTH COURSE. IN ADDITION, THROUGH THE RODDEN SCHOLARSHIP FUND, TWO ASANTE ASHLAND SURGICAL STAFF RECEIVED SCHOLARSHIPS ALLOWING THEM TO ATTEND THE 2015 ACADEMY OF OPHTHALMOLOGY MEETING. FURTHERMORE, A GRANT FROM THE OREGON HEALTH & SCIENCE UNIVERSITY OFFICE OF RURAL HEALTH SMALL HOSPITAL IMPROVEMENT PROGRAM PROVIDED FUNDING FOR LEAN TRAINING FOR DEPARTMENT LEADERS $10,342 M. UROLOGY PROGRAM - DONOR DESIGNATED GIFTS AND ENDOWMENT EARNINGS WERE USED TO PURCHASE THE FIRST PHASE OF EQUIPMENT NEEDED FOR THE NEW UROLOGY PROGRAM AT ASANTE ASHLAND COMMUNITY HOSPITAL $14,922 N. WOMEN'S HEALTH INITIATIVE - CONTRIBUTIONS TO OUR 2015 PATRONS CAMPAIGN AND LIGHTS FOR LIFE WERE USED TO HELP PURCHASE NEW EQUIPMENT NEEDED FOR BREAST RECONSTRUCTION AND GYNECOLOGICAL SURGERIES $61,390 O. VOLUNTEER PROGRAM - A BEQUEST FROM SUSAN YEOMAN SUPPORTED THE MASSAGE THERAPY PROGRAM AND HELPED PURCHASE NEW SHIRTS FOR VOLUNTEERS $1,000 TOTAL PROGRAM SERVICE EXPENSES $323,952 Form 990, Part VI, Section A, line 6 FOUNDATION BOARD MEMBERS SERVE AS VOTING MEMBERS WITH AUTHORITY AND RESPONSIBILITY TO DEVELOP POLICIES, PROCEDURES, AND REGULATIONS NECESSARY TO OPERATE THE FOUNDATION, PARTICIPATE IN FUNDRAISING THROUGH PERSONAL CONTRIBUTIONS, AND PARTICPATE IN THE VARIOUS CAMPAIGNS NECESSARY TO FINANCE THE ONGOING OPERATION OF THE FOUNDATION AND ITS WORK WITH THE HOSPITAL. BOARD MEMBERS SERVE A THREE YEAR TERM (UNLESS ELECTED TO FILL AN UNEXPIRED TERM). Form 990, Part VI, Section A, line 7a THE OFFICERS SHALL BE ELECTED BY, AND SHALL SERVE AT THE PLEASURE OF, THE BOARD, AND SHALL HOLD THEIR RESPECTIVE OFFICES UNTIL THEIR RESIGNATION, REMOVAL, OR OTHER DISQUALIFICATION FROM SERVICE, OR UNTIL THEIR RESPECTIVE SUCCESSORS SHALL BE ELECTED. THE PRESIDENT SHALL BE ELECTED FOR A TWO-YEAR TERM OF OFFICE. VICE-PRESIDENT, SECRETARY AND TREASURER SHALL BE ELECTED ANNUALLY. Form 990, Part VI, Section A, line 7b FOUNDATION BOARD MEMBERS ARE EXPECTED TO ATTEND MONTHLY BOARD MEETINGS, STANDING COMMITTEES (AS ASSIGNED), AD HOC COMMITTEE MEETINGS (AS APPOINTED) AND SPECIAL EVENTS (AS ANNOUNCED). CONTINUITY OF ATTENDANCE AND PARTICIPATION AS A POLICY MAKER AND PLANNER IS IMPERATIVE FOR SERVING AS A VOTING MEMBER. Form 990, Part VI, Section B, line 11b THE ACH FOUNDATION HAS A STANDING ASSET MANAGEMENT COMMITTEE THAT MEETS QUARTERLY TO REVIEW FINANCIAL STATEMENTS, INCLUDING EXPENSES, INCOME, GRANTS, CASH DISBURSEMENTS, BALANCE SHEET, PROFIT AND LOSS, AND ANY AUDIT LETTERS. IN ADDITION, TIME IS ALLOCATED AT EACH QUARTERLY BOARD MEETING TO REVIEW FINANCIAL STATEMENTS AND THE ANNUAL AUDIT IS PRESENTED TO THE FULL FOUNDATION BOARD UPON ITS COMPLETION. BOTH THE ASSET MANAGEMENT COMMITTEE AND THE BOARD MONITOR THE FINANCIAL RESOURCES TO ENSURE THAT FUNDS ARE APPROPRIATELY ACCOUNTED FOR. THE FOUNDATION BOARD TREASURER REVIEWS THE FINANCIAL STATEMENTS ON A MONTHLY BASIS. FINANCIAL STATEMENTS: 1. THE ACH FOUNDATION IS NOT REQUIRED BY LAW TO UNDERGO AN AUDIT BY AN INDEPENDENT AUDITOR. 2. THE ACH FOUNDATION HAS NOT RECEIVED FEDERAL FUNDS THAT REQUIRES ONE OR MORE AUDITS. 3. THE ACH FOUNDATION BOARD HAS AN ESTABLISHED ASSET MANAGEMENT COMMITTEE WHICH MAKES RECOMMENDATIONS ON THE SELECTION OF THE INDEPENDENT AUDITOR TO THE FOUNDATION BOARD. IN ADDITION, THEY OVERSEE THE INDEPENDENT AUDITOR. 4. THE ACH FOUNDATION CURRENTLY HAS FINANCIAL STATEMENTS COMPILED BY AN INDEPENDENT ACCOUNTANT AND AUDITED ANNUALLY BY A QUALIFIED THIRD-PARTY. Form 990, Part VI, Section B, line 12c ALL BOARD MEMBERS ARE EXPECTED TO ACCEPT AND ADHERE TO POLICIES AND HOLD FELLOW BOARD MEMBERS AND STAFF TO THE SAME STANDARDS. MONITORING OF SUCH IS ONGOING. Form 990, Part VI, Section C, line 18 THE FOUNDATION'S DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION MAY BE REQUESTED FOR VIEWING BY CONTACTING THE FOUNDATION'S OFFICE. Form 990, Part VI, Section C, line 19 THE FOUNDATION'S FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AND BY VISITING THE WEBSITE WWW.ACHFOUNDATION.ORG Form 990, Part XI, line 9: CHANGE IN MARKET VALUE OF TRUST ASSETS 2,969. IN-KIND EXPENSES -298,183. FINANCIAL STATEMENT AND AUDIT OVERSIGHT THE OVERSIGHT OR SELECTION PROCESS HAS NOT CHANGED DURING THE YEAR.