2016-08-29T14:31:57-05:00 2015-12-31 204749363 ISLER MEDFORD LLC 839 ALDER CREEK DR MEDFORD OR 97504 990 2015-01-01 930691238 ASHLAND COMMUNITY HOSPITAL FOUNDATION ASHL 5412014014 280 MAPLE STREET ASHLAND OR 97520 BRANDT CULLEN TREASURER 5412014014 2016-08-10 1 CAROLYN M RYDER P00033827 5417797641 2015 2016-12-15 16:53:06Z JANET TROY 280 MAPLE STREET ASHLAND OR 97520 2422568 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 14 14 0 0 178500 0 619650 338671 66939 31185 1199551 287222 178643 178640 2064783 835718 71419 450382 0 0 0 0 0 0 0 283508 225096 354927 675478 1709856 160240 6503472 6388945 146748 136328 6356724 6252617 X OUR MISSION IS TO SOLICIT, STEWARD AND GRANT FUNDS TO SUPPORT ASANTE ASHLAND COMMUNITY HOSPITAL. 0 0 450382 450382 117769 SEE SCHEDULE O 5639 31185 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. 456021 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 14 14 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 KAREN DRESCHER DIRECTOR 2.00 X 0 0 0 ERIC HERRON DIRECTOR 2.00 X 0 0 0 DIANE WILLIAMS 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 PAM HAMMOND MORRIS DIRECTOR 2.00 X 0 0 0 RICK NAGEL DIRECTOR 2.00 X 0 0 0 JOY DOBSON WAY DIRECTOR 2.00 X 0 0 0 ELIZABETH A MURPHY PRESIDENT 2.00 X 0 0 0 MAVIS E CLOUTIER SECRETARY 2.00 X 0 0 0 BRANDT CULLEN TREASURER 2.00 X 0 0 0 SANDRA SLATTERY PAST-PRESIDENT 2.00 X 0 0 0 0 0 0 0 0 0 0 0 338671 338671 RENT OF MED FACILITIES 531390 31185 31185 31185 169593 169593 178500 0 178500 178500 178500 1704479 1586850 117629 117629 117629 MISCELLANEOUS INCOME 561000 140 140 140 835718 148954 178500 169593 396530 396530 53852 53852 29210 29210 34322 34322 1466 1466 295 295 10414 10414 4131 4131 OTHER OPERATING EXPENSE 143750 143750 OTHER RENTAL EXPENSE 1508 1508 675478 456021 219457 0 46513 6457 233863 301138 4073 17035 2296 2896 569243 75966 497408 493277 5719319 5568142 6503472 6388945 9105 8738 137643 127590 146748 136328 X 2092623 2116680 866500 738336 3397601 3397601 6356724 6252617 6503472 6388945 X 160240 -264371 24 X X 0 1 X 1 0 X 356672 257954 2635877 619650 338671 4208824 356672 257954 2635877 619650 338671 4208824 4208824 552331 571982 541244 396797 379418 2441772 7056 10708 1473 19237 6669833 2925 0.63100 0.60140 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 53852 2541910 0 0 0 3209768 0 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 675700 44426 2609 10667 12025 4659 695384 0 0 411472 411472 157771 75966 81805 493277 MUTUAL FUNDS 5393709 F UNITRUST ASSETS 174433 F 5568142 ANNUITY OBLIGATION 124990 DEPOSITS 2600 127590 X 852738 -264371 281367 24 17020 835718 0 835718 956845 281367 281367 675478 0 675478 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, 2015, THE ACTIVITY REPORTED OPERATING INCOME OF $0 THAT WAS APPLIED AGAINST 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 2012, 2013, AND 2014 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 24. 0 ASANTE ASHLAND COMMUNITY HOSPITAL PO BOX 98 ASHLAND OR 97520 396530 FMV FUNDING PROVIDED TO ASSIST WITH: EQUIPMENT PURCHASES, GENERAL EDUCATION, AND HOSPICE CENTER. 1 NURSING SCHOLARSHIPS AWARDED 21 53852 FMV X ACH ADMIN/OFFICE SPACE 1 262103 FMV X OTHER SERVICES/GIFTS 28 19264 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. CHARITY CARE PROGRAM - DONOR DESIGNATED GIFTS WERE USED TO HELP ASANTE ASHLAND COMMUNITY HOSPITAL PROVIDE CARE TO UNINSURED PATIENTS $120 B. COMMUNITY MEDICATION ASSISTANCE PROGRAM - DONOR DESIGNATED GIFTS WERE USED TO PROVIDE MEDICATION ASSISTANCE FOR PATIENTS IN NEED OF MEDICATION WHO WERE UNABLE TO PAY $1,180 C. GREATEST NEEDS - 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 $30,067 D. EVANS NURSING SCHOLARSHIPS - EIGHT NURSING STUDENTS ENROLLED AT ROGUE COMMUNITY COLLEGE AND OREGON HEALTH SCIENCE UNIVERSITY (ASHLAND CAMPUS) RECEIVED A TOTAL OF $52,500 IN SCHOLARSHIPS THROUGH THE WILLIAM G. AND RUTH T. EVANS ENDOWED NURSING SCHOLARSHIP FUND. AN ADDITIONAL 13 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 FOR A TOTAL OF $5,518 $58,018 E. HOSPICE - DONOR DESIGNATED GIFTS WERE USED TO SUPPORT THE ONGOING WORK OF THIS SERVICE $44,000 F. DIAGNOSTIC IMAGING - DONOR DESIGNATED GIFTS AND ENDOWMENT EARNING CONTRIBUTED TO THE CREATION OF A DIGITAL X-RAY SUITE TO SERVE OUR EMERGENCY DEPARTMENT AND INPATIENTS $124,613 G. FAMILY BIRTH CENTER - DONOR DESIGNATED GIFTS WERE USED TO PURCHASE NEW EQUIPMENT FOR THE FAMILY BIRTH CENTER. IN ADDITION, A GRANT FROM THE GLAWDYS AND JOHN ZURLO CHARITABLE FOUNDATION WAS USED TO PURCHASE THREE NEW PEDIATRIC CODE CHARTS TO SERVE PATIENTS THROUGHOUT THE HOSPITAL $158,760 H. RODDEN SCHOLARSHIP FUND - THROUGH THE RODDEN SCHOLARSHIP FUND, TWO ASANTE ASHLAND SURGICAL STAFF RECEIVED SCHOLARSHIPS ALLOWING THEM TO ATTEND THE 2015 ACADEMY OF OPHTHALMOLOGY MEETING $1,430 I. STAFF EDUCATION AND TRIANING - A GRANT FROM THE OREGON HEALTH & SCIENCE UNIVERSITY OFFICE OF RURAL HEALTH SMALL HOSPITAL IMPROVEMENT PROGRAM PROVIDED FUNDING FOR LEAN TRAINING FOR DEPARTMENT LEADERS $7,828 J. WOMEN'S HEALTH INITIATIVE - CONTRIBUTIONS TO OUR PATRONS CAMPAIGN AND LIGHTS FOR LIFE WERE USED TO HELP PURCHASE THE FIRST PHASE OF NEW EQUIPMENT NEEDED FOR GYNECOLOGICAL SURGERIES $28,514 TOTAL PROGRAM SERVICE EXPENSES $454,530 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 11 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 24. FINANCIAL STATEMENT AND AUDIT OVERSIGHT THE OVERSIGHT OR SELECTION PROCESS HAS NOT CHANGED DURING THE YEAR.