MLCHC COMMUNITY SERVICES: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
MLCHC COMMUNITY SERVICES (EIN 46-3517778)
Tax period
2014-04-01 to 2015-03-31
Filed
2016-02-08
IRS object ID
201600399349300140
Schema version
2014v6.0
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

FieldValueIRS element (for citing)
Return2016-02-08T10:36:36-06:00ReturnTs
Tax Period End2015-03-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN911194016PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLARK NUBER PSBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110900 NE 4TH STREET SUITE 1700AddressLine1Txt
CityBELLEVUECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98004ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN463517778EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MLCHC COMMUNITY SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMLCHBusinessNameControlTxt
Phone5097646102PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1605 SOUTH COOLIDGE STREETAddressLine1Txt
CityMOSES LAKECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98837ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAMANDA DUZONPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone5097646102PhoneNum
Signature2016-02-06SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKATHRYN J ONGPreparerPersonNm
PTINP00746598PTIN
Phone4254544919PhoneNum
Preparation2016-02-06PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-04-25 22:37:26ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSHEILA A CHILSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1605 SOUTH COOLIDGE STREETAddressLine1Txt
CityMOSES LAKECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98837ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$133,200GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MLCHC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2013FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionMLCHC COMMUNITY SERVICES WAS CREATED FOR THE NEW MARKET TAX CREDIT TRANSACTION. THIS ALLOWED FOR THE CONSTRUCTION OF A NEW QUINCY FACILITY.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers4TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$139,518PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$133,200CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$139,518PYTotalRevenueAmt
CY Total Revenue$133,200CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$587,045CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$54,940PYOtherExpensesAmt
CY Other Expenses$511,166CYOtherExpensesAmt
PY Total Expenses$54,940PYTotalExpensesAmt
CY Total Expenses$1,098,211CYTotalExpensesAmt
PY Revenues Less Expenses$84,578PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$965,011CYRevenuesLessExpensesAmt
Total Assets BOY$9,511,488TotalAssetsBOYAmt
Total Assets EOY$7,858,301TotalAssetsEOYAmt
Total Liabilities BOY$9,426,910TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,738,734TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$84,578NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$880,433NetAssetsOrFundBalancesEOYAmt
MissionMLCHC COMMUNITY SERVICES WAS CREATED FOR THE NEW MARKET TAX CREDIT TRANSACTION. THIS ALLOWED FOR THE CONSTRUCTION OF A NEW QUINCY FACILITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$587,045ExpenseAmt
Grant$587,045GrantAmt
DescMLCHC COMMUNITY SERVICES IS ORGANIZED AND OPERATED EXCLUSIVELY TO BENEFIT MOSES LAKE COMMUNITY HEALTH CENTER (MLCHC), A WASHINGTON NONPROFIT CORPORATION, BY PERFORMING THE FUNCTIONS OF, OR CARRYING OUT THE PURPOSES OF MLCHC; SUCH PURPOSES BEING TO PROVIDE HEALTH SERVICES TO, IMPROVE HEALTH SERVICES OF, AND OTHERWISE IMPROVE THE HEALTH CONDITIONS OF MIGRATORY AGRICULTURAL WORKERS, RESIDENT SEASONAL AGRICULTURAL WORKERS, RURAL AND COMMUNITY POOR AND THEIR FAMILIES.Desc
Total Program Service Expenses$587,045TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AMANDA DUZONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5097646102PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1605 SOUTH COOLIDGE STREETAddressLine1Txt
CityMOSES LAKECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98837ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
SHEILA A CHILSON
CHAIR1.0040.00Yes (X)Yes (X)$0$167,197$19,110
SCOTT CAMPBELL
SECRETARY1.002.00Yes (X)Yes (X)$0$0$0
MATTHEW BENSON
TREASURER1.002.00Yes (X)Yes (X)$0$0$0
JOHN BROWNE
DIRECTOR1.000.00Yes (X)$0$0$0
LEANNE PARTON
DIRECTOR1.000.00Yes (X)$0$0$0
AMANDA DUZON
CFO1.0040.00Yes (X)$0$90,443$10,879
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$257,640TotReportableCompRltdOrgAmt
Total Other Compensation$29,989TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ALDRICH & ASSOCIATESBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1810 240TH STREET SEAddressLine1Txt
CityBOTHELLCityNm
State AbbreviationWAStateAbbreviationCd
ZIP980219397ZIPCd
FieldValueIRS element (for citing)
ServicesGENERAL CONTRACTORServicesDesc
Compensation$1,131,104CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRENTAL INCOMEDesc
Total Revenue Column$133,200TotalRevenueColumnAmt
Related Or Exempt Func Income$133,200RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$133,200TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$133,200TotalRevenueColumnAmt
Related Or Exempt Func Income$133,200RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$587,045TotalAmt
Program Services$587,045ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,523TotalAmt
Management And General$1,523ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$113,921TotalAmt
Management And General$113,921ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$309,259TotalAmt
Management And General$309,259ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescMINOR EQUIPMENTDesc
Total$86,463TotalAmt
Management And General$86,463ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,098,211TotalAmt
Program Services$587,045ProgramServicesAmt
Management And General$511,166ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,428,176BOYAmt
EOY$24,976EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,652,848LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$244,156LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,561,518BOYAmt
EOY$7,408,692EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$521,794BOYAmt
EOY$424,633EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$9,511,488BOYAmt
EOY$7,858,301EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$695,910BOYAmt
EOY$8,734EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$8,731,000BOYAmt
EOY$8,730,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,426,910BOYAmt
EOY$8,738,734EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$84,578BOYAmt
EOY-$880,433EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$84,578BOYAmt
EOY-$880,433EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,511,488BOYAmt
EOY$7,858,301EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$965,011ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1MOSES LAKE COMMUNITY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN911537371EIN
Organization Type7OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$587,045SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$587,045SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$244,518OtherCostOrOtherBasisAmt
Book Value$244,518BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,838,818OtherCostOrOtherBasisAmt
Depreciation$185,589DepreciationAmt
Book Value$6,653,229BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$569,512OtherCostOrOtherBasisAmt
Depreciation$58,567DepreciationAmt
Book Value$510,945BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,408,692TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$23,514,884TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$23,514,884RevenueSubtotalAmt
Other Revenues Not Included-$23,381,684OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$23,381,684RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$133,200TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$22,893,704TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$22,382,538OtherExpensesIncludedAmt
Expenses Not Reported$22,382,538ExpensesNotReportedAmt
Expenses Subtotal$511,166ExpensesSubtotalAmt
Other Expenses Not Included$587,045OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$587,045ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,098,211TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 4B - OTHER ADJUSTMENTS:REVENUE FROM AFFILIATE -23,381,684.
PART XII, LINE 2D - OTHER ADJUSTMENTS:EXPENSES FROM AFFILIATE 22,382,538.
PART XII, LINE 4B - OTHER ADJUSTMENTS:INTERCOMPANY TRANSFER 587,045.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1MOSES LAKE COMMUNITY HEALTH CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1605 SOUTH COOLIDGE STREETAddressLine1Txt
CityMOSES LAKECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98837ZIPCd
FieldValueIRS element (for citing)
Recipient EIN911537371RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$587,045CashGrantAmt
Purpose Of GrantGENERAL SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE I, PART II;FormAndLineReferenceDesc
ExplanationAS PART OF THE NEW MARKETS TAX CREDIT FINANCING FINAL ALLOCATIONS, THE ORGANIZATION TRANSFERRED $587,045 TO ITS SUPPORTED ORGANIZATION, MOSES LAKE COMMUNITY HEALTH CENTER.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonSHEILA A CHILSONPersonNm
TitleCHAIRTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$166,997CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$200BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$6,366DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$12,744NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$186,307TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationFOR THE CHAIR, THE BOARD OF DIRECTORS OF MOSES LAKE COMMUNITY HEALTH CENTER, A RELATED ORGANIZATION, REVIEWS SALARY SURVEYS AND REGIONAL MARKET COMPARISONS TO DETERMINE APPROPRIATE COMPENSATION LEVELS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 6:THE BOARD OF DIRECTORS PER MLCHC COMMUNITY SERVICES BYLAWS REQUIRES A BOARD COMPOSITION OF 5 MEMBERS. ALL VOLUNTEER POSITIONS ARE RELATED TO INVOLVEMENT ON THE BOARD, EITHER AS AN ELECTED MEMBER OR ADVISORY MEMBER. THESE INDIVIDUALS CONTRIBUTE A MINIMUM OF 1 HOUR PER YEAR IN THIS CAPACITY. ONE MEMBER OF THE BOARD IS COMPENSATED BY MOSES LAKE COMMUNITY HEALTH CENTER, A RELATED ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11UPON COMPLETION OF THE FORM 990, THE RETURN WILL BE REVIEWED IN DETAIL WITH THE BOARD FINANCE COMMITTEE OF MLCHC, A RELATED ORGANIZATION, AND THEN IN SUMMARY WITH THE BOARD OF DIRECTORS OF MLCHC. UPON APPROVAL BY THE BOARD OF DIRECTORS, THE FINAL FORM 990 WILL BE SUBMITTED TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE AVAILABLE FOR VIEWING UPON REQUEST AT THE ORGANIZATION'S MAIN BUSINESS OFFICE IN THE PRESENCE OF THE CFO OR CEO OF MOSES LAKE COMMUNITY HEALTH CENTER, A RELATED ORGANIZATION.
FORM 990, PART VI, LINES 12, 13, AND 14:MLCHC COMMUNITY SERVICES RELIES ON THE CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY AND DOCUMENT RETENTION AND DESTRUCTION POLICY OF MOSES LAKE COMMUNITY HEALTH CENTER, A RELATED ORGANIZATION.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1MOSES LAKE COMMUNITY HEALTH CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1605 SOUTH COOLIDGE STREETAddressLine1Txt
CityMOSES LAKECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98837ZIPCd
FieldValueIRS element (for citing)
EIN911537371EIN
Primary ActivitiesPRIMARY HEALTH SERVICESPrimaryActivitiesTxt
Legal Domicile StateWALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 7PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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