2016-02-08T10:36:36-06:00 2015-03-31 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2014-04-01 463517778 MLCHC COMMUNITY SERVICES MLCH 5097646102 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 AMANDA DUZON CHIEF FINANCIAL OFFICER 5097646102 2016-02-06 1 KATHRYN J ONG P00746598 4254544919 2016-02-06 2014 2016-04-25 22:37:26Z SHEILA A CHILSON 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 133200 0 X WWW.MLCHC.ORG X 2013 WA MLCHC COMMUNITY SERVICES WAS CREATED FOR THE NEW MARKET TAX CREDIT TRANSACTION. THIS ALLOWED FOR THE CONSTRUCTION OF A NEW QUINCY FACILITY. 5 4 0 4 0 0 139518 0 0 133200 0 0 0 0 139518 133200 0 587045 0 0 0 0 0 0 0 54940 511166 54940 1098211 84578 -965011 9511488 7858301 9426910 8738734 84578 -880433 MLCHC COMMUNITY SERVICES WAS CREATED FOR THE NEW MARKET TAX CREDIT TRANSACTION. THIS ALLOWED FOR THE CONSTRUCTION OF A NEW QUINCY FACILITY. 0 0 587045 587045 MLCHC 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. 587045 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 X 5 4 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 X AMANDA DUZON 5097646102 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 SHEILA A CHILSON CHAIR 1.00 40.00 X X 0 167197 19110 SCOTT CAMPBELL SECRETARY 1.00 2.00 X X 0 0 0 MATTHEW BENSON TREASURER 1.00 2.00 X X 0 0 0 JOHN BROWNE DIRECTOR 1.00 0.00 X 0 0 0 LEANNE PARTON DIRECTOR 1.00 0.00 X 0 0 0 AMANDA DUZON CFO 1.00 40.00 X 0 90443 10879 0 257640 29989 0 0 1 0 ALDRICH & ASSOCIATES 810 240TH STREET SE BOTHELL WA 980219397 GENERAL CONTRACTOR 1131104 1 RENTAL INCOME 133200 133200 133200 133200 133200 0 0 587045 587045 1523 1523 113921 113921 309259 309259 MINOR EQUIPMENT 86463 86463 1098211 587045 511166 0 2428176 24976 7652848 244156 6561518 7408692 521794 424633 9511488 7858301 695910 8734 8731000 8730000 9426910 8738734 X 84578 -880433 84578 -880433 9511488 7858301 -965011 0 X 0 1 X 0 0 X X X 1 MOSES LAKE COMMUNITY HEALTH CENTER 911537371 7 1 587045 0 1 587045 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 244518 244518 6838818 185589 6653229 569512 58567 510945 7408692 23514884 0 23514884 -23381684 -23381684 133200 22893704 22382538 22382538 511166 587045 587045 1098211 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. 0 MOSES LAKE COMMUNITY HEALTH CENTER 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 911537371 501(C)(3) 587045 GENERAL SUPPORT 1 0 FORM 990, SCHEDULE I, PART II; AS PART OF THE NEW MARKETS TAX CREDIT FINANCING FINAL ALLOCATIONS, THE ORGANIZATION TRANSFERRED $587,045 TO ITS SUPPORTED ORGANIZATION, MOSES LAKE COMMUNITY HEALTH CENTER. 0 0 0 0 0 0 0 0 0 SHEILA A CHILSON CHAIR 0 166997 0 200 0 0 0 6366 0 12744 0 186307 0 0 PART I, LINE 3 FOR 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. 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 11 UPON 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 19 THESE 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. MOSES LAKE COMMUNITY HEALTH CENTER 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 911537371 PRIMARY HEALTH SERVICES WA 501(C)(3) LINE 7 N/A 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0