2016-04-28T18:33:17-05:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2015-01-01 911143445 HARBORS HOME HEALTH & HOSPICE HARB 3605325454 201 7TH STREET HOQUIAM WA 98550 ARDITH SAVOY PRESIDENT 3605325454 2016-04-20 1 DANIEL M FREIN CPA P00856532 4252506100 2015 2016-09-27 15:27:22Z ARDITH SAVOY 201 7TH STREET HOQUIAM WA 98550 6925562 0 X WWW.MYHHHH.ORG X 1981 WA TO PROVIDE HOME HEALTH AND HOSPICE SERVICES TO THOSE WHO NEED ASSISTANCE. 11 11 64 19 0 0 66311 9132 5094998 6799695 98824 100467 1289 16268 5261422 6925562 0 2694 0 0 3663401 4186512 0 0 0 1589837 2087957 5253238 6277163 8184 648399 4425757 5043927 694779 784420 3730978 4259507 TO PROVIDE HOME HEALTH AND HOSPICE SERVICES TO PERSONS IN GRAYS HARBOR AND PACIFIC COUNTIES WHO NEED ASSISTANCE TO REMAIN ACTIVE AND INDEPENDENT WITHIN THEIR OWN HOME. 0 0 4409429 2694 6799695 THE ORGANIZATION PROVIDED SKILLED NURSING CARE, PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH PATHOLOGY, MEDICAL AND SOCIAL SERVICES, AND HOME HEALTH AID TO 1,485 PATIENTS IN THE GRAYS HARBOR AND PACIFIC COUNTY REGION DURING 2015. THE HOME HEALTH AIDS ALSO CONDUCTED MULTIPLE FOOT CLINICS THROUGHOUT GRAYS HARBOR AND PACIFIC COUNTIES THROUGHOUT THE YEAR. 4409429 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 12 0 1 64 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X TOM MAYR 3605325454 201 7TH STREET HOQUIAM WA 98550 LAURIE CLARY PRESIDENT 1.00 X X 0 0 0 ARDITH SAVOY RN VICE PRESIDENT 1.00 X X 0 0 0 JERRY KELTNER TREASURER & SECRETARY 1.00 X X 0 0 0 DR DANIEL CANFIELD DIRECTOR 1.00 X 0 0 0 GARY FRIEHAUF DIRECTOR 1.00 X 0 0 0 PETER HEGG DIRECTOR 1.00 X 0 0 0 MIKE MURPHY DIRECTOR 1.00 X 0 0 0 CAROL O'NEIL RN DIRECTOR 1.00 X 0 0 0 EDWARD QUIJADA DIRECTOR 1.00 X 0 0 0 NORM SPRAGUE DIRECTOR 1.00 X 0 0 0 LEIF TANGVALD DIRECTOR 1.00 X 0 0 0 JOEL STEPHENS CEO 41.00 X 103597 0 10765 THOMAS MAYR CFO 40.00 X 70554 0 5725 MARK SZTROIN PHYSICAL THERAPIST 40.00 X 192481 0 13801 RALPH CURRY OCCUPATIONAL THERAPIST 40.00 X 111675 0 9676 BRENT ROBERTS PHYSICAL THERAPIST 40.00 X 103637 0 10103 581944 0 50070 4 0 1 0 0 9132 9132 PATIENT REVENUE 621610 6666748 6666748 MANAGEMENT FEE 561000 132947 132947 6799695 70485 70485 16188 0 16188 16188 16188 29982 0 29982 29982 29982 MISCELLANEOUS 900099 80 80 80 6925562 6799695 0 116735 2694 2694 190641 190641 2471363 1772807 698556 171205 129598 41607 1130287 800338 329949 223016 157355 65661 16677 16677 18799 18799 112516 104419 8097 14237 10045 4192 163170 82719 80451 187287 132145 55142 263779 174695 89084 290865 290865 38516 27176 11340 477092 336626 140466 40420 28519 11901 MEDICAL SUPPLIES 309246 250607 58639 OTHER COSTS 94797 66094 28703 DUES AND SUBSCRIPTIONS 60556 42727 17829 6277163 4409429 1867734 0 434518 469006 596736 740076 10500 10500 131037 91793 1098768 819941 679703 278827 2573263 3453725 4425757 5043927 616123 704332 78656 80088 694779 784420 X 3730746 4259507 232 0 3730978 4259507 4425757 5043927 648399 -119870 0 X 0 1 X 1 0 X 24493 40715 15062 66311 9132 155713 5289282 5298012 4413437 5094998 6799695 26895424 5313775 5338727 4428499 5161309 6808827 27051137 0 0 0 27051137 166995 145260 115401 74556 86673 588885 166995 145260 115401 74556 86673 588885 23306 3385 4536 1289 80 32596 5504076 5487372 4548436 5237154 6895580 27672618 0.97750 0.96980 0.02130 0.02570 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MANAGEMENT FEE MISCELLANEOUS INCOME 0 0 0 0 0 0 0 0 1 3104 3104 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF MULTIPLE ORGANIZATIONS: WA STATE HOSPICE & PALLIATIVE CARE ASSOCIATION, NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE, NATIONAL HOSPICE & PALLIATIVE CARE ASSOCIATION, HOME CARE ASSOCIATION OF WASHINGTON. THE AMOUNT REPORTED IS THE PORTION OF THE ORGANIZATION'S DUES THAT ARE SPENT ON LOBBYING ACTIVITIES. 23402 11439 11963 1064267 808502 255765 11099 11099 278827 X 6656557 -119870 -119870 6776427 149135 149135 6925562 6128028 0 6128028 149135 149135 6277163 PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. THE ORGANIZATION IS CLASSIFIED AS A PUBLIC CHARITY. ACCORDINGLY, THERE IS NO PROVISION FOR FEDERAL INCOME TAXES ON THE FINANCIAL STATEMENTS. THE ORGANIZATION FILES FEDERAL FORM 990, RETURN OF ORGANIZATION EXEMPTION FROM INCOME TAX, AND HAS ADOPTED NO POSITIONS THAT ARE NOT HIGHLY LIKELY TO BE SUSTAINED IF EXAMINED BY RELEVANT AUTHORITIES. TAX YEARS ENDING PRIOR TO 2012 ARE CLOSED TO EXAMINATION. PART XI, LINE 4B - OTHER ADJUSTMENTS: PSP RENT & MAINTENANCE FEES 16,188. PSP ADMIN CONTRACTED SERVICES 132,947. PART XII, LINE 4B - OTHER ADJUSTMENTS: PSP RENT AND MAINTENANCE FEES 16,188. PSP ADMIN CONTRACT SERVICES 132,947. X X X 0 0 0 0 0 0 0 0 0 MARK SZTROIN PHYSICAL THERAPIST 190981 0 1500 0 0 0 13495 0 306 0 206282 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS COMPOSED OF THE OFFICERS OF THE BOARD. THE MEETINGS OF THE EXECUTIVE COMMITTEE ARE HELD AS NECESSARY TO FACILITATE THE BUSINESS OF THE CORPORATION AND RECOMMEND ACTIONS TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 WAS PREPARED BY A CERTIFIED PUBLIC ACCOUNTING FIRM AND REVIEWED BY THE ADMINISTRATOR, FINANCIAL MANAGER, AND DISTRIBUTED TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS ITS BOARD MEMBERS AND EMPLOYEES CONTINUOUSLY TO ENSURE THAT CONFLICTS OF INTEREST ARE AVOIDED. THIS MANIFESTS ITSELF IN BOARD VOTES WHERE MEMBERS WITH POSSIBLE CONFLICTS OF INTEREST ABSTAIN FROM CERTAIN VOTES. EMPLOYEES ARE NOT ALLOWED TO MAINTAIN EMPLOYMENT WHERE A CONFLICT OF INTEREST EXISTS. FORM 990, PART VI, SECTION B, LINE 15 EXEMPT SALARIES ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THEY SPECIFICALLY REVIEW THE COMPENSATION OF THE ADMINISTRATORS, FINANCIAL MANAGERS AND INFORMATION SERVICES AND PERIODICALLY SEEK SALARY SURVEY INFORMATION WHEN SETTING THESE SALARIES. THIS PROCESS WAS LAST PERFORMED IN 2016. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT OPEN TO THE PUBLIC. ONLY THE FORMS 990 AND 1023 ARE MADE AVAILABLE TO THE PUBLIC.