ISLAND HOSPITAL HEALTH FOUNDATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
ISLAND HOSPITAL HEALTH FOUNDATION (EIN 91-1030686)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-16
IRS object ID
201503209349306185
Schema version
2014v5.0
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)
Return2015-11-16T12:01:46-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN910189318PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12707 COLBY AVENUE SUITE 801AddressLine1Txt
CityEVERETTCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98201ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN911030686EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ISLAND HOSPITAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlISLABusinessNameControlTxt
Phone3602994201PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 24TH STREETAddressLine1Txt
CityANACORTESCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98221ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWILLIAM RABELPersonNm
Person TitleTREASURERPersonTitleTxt
Phone3602994201PhoneNum
Signature2015-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonROBERT GRANNUMPreparerPersonNm
PTINP00355876PTIN
Phone4252597227PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARK BACKMANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 24TH STREETAddressLine1Txt
CityANACORTESCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98221ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$842,751GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ISLANDHOSPITALFOUNDATION.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1978FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionTO RAISE FUNDS TO SUPPORT ISLAND HOSPITAL AND ITS COMMITMENT TO COMMUNITY HEALTH IN ANACORTES, LA CONNER, NORTH WHIDBEY ISLAND AND THE SAN JUAN ISLANDS.ActivityOrMissionDesc
Voting Members Governing Body20VotingMembersGoverningBodyCnt
Voting Members Independent20VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers55TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$608,884PYContributionsGrantsAmt
CY Contributions Grants$476,267CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$130,503PYInvestmentIncomeAmt
CY Investment Income$86,133CYInvestmentIncomeAmt
PY Other Revenue-$112,532PYOtherRevenueAmt
CY Other Revenue$29,380CYOtherRevenueAmt
PY Total Revenue$626,855PYTotalRevenueAmt
CY Total Revenue$591,780CYTotalRevenueAmt
PY Grants And Similar Paid$507,890PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$498,561CYGrantsAndSimilarPaidAmt
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$108,892CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$30,488CYTotalFundraisingExpenseAmt
PY Other Expenses$175,364PYOtherExpensesAmt
CY Other Expenses-$97,678CYOtherExpensesAmt
PY Total Expenses$683,254PYTotalExpensesAmt
CY Total Expenses$509,775CYTotalExpensesAmt
PY Revenues Less Expenses-$56,399PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$82,005CYRevenuesLessExpensesAmt
Total Assets BOY$2,311,082TotalAssetsBOYAmt
Total Assets EOY$2,521,701TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$67,020TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,311,082NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,454,681NetAssetsOrFundBalancesEOYAmt
MissionTO RAISE FUNDS TO SUPPORT ISLAND HOSPITAL AND ITS COMMITMENT TO COMMUNITY HEALTH IN ANACORTES, LA CONNER, NORTH WHIDBEY ISLAND AND THE SAN JUAN ISLANDS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$100,000ExpenseAmt
Grant$100,000GrantAmt
DescFUND HOSPITAL RENOVATION AND EXPANSION COSTS NOT MET BY TAX REVENUE. THIS INCLUDES THE MEDICAL ARTS PAVILION HOUSING CANCER CARE, PHYSICAL THERAPY, AND WOUND CARE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$458,280ExpenseAmt
Grant$398,561GrantAmt
DescSINCE 1962, ISLAND HOSPITAL HAS PROVIDED HIGH QUALITY, COMPASSIONATE AND PERSONALIZED HEALTH CARE TO OUR COMMUNITY. ISLAND HOSPITAL MAINTAINS A PROGRESSIVE STAND IN DELIVERING THE BEST HEALTH CARE EXPERIENCES FOR PATIENTS AND THEIR FAMILIES BY PLACING THEIR EMOTIONAL AND MEDICAL NEEDS FIRST AND FOREMOST.THE ISLAND HOSPITAL FOUNDATION SUPPORTS ISLAND HOSPITAL'S VITAL MISSION BY RAISING MUCH-NEEDED FUNDS FOR THE BENEFIT OF COMMUNITY HEALTH. FOUNDED IN 1979, THE FOUNDATION IS AN INDEPENDENT, NONPROFIT CORPORATION HEADED BY A 20-MEMBER VOLUNTEER BOARD OF DIRECTORS. THESE DEDICATED CIVIL AND BUSINESS LEADERS GENEROUSLY DONATE THEIR TIME, TALENTS, AND ENERGY TO DIRECT THE FOUNDATION'S POLICIES AND SECURE ITS FINANCIAL FUTURE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$558,280TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
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 ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
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 Members20GoverningBodyVotingMembersCnt
Independent Voting Member20IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or MisuseYes (1)MaterialDiversionOrMisuseInd
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 BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JEANNETTE PAPADAKISBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3602994201PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 24TH STAddressLine1Txt
CityANACORTESCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98221ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
MARK BACKMAN
PRESIDENT3.00Yes (X)Yes (X)$0$0$0
TOM MURPHY
VICE PRESIDENT3.00Yes (X)Yes (X)$0$0$0
RICHARD HUMPHREY
TREASURER3.00Yes (X)Yes (X)$0$0$0
BILL RABEL
SECRETARY3.00Yes (X)Yes (X)$0$0$0
STEVE RUTZ
IMMEDIATE PAST PRESIDENT1.00Yes (X)$0$0$0
JOSH BALDWIN
DIRECTOR1.00Yes (X)$0$0$0
SHELLIE BOGOSIAN
DIRECTOR1.00Yes (X)$0$0$0
LARRY BUGHI
DIRECTOR1.00Yes (X)$0$0$0
COLLEEN CRAIG
DIRECTOR1.00Yes (X)$0$0$0
DIXIE DAVID
DIRECTOR1.00Yes (X)$0$0$0
DESHA FURIN
DIRECTOR1.00Yes (X)$0$0$0
TROY KUNZ
DIRECTOR1.00Yes (X)$0$0$0
TOM LACROIX
DIRECTOR1.00Yes (X)$0$0$0
DAVE MARGESON
DIRECTOR1.00Yes (X)$0$0$0
KRISTA OICLES
DIRECTOR1.00Yes (X)$0$0$0
AARON RASMUSSEN
DIRECTOR1.00Yes (X)$0$0$0
RUSTAN ROBERTSON
DIRECTOR1.00Yes (X)$0$0$0
JIM ROE
DIRECTOR1.00Yes (X)$0$0$0
DAVID SLEPYAN
DIRECTOR1.00Yes (X)$0$0$0
MARILYN STADLER
DIRECTOR1.00Yes (X)$0$0$0
BERNADETTE STANEK
FOUNDATION DIRECTOR (1/2014-9/2014)40.00Yes (X)$41,413$0$7,799
FieldValueIRS element (for citing)
Total Reportable Comp From Org$41,413TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$7,799TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$198,005FundraisingAmt
All Other Contributions$278,262AllOtherContributionsAmt
Noncash Contributions$40,970NoncashContributionsAmt
Total Contributions$476,267TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$50,492TotalRevenueColumnAmt
Exclusion$50,492ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$188,831SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$153,190SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$35,641SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$35,641TotalRevenueColumnAmt
Exclusion$35,641ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$127,161FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$198,005ContriRptFundraisingEventAmt
Fundraising Direct Expenses$97,781FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,380TotalRevenueColumnAmt
Exclusion$29,380ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$591,780TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$115,513ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$490,049TotalAmt
Program Services$490,049ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$8,512TotalAmt
Program Services$8,512ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$84,132TotalAmt
Program Services$33,653ProgramServicesAmt
Management And General$29,446ManagementAndGeneralAmt
Fundraising$21,033FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$24,760TotalAmt
Program Services$9,904ProgramServicesAmt
Management And General$8,666ManagementAndGeneralAmt
Fundraising$6,190FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$12,260TotalAmt
Management And General$12,260ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$12,019TotalAmt
Management And General$12,019ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$8,500TotalAmt
Management And General$8,500ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$12,029TotalAmt
Program Services$12,029ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$7,275TotalAmt
Program Services$4,010ProgramServicesAmt
Fundraising$3,265FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
ADMINISTRATIVE EXPENSE$22,498$22,498
BAD DEBT EXPENSE$123$123
FRAUD EXPENSE NET OF IN-$178,634-$178,634

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,252TotalAmt
Management And General$6,252ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$509,775TotalAmt
Program Services$558,280ProgramServicesAmt
Management And General-$78,993ManagementAndGeneralAmt
Fundraising$30,488FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,601BOYAmt
EOY$64,864EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$136,636BOYAmt
EOY$66,551EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$58,600BOYAmt
EOY$308,457EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,250EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$343EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,108,245BOYAmt
EOY$2,080,236EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,311,082BOYAmt
EOY$2,521,701EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$67,020EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$67,020EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,993,009BOYAmt
EOY$2,135,707EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$117,073BOYAmt
EOY$117,974EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$201,000BOYAmt
EOY$201,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,311,082BOYAmt
EOY$2,454,681EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,311,082BOYAmt
EOY$2,521,701EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$82,005ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$23,673NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$37,921DonatedServicesAndUseFcltsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (1)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS Audited0FSAuditedInd
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$427,076CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$830,493CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$581,891CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$608,884CurrentTaxYearMinus1YearAmt
Current Tax Year$476,267CurrentTaxYearAmt
Total$2,924,611TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$427,076CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$830,493CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$581,891CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$608,884CurrentTaxYearMinus1YearAmt
Current Tax Year$476,267CurrentTaxYearAmt
Total$2,924,611TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$158,587SubstantialContributorsTotAmt
Public Support Total170$2,766,024PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$31,696CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$35,821CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$63,414CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$58,963CurrentTaxYearMinus1YearAmt
Current Tax Year$50,492CurrentTaxYearAmt
Total$240,386TotalAmt
FieldValueIRS element (for citing)
Total Support$3,164,997TotalSupportAmt
Gross Receipts Rltd Activities$503,338GrossReceiptsRltdActivitiesAmt
Public Support CY1700.87390PublicSupportCY170Pct
Public Support PY1700.79730PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,714,403BeginningYearBalanceAmt
Investment Earnings Or Losses$87,727InvestmentEarningsOrLossesAmt
Other Expenditures$40,339OtherExpendituresAmt
End Year Balance$1,761,791EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,503,114BeginningYearBalanceAmt
Investment Earnings Or Losses$252,194InvestmentEarningsOrLossesAmt
Other Expenditures$40,904OtherExpendituresAmt
End Year Balance$1,714,404EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,374,984BeginningYearBalanceAmt
Investment Earnings Or Losses$173,234InvestmentEarningsOrLossesAmt
Other Expenditures$45,104OtherExpendituresAmt
End Year Balance$1,503,114EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,386,988BeginningYearBalanceAmt
Contributions$33,591ContributionsAmt
Investment Earnings Or Losses-$17,903InvestmentEarningsOrLossesAmt
Other Expenditures$27,692OtherExpendituresAmt
End Year Balance$1,374,984EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$252,065BeginningYearBalanceAmt
Contributions$1,129,508ContributionsAmt
Investment Earnings Or Losses$119,052InvestmentEarningsOrLossesAmt
Other Expenditures$62,572OtherExpendituresAmt
Administrative Expenses$51,065AdministrativeExpensesAmt
End Year Balance$1,386,988EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.84870BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.03410PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.11720TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE INCOME FROM THE ENDOWMENTS IS TO BE USED FOR TWO PURPOSES: HOSPITAL IDENTIFIED COMMUNITY HEALTH NEEDS AND TO PROVIDE FUNDS FOR THE BENEFIT OF THE BIRTHING CENTER.
PART X, LINE 2:AS A CHARITABLE FOUNDATION, ISLAND HOSPITAL FOUNDATION IS A NOT-FOR-PROFIT CORPORATION AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PERSUANT TO SECTION 501(A). THE FOUNDATION HAS ACCOUNTED FOR UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLY AND WAS REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2014, THE FOUNDATION HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL OR DISCLOSURE.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GALA OF HOPEEvent1Nm
Gross Receipts Event1$244,026GrossReceiptsEvent1Amt
Charitable Contri Event1$150,381CharitableContriEvent1Amt
Gross Revenue Event1$93,645GrossRevenueEvent1Amt
Rent Facility Costs Event1$41,138RentFacilityCostsEvent1Amt
Food And Beverage Event1$516FoodAndBeverageEvent1Amt
Entertainment Event1$4,295EntertainmentEvent1Amt
Other Direct Expenses Event1$9,162OtherDirectExpensesEvent1Amt
Event2GOLF CLASSICEvent2Nm
Gross Receipts Event2$81,140GrossReceiptsEvent2Amt
Charitable Contri Event2$47,624CharitableContriEvent2Amt
Gross Revenue Event2$33,516GrossRevenueEvent2Amt
Non Cash Prizes Event2$1,023NonCashPrizesEvent2Amt
Rent Facility Costs Event2$36,551RentFacilityCostsEvent2Amt
Other Direct Expenses Event2$5,096OtherDirectExpensesEvent2Amt
Gross Receipts Total$325,166GrossReceiptsTotalAmt
Charitable Contributions Tot$198,005CharitableContributionsTotAmt
Gross Revenue Total Events$127,161GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$1,023NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$77,689RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$516FoodAndBeverageTotalEventsAmt
Entertainment Total Events$4,295EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$14,258OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$97,781DirectExpenseSummaryEventsAmt
Net Income Summary$29,380NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ISLAND HOSPITAL SKAGIT COUNTY PUBLIC HOSPITAL DISTRICT NO 2BusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 24TH STREETAddressLine1Txt
CityANACORTESCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98221ZIPCd
FieldValueIRS element (for citing)
Recipient EIN910729255RecipientEIN
IRC Section170(C)IRCSectionDesc
Cash Grant$490,049CashGrantAmt
Purpose Of GrantSUPPORT OF HEALTH PROGRAMS AT HOSPITALPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeONCOLOGY GRANTSGrantTypeTxt
Recipient24RecipientCnt
Cash Grant$8,512CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationALL GRANTS AND ASSISTANCE ARE ONLY PROVIDED TO THE SUPPORTED ORGANIZATION ISLAND HOSPITAL AND UTILIZED ONLY FOR THE PURPOSE OF THAT GRANT (I.E. HEALTH SCREENING PROGRAM, DIABETES CARE). ISLAND HOSPITAL IS RESPONSIBLE FOR ENSURING FUNDS TRANSFERRED FROM ISLAND HOSPITAL FOUNDATION ARE DESIGNATED AND UTILIZED ONLY FOR THE PURPOSE INSTRUCTED, AND THE FOUNDATION RECEIVES REPORTS SHOWING FUNDS WERE DISBURSED TO DEPARTMENTS AS INSTRUCTED.ExplanationTxt

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescVARIOUSDesc
Contribution64ContributionCnt
Noncash Contributions Rpt F990$40,970NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationNUMBER OF CONTRIBUTORS IS THE ACTUAL NUMBER OF CONTRIBUTORS OF NON-CASH ITEMS, EXCLUDING CONTRIBUTORS OF SERVICES.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 2A:ISLAND HOSPITAL FOUNDATION HAS AN OPERATING AGREEMENT WITH AN UNRELATED THIRD PARTY WHICH INCLUDES SHARING OF EMPLOYEES UNDER A COMMON PAYMASTER ARRANGMENT.
FORM 990, PART VI, SECTION A, LINE 5IN 2014, THE FOUNDATION IDENTIFIED FRAUDULENT ACTIVITY. TOTAL LOSS WAS ESTIMATED TO BE APPROXIMATELY $285,000. THE PORTION OF THE LOSS THAT RELATED TO 2014 AND 2013 WAS ESTIMATED AT $77,494 AND $90,101, RESPECTIVELY. THE LOSS IS EXPECTED TO BE COVERED BY INSURANCE TO THE EXTENT ALLOWED BY THE INSURANCE CONTRACT LESS DEDUCTIBLES.
FORM 990, PART VI, SECTION B, LINE 11A DRAFT FORM 990 WAS PROVIDED TO THE FULL BOARD FOR REVIEW. AFTER CHANGES WERE INCORPORATED THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWED THE FILING PRIOR TO SUBMISSION TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C1. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON: A. HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, B. HAS READ AND UNDERSTANDS THE POLICY, C. HAS AGREED TO COMPLY WITH THE POLICY, AND D. UNDERSTANDS IHF IS A CHARITABLE ORGANIZATION AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. 2. EACH VOTING MEMBER OF THE BOARD SHALL ANNUALLY SIGN A STATEMENT WHICH DECLARES WHETHER SUCH PERSON IS AN INDEPENDENT DIRECTOR. 3. IF AT ANY TIME DURING THE YEAR, THE INFORMATION IN THE ANNUAL STATEMENT CHANGES MATERIALLY, THE DIRECTOR SHALL DISCLOSE SUCH CHANGES AND REVISE THE ANNUAL DISCLOSURE FORM. 4. THE EXECUTIVE COMMITTEE SHALL REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THIS POLICY BY REVIEWING ANNUAL STATEMENTS AND TAKING SUCH OTHER ACTIONS AS ARE NECESSARY FOR EFFECTIVE OVERSIGHT.
FORM 990, PART VI, SECTION C, LINE 19ALL ORGANIZATIONAL, FINANCIAL, AND TAX DOCUMENTS, INCLUDING FORM 990, ARE AVAILABLE UPON REQUEST.

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