TAHOE FOREST HEALTH SYSTEM FOUNDATION: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
TAHOE FOREST HEALTH SYSTEM FOUNDATION (EIN 94-3047869)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-15
IRS object ID
201511359349308206
Schema version
2013v4.0
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)
Return2015-05-15T17:10:13-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN480567703PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KCOE ISOM LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13013 CERES AVENUEAddressLine1
CityCHICOCity
StateCAState
ZIP Code95973ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN943047869EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TAHOE FOREST HEALTH SYSTEM FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlTAHOBusinessNameControlTxt
Phone5305826329PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2508AddressLine1
CityTRUCKEECity
StateCAState
ZIP Code961602508ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARTHA SIMONPersonNm
Person TitleCHIEF DEVELOPMENT OFFICERPersonTitleTxt
Phone5305826329PhoneNum
Signature2015-05-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWILLIAM E PETERSONPreparerPersonNm
PTINP00273088PTIN
Phone5308916474PhoneNum
Preparation2015-05-14PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARTHA SIMONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2508AddressLine1
CityTRUCKEECity
StateCAState
ZIP Code961602508ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$1,481,290GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.TFHD.COM/TAHOEFORESTFOUNDATION.ASPWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1987FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO CREATE A CULTURE OF COLLABORATION WHICH FACILITATES THE EXPLORATION OF CREATIVE OPPORTUNITIES AND SOLUTIONS THAT RESULT IN EXCELLENCE IN COMMUNITY HEALTH CAREActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$898,632PYContributionsGrantsAmt
CY Contributions Grants$1,145,232CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$205,660PYOtherRevenueAmt
CY Other Revenue$122,374CYOtherRevenueAmt
PY Total Revenue$1,104,292PYTotalRevenueAmt
CY Total Revenue$1,267,606CYTotalRevenueAmt
PY Grants And Similar Paid$571,198PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$823,876CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$366,482PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$365,142CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$114,099CYTotalFundraisingExpenseAmt
PY Other Expenses$86,234PYOtherExpensesAmt
CY Other Expenses$106,302CYOtherExpensesAmt
PY Total Expenses$1,023,914PYTotalExpensesAmt
CY Total Expenses$1,295,320CYTotalExpensesAmt
PY Revenues Less Expenses$80,378PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$27,714CYRevenuesLessExpensesAmt
Total Assets BOY$1,802,708TotalAssetsBOYAmt
Total Assets EOY$1,952,106TotalAssetsEOYAmt
Total Liabilities BOY$230,537TotalLiabilitiesBOYAmt
Total Liabilities EOY$241,193TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,572,171NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,710,913NetAssetsOrFundBalancesEOYAmt
MissionTO CREATE A CULTURE OF COLLABORATION WHICH FACILITATES THE EXPLORATION OF CREATIVE OPPORTUNITIES AND SOLUTIONS THAT RESULT IN EXCELLENCE IN COMMUNITY HEALTH CAREMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$634,138ExpenseAmt
Grant$563,846GrantAmt
DescPROVIDED SUPPORT TO THE TAHOE FOREST HOSPITAL DISTRICT FOR THE TAHOE FOREST CANCER CENTER AND CANCER RESEARCHDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$33,949ExpenseAmt
Grant$30,186GrantAmt
DescPROVIDED SUPPORT TO THE TAHOE FOREST HOSPITAL DISTRICT'S HOSPICE PROGRAMDesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$258,497ExpenseAmt
Grant$229,844GrantAmt
DescPROVIDED SUPPORT TO A VARIETY OF SERVICES AND PROGRAMS AT THE TAHOE FOREST HOSPITAL DISTRICT, INCLUDING THE CHILDREN'S CENTER, COMMUNITY WELLNESS, EMERGENCY SERVICES, PHYSICAL THERAPY, HOME HEALTH, AND THE WOMEN & FAMILY CENTERDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$926,584TotalProgramServiceExpensesAmt
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 EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
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 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 ContriYes (1)DeductibleNonCashContriInd
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
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 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 Members13GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
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 BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TAHOE FOREST HOSPITAL DISTRICTBusinessNameLine1
FieldValueIRS element (for citing)
Phone5305823489PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110121 PINE AVENUEAddressLine1
CityTRUCKEECity
StateCAState
ZIP Code96160ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeInd
TOM HOBDAY
DIRECTOR5.00Yes (X)$0$0$0
PAMELA HOBDAY
DIRECTOR5.00Yes (X)$0$0$0
TRINKIE WATSON
DIRECTOR5.00Yes (X)$0$0$0
BETSY COLE
DIRECTOR5.00Yes (X)$0$0$0
BILL ROCK
VICE PRESIDENT5.00Yes (X)$0$0$0Yes (X)
SARAH JACKSON
SECRETARY5.00Yes (X)$0$14,199$0Yes (X)40.00
STUART YOUNT
TREASURER5.00Yes (X)$0$0$0Yes (X)
CHRIS RYMAN
DIRECTOR5.00Yes (X)$0$0$0Yes (X)
WARREN KOCMOND
DIRECTOR5.00Yes (X)$0$0$0
DALE CHAMLIN
DIRECTOR5.00Yes (X)$0$0$0
TED OWENS
EXECUTIVE DIRECTOR5.00$0$109,321$0Yes (X)40.00
MARTHA SIMON
CHIEF DEVELOPMENT OFFICER5.00$0$122,316$0Yes (X)40.00
ROBERT SCHAPPER
DIRECTOR5.00$0$483,647$040.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$729,483TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$189,672FundraisingAmt
Related Organizations$676,542RelatedOrganizationsAmt
Government Grants$4,375GovernmentGrantsAmt
All Other Contributions$274,643AllOtherContributionsAmt
Noncash Contributions$673,847NoncashContributionsAmt
Total Contributions$1,145,232TotalContributionsAmt
Fundraising Gross Income$336,058FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$189,672ContriRptFundraisingEventAmt
Fundraising Direct Expenses$213,684FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$122,374TotalRevenueColumnAmt
Exclusion$122,374ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,267,606TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$122,374ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$823,876TotalAmt
Program Services$823,876ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$231,637TotalAmt
Program Services$69,491ProgramServicesAmt
Management And General$92,655ManagementAndGeneralAmt
Fundraising$69,491FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,414TotalAmt
Management And General$7,707ManagementAndGeneralAmt
Fundraising$7,707FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$12,193TotalAmt
Program Services$3,430ProgramServicesAmt
Management And General$4,953ManagementAndGeneralAmt
Fundraising$3,810FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$105,898TotalAmt
Program Services$29,787ProgramServicesAmt
Management And General$43,020ManagementAndGeneralAmt
Fundraising$33,091FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$28,000TotalAmt
Management And General$28,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$26,191TotalAmt
Management And General$26,191ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$15,931TotalAmt
Management And General$15,931ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$25,473TotalAmt
Management And General$25,473ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,524TotalAmt
Management And General$1,524ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescREPAIRS AND MAINTENANCEDesc
Total$1,981TotalAmt
Management And General$1,981ManagementAndGeneralAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$7,202TotalAmt
Management And General$7,202ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,295,320TotalAmt
Program Services$926,584ProgramServicesAmt
Management And General$254,637ManagementAndGeneralAmt
Fundraising$114,099FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$673,529BOYAmt
EOY$636,397EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$187,299BOYAmt
EOY$86,706EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,753LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,753LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$941,880BOYAmt
EOY$1,229,003EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,802,708BOYAmt
EOY$1,952,106EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$134,600BOYAmt
EOY$219,732EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$95,937BOYAmt
EOY$21,461EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$230,537BOYAmt
EOY$241,193EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$268,813BOYAmt
EOY$106,129EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,303,358BOYAmt
EOY$1,604,784EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,572,171BOYAmt
EOY$1,710,913EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,802,708BOYAmt
EOY$1,952,106EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$27,714ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$166,456OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
CertificationYes (X)CertificationInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1TAHOE FOREST HOSPITAL DISTRICTBusinessNameLine1
FieldValueIRS element (for citing)
EIN946004062EIN
Organization Type3OrganizationTypeDesc
Governing Document ListedYes (1)GoverningDocumentListedInd
Supported Org NotifiedYes (1)SupportedOrgNotifiedInd
US OrganizedYes (1)USOrganizedInd
Support$823,876SupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$823,876SupportSumAmt

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$937,938BeginningYearBalanceAmt
Contributions$113,410ContributionsAmt
Investment Earnings Or Losses$162,638InvestmentEarningsOrLossesAmt
Administrative Expenses$8,025AdministrativeExpensesAmt
End Year Balance$1,205,961EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$645,885BeginningYearBalanceAmt
Contributions$192,238ContributionsAmt
Investment Earnings Or Losses$102,497InvestmentEarningsOrLossesAmt
Administrative Expenses$2,682AdministrativeExpensesAmt
End Year Balance$937,938EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$210,461BeginningYearBalanceAmt
Contributions$432,646ContributionsAmt
Investment Earnings Or Losses$8,330InvestmentEarningsOrLossesAmt
Administrative Expenses$5,552AdministrativeExpensesAmt
End Year Balance$645,885EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Contributions$203,787ContributionsAmt
Investment Earnings Or Losses$11,562InvestmentEarningsOrLossesAmt
Grants Or Scholarships$3,715GrantsOrScholarshipsAmt
Administrative Expenses$1,173AdministrativeExpensesAmt
End Year Balance$210,461EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,753OtherCostOrOtherBasisAmt
Depreciation$2,753DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
OTHER ASSETS$23,023
BENEFICIAL INTEREST IN COMMUNITY FOR CANCER CARE ENDOWMENT$1,205,980
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,229,003TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO TAHOE FOREST HOSPITAL DISTRICT$18,116
HELD IN TRUST FOR OTHERS$3,345
FieldValueIRS element (for citing)
Total Liability$21,461TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,647,746TotalRevEtcAuditedFinclStmtAmt
Other Revenue$166,456OtherRevenueAmt
Revenue Not Reported$166,456RevenueNotReportedAmt
Revenue Subtotal$1,481,290RevenueSubtotalAmt
Other Revenues Not Included-$213,684OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$213,684RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,267,606TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,509,004TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$213,684OtherExpensesIncludedAmt
Expenses Not Reported$213,684ExpensesNotReportedAmt
Expenses Subtotal$1,295,320ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,295,320TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE ENDOWMENT FUND IS INTENDED TO SUPPORT THE CANCER CENTER IN THE TREATMENT, SUPPORT, AND PREVENTION OF CANCER.
PART X, LINE 2:THE FOUNDATION ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES AND HOW AN UNCERTAIN TAX POSITION IS RECOGNIZED IN FINANCIAL STATEMENTS. THE FOUNDATION ANALYZES TAX POSITIONS TAKEN IN PREVIOUSLY FILED RETURNS AND TAX POSITIONS EXPECTED TO BE TAKEN IN FUTURE RETURNS. BASED ON THIS ANALYSIS, A LIABILITY IS RECORDED IF UNCERTAIN TAX BENEFITS HAVE BEEN RECEIVED. THE FOUNDATION'S PRACTICE IS TO RECOGNIZE INTEREST AND PENALTIES, IF ANY, RELATED TO UNCERTAIN TAX POSITIONS IN THE TAX EXPENSE. THERE WERE NO UNCERTAIN TAX POSITIONS IDENTIFIED OR RELATED INTEREST AND PENALTIES RECORDED AS OF JUNE 30, 2013, AND THE FOUNDATION DOES NOT EXPECT THIS TO CHANGE SIGNIFICANTLY OVER THE NEXT TWELVE MONTHS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN BENEFICIAL INTEREST IN ENDOWMENT 166,456.
PART XI, LINE 4B - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES NETTED AGAINST FUNDRAISING REVENUE -213,684.
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES NETTED AGAINST FUNDRAISING REVENUE 213,684.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1GENE UPSHAW MEMORIAL GOLF CLASSICNameOfEvent1Amt
Gross Receipts Event1$322,265GrossReceiptsEvent1Amt
Charitable Contri Event1$51,432CharitableContriEvent1Amt
Gross Revenue Event1$270,833GrossRevenueEvent1Amt
Rent Facility Costs Event1$35,375RentFacilityCostsEvent1Amt
Other Direct Expenses Event1$136,642OtherDirectExpensesEvent1Amt
Name Of Event2BEST OF TAHOE CHEFSNameOfEvent2Amt
Gross Receipts Event2$203,465GrossReceiptsEvent2Amt
Charitable Contri Event2$138,240CharitableContriEvent2Amt
Gross Revenue Event2$65,225GrossRevenueEvent2Amt
Rent Facility Costs Event2$20,250RentFacilityCostsEvent2Amt
Food And Beverage Event2$1,545FoodAndBeverageEvent2Amt
Entertainment Event2$2,661EntertainmentEvent2Amt
Other Direct Expenses Event2$17,211OtherDirectExpensesEvent2Amt
Other Events Total2OtherEventsTotalCnt
Gross Receipts Total$525,730GrossReceiptsTotalAmt
Charitable Contributions Tot$189,672CharitableContributionsTotAmt
Gross Revenue Total Events$336,058GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$55,625RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$1,545FoodAndBeverageTotalEventsAmt
Entertainment Total Events$2,661EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$153,853OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$213,684DirectExpenseSummaryEventsAmt
Net Income Summary$122,374NetIncomeSummaryAmt

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 Line1TAHOE FOREST HOSPITAL DISTRICTBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line110121 PINE AVENUEAddressLine1
CityTRUCKEECity
StateCAState
ZIP Code96160ZIPCode
FieldValueIRS element (for citing)
Recipient EIN946004062RecipientEIN
IRC Section115(1)IRCSectionDesc
Cash Grant$823,876CashGrantAmt
Valuation Method UsedN/AValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc
Purpose Of GrantTO SUPPORT AND ENHANCE HEALTHCARE IN THE DISTRICT'S SERVICE AREA.PurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE FOUNDATION EXISTS TO SUPPORT AND ENHANCE HEALTHCARE IN THE TAHOE FOREST HOSPITAL DISTRICT'S (THE DISTRICT) SERVICE AREA. ACCORDINGLY, THE FOUNDATION'S ASSISTANCE REPRESENTS PAYMENTS DIRECTLY MADE TO THE DISTRICT IN FURTHERANCE OF THESE PURPOSES. THE BOARD OF DIRECTORS FROM THE FOUNDATION AND THE DISTRICT PERFORM MONITORING PROCEDURES TO ENSURE THAT THE ASSISTANCE PROVIDED BY THE FOUNDATION IS USED TO SUPPORT AND ENHANCE HEALTHCARE IN THE DISTRICT'S SERVICE AREA.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
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)
PersonROBERT SCHAPPERPersonNm
TitleDIRECTORTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$395,585CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$88,062BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$483,647TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescEXPENSES-TFHDDesc
Contribution1ContributionCnt
Noncash Contributions Rpt F990$673,876NoncashContributionsRptF990Amt
Method Of Determining RevenuesACTUAL AMOUNT PAIDMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationTHE FOUNDATION RECEIVED IN-KIND SUPPORT FROM THE TAHOE FOREST HOSPITAL DISTRICT, PRINCIPALLY IN THE FORM OF EMPLOYEE WAGES AND BENEFITS. THE VALUE OF THIS SUPPORT IS MEASURED BY ACTUAL EXPENSES PAID ON THE FOUNDATIONS'S BEHALF. SCHEDULE M, PART 1, COLUMN (B): THE FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTORS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 1A, LINE 2A:THE TAHOE FOREST HOSPITAL DISTRICT FILES AND REPORTS ALL W-2S, 1099S, AND PAYROLL COMPLIANCE FOR THE FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 2BOARD MEMBERS TOM AND PAM HOBDAY ARE MARRIED.
FORM 990, PART VI, SECTION B, LINE 11THE BOARD PLACES THE FORM 990 ON ITS AGENDA FOR ITS REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 15AA COMPENSATION STUDY IS USED.
FORM 990, PART VI, SECTION C, LINE 19THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:CHANGE IN BENEFICIAL INTEREST 166,456.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1TAHOE FOREST HOSPITAL DISTRICTBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line110121 PINE AVENUEAddressLine1
CityTRUCKEECity
StateCAState
ZIP Code96160ZIPCode
FieldValueIRS element (for citing)
EIN946004062EIN
Primary ActivitiesHEALTHCAREPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Exempt Code Section115(1)ExemptCodeSectionTxt
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 OrgYes (1)GiftGrntCapContriFromOthOrgInd
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 Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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