2015-08-31T17:13:44-05:00 2015-03-31 910189318 MOSS ADAMS LLP PO BOX 22650 YAKIMA WA 989072650 990 2014-04-01 237297657 COLUMBIA VALLEY COMMUNITY HEALTH COLU 5096644575 600 ORONDO AVE SUITE 1 WENATCHEE WA 98801 PATRICK BUCKNUM CEO 5096644575 2015-07-30 1 CHRISTOPHER E RIVARD P00022321 5092487750 2014 2016-03-07 17:11:31Z PATRICK BUCKNUM 600 ORONDO AVE SUITE 1 WENATCHEE WA 98801 29990896 0 X WWW.CVCH.ORG X 1972 WA THE MISSION OF COLUMBIA VALLEY COMMUNITY HEALTH IS TO PROVIDE ACCESS TO IMPROVED HEALTH AND WELLNESS WITH COMPASSION AND RESPECT FOR ALL. 10 10 317 10 0 0 4730954 5413492 19144417 24452291 -1480 -68458 3880 -11708 23877771 29785617 46341 26015 0 0 16046179 16324865 13006 25820 130423 6106500 6060374 22212026 22437074 1665745 7348543 28078744 34588658 10160379 9236471 17918365 25352187 THE MISSION OF COLUMBIA VALLEY COMMUNITY HEALTH IS TO PROVIDE ACCESS TO IMPROVED HEALTH AND WELLNESS WITH COMPASSION AND RESPECT FOR ALL. 0 0 16348945 26015 23584289 PROVIDE COMPREHENSIVE MEDICAL, MENTAL HEALTH AND DENTAL CARE TO SEASONAL AND MIGRANT FARM WORKERS AND THE MEDICALLY UNDERSERVED POPULATION OF THE AREA. THIS INCLUDES GENERAL MEDICINE, DENTAL, PRENATAL, AND OBSTETRIC CARE ON AN OUTPATIENT BASIS. AN ON SITE PHARMACY PROVIDES PATIENT PRESCRIPTION SERVICES TO ENSURE PATIENTS OBTAIN NEEDED MEDICATIONS. 705050 0 868002 INTERMEDIARY FOR PROVIDING SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN. INCLUDES NUTRITION EDUCATION, REFERRAL FOR HEALTH CARE FOR LOW-INCOME WOMEN AS WELL AS INFANTS AND CHILDREN UNDER AGE FIVE. PROGRAM FOCUS IS FOR BOTH INFANTS AND CHILDREN IN THE CRITICAL PERIODS OF GROWTH AND DEVELOPMENT UNDER AGE FIVE. 17053995 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 58 0 1 317 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X KRISTAL ALBRECHT 5096626000 600 ORONDO AVE SUITE 1 WENATCHEE WA 98801 JOANNE HILL PRESIDENT 2.00 X X 0 0 0 JOAN ALWAY VICE PRESIDENT 2.00 X X 0 0 0 KRISTINA STEPPER TREASURER 2.00 X X 0 0 0 RICH WATSON TREASURER 2.00 X X 0 0 0 IRENE BAZAN SECRETARY 2.00 X X 0 0 0 RUTH CABRERA DE ALPIRE BOARD MEMBER 2.00 X 0 0 0 DOUGLAS HEAD BOARD MEMBER 2.00 X 0 0 0 MARY HUNT BOARD MEMBER UNTIL 04/12/14 2.00 X 0 0 0 LOLY LARSON BOARD MEMBER 2.00 X 0 0 0 MARGARITO RODRIGUEZ BOARD MEMBER UNTIL 10/16/14 2.00 X 0 0 0 ROBERT SCOTT JR BOARD MEMBER 2.00 X 0 0 0 TERESA ZEPEDA BOARD MEMBER 2.00 X 0 0 0 PATRICK BUCKNUM CEO 40.00 X 226494 0 28535 CAROL DIEDE COO 40.00 X 141994 0 23682 KRISTAL ALBRECHT CFO 40.00 X 166375 0 16622 MALCOLM BUTLER MEDICAL OFFICER 40.00 X 277764 0 29301 BRUCE V WILCOX DENTAL OFFICER 40.00 X 237227 0 28390 KENNETH SHERMER PHYSICIAN 40.00 X 228756 0 28143 PATRICK MCLAUGHLIN PHYSICIAN 40.00 X 198209 0 26695 JEFFERY HINCKLEY DENTIST 40.00 X 194881 0 26662 BRENDA BAUMEISTER PHYSICIAN 40.00 X 176219 0 25727 LOUISE SIMONS PHYSICIAN 32.00 X 165433 0 22591 2013352 0 256348 30 0 1 0 CENTRAL WASHINGTON TITLE SERVICES 1205 N WENATCHEE AVE WENATCHEE WA 98801 TITLE SERVICES 312229 NEXTGEN HEALTHCARE PO BOX 511449 LOS ANGELES CA 90051 SOFTWARE MAINTENANCE 189181 GL WHITE CONSTRUCTION INC 205 HIDDEN MEADOW DRIVE WENATCHEE WA 98801 CONSTRUCTION 154659 THE STUDER GROUP 350 W CEDAR ST SUITE 300 PENSACOLA FL 32502 CONSULTING, TRAINING 146150 4 5346337 67155 5887 5413492 NET PATIENT SERVICE REVENUE 621400 15755746 15755746 ENHANCEMENT REVENUE 621400 5029073 5029073 CAPITATION REVENUE 621400 2799469 2799469 CONTRACT SERVICES 621400 671061 671061 MEANINGFUL USE INCENTIVE REVENUE 621400 153000 153000 43942 43942 24452291 55285 55285 69828 81536 -11708 -11708 -11708 123743 -123743 -123743 -123743 29785617 24452291 0 -80166 26015 26015 1206983 329476 877507 12103285 10248941 1804771 49573 612946 495269 115442 2235 1364423 1099503 255337 9583 1037228 824343 209329 3556 44543 44543 64888 16282 48606 25820 25820 92086 34523 20626 36937 231226 118213 112877 136 669729 242645 424999 2085 628653 430345 198308 34511 20016 14495 253026 119144 133384 498 219877 159735 60142 1286472 863201 423271 104455 58428 46027 PATIENT & PHARMACEUTICA 1327964 1327920 44 CONSULTING/CONTRACTING 417552 114897 302655 OTHER EQUIPMENT 296884 258314 38570 STAFF RECRUTING 103679 92903 10776 284829 173882 110947 22437074 17053995 5252656 130423 2007314 3910817 7916164 11933517 205742 107448 1519485 1361677 135539 149769 153009 256386 25999974 9130930 16141491 16869044 28078744 34588658 1927197 2726753 6254618 5822873 1978564 686845 10160379 9236471 X 17886862 25294604 31503 57583 17918365 25352187 28078744 34588658 7348543 85279 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2053306 2053306 17467016 5780525 11686491 974317 800885 173432 4232136 2499463 1732673 1273199 50057 1223142 16869044 OTHER LIABILITIES 686845 686845 X 29952432 85279 81536 166815 29785617 0 29785617 22518610 81536 81536 22437074 0 22437074 PART X, LINE 2: THE ORGANIZATION IS A NOTFORPROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS USING A STANDARD THAT PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. AS OF MARCH 31, 2015 AND 2014, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AUTHORITIES FOR FISCAL YEARS 2012 AND LATER. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 81,536. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 81,536. X 0 WA 1 PAYMENT OF MEDICAL BILLS FOR INDIVIDUALS WHO NEED ASSISTANCE - HELPING HANDS 201 26015 PART I, LINE 2: PER THE CLIENTS FUNDING POLICY TO BE CONSIDERED FOR THE HELPING HANDS FUND, THE PATIENT'S HOUSEHOLD INCOME SHOULD NOT EXCEED TWO HUNDRED PERCENT (200%) OF THE POVERTY GUIDELINES. AS THE HELPING HANDS FUND IS THE PAYER OF LAST RESORT, ALL OUTSIDE FUNDING SOURCES (INCLUDING, BUT NOT LIMITED TO, GRANTS, GOVERNMENT ASSISTANCE, PRIVATE FOUNDATIONS, AND PATIENT ASSISTANCE PROGRAMS) WILL BE REVIEWED AND UTILIZED BEFORE DETERMINING HELPING HANDS FUND ELIGIBILITY. THE COMMITTEE WILL REVIEW AND VOTE ON ELIGIBLE APPLICATIONS ON A CASE BY CASE BASIS. FOR APPLICATIONS REFERRED BY PROVIDERS, AN URGENT NEED REQUEST FORM WILL BE COMPLETED BY THE PROVIDER AND SIGNED BY A COMMITTEE MEMBER. IF THE ESTIMATED COST IS BETWEEN $200 AND $299, A MANAGEMENT TEAM MEMBER'S SIGNATURE IS ALSO REQUIRED. URGENT NEED REQUEST EQUAL TO OR GREATER THAN $300 MUST BE APPROVED BY THE COMMITTEE VIA EMAIL VOTE BEFORE FUNDING CAN OCCUR. NON URGENT NEED APPLICATIONS WILL BE REVIEWED AT MONTHLY COMMITTEE MEETINGS. IN ADDITION TO THE APPLICATION, FURTHER INFORMATION MAY BE OBTAINED BY THE COMMITTEE TO AID WITH ELIGIBILITY DETERMINATION. IF THE NEED DICTATES, THE COMMITTEE MAY CONSIDER AN APPLICATION PRIOR TO THE MONTHLY MEETING. APPLICANTS REQUESTING RELIEF ON CVCH ACCOUNTS WILL GENERALLY RECEIVE A DECISION AND NOTIFICATION BY A COMMITTEE REPRESENTATIVE WITHIN 60 DAYS OF COMMITTEE REVIEW. IN MAKING A DETERMINATION OF ELIGIBILITY, THE COMMITTEE MAY CONSIDER WHETHER THE PATIENT HAS NEGOTIATED IN GOOD FAITH WITH THE CVCH BILLING DEPARTMENT, KEPT PATIENT SERVICE APPOINTMENTS, MADE PAYMENTS, AND/OR DEMONSTRATED INTEREST IN CLEARING HIS/HER ACCOUNT. X 1 1 X X X X X X 0 0 0 0 0 0 0 0 0 PATRICK BUCKNUM CEO 196016 0 20000 0 10478 0 10419 0 18116 0 255029 0 0 0 CAROL DIEDE COO 127118 0 5262 0 9614 0 6530 0 17152 0 165676 0 0 0 KRISTAL ALBRECHT CFO 135612 0 16014 0 14749 0 7448 0 9174 0 182997 0 0 0 MALCOLM BUTLER MEDICAL OFFICER 238426 0 15850 0 23488 0 11839 0 17462 0 307065 0 0 0 BRUCE V WILCOX DENTAL OFFICER 169377 0 52673 0 15177 0 10943 0 17447 0 265617 0 0 0 KENNETH SHERMER PHYSICIAN 126960 0 66837 0 34959 0 10681 0 17462 0 256899 0 0 0 PATRICK MCLAUGHLIN PHYSICIAN 119633 0 62681 0 15895 0 9359 0 17336 0 224904 0 0 0 JEFFERY HINCKLEY DENTIST 136252 0 28192 0 30437 0 9233 0 17429 0 221543 0 0 0 BRENDA BAUMEISTER PHYSICIAN 169133 0 0 0 7086 0 8296 0 17430 0 201945 0 0 0 LOUISE SIMONS PHYSICIAN 101933 0 51484 0 12016 0 7869 0 14722 0 188024 0 0 0 PART I, LINE 1A HOUSING ALLOWANCES ARE CONSIDERED TO BE TAXABLE EARNINGS IN ACCORDANCE WITH PAYROLL LAWS. THE INTERNAL COMPENSATION POLICY GOVERNS COMPENSATION FOR AGENCY POSITIONS. KRISTAL ALBRECHT, CFO RECEIVES THIS BENEFIT. A WA HEALTHCARE FACILITIES 911108929 2010-12-16 7200000 REMODELING & RENOVATION 0 0 0 A 3855365 7200000 29142 58202 4231702 2012 1 0 0 1 A 0 1 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED EITHER BY THE BOARD OR FINANCE COMMITTEE PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE IS UPDATED ANNUALLY FOR BOARD MEMBERS. FOR STAFF MEMBERS, THE PROCESS FOR EVALUATING CONFLICT OF INTEREST ISSUES IS OUTLINED IN POLICY ADM-CC-02, EMPLOYEE CONFLICT OF INTEREST. EMPLOYEES SUBMIT THEIR REQUEST FOR REVIEW OF OUTSIDE EMPLOYMENT TO THE HUMAN RESOURCES (HR) DIRECTOR, GENERALLY VIA EMAIL. THE HR DIRECTOR REVIEWS THE REQUEST WITH THE EMPLOYEE'S IMMEDIATE SUPERVISOR AND APPROPRIATE MANAGER AND/OR DIRECTOR UP TO THE MANAGEMENT TEAM MEMBER. IF APPROVED VIA THIS CHAIN OF COMMAND, THE REQUEST IS SUBMITTED TO THE CEO FOR FINAL APPROVAL. A WRITTEN RESPONSE IS PROVIDED TO THE EMPLOYEE OUTLINING ANY GUIDELINES. IN THE CASE OF HIGHLY SENSITIVE CONFLICT OF INTEREST ISSUES, EMPLOYEES MAY CONSULT WITH THE CEO DIRECTLY. FORM 990, PART VI, SECTION B, LINE 15 DATA PULLED FROM: 1) NACHC HEALTH CENTER COMPENSATION & BENEFITS REPORT, 2) MILLIMAN NORTHWEST HEALTH CARE INDUSTRY SALARY SURVEY, AND 3) INDEPENDENT SALARY SURVEYS CONDUCTED THROUGH HR. INFORMATION IS REVIEWED BY THE CEO, WHO MAKES RECOMMENDATIONS TO THE BOARD FOR FINAL APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST, BUT NOT PUBLISHED EXTERNALLY. GOVERNING DOCUMENTS ARE NOT SHARED. AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, AND THE FORM 990 IS AVAILABLE ON GUIDESTAR. FORM 990, PART VIII, LINE 2C: NO CHANGE FROM PRIOR YEAR.