2015-05-06T19:20:31-05:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2014-01-01 911400684 PERSONAL SERVICE PROVIDERS PERS 3605381540 201 7TH STREET HOQUIAM WA 98550 TERRY FULTZ PRESIDENT 3605381540 2015-04-30 1 DANIEL M FREIN CPA P00856532 4252506100 2014 2016-02-25 16:41:14Z X TERRY FULTZ 201 7TH STREET HOQUIAM WA 98550 2439153 0 X WWW.PSPROVIDERS.ORG X 1987 WA TO PROVIDE HOME CARE TO INDIVIDUALS RECOVERING AND IN NEED OF LONG-TERM CARE. 5 5 157 5 0 0 0 0 2379963 2431062 13304 7883 222 208 2393489 2439153 0 0 0 0 2121698 2020708 0 0 0 369048 387840 2490746 2408548 -97257 30605 1266674 1210065 249265 165028 1017409 1045037 TO PROVIDE HOME CARE (DOMESTIC, PERSONAL AND RESPITE) TO INDIVIDUALS RECOVERING FROM ILLNESS OR INJURY AND IN NEED OF LONG-TERM CARE. 0 0 2088023 0 2419296 HOME CARE AND HEALTH MAINTENANCE VISITS - DURING 2014, THE ORGANIZATION PROVIDED SERVICE TO 263 CLIENTS. 35227 0 11766 CAREGIVER TRAINING - TO PROVIDE INSTRUCTION TO IN-HOME CAREGIVERS. 2123250 1 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 7 0 1 157 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 1 0 1 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 WA X TOM MAYR 3605325454 201 7TH STREET HOQUIAM WA 98550 X TERRY FULTZ PRESIDENT 1.00 X X 0 0 0 PAT SCHNEIDER TREASURER 1.00 X X 0 0 0 LOIS BANGERT SECRETARY 1.00 X X 0 0 0 CORALIE WILLIAMS MEMBER 1.00 X 0 0 0 NORM SPRAGUE MEMBER 1.00 X 0 0 0 JOEL STEPHENS CEO 10.00 X 0 0 0 TOM MAYR CFO 10.00 X 0 0 0 0 0 0 0 0 0 0 HARBORS HOME HEALTH & HOSPICE 201 7TH STREET HOQUIAM WA 98550 MANAGEMENT SERVICES 121415 1 HOME CARE 812900 2419296 2419296 CAREGIVER TRAINING 611600 11766 11766 2431062 7883 7883 MISCELLANEOUS INCOME 900099 208 208 208 2439153 2431062 0 8091 1424559 1255816 168743 482263 425138 57125 113886 100396 13490 121415 107033 14382 2851 2513 338 37067 32676 4391 8274 7294 980 5332 4700 632 79608 70178 9430 30360 26763 3597 44704 39409 5295 16856 14859 1997 20078 17700 2378 BAD DEBT 15108 13318 1790 EQUIP REPAIRS & MAINT 4085 3601 484 MISCELLANEOUS 1457 1287 170 DUES AND SUBSCRIPTIONS 645 569 76 2408548 2123250 285298 0 278881 253633 281576 234132 2631 2631 138223 55914 71105 82309 632481 637360 1266674 1210065 249265 165028 249265 165028 X 1017409 1045037 1017409 1045037 1266674 1210065 30605 -2977 0 X 0 1 X 1 0 X 5000 5000 2526224 2532587 2528510 2379963 2431062 12398346 2526224 2537587 2528510 2379963 2431062 12403346 0 0 0 12403346 21645 20414 18887 16098 7883 84927 21645 20414 18887 16098 7883 84927 13 54 59 222 208 556 2547882 2558055 2547456 2396283 2439153 12488829 0.99320 0.99200 0.00680 0.00790 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS 138223 55914 82309 82309 X 2436176 -2977 -2977 2439153 0 2439153 2408548 0 2408548 0 2408548 PART X, LINE 2: PERSONAL SERVICE PROVIDERS IS A NOT-FOR-PROFIT 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 2011 ARE CLOSED TO EXAMINATION. THE ORGANIZATION HAS RECOGNIZED NO INTEREST OR PENALTIES RELATED TO TAXES IN THE ACCOMPANYING FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION COMPENSATES HARBORS HOME HEALTH & HOSPICE, AN UNRELATED 501(C)(3) ORGANIZATION, TO PROVIDE MANAGEMENT SERVICES. FORM 990, PART VI, SECTION A, LINE 4 THE BUSINESS AND PROPERTY OF THE CORPORATION SHALL BE MANAGED BY A BOARD OF DIRECTORS CONSISTING OF NOT LESS THAN THREE AND NOT MORE THAN NINE DIRECTORS. THE TERM OF OFFICE OF EACH DIRECTOR SHALL BE FOR THREE YEARS OR UNTIL HIS/HER SUCCESSOR IS ELECTED. A DIRECTOR MAY SUCCEED HIMSELF/HERSELF IN OFFICE. THREE MEMBERS OF THE BOARD OF DIRECTORS SHALL CONSTITUTE A QUORUM. FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP IN THE ORGANIZATION IS OPEN TO ANY MEMBER OF THE PUBLIC WHO AGREES TO PROMOTE THE PURPOSE OF THE ORGANIZATION. 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 THE SERVICES OF THE CEO AND OTHER OFFICERS ARE PROVIDED AS PART OF THE MANAGEMENT CONTRACT WITH HARBORS HOME HEALTH & HOSPICE. THEIR COMPENSATION IS DETERMINED BY HARBORS HOME HEALTH & HOSPICE. 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 FORMS 990 AND 1023 ARE MADE AVAILABLE TO THE PUBLIC.