PEACEHEALTH ST JOSEPH MEDICAL CENTER FOUNDATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
PEACEHEALTH ST JOSEPH MEDICAL CENTER FOUNDATION (EIN 72-1545902)
Tax period
2014-07-01 to 2015-06-30
Filed
2015-11-13
IRS object ID
201543179349307859
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)
Return2015-11-13T15:25:04-06:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN930623286PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1AKT LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1680 HAWTHORNE AVE SE 140AddressLine1Txt
CitySALEMCityNm
State AbbreviationORStateAbbreviationCd
ZIP97301ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN721545902EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PEACEHEALTH STJOSEPH MEDICAL CENTER FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPEACBusinessNameControlTxt
Phone3607886866PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12901 SQUALICUM PARKWAYAddressLine1Txt
CityBELLINGHAMCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98225ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKATIE JANSENPersonNm
Person TitleTREASURERPersonTitleTxt
Phone3607886866PhoneNum
Signature2015-11-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOSHUA MORROW CPAPreparerPersonNm
PTINP01026428PTIN
Phone5035857774PhoneNum
Preparation2015-11-11PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-04-25 22:37:26ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKATIE JANSENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12901 SQUALICUM PARKWAYAddressLine1Txt
CityBELLINGHAMCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98225ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,065,932GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PEACEHEALTH.ORG/FOUNDATION/ST-JOSEPHWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2003FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionRAISE CONRIBUTIONS AND ESTABLISH ENDOWMENTS TO SUPPORT PEACEHEALTH ST.JOSEPH MEDICAL CENTER.ActivityOrMissionDesc
Voting Members Governing Body23VotingMembersGoverningBodyCnt
Voting Members Independent22VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers39TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,716,957PYContributionsGrantsAmt
CY Contributions Grants$2,330,547CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$50,192PYInvestmentIncomeAmt
CY Investment Income$32,270CYInvestmentIncomeAmt
PY Other Revenue-$216,149PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,551,000PYTotalRevenueAmt
CY Total Revenue$2,362,817CYTotalRevenueAmt
PY Grants And Similar Paid$704,703PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$641,941CYGrantsAndSimilarPaidAmt
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$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$11,953CYTotalFundraisingExpenseAmt
PY Other Expenses$643,939PYOtherExpensesAmt
CY Other Expenses$14,833CYOtherExpensesAmt
PY Total Expenses$1,348,642PYTotalExpensesAmt
CY Total Expenses$656,774CYTotalExpensesAmt
PY Revenues Less Expenses$202,358PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,706,043CYRevenuesLessExpensesAmt
Total Assets BOY$4,951,527TotalAssetsBOYAmt
Total Assets EOY$7,748,898TotalAssetsEOYAmt
Total Liabilities BOY$266,199TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,463,469TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,685,328NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,285,429NetAssetsOrFundBalancesEOYAmt
MissionTHE MISSION OF THE FOUNDATION IS TO SUPPORT PEACEHEALTH ST. JOSEPH MEDICAL CENTER, LOCATED IN BELLINGHAM, WASHINGTON, BY SOLICITING, RECEIVING, MANAGING, ADMINISTERING AND DISTRIBUTING FUNDS OR OTHER GIFTS TO OR FOR THE BENEFIT OF PEACEHEALTH ST. JOSEPH MEDICAL CENTER.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$641,941ExpenseAmt
Grant$641,941GrantAmt
DescSUPPORT OF PEACEHEALTH ST. JOSEPH MEDICAL CENTER FOR EDUCATION, PATIENT SUPPORT, NURSING SUPPORT, RESEARCH, CAPITAL EXPENDITURES, SCHOLARSHIPS AND CHARITY CARE. THE FOUNDATION RECEIVES FROM PEACEHEALTH ST. JOSEPH MEDICAL CENTER AND PEACEHEALTH CORPORATION DONATED USE OF FACILITIES AND SERVICES, WHICH INCLUDE SPACE RENTAL, PROPERTY AND EQUIPMENT, UTILITIES, EMPLOYEES AND OTHER ITEMS. THE ESTIMATED FAIR MARKET VALUE OF $875,336 OF SUCH ITEMS HAS BEEN REFLECTED IN THE FINANCIAL STATEMENTS AS A PART OF IN-KIND CONTRIBUTIONS AND EXPENSES BUT PER IRS RULES IS NOT REFLECTED ON THE FORM 990.Desc
Total Program Service Expenses$641,941TotalProgramServiceExpensesAmt
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 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 Activities0FundraisingActivitiesInd
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 ContributionYes (1)DeductibleArtContributionInd
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
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 Members23GoverningBodyVotingMembersCnt
Independent Voting Member22IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
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 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 CEOYes (1)CompensationProcessCEOInd
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 Line1NICOLE POYNERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3607886540PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12901 SQUALICUM PARKWAYAddressLine1Txt
CityBELLINGHAMCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98225ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
JOHN HUNTLEY
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
SHAUN SULLIVAN MD
VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
MARION ROBIN FOOTE
TREASURER1.00Yes (X)Yes (X)$0$0$0
CHRISTINE THOMPSON
SECRETARY1.00Yes (X)Yes (X)$0$0$0
NANCY STEIGER
DIRECTOR1.00Yes (X)$0$0$0
MARK MCCAMPBELL
DIRECTOR1.00Yes (X)$0$317,616$30,04740.00
WILLIAM HALL MD
DIRECTOR1.00Yes (X)$0$0$040.00
RICHARD J LEONE MD
DIRECTOR1.00Yes (X)$0$627,496$36,83440.00
DALE ZENDER
DIRECTOR1.00Yes (X)$0$397,701$36,50140.00
CHARLES ARIZ MD
DIRECTOR1.00Yes (X)$0$0$0
BRAD BEARDEN OD
DIRECTOR1.00Yes (X)$0$0$0
MICHAEL BRADBURN
DIRECTOR1.00Yes (X)$0$0$0
BRAD DEHAAN
DIRECTOR1.00Yes (X)$0$0$0
AMY ESARY
DIRECTOR1.00Yes (X)$0$0$0
ROSEMARIE FRANCIS
DIRECTOR1.00Yes (X)$0$0$0
DENNY HOLMSTROM
DIRECTOR1.00Yes (X)$0$0$0
FRANK IMHOF
DIRECTOR1.00Yes (X)$0$0$0
KATIE JANSEN
DIRECTOR1.00Yes (X)$0$0$0
LYNETTE JENSEN
DIRECTOR1.00Yes (X)$0$0$0
CHET KENOYER
DIRECTOR1.00Yes (X)$0$0$0
MIKE PERRY
DIRECTOR1.00Yes (X)$0$0$0
SARAH ROTHENBUHLER
DIRECTOR1.00Yes (X)$0$0$0
JON SITKIN
DIRECTOR1.00Yes (X)$0$0$0
HOLLY STUDLEY
DIRECTOR1.00Yes (X)$0$0$0
CHERYL WEG
DIRECTOR1.00Yes (X)$0$0$0
DOUG WIGHT
DIRECTOR1.00Yes (X)$0$0$0
ANNA WILLIAMS
DIRECTOR1.00Yes (X)$0$0$0
ANNE RASMUSSEN SEE SCHEDULE 0
EXECUTIVE DIRECTOR20.00Yes (X)$0$131,044$3,7530.00
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,473,857TotReportableCompRltdOrgAmt
Total Other Compensation$107,135TotalOtherCompensationAmt
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
All Other Contributions$2,330,547AllOtherContributionsAmt
Noncash Contributions$80,874NoncashContributionsAmt
Total Contributions$2,330,547TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,669TotalRevenueColumnAmt
Exclusion$34,669ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$700,716SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$703,115SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$2,399SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$2,399TotalRevenueColumnAmt
Exclusion-$2,399ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,362,817TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$32,270ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$641,941TotalAmt
Program Services$641,941ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
FUNDRAISING EXPENSE$11,953$0$0$11,953
BANK CHARGES$2,880$0$2,880$0

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$656,774TotalAmt
Program Services$641,941ProgramServicesAmt
Management And General$2,880ManagementAndGeneralAmt
Fundraising$11,953FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,523,789BOYAmt
EOY$3,497,008EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$643,037BOYAmt
EOY$1,740,585EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,486,601BOYAmt
EOY$2,211,101EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$204,225BOYAmt
EOY$211,790EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$93,875BOYAmt
EOY$88,414EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,951,527BOYAmt
EOY$7,748,898EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$266,199BOYAmt
EOY$1,463,469EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$266,199BOYAmt
EOY$1,463,469EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,157,119BOYAmt
EOY$2,368,545EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,157,933BOYAmt
EOY$3,346,608EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$370,276BOYAmt
EOY$570,276EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,685,328BOYAmt
EOY$6,285,429EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,951,527BOYAmt
EOY$7,748,898EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,706,043ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$28,725NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$134,667OtherChangesInNetAssetsAmt
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)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,730,933CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,358,922CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,549,089CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,716,957CurrentTaxYearMinus1YearAmt
Current Tax Year$2,330,547CurrentTaxYearAmt
Total$11,686,448TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,730,933CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,358,922CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,549,089CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,716,957CurrentTaxYearMinus1YearAmt
Current Tax Year$2,330,547CurrentTaxYearAmt
Total$11,686,448TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$1,560,816SubstantialContributorsTotAmt
Public Support Total170$10,125,632PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$44,176CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$58,577CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$71,020CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$63,868CurrentTaxYearMinus1YearAmt
Current Tax Year$42,237CurrentTaxYearAmt
Total$279,878TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$2,382CurrentTaxYearMinus2YearsAmt
Total$2,382TotalAmt
FieldValueIRS element (for citing)
Total Support$11,968,708TotalSupportAmt
Public Support CY1700.84600PublicSupportCY170Pct
Public Support PY1700.87960PublicSupportPY170Pct
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$1,643,493BeginningYearBalanceAmt
Contributions$321,263ContributionsAmt
Investment Earnings Or Losses$51,711InvestmentEarningsOrLossesAmt
Administrative Expenses$3,523AdministrativeExpensesAmt
End Year Balance$2,012,944EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,386,904BeginningYearBalanceAmt
Contributions$54,250ContributionsAmt
Investment Earnings Or Losses$204,559InvestmentEarningsOrLossesAmt
Administrative Expenses$2,220AdministrativeExpensesAmt
End Year Balance$1,643,493EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,273,160BeginningYearBalanceAmt
Investment Earnings Or Losses$113,744InvestmentEarningsOrLossesAmt
End Year Balance$1,386,904EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,125,630BeginningYearBalanceAmt
Contributions$154,645ContributionsAmt
Investment Earnings Or Losses-$2,293InvestmentEarningsOrLossesAmt
Grants Or Scholarships$4,000GrantsOrScholarshipsAmt
Administrative Expenses$822AdministrativeExpensesAmt
End Year Balance$1,273,160EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$989,556BeginningYearBalanceAmt
Contributions$67,276ContributionsAmt
Investment Earnings Or Losses$69,561InvestmentEarningsOrLossesAmt
Grants Or Scholarships$763GrantsOrScholarshipsAmt
End Year Balance$1,125,630EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.60000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.28000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.12000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$3,261,417TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$28,725NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$875,336DonatedServicesAndUseFcltsAmt
Other Revenue-$5,461OtherRevenueAmt
Revenue Not Reported$898,600RevenueNotReportedAmt
Revenue Subtotal$2,362,817RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,362,817TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,661,316TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$875,336DonatedServicesUseFcltsAmt
Other Expenses Included$129,206OtherExpensesIncludedAmt
Expenses Not Reported$1,004,542ExpensesNotReportedAmt
Expenses Subtotal$656,774ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$656,774TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE ENDOWMENT FUNDS ARE TO FURTHER THE ORGANIZATION'S EXEMPT PURPOSE.
PART X, LINE 2:FOR THE YEARS ENDED JUNE 30, 2015 AND 2014, MANAGEMENT OF THE FOUNDATION BELIEVES THAT THERE HAS BEEN NO ACTIVITY THAT WOULD JEOPARDIZE THE TAX POSITION, BEING A TAX EXEMPT ORGANIZATION, AND THAT IT IS MORE LIKELY THAN NOT, BASED ON THE TECHNICAL MERITS, THAT THIS POSITION WOULD BE SUSTAINED UPON EXAMINATION. THE FOUNDATION RECOGNIZES INTEREST AND PENALTIES, IF ANY, RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE. THERE WERE NONE FOR THE YEARS ENDED JUNE 30, 2015 AND 2014.
PART XI, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN VALUE OF ASSETS HELD IN TRUST -5,461.
PART XII, LINE 2D - OTHER ADJUSTMENTS:LOSS ON UNCOLLECTIBLE PLEDGE 129,206.

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 Line1PEACEHEALTHBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11115 SE 164TH AVE SUITE 332AddressLine1Txt
CityVANCOUVERCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98683ZIPCd
FieldValueIRS element (for citing)
Recipient EIN910939479RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$561,067CashGrantAmt
Non Cash Assistance$80,874NonCashAssistanceAmt
Valuation Method UsedFMVValuationMethodUsedDesc
Non Cash AssistanceMARBLE STATUE, HARP AND PATIENT SUPPLIESNonCashAssistanceDesc
Purpose Of GrantPATIENT CAREPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MARK MCCAMPBELL
DIRECTOR$0$241,099$0$70,412$0$6,105$0$27,300$0$2,747$0$347,663$0$0
RICHARD J LEONE MD
DIRECTOR$0$564,160$0$60,260$0$3,076$0$33,420$0$3,414$0$664,330$0$0
DALE ZENDER
DIRECTOR$0$351,619$0$42,709$0$3,373$0$31,720$0$4,781$0$434,202$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION DOES NOT HAVE ANY PAID EMPLOYEES. EMPLOYEES ARE COMPENSATED BY PEACEHEALTH (A RELATED ORGANIZATION) WHICH USES A MARKET BASED COMPENSATION PROGRAM UTILIZING SEVERAL INDEPENDENT THIRD PARTY COMPENSATION MARKET SURVEYS TO ESTABLISH PAY RANGES FOR THE POSITION. PEACEHEALTH ESTABLISHES THE INDIVIDUAL RATE OF PAY WITHIN THE PAY RANGE BASED ON RELEVANT EXPERIENCE/SKILLS/COMPETENCE TO DO THE JOB. THE RANGES OF PAY RATES ARE REVIEWED ON AN ANNUAL BASIS.ExplanationTxt

Schedule M IRS990ScheduleM

Works Of Art WorksOfArtGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$76,000NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990AmtMethod Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)HARP1$4,000FMV
Yes (X)SUPPLIES FOR PATIENTS3$874FMV
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE 990 IS PREPARED BY AN INDEPENDENT CPA FIRM AND IS PRESENTED TO THE BOARD FOR APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS, OFFICERS, AGENTS AND EMPLOYEES ARE REQUIRED TO SIGN ANNUALLY, OUR IN-DEPTH CONFLICT OF INTEREST DISCLOSURE POLICY WHICH AFFIRMS THEY HAVE READ, UNDERSTOOD AND AGREED WITH THE CONFLICT OF INTEREST POLICY AND HAVE ANSWERED ALL QUESTIONS ON THE DISCLOSURE FULLY AND HONESTLY. THE OFFICERS, DIRECTORS, AGENTS AND EMPLOYEES ARE COVERED UNDER THIS POLICY. EACH BOARD MEMBER IS REQUIRED TO SIGN A COPY WHICH IS REVIEWED BY THE EXECUTIVE DIRECTOR. IT MUST BE SIGNED BEFORE THEY ATTEND ANY BOARD OR COMMITEE MEETINGS. BEFORE AN ITEM IS PUT ON AN AGENDA, THE BOARD/COMMITTEE WILL REVIEW AND ASCERTAIN IF THERE WILL BE ANY CONFLICTS ON THE BOARD AND IF SO, THE BOARD MEMBER IS CONTACTED AND TOLD ABOUT THE SUBJECT OF DISCUSSION. THE BOARD/COMMITTEE DECIDES IF IT IS IN FACT A CONFLICT AND IF SO, THE BOARD MEMBER IS ASKED TO EXCUSE THEMSELVES FROM THE ROOM DURING DISCUSSION AND VOTING BY THE EXECUTIVE DIRECTOR OR COMMITTEE CHAIR.
FORM 990, PART VI, SECTION B, LINE 15ATHE FOUNDATION'S EXECUTIVE DIRECTOR IS COMPENSATED BY PEACEHEALTH (A RELATED ORGANIZATION) WHICH USES A MARKET BASED COMPENSATION PROGRAM UTILIZING SEVERAL INDEPENDENT THIRD PARTY COMPENSATION MARKET SURVEYS TO ESTABLISH PAY RANGES FOR THE POSITION. PEACEHEALTH THEN ESTABLISHES THE INDIVIDUAL RATE OF PAY WITHIN THE PAY RANGE BASED ON RELEVANT EXPERIENCE/SKILLS/COMPETENCE TO DO THE JOB. THIS RATE OFFERED TO THE EXECUTIVE DIRECTOR AT TIME OF HIRE WAS DETERMINED THROUGH A DISCUSSION BETWEEN THE REGIONAL DIRECTOR OF HUMAN RESOURCES AND THE ADMINISTRATIVE DIRECTOR OF HUMAN RESOURCES. THE RANGES AND RATE OF PAY ARE REVIEWED ON AN ANNUAL BASIS. COMPENSATION WAS LAST REVIEWED ON JUNE 30, 2015.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE IN THE FOUNDATION OFFICE UPON REQUEST.
FORM 990 PART VIII, LINE 30ANNE RASMUSSEN, EXECUTIVE DIRECTOR: HER COMPENSATION IS PAID BY THE RELATED ORGANIZATION FOR SERVICES TO THE FILING ORGANIZATION. HER REPORTABLE COMPENSATION IS ZERO FOR THE FILING ORGANIZATION BUT HER AVERAGE HOURS PER WEEK IS 20 AS SHE SPENDS PART OF HER TIME WORKING AT THE FILING ORGANIZATION AND AT WHATCOM HOSPICE FOUNDATION (A RELATED ORGANIZATION TO PEACEHEALTH)
FORM 990, PART XI, LINE 9:CHANGE IN VALUE OF TRUST -5,461. LOSS ON UNCOLLECTIBLE PLEDGE -129,206.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1PEACEHEALTHBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11115 SE 164TH AVE SUITE 332AddressLine1Txt
CityVANCOUVERCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98683ZIPCd
FieldValueIRS element (for citing)
EIN910939479EIN
Primary ActivitiesHOSPITALPrimaryActivitiesTxt
Legal Domicile StateWALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 3PublicCharityStatusTxt
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 Org0GiftGrntCapContriFromOthOrgInd
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 OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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