2014-07-15T10:08:14-05:00 2013-10-31 910189318 MOSS ADAMS LLP 402 E YAKIMA AVENUE YAKIMA WA 98901 990 2012-11-01 911022358 YAKIMA VALLEY MEMORIAL HOSPITAL CHARITABLE FOUNDATION YAKI 5095765794 2701 TIETON DRIVE YAKIMA WA 98902 ANNE CAFFERY 5095765794 2014-07-14 1 CHRISTOPHER E RIVARD P00022321 5092487750 2012 2015-11-30 17:44:51Z THE MEMORIAL FOUNDATION ANNE CAFFERY 2701 TIETON DRIVE YAKIMA WA 98902 4387844 0 X WWW.MEMFOUND.ORG X 1978 WA THE FOUNDATION RAISES AND DISTRIBUTES FUNDS TO PROMOTE AND SUPPORT HEALTH CARE SERVICES IN COORDINATION WITH YAKIMA VALLEY MEMORIAL HOSPITAL. 27 27 0 189 0 0 2324045 3177689 0 0 102294 256504 -14128 34188 2412211 3468381 5387509 2329552 0 0 0 0 0 0 90358 278112 294287 5665621 2623839 -3253410 844542 5217588 6345203 377859 386742 4839729 5958461 X ADVANCE AND TRANSFORM HEALTHCARE IN YAKIMA. 1 0 884521 884521 CHILDREN'S VILLAGE - SUPPORTING SERVICES FOR CHILDREN WITH SPECIAL HEALTHCARE NEEDS 42180 42180 NORTH STAR LODGE - SUPPORTING A FULL-SERVICE OUTPATIENT CANCER TREATMENT FACILITY. 371458 371458 HOSPICE HOME HEALTH CARE - SUPPORTING HOSPICE/HOME HEALTH SERVICES INCLUDING END OF LIFE SERVICES TO PATIENTS (INCLUDING PALLIATIVE CARE/TRANSITIONS). 1031393 1031393 SUPPORT NUMEROUS HEALTHCARE/HEALTHCARE RELATED PROGRAMS. 1031393 1031393 2329552 1 1 0 0 0 1 0 0 0 1 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 27 27 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X BONNIE DWARSHUIS 5092495204 3800 SUMMITVIEW AVENUE YAKIMA WA 98902 X ANNE NAPIER CAFFERY 40.00 X X 0 0 0 MARIE HALVERSON 2.00 X X 0 0 0 B JEAN PRYOR 2.00 X X 0 0 0 DOLORES DESSERAULT 1.00 X 0 0 0 LEE CALLARMAN 1.00 X 0 0 0 WEST H CAMPBELL 1.00 X 0 0 0 DARRELL BLUE 1.00 X 0 0 0 BILL DOLSEN 1.00 X 0 0 0 DR DANIEL DOORNICK 1.00 X 0 0 0 CHRIS FALK 1.00 X 0 0 0 JUDI GILMORE 1.00 X 0 0 0 DR JAMES HAVEN 1.00 X 0 0 0 CINDI STEWART 1.00 X 0 0 0 ROYAL KEITH 1.00 X 0 0 0 RICK LINNEWEH 1.00 X 0 0 0 DR TIMOTHY MELHORN 1.00 X 0 0 0 MICHAEL MOEN 1.00 X 0 0 0 MARGARET NUTLEY 1.00 X 0 0 0 SCOTT OLANDER 1.00 X 0 0 0 MARY JO PEREZ 1.00 X 0 0 0 ROBERT G PRICE 1.00 X 0 0 0 CINDI STEWART 1.00 X 0 0 0 MARVIN SUNDQUIST 1.00 X 0 0 0 BILL WHEELER 1.00 X X 0 0 0 DR ROBERT WILLIAMS 1.00 X 0 0 0 ANN WILLIS 1.00 X 0 0 0 0 0 0 0 0 0 0 0 128804 272820 2776065 103226 3177689 101381 101381 1073023 917900 155123 155123 155123 35751 128804 1563 34188 34188 3468381 0 0 290692 2329552 2329552 19930 19930 62323 25118 37205 1118 1118 REIMBURSED EXPENSES 111567 74771 36796 NET ANNUITY 82050 82050 UNCOLLECTIBLE PLEDGES 15458 15458 OTHER 1841 942 899 2623839 2329552 203929 90358 748508 1580827 949552 721164 2966830 3474814 150749 150643 401949 417755 5217588 6345203 377859 386742 377859 386742 X 1213561 1112447 3313483 4533329 312685 312685 4839729 5958461 5217588 6345203 844542 274190 0 X X 0 1 X 1 0 X 3047277 3902384 4233991 2324045 3177689 16685386 3047277 3902384 4233991 2324045 3177689 16685386 1248411 15436975 146797 93945 129853 82019 101381 553995 25680 57421 18988 10927 35751 148767 17388148 0.88780 0.84450 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: GROSS RECEIPTS FROM EVENTS - 2008 AMOUNT: $ 25,680. 2009 AMOUNT: $ 57,421. 2010 AMOUNT: $ 18,988. 2011 AMOUNT: $ 10,927. 2012 AMOUNT: $ 35,751. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 5000 114218 1 1 0 493442 48519 1244 540717 445636 49548 1742 493442 437873 9402 1639 445636 389617 49888 1632 437873 323655 67626 1664 389617 0.00000 0.57830 0.42170 0 0 0 CHARITABLE TRUST 173766 GIFT ANNUITIES 243989 417755 DUE TO YVMH 44807 DEFERRED LIABILITIES 274311 DUE TO EPIC 33812 DUE TO NURSING HOME 33812 386742 X 3744135 274190 1564 275754 3468381 0 3468381 2625403 1564 1564 2623839 0 2623839 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE INTENDED USE FOR THE ENDOWMENT FUNDS ARE CHILDREN'S HEALTHCARE NEEDS AND CANCER PATIENTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE FOUNDATION IS A TAX-EXEMPT ORGANIZATION QUALIFYING UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE FOUNDATION'S TAX-EXEMPT PURPOSE WOULD BE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THE FOUNDATION DID NOT ENGAGE IN AN ACTIVITY UNRELATED TO ITS TAX-EXEMPT PURPOSE; ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. IN ACCORDANCE WITH REQUIREMENTS RELATED TO ACCOUNTING FOR UNCERTAINTIES IN INCOME TAXES, THE FOUNDATION HAS DETERMINED THEY HAVE NO UNCERTAIN TAX POSITIONS AT OCTOBER 31, 2013 AND 2012. IN ADDITION, THE FOUNDATION QUALIFIED FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS OTHER THAN A PRIVATE FOUNDATION UNDER SECTION 509(A)(1). FOLLIES 107160 88848 18312 GOLF TOURNAMENT 34315 22579 11736 1 23080 17377 5703 1356 207 164555 128804 35751 1356 207 1563 34188 1 YAKIMA VALLEY MEMORIAL HOSPITAL 2811 TIETON DR YAKIMA WA 98902 910567263 501(C)3 2329552 TO PROVIDE SUPPORT TO THE YAKIMA VALLEY MEMORIAL HOSPITAL IN THEIR PURSUIT OF HEALTH IMPROVEMENT, EDUCATION, AND IMPROVING OUR COMMUNITY. 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE PRESIDENT/CEO REVIEWS BUDGETS AND PROFIT/LOSS STATEMENTS OF THE PROGRAMS RECEIVING ALLOCATION AWARDS ON, AT LEAST, AN ANNUAL BASIS. X 16216 FMV X 2 81553 MEAN ON DATE OF TRANSFER X 134 3564 SALES VALUE X GIFT CARDS 21 1280 FACE VALUE OF CARDS X MEMBERSHIPS 4 439 FMV X TRIP 1 175 FMV 0 0 1 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 COTTAGE IN THE MEADOW, A HOSPICE IN-PATIENT CARE FACILITY OPENED IN SEPTEMBER OF 2012 THAT BECAME FULLY OPERATIONAL IN DECEMBER OF 2013. FORM 990, PART VI, SECTION B, LINE 11 THE REVIEW AND APPROVAL OF THE FORM 990 IS DELEGATED TO THE EXECUTIVE COMMITTEE OF THE BOARD. THE FORM 990 IS THEN SUBMITTED TO THE FULL VOTING BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES TO SIGN NEW CONFLICT OF INTEREST STATEMENTS. FORM 990, PART VI, SECTION B, LINE 15 SALARIES FOR TOP MANAGEMENT ARE DETERMINED AND REVIEWED BY THE HOSPITAL'S BOARD OF DIRECTORS AND COMPENSATION COMMITTEE. THE FOUNDATION DOES NOT PAY WAGES, IT REIMBURSES THE HOSPITAL FOR APPLICABLE EMPLOYEE COSTS. FORM 990, PART VI, SECTION C, LINE 18 UPON REQUEST DURING BUSINESS HOURS, MONDAY THROUGH FRIDAY, 8:00 AM - 5:00 PM FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST DURING BUSINESS HOURS, MONDAY THROUGH FRIDAY, 8:00 AM - 5:00 PM FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR.