2014-07-30T17:43:09-05:00 2013-12-31 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2013-01-01 911400684 PERSONAL SERVICE PROVIDERS PERS 3605381540 720 LEVEE STREET HOQUIAM WA 98550 TERRY FULTZ PRESIDENT 3605381540 2014-07-24 1 DANIEL M FREIN P00856532 4252506100 2013 2015-11-30 17:44:51Z X JOEL STEPHENS 201 7TH STREET HOQUIAM WA 98550 2396283 0 X WWW.PSPROVIDERS.ORG X 1987 WA TO PROVIDE HOME CARE TO INDIVIDUALS RECOVERING AND IN NEED OF LONG-TERM CARE. 6 6 177 6 0 0 0 0 2528510 2379963 18887 13304 59 222 2547456 2393489 0 0 0 0 2271585 2121698 0 0 0 176247 369048 2447832 2490746 99624 -97257 1370619 1266674 252478 249265 1118141 1017409 TO PROVIDE HOME CARE (DOMESTIC, PERSONAL AND RESPITE) TO INDIVIDUALS RECOVERING FROM ILLNESS OR INJURY AND IN NEED OF LONG-TERM CARE. 0 0 2053458 0 2353688 HOME CARE AND HEALTH MAINTENANCE VISITS - DURING 2013, THE ORGANIZATION PROVIDED SERVICE TO 294 CLIENTS. 62729 0 26275 CAREGIVER TRAINING - TO PROVIDE INSTRUCTION TO IN-HOME CAREGIVERS. 2116187 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 5 0 1 177 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 1 0 0 1 0 0 1 1 0 0 0 1 1 1 1 0 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 DELILA THORP MEMBER 1.00 X 0 0 0 JIM WREY MEMBER 1.00 X 0 0 0 JOEL STEPHENS CEO 10.00 X 0 0 0 CRAIG GOODWIN 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 112912 1 HOME CARE 812900 2353688 2353688 CAREGIVER TRAINING 611600 26275 26275 2379963 16098 16098 2794 -2794 -2794 -2794 MISCELLANEOUS INCOME 900099 222 222 222 2393489 2379963 0 13526 1582304 1344357 237947 380979 323687 57292 158415 134593 23822 112912 95932 16980 7257 6166 1091 31948 27144 4804 6550 5565 985 6682 5677 1005 71092 60401 10691 30366 25800 4566 28431 24156 4275 16216 13777 2439 18071 15353 2718 BAD DEBT 24987 21229 3758 EQUIP REPAIRS & MAINT 7309 6210 1099 MISCELLANEOUS 4915 4176 739 DUES AND SUBSCRIPTIONS 2312 1964 348 2490746 2116187 374559 0 50 278881 429110 244632 281576 20326 2631 120379 49274 68984 71105 607517 632481 1370619 1266674 252478 249265 252478 249265 X 1118141 1017409 1118141 1017409 1370619 1266674 -97257 -3475 0 X 0 1 X 1 0 X 5000 5000 2588796 2526224 2532587 2528510 2379963 12556080 2588796 2526224 2537587 2528510 2379963 12561080 0 0 0 12561080 23202 21645 20414 18887 16098 100246 23202 21645 20414 18887 16098 100246 383 13 54 59 222 731 2612381 2547882 2558055 2547456 2396283 12662057 0.99200 0.99150 0.00790 0.00970 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS 103866 49274 54592 16513 16513 71105 X 2392808 -3475 -3475 2396283 -2794 -2794 2393489 2490746 0 2490746 0 2490746 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 2010 ARE CLOSED TO EXAMINATION. THE ORGANIZATION HAS RECOGNIZED NO INTEREST OR PENALTIES RELATED TO TAXES IN THE ACCOMPANYING FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT -2,794. 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 6 MEMBERSHIP IN THE ORGANIZATION IS OPEN TO ANY MEMBER OF THE PUBLIC WHO AGREES TO PROMOTE THE PURPOSES 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 EITHER THE BOARD PRESIDENT OR BOARD TREASURER. 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.