2014-05-15T18:48:19-05:00 2013-06-30 942222122 MATSON AND ISOM 3013 CERES AVENUE CHICO CA 95973 990 2012-07-01 200752156 INCLINE VILLAGE COMMUNITY HOSPITAL FOUNDATION INCL 7758334100 880 ALDER AVENUE INCLINE VILLAGE NV 89451 MARTHA SIMON 5305826329 2014-05-15 1 BILL PETERSON P00273088 5308916474 2014-05-15 2012 2015-11-30 17:44:51Z MARTHA SIMON 880 ALDER AVENUE INCLINE VILLAGE NV 89451 486323 0 X WWW.TFHD.COM/IVCHFOUNDATION.ASP X 2004 NV TO ASSIST THE INCLINE VILLAGE COMMUNITY HOSPITAL IN DELIVERING OPTIMAL HEALTH CARE SERVICES 23 21 0 21 0 0 498832 485587 0 0 1319 736 0 0 500151 486323 188200 452614 0 0 120486 23145 55290 55290 62234 43310 82450 407286 613499 92865 -127176 836377 709201 0 0 836377 709201 TO ASSIST THE INCLINE VILLAGE COMMUNITY HOSPITAL IN DELIVERING OPTIMAL HEALTH CARE SERVICES, IMPROVE COMMUNITY AWARENESS, AND INVOLVE COMMUNITY RESIDENTS IN DEVELOPING A LONG-TERM VISION FOR HEALTH CARE 0 0 420802 420802 THE FOUNDATION SUPPORTS AND ENHANCES THE INCLINE VILLAGE COMMUNITY HOSPITAL PROGRAMS, AN AFFILIATE OF THE TAHOE FOREST HOSPITAL DISTRICT. THIS INCLUDES HELPING WITH REMODELING PROJECTS AT INCLINE VILLAGE COMMUNITY HOSPITAL. 38756 31812 THE FOUNDATION PROVIDES SUPPORT FOR VARIOUS OTHER EXPENSES TO ASSIST THE INCLINE VILLAGE COMMUNITY HOSPITAL IN DELIVERING OPTIMAL HEALTH CARE SERVICES IN NORTH LAKE TAHOE. 459558 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 X 23 21 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X TAHOE FOREST HOSPITAL DISTRICT 5305823489 10121 PINE AVENUE TRUCKEE CA 96160 GARY FINCH 2.00 X 0 0 0 LYNN GILLETTE 2.00 X 0 0 0 STUART JED 2.00 X 0 0 0 SHANE JOHNSON MD 2.00 X 0 0 0 ROBERT KENNEDY 2.00 X 0 0 0 DONALD MASON MD 2.00 X 0 0 0 FRED PRITCHARD 2.00 X 0 0 0 JONATHAN SMITH OD 2.00 X 0 0 0 MANUEL SYLVESTER 2.00 X 0 0 0 CEASAR NAPLES 2.00 X 0 0 0 CRAIG BIDDLE 2.00 X 0 0 0 MICHELLE SCHMITTER 2.00 X 0 0 0 ROGER KAHN 2.00 X 0 0 0 JUDY NEWLAND RN 2.00 40.00 X 0 160266 0 ROBERT SCHAPPER 2.00 40.00 X 0 518590 0 NAN HEALY 2.00 X 0 0 0 HOLLY LEFKOWITZ 2.00 X 0 0 0 DAVID COLLINS 2.00 X X 0 0 0 MARGO LALCHANDANI 2.00 X X 0 0 0 RALPH KUHN MD 2.00 X X 0 0 0 WARREN KOCMOND 2.00 X X 0 0 0 MARY ANSARI 2.00 X X 0 0 0 GERRY EICK 2.00 X X 0 0 0 0 678856 0 0 0 1 0 0 158102 327485 163782 485587 736 736 486323 0 0 736 452614 452614 1059 318 423 318 7073 2122 2829 2122 13585 4076 5433 4076 1428 428 572 428 15470 15470 55290 55290 50085 50085 7624 7624 3267 3267 MISCELLANEOUS 4120 4120 REPAIRS AND MAINTENANCE 1884 1884 613499 459558 91707 62234 55053 29785 621766 665729 159558 13687 836377 709201 0 0 X 3690 3690 832687 705511 836377 709201 836377 709201 -127176 0 X 0 1 X 1 0 X X X 0 0 0 TAHOE FOREST HOSPITAL DISTRICT 946004062 3 1 1 1 452614 1 452614 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X 486323 0 486323 0 486323 613499 0 613499 0 613499 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE FOUNDATION ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES AND HOW AN UNCERTAIN TAX POSITION IS RECOGNIZED IN FINANCIAL STATEMENTS. THE FOUNDATION ANALYZES TAX POSITIONS TAKEN IN PREVIOUSLY FILED RETURNS AND TAX POSITIONS EXPECTED TO BE TAKEN IN FUTURE RETURNS. BASED ON THIS ANALYSIS, A LIABILITY IS RECORDED IF UNCERTAIN TAX BENEFITS HAVE BEEN RECEIVED. THE FOUNDATION'S PRACTICE IS TO RECOGNIZE INTEREST AND PENALTIES, IF ANY, RELATED TO UNCERTAIN TAX POSITIONS IN THE TAX EXPENSE. THERE WERE NO UNCERTAIN TAX POSITIONS IDENTIFIED OR RELATED INTEREST AND PENALTIES RECORDED AS OF JUNE 30, 2013, AND THE FOUNDATION DOES NOT EXPECT THIS TO CHANGE SIGNIFICANTLY OVER THE NEXT 12 MONTHS. X X 1 MICHELLE SCHMITTER 705 W MUSSER STREET CARSON CITY NV 89703 CAPITAL CAMPAIGN MANAGEMENT 0 0 55290 -55290 55290 -55290 NV EXPLANATION OF FUNDRAISING PAYMENTS SCHEDULE G, PART I, LINE 2B, COLUMN (V) MICHELLE SCHMITTER IS AN INDEPENDENT CONTRACTOR WHO PERFORMS FUNDRAISING AND OTHER SERVICES FOR THE FOUNDATION. APPROXIMATELY, 70% OF HER TIME IS SPENT ON FUNDRAISING. THE AMOUNT REPORTED IS 100% OF HER CONTRACTED FEE. 1 TAHOE FOREST HOSPITAL DISTRICT PO BOX 759 TRUCKEE CA 96160 946004062 115(1) 452614 TO SUPPORT AND ENHANCE HEALTHCARE IN THE DISTRICT'S SERVICE AREA. 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE INCLINE VILLAGE COMMUNITY HOSPITAL FOUNDATION SELECTS VARIOUS ACTIVITIES OF THE TAHOE FOREST HOSPITAL DISTRICT TO SUPPORT. THEREFORE, MONITORING IS NOT REQUIRED. X 0 0 0 0 0 0 0 0 0 JUDY NEWLAND RN 0 151152 0 9114 0 0 0 0 0 0 0 160266 0 0 ROBERT SCHAPPER 0 410213 0 108377 0 0 0 0 0 0 0 518590 0 0 X EXPENSES-TFHD 1 158102 ACTUAL AMOUNT PAID 0 0 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTIONS: PART I, COLUMN (B): THE FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTORS. THE FOUNDATION RECEIVED IN-KIND SUPPORT FROM THE TAHOE FOREST HOSPITAL DISTRICT. THE VALUE OF THIS SUPPORT IS MEASURED BY ACTUAL EXPENSES PAID ON THE FOUNDATION'S BEHALF. FORM 990, PART V, LINE 1A, LINE 2A: THE TAHOE FOREST HOSPITAL DISTRICT FILES AND REPORTS ALL W-2S, 1099S, AND PAYROLL COMPLIANCE FOR THE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS DISTRIBUTED TO THE GOVERNING BODY FOR REVIEW. FORM 990, PART VI, SECTION C, LINE 19 ANY INTERESTED PARTIES WHO DESIRE TO OBTAIN A COPY OF ANY OF THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS CAN CONTACT THE OFFICE AND REQUEST A PAPER COPY. ANY DOCUMENTS REQUESTED ARE PRINTED AND HANDED TO THE INTERESTED PARTIES AT THE OFFICE. TAHOE FOREST HOSPITAL DISTRICT PO BOX 759 TRUCKEE CA 96160 946004062 HEALTHCARE CA 115(1) N/A N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0