2014-08-14T18:17:48-05:00 2014-03-31 910189318 MOSS ADAMS LLP 402 E YAKIMA AVENUE STE 110 YAKIMA WA 98901 990 2013-04-01 237297657 COLUMBIA VALLEY COMMUNITY HEALTH COLU 5096644575 600 ORONDO AVE SUITE 1 WENATCHEE WA 98801 PATRICK BUCKNUM CEO 5096644575 2014-08-07 1 CHRISTOPHER E RIVARD P00022321 5092487750 2013 2015-11-30 17:44:51Z PATRICK BUCKNUM 600 ORONDO AVE SUITE 1 WENATCHEE WA 98801 24015339 0 X WWW.CVCH.ORG X 1972 WA THE MISSION OF COLUMBIA VALLEY COMMUNITY HEALTH IS TO PROVIDE ACCESS TO IMPROVED HEALTH AND WELLNESS WITH COMPASSION AND RESPECT FOR ALL. 11 11 302 11 0 0 4878203 4730954 17172221 19144417 48477 -1480 4053 3880 22102954 23877771 38133 46341 0 0 14816601 16046179 9260 13006 145205 5418955 6106500 20282949 22212026 1820005 1665745 26860293 28078744 10580012 10160379 16280281 17918365 THE MISSION OF COLUMBIA VALLEY COMMUNITY HEALTH IS TO PROVIDE ACCESS TO IMPROVED HEALTH AND WELLNESS WITH COMPASSION AND RESPECT FOR ALL. 0 0 16017977 46341 17502736 PROVIDE COMPREHENSIVE MEDICAL, MENTAL HEALTH AND DENTAL CARE TO SEASONAL AND MIGRANT FARM WORKERS AND THE MEDICALLY UNDERSERVED POPULATION OF THE AREA. THIS INCLUDES GENERAL MEDICINE, DENTAL, PRENATAL, AND OBSTETRIC CARE ON AN OUTPATIENT BASIS. AN ON SITE PHARMACY PROVIDES PATIENT PRESCRIPTION SERVICES TO ENSURE PATIENTS OBTAIN NEEDED MEDICATIONS. 753441 753441 INTERMEDIARY FOR PROVIDING SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN. INCLUDES NUTRITION EDUCATION, REFERRAL FOR HEALTH CARE FOR LOW-INCOME WOMEN AS WELL AS INFANTS AND CHILDREN UNDER AGE FIVE. PROGRAM FOCUS IS FOR BOTH INFANTS AND CHILDREN IN THE CRITICAL PERIODS OF GROWTH AND DEVELOPMENT UNDER AGE FIVE. 16771418 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 61 0 1 302 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X KRISTAL ALBRECHT 5096626000 600 ORONDO AVE SUITE 1 WENATCHEE WA 98801 JOANNE HILL PRESIDENT 2.00 X X 0 0 0 JOAN ALWAYS VICE PRESIDENT 2.00 X X 0 0 0 RICHARD BLIGGENSTORFER TREASURER UNTIL 02/25/2014 2.00 X X 0 0 0 RICH WATSON TREASURER 2.00 X X 0 0 0 MARGARITO RODRIGUEZ SECRETARY 2.00 X X 0 0 0 IRENE BAZAN BOARD MEMBER 2.00 X 0 0 0 DOUGLAS HEAD BOARD MEMBER 2.00 X 0 0 0 MARY HUNT BOARD MEMBER 2.00 X 0 0 0 LOLY LARSON BOARD MEMBER 2.00 X 0 0 0 BERTHA SANCHEZ BOARD MEMBER 2.00 X 0 0 0 ROBERT SCOTT JR BOARD MEMBER 2.00 X 0 0 0 KRISTINA STEPPER BOARD MEMBER 2.00 X 0 0 0 JUAN VALLE BOARD MEMBER 2.00 X 0 0 0 PATRICK BUCKNUM CEO 40.00 X 242041 0 31872 CAROL DIEDE COO 40.00 X 147431 0 29130 KRISTAL ALBRECHT CFO 40.00 X 158185 0 16283 MALCOLM BUTLER MEDICAL OFFICER 40.00 X 278889 0 35585 BRUCE V WILCOX DENTAL OFFICER 40.00 X 217048 0 17383 KENNETH SHERMER PHYSICIAN 40.00 X 211618 0 32499 JEFFERY HINCKLEY DENTIST 40.00 X 189556 0 31512 LORINDA PARKS PHYSICIAN 40.00 X 183589 0 23804 PATRICK MCLAUGHLIN PHYSICIAN 40.00 X 182221 0 31219 BRENDA BAUMEISTER PHYSICIAN 40.00 X 175877 0 30886 1986455 0 280173 23 0 1 0 ALDRICH & ASSOCIATES 810 - 240TH ST SE BOTHELL WA 98021 CONSTRUCTION 1095208 GL WHITE CONSTRUCTION INC 205 HIDDEN MEADOW DRIVE WENATCHEE WA 98801 CONSTRUCTION 541662 NEXTGEN HEALTHCARE PO BOX 511449 LOS ANGELES CA 900518004 SOFTWARE MAINTENANCE 170387 STUDER GROUP 913 GULF BREEZE PARKWAY SUITE 6 GULF BREEZE FL 32561 LEADERSHIP TRAINING 143402 KDF ARCHITECTURE 1310 NORTH 16TH AVE YAKIMA WA 989021354 ARCHITECTURE FEES 118410 5 4680818 50136 2800 4730954 NET PATIENT SERVICE REVENUE 621400 13269389 13269389 ENHANCEMENT REVENUE 621400 3109184 3109184 CAPITATION REVENUE 621400 1211738 1211738 MEDICAL REIMBURSEMENT SETTLEMENT 621400 888240 888240 CONTRACT SERVICES 621400 429106 429106 236760 236760 19144417 64750 64750 75218 71338 3880 3880 3880 66230 -66230 -66230 -66230 23877771 18256177 0 890640 46341 46341 1176754 297895 878859 11610952 9643611 1915648 51693 563102 476266 84510 2326 1716691 1456161 250680 9850 978680 765774 208913 3993 34922 34922 40885 40885 13006 13006 405284 198916 206368 121359 32255 24803 64301 359066 183355 175711 607388 300568 306820 504045 372260 131785 26086 21263 4787 36 394117 205466 188651 233996 170623 63373 1277370 886830 390540 126270 63565 62705 PATIENT & PHARMACEUTICA 1174567 1174567 OTHER 360451 222865 137586 STAFF RECRUITING 118905 106144 12761 B&O TAX 73484 11409 62075 248305 135284 113021 22212026 16771418 5295403 145205 2413780 2007314 7844720 7916164 467899 205742 1019363 1519485 161810 135539 137490 153009 24317888 8176397 14815231 16141491 26860293 28078744 1941930 1927197 6670494 6254618 1967588 1978564 10580012 10160379 X 16239533 17886862 40748 31503 16280281 17918365 26860293 28078744 1665745 -27661 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1892561 1892561 17170337 4864156 12306181 974317 728654 245663 4151200 2518877 1632323 129473 64710 64763 16141491 OTHER LIABILITIES 1978564 1978564 X 23921448 -27661 71338 43677 23877771 0 23877771 22283364 71338 71338 22212026 0 22212026 PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. EFFECTIVE JANUARY 1, 2009, THE ORGANIZATION ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. AS OF MARCH 31, 2014 AND 2013, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AUTHORITIES FOR FISCAL YEARS 2010 AND LATER. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 71,338. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 71,338. 1 PAYMENT OF MEDICAL BILLS FOR INDIVIDUALS WHO NEED ASSISTANCE. 350 46341 PART I, LINE 2: PER THE CLIENTS FUNDING POLICY TO BE CONSIDERED FOR THE HELPING HANDS FUND, THE PATIENT'S HOUSEHOLD INCOME SHOULD NOT EXCEED TWO HUNDRED PERCENT (200%) OF THE POVERTY GUIDELINES. AS THE HELPING HANDS FUND IS THE PAYER OF LAST RESORT, ALL OUTSIDE FUNDING SOURCES (INCLUDING, BUT NOT LIMITED TO, GRANTS, GOVERNMENT ASSISTANCE, PRIVATE FOUNDATIONS, AND PATIENT ASSISTANCE PROGRAMS) WILL BE REVIEWED AND UTILIZED BEFORE DETERMINING HELPING HANDS FUND ELIGIBILITY. THE COMMITTEE WILL REVIEW AND VOTE ON ELIGIBLE APPLICATIONS ON A CASE BY CASE BASIS. FOR APPLICATIONS REFERRED BY PROVIDERS, AN URGENT NEED REQUEST FORM WILL BE COMPLETED BY THE PROVIDER AND SIGNED BY A COMMITTEE MEMBER. IF THE ESTIMATED COST IS BETWEEN $200 AND $299, A MANAGEMENT TEAM MEMBER'S SIGNATURE IS ALSO REQUIRED. URGENT NEED REQUEST EQUAL TO OR GREATER THAN $300 MUST BE APPROVED BY THE COMMITTEE VIA EMAIL VOTE BEFORE FUNDING CAN OCCUR. NON URGENT NEED APPLICATIONS WILL BE REVIEWED AT MONTHLY COMMITTEE MEETINGS. IN ADDITION TO THE APPLICATION, FURTHER INFORMATION MAY BE OBTAINED BY THE COMMITTEE TO AID WITH ELIGIBILITY DETERMINATION. IF THE NEED DICTATES, THE COMMITTEE MAY CONSIDER AN APPLICATION PRIOR TO THE MONTHLY MEETING. APPLICANTS REQUESTING RELIEF ON CVCH ACCOUNTS WILL GENERALLY RECEIVE A DECISION AND NOTIFICATION BY A COMMITTEE REPRESENTATIVE WITHIN 60 DAYS OF COMMITTEE REVIEW. IN MAKING A DETERMINATION OF ELIGIBILITY, THE COMMITTEE MAY CONSIDER WHETHER THE PATIENT HAS NEGOTIATED IN GOOD FAITH WITH THE CVCH BILLING DEPARTMENT, KEPT PATIENT SERVICE APPOINTMENTS, MADE PAYMENTS, AND/OR DEMONSTRATED INTEREST IN CLEARING HIS/HER ACCOUNT. X 1 1 X X X X X X 0 0 0 0 0 0 0 0 0 PATRICK BUCKNUM CEO 200114 0 21923 0 20004 0 9349 0 22523 0 273913 0 0 0 CAROL DIEDE COO 129217 0 18195 0 19 0 6887 0 22243 0 176561 0 0 0 KRISTAL ALBRECHT CFO 129196 0 22772 0 6217 0 7350 0 8933 0 174468 0 0 0 MALCOLM BUTLER MEDICAL OFFICER 252753 0 26093 0 43 0 13028 0 22557 0 314474 0 0 0 BRUCE V WILCOX DENTAL OFFICER 203526 0 13500 0 22 0 4701 0 12682 0 234431 0 0 0 KENNETH SHERMER PHYSICIAN 150396 0 56474 0 4748 0 9942 0 22557 0 244117 0 0 0 JEFFERY HINCKLEY DENTIST 153444 0 31029 0 5083 0 8988 0 22524 0 221068 0 0 0 LORINDA PARKS PHYSICIAN 132766 0 50821 0 2 0 8271 0 15533 0 207393 0 0 0 PATRICK MCLAUGHLIN PHYSICIAN 130589 0 51627 0 5 0 8788 0 22431 0 213440 0 0 0 BRENDA BAUMEISTER PHYSICIAN 175856 0 0 0 21 0 8360 0 22526 0 206763 0 0 0 PART I, LINE 1A HOUSING ALLOWANCES ARE CONSIDERED TO BE TAXABLE EARNINGS IN ACCORDANCE WITH PAYROLL LAWS. THE INTERNAL COMPENSATION POLICY GOVERNS COMPENSATION FOR AGENCY POSITIONS. A WA HEALTHCARE FACILITIES 911108929 2010-12-16 7200000 REMODELING & RENOVATION 0 0 0 A 3439489 7200000 29142 58202 4231702 2012 1 0 0 1 A 0 1 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED EITHER BY THE BOARD OR FINANCE COMMITTEE PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE IS UPDATED ANNUALLY FOR BOARD MEMBERS. FOR STAFF MEMBERS, THE PROCESS FOR EVALUATING CONFLICT OF INTEREST ISSUES IS OUTLINED IN POLICY ADM-CC-02, EMPLOYEE CONFLICT OF INTEREST. EMPLOYEES SUBMIT THEIR REQUEST FOR REVIEW OF OUTSIDE EMPLOYMENT TO THE HUMAN RESOURCES (HR) DIRECTOR, GENERALLY VIA EMAIL. THE HR DIRECTOR REVIEWS THE REQUEST WITH THE EMPLOYEE'S IMMEDIATE SUPERVISOR AND APPROPRIATE MANAGER AND/OR DIRECTOR UP TO THE MANAGEMENT TEAM MEMBER. IF APPROVED VIA THIS CHAIN OF COMMAND, THE REQUEST IS SUBMITTED TO THE CEO FOR FINAL APPROVAL. A WRITTEN RESPONSE IS PROVIDED TO THE EMPLOYEE OUTLINING ANY GUIDELINES. IN THE CASE OF HIGHLY SENSITIVE CONFLICT OF INTEREST ISSUES, EMPLOYEES MAY CONSULT WITH THE CEO DIRECTLY. FORM 990, PART VI, SECTION B, LINE 15 DATA PULLED FROM: 1) NACHC HEALTH CENTER COMPENSATION & BENEFITS REPORT, 2) MILLIMAN NORTHWEST HEALTH CARE INDUSTRY SALARY SURVEY, AND 3) INDEPENDENT SALARY SURVEYS CONDUCTED THROUGH HR. INFORMATION IS REVIEWED BY THE CEO, WHO MAKES RECOMMENDATIONS TO THE BOARD FOR FINAL APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST, BUT NOT PUBLISHED EXTERNALLY. GOVERNING DOCUMENTS ARE NOT SHARED. AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, AND THE FORM 990 IS AVAILABLE ON GUIDESTAR. FORM 990, PART VIII, LINE 2C: NO CHANGE FROM PRIOR YEAR.