2014-11-14T16:12:33-06:00 2013-12-31 930418710 DELAP LLP 5885 MEADOWS ROAD NO 200 LAKE OSWEGO OR 97035 990 2013-01-01 930854433 MID-COLUMBIA HEALTH FOUNDATION MID- 5412961111 1700 E 19TH STREET THE DALLES OR 97058 ROBERT BAILEY TREASURER 5412961111 2014-11-13 1 MARK E EKLUND CPA P00156145 5036974118 2013 2015-11-30 17:44:51Z CYNTHIA KORTGE 1700 E 19TH STREET THE DALLES OR 97058 1652472 0 X WWW.MCMC.NET X 1983 OR WORK TOGETHER WITH AND PROVIDE FINANCIAL SUPPORT TO MID-COLUMBIA MEDICAL CENTER IN ORDER TO PROVIDE ACCESS TO QUALITY HEALTHCARE FOR OUR COMMUNITY. 15 10 5 86 0 0 762248 822899 0 0 -18002 48024 101620 101127 845866 972050 399462 551393 0 0 293513 301349 0 0 0 186246 226856 879221 1079598 -33355 -107548 3265138 3375144 309086 200078 2956052 3175066 WORK TOGETHER WITH AND PROVIDE FINANCIAL SUPPORT TO MID-COLUMBIA MEDICAL CENTER IN ORDER TO PROVIDE ACCESS TO QUALITY HEALTHCARE FOR OUR COMMUNITY. 0 0 1038165 551393 52384 THE PRIMARY PURPOSE OF THE FOUNDATION IS TO PROVIDE FUNDRAISING FOR THE MID-COLUMBIA MEDICAL CENTER (ID# 93-0386936) AS WELL AS GRANTS / SCHOLARSHIPS TO THE GENERAL PUBLIC. 1038165 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 1 0 0 1 1 0 0 0 0 0 1 0 0 0 1 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 10 0 0 0 0 1 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 OR X MID-COLUMBIA MEDICAL CENTER 5412961111 1700 E 19TH STREET THE DALLES OR 97058 NAOMI GRIMSLEY DIRECTOR 1.00 X 0 0 0 DR PAULA LEE-VALKOV DIRECTOR 1.00 X 0 12397 0 ROBERT BAILEY TREASURER 1.00 X 0 0 0 CYNTHIA KORTGE CHAIR 1.00 X 0 0 0 PHIL KASER SECRETARY 1.00 X 0 0 0 SHAWN CARROLL DIRECTOR 1.00 X 0 0 0 PAM CLAUSEN DIRECTOR 1.00 X 0 0 0 DR FRANK TODA DIRECTOR 1.00 X 0 0 0 ROB CARNAHAN DIRECTOR 1.00 X 0 0 0 JASON COREY VICE-CHAIR 1.00 X 0 0 0 LINDA TRAUTZ DIRECTOR 50.00 X 0 64574 13428 DUANE FRANCIS DIRECTOR 50.00 X 0 604132 147703 DAVE GILDERSLEEVE DIRECTOR 1.00 X 0 0 0 BRIAN LAUTERBACH DIRECTOR 1.00 X 0 0 0 KRISTI MCCAVIC DIRECTOR 1.00 X 0 0 0 0 681103 161131 0 0 1 0 0 492275 330624 822899 43183 43183 650517 645676 4841 4841 4841 87139 34746 52393 52393 COFFEE CART FUND 722210 48734 48734 48734 972050 0 0 149151 460248 460248 91145 91145 269502 269502 12069 12069 340 340 19438 19438 144342 144342 3000 3000 8157 8157 9889 9889 13311 13311 21633 21633 1925 1925 313 313 FOOD PURCHASES 16343 16343 SUPPLIES 6523 6523 MISCELLANEOUS EXPENSES 1420 798 622 1079598 1038165 41433 0 331385 249033 729286 715134 22642 35272 42559 0 2439 3846 4227 40811 38292 2832 2519 1850938 2028512 281650 338008 3265138 3375144 5688 9572 136121 167277 190506 309086 200078 X 1711492 2078568 879926 727746 364634 368752 2956052 3175066 3265138 3375144 X -107548 293433 33129 X X 0 1 X 1 0 X 888476 590612 484772 300662 335624 2600146 888476 590612 484772 300662 335624 2600146 523582 2076564 6541 12181 70514 -18002 48024 119258 2719404 453135 0.76360 0.95580 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1244560 317585 50467 516114 1096498 1260381 281874 31231 328926 1244560 1278290 413749 6603 438261 1260381 357664 32657 402 23127 367596 358543 13818 890 15587 357664 0.53530 0.33630 0.12840 0 0 40811 38292 2519 2519 CHARITABLE REMAINDER TRUST 338008 338008 ANNUITIES - CHARITABLE REMAINDER TRUST 190506 190506 X PART V, LINE 4: FOR DESCRIPTION OF INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS, PLEASE SEE THE ATTACHED LIST OF FUNDS. PART X, LINE 2: INCOME TAX POSITIONS THAT MEET A "MORE-LIKELY-THAN-NOT" RECOGNITION THRESHOLD ARE MEASURED AT THE LARGEST AMOUNT OF INCOME TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH INCOME TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED INCOME TAX BENEFITS IN THE REGIONS COMBINED BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS WOULD BE CLASSIFIED AS INCOME TAXES IN THE STATEMENTS OF OPERATIONS. THERE WERE NO UNRECOGNIZED INCOME TAX BENEFITS, NOR ANY INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS, ACCRUED OR EXPENSED AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012. FESTIVAL OF TREES 36892 36892 1904 7458 TOURNAMENT OF TRADTION GOLF BENEFIT 33743 33743 4285 7877 4 16504 16504 2343 10879 87139 87139 8532 26214 34746 52393 1 HAVEN FROM DOMESTIC VIOLENCE PO BOX 576 THE DALLES OR 97058 930798451 501(C)(3) 5000 SCHOLARSHIPS LA CLINICA DEL CARINO FAMILY HEALTH CARE CENTER INC 849 PACIFIC AVENUE HOOD RIVER OR 97031 930910794 501(C)(3) 47508 GENERAL OPERATING EXPENSES MID-COLUMBIA MEDICAL CENTER 1700 E 19TH STREET THE DALLES OR 97058 930386936 501(C)(3) 113787 GENERAL OPERATING EXPENSES SOUTH GILLIAM COUNTY HEALTH DISTRICT 422 N MAIN STREET CONDON OR 97823 184538 GENERAL OPERATING EXPENSES MASTER SGT. MARK W. COLEMAN MEMORIAL SCHOLARSHIP 1 2094 EVELYN KASER NURSING SCHOLARSHIP 3 750 LORNA & JOSEPH HALLIDAY FAMILY NURSING SCHOLARSHIP 1 500 MCMC BOARD OF TRUSTEES FUTURE HEALTH PROFESSIONALS 1 2000 NON-TRADITIONAL NURSING SCHOLARSHIP 7 5010 MCMC DEPENDENT SCHOLARSHIP 7 3747 MCMC EMPLOYEE SCHOLARSHIP 6 5585 RANDY ROOD MEMORIAL SCHOLARSHIP 33 71459 PART I, LINE 2: AN INTERNAL GRANT MANAGER TRACKS ALL EXPENSES RELATED TO THE GRANT AND REPORTS THEM PERIODICALLY IN A WRITTEN REPORT TO THE GRANTOR. SOME GRANTS CONTAIN LINE-ITEM BUDGETS WHICH ALSO MUST BE MET AND ARE SUBJECT TO AUDIT BY THE GRANTOR. X X X X X 0 1 0 0 0 0 0 0 0 DUANE FRANCIS DIRECTOR 0 568607 0 35525 0 0 0 114705 0 32998 0 751835 0 0 PART I, LINE 4B DUANE FRANCIS - $101,955 MID-COLUMBIA MEDICAL CENTER RELATED TO MID-COLUMBIA MEDICAL CENTER BY COMMON BOARD OPERATING EXPENSES X 2439 0 0 0 2439 PATRICK GRIMSLEY SPOUSE OF CURRENT DIRECTOR NAOMI GRIMSLEY 332147 CONTRACTED ER PHYSICIAN AND MEDICAL DIRECTOR 0 DESIGN STRUCTURES LLC ENTITY IN WHICH CURRENT DIRECTOR DAVE GILDERSLEEVE SERVES AS AN OFFICER 92856 VARIOUS CONSTRUCTION PROJECTS 0 FORM 990, PART VI, SECTION A, LINE 6 HEALTHCARE FOR THE MID-COLUMBIA REGION IS THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11 NO REVIEW OF FORM 990 IS DONE BY THE BOARD FORM 990, PART VI, SECTION B, LINE 12C WE ANNUALLY REQUIRE DIRECTORS,OFFICERS AND EXECUTIVE MANAGEMENT TEAM TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. IF A CONFLICT WAS DISCOVERED FOR A PERSON WITH A SIGNED DISCLOSURE STATEMENT, THEY WOULD BE SUBJECT TO CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION FOR VIOLATION OF OUR POLICY. IF THEY SELF-DISCLOSED A POTENTIAL CONFLICT OF INTEREST ON THE FORM, WE WOULD GATHER INFORMATION ON THE ISSUE AND MAKE A DETERMINATION ON HOW SEVERE THE CONFLICT IS AND WHETHER OR NOT THE EMPLOYEE OR DIRECTOR COULD REMAIN AN EMPLOYEE. THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE CEO IS COMPENSATED BY HEALTH CARE FOR THE MID-COLUMBIA REGION, A RELATED ORGANIZATION. THE BOARD OF HEALTH CARE FOR THE MID-COLUMBIA REGION ENGAGES A PROFESSIONAL FIRM TO DO A REGIONAL AND NATIONAL SURVEY, ALONG WITH A COMPARISON OF ORGANIZATION COMPLEXITY AND STRUCTURE, AND THEN RECOMMENDS A SALARY AND BENEFITS RANGE TO THE BOARD. THIS IS ALL DONE CONFIDENTIALLY WITHOUT CEO PARTICIPATION. THE CEO THEN NEGOTIATES WITH THE BOARD, WHICH COMPARES THE COMPENSATION DISCUSSED WITH THE ANALYSIS PREVIOUSLY DESCRIBED AND VOTES ON AND APPROVES A NEW CONTRACT IN EXECUTIVE SESSION WITHOUT CEO PRESENCE OR PARTICIPATION IN THE VOTE. COMPENSATION OF THE ORGANIZATIONS OFFICERS OR KEY EMPLOYEES IS DETERMINED BY A SURVEY OF MARKET RATES FOR SIMILAR POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL INFORMATION AVAILABLE TO THE PUBLIC AT THE CHARITABLE ACTIVITES DIVISION OF THE OREGON DEPARTMENT OF JUSTICE. FORM 990, PART XI, LINE 9: CHANGE IN THE FV OF CHARITABLE REMAINDER TRUST 33,129. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THEIR FINANCIAL STATEMENTS & SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. HEALTH CARE FOR THE MID-COLUMBIA REGION 1700 E 19TH STREET THE DALLES OR 97058 930847905 HEALTH SERVICES OR 501(C)(3) 3 HEALTHCARE FOR THE MID-COLUMBIA REGION 0 MID-COLUMBIA MEDICAL CENTER 1700 E 19TH STREET THE DALLES OR 97058 930386936 ACUTE HOSPITAL CARE OR 501(C)(3) 3 HEALTHCARE FOR THE MID-COLUMBIA REGION 0 DRY HOLLOW INC 1700 E 19TH STREET THE DALLES OR 97058 930631350 RENTAL BUILDING OR HEALTHCARE FOR THE MID-COLUMBIA REGION C 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 MID-COLUMBIA MEDICAL CENTER B 113787 GRANTS PAID MID-COLUMBIA MEDICAL CENTER C 492275 GRANTS RECEIVED MID-COLUMBIA MEDICAL CENTER D 2439 LOANS TO RELATED PARTY MID-COLUMBIA MEDICAL CENTER O 301350 EMPLOYEE GROSS PAY