2014-05-15T18:48:08-05:00 2013-06-30 942222122 MATSON AND ISOM 3013 CERES AVENUE CHICO CA 95973 990 2012-07-01 943047869 TAHOE FOREST HEALTH SYSTEM FOUNDATION TAHO 5305826329 PO BOX 2508 TRUCKEE CA 961602508 MARTHA SIMON 5305826329 2014-05-14 1 BILL PETERSON P00273088 5308916474 2014-05-14 2012 2015-11-30 17:44:51Z MARTHA SIMON PO BOX 2508 TRUCKEE CA 961602508 1269024 0 X WWW.TFHD.COM/TAHOEFORESTFOUNDATION.ASP X 1987 CA TO CREATE A CULTURE OF COLLABORATION THAT RESULTS IN EXCELLENCE IN COMMUNITY HEALTH CARE 13 12 0 854 0 0 1541645 898632 0 0 18008 0 248105 205660 1807758 1104292 620551 571198 0 0 335162 366482 0 0 114136 181517 86234 1137230 1023914 670528 80378 1335268 1802708 135528 230537 1199740 1572171 TO CREATE A CULTURE OF COLLABORATION WHICH FACILITATES THE EXPLORATION OF CREATIVE OPPORTUNITIES AND SOLUTIONS THAT RESULT IN EXCELLENCE IN COMMUNITY HEALTH CARE 0 0 569451 481983 PROVIDED SUPPORT TO THE TAHOE FOREST HOSPITAL DISTRICT FOR THE TAHOE FOREST CANCER CENTER AND CANCER RESEARCH 55177 46702 PROVIDED SUPPORT TO THE TAHOE FOREST HOSPITAL DISTRICT'S HOSPICE PROGRAM 50228 42513 PROVIDED SUPPORT TO A VARIETY OF SERVICES AND PROGRAMS AT THE TAHOE FOREST HOSPITAL DISTRICT, INCLUDING THE CHILDREN'S CENTER, COMMUNITY WELLNESS, EMERGENCY SERVICES, PHYSICAL THERAPY, HOME HEALTH, AND THE WOMEN & FAMILY CENTER 674856 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 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 13 12 1 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 CA X TAHOE FOREST HOSPITAL DISTRICT 5305823489 10121 PINE AVENUE TRUCKEE CA 96160 TOM HOBDAY 5.00 X 0 0 0 PAMELA HOBDAY 5.00 X 0 0 0 ROGER KAHN 5.00 X 0 0 0 BOB KENNEDY 5.00 X 0 0 0 ROGER WITTENBERG 5.00 X 0 0 0 TRINKIE WATSON 5.00 X 0 0 0 DAVE COLLINS 5.00 X 0 0 0 BETSY COLE 5.00 X 0 0 0 ROBERT SCHAPPER 5.00 40.00 X 0 518590 0 CHRIS RYMAN 5.00 X X 0 0 0 BILL ROCK 5.00 X X 0 0 0 SARAH JACKSON 5.00 X X 0 0 0 STUART YOUNT 5.00 X X 0 0 0 TED OWENS 40.00 X 0 83810 0 MARTHA SIMON 40.00 X 0 133004 0 0 735404 0 0 0 1 0 0 80234 615999 1380 201019 615855 898632 370392 80234 164732 205660 205660 1104292 0 0 205660 571198 571198 241316 72395 96526 72395 14635 7318 7317 18378 5198 7456 5724 92153 26065 37388 28700 18110 18110 25069 25069 11141 11141 25743 25743 371 371 REPAIRS AND MAINTENANCE 1884 1884 3916 3916 1023914 674856 234922 114136 375449 673529 309594 187299 2753 2753 0 0 398 0 649827 941880 1335268 1802708 96225 134600 39303 95937 135528 230537 X 49786 268813 1149954 1303358 1199740 1572171 1335268 1802708 X 80378 292053 X 0 1 X 1 0 X X X 0 0 0 TAHOE FOREST HOSPITAL DISTRICT 946004062 3 1 1 1 571198 1 571198 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 645885 192238 102497 0 0 2682 937938 210461 432646 8330 0 0 5552 645885 0 203787 11562 3715 0 1173 210461 1.00000 1 0 2753 2753 0 0 OTHER ASSETS 3942 BENEFICIAL INTEREST IN COMMUNITY FOR CANCER CARE ENDOWMENT 937938 941880 DUE TO TAHOE FOREST HOSPITAL DISTRICT 94953 HELD IN TRUST FOR OTHERS 984 95937 X 1561077 292053 292053 1269024 -164732 -164732 1104292 1188646 164732 164732 1023914 0 1023914 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENT FUND IS INTENDED TO SUPPORT THE CANCER CENTER IN THE TREAMENT, SUPPORT, AND PREVENTION OF CANCER. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE FOUNDATION ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FASB 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 TWELVE MONTHS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN ENDOWMENT 292,053. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NETTED AGAINST FUNDRAISING REVENUE -164,732. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NETTED AGAINST FUNDRAISING REVENUE 164,732. GENE UPSHAW MEMORIAL GOLF CLASSIC 238617 24134 214483 44900 543 83384 BEST OF TAHOE CHEFS 200725 56100 144625 15000 1979 2372 13541 1 11284 0 11284 3013 450626 80234 370392 59900 2522 2372 99938 164732 205660 1 TAHOE FOREST HOSPITAL DISTRICT 10121 PINE AVENUE TRUCKEE CA 96160 946004062 115(1) 571198 N/A N/A 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 FOUNDATION EXISTS TO SUPPORT AND ENHANCE HEALTHCARE IN THE TAHOE FOREST HOSPITAL DISTRICT'S (THE DISTRICT) SERVICE AREA. ACCORDINGLY, THE FOUNDATION'S ASSISTANCE REPRESENTS PAYMENTS DIRECTLY MADE TO THE DISTRICT IN FURTHERANCE OF THESE PURPOSES. THE BOARD OF DIRECTORS FROM THE FOUNDATION AND THE DISTRICT PERFORM MONITORING PROCEDURES TO ENSURE THAT THE ASSISTANCE PROVIDED BY THE FOUNDATION IS USED TO SUPPORT AND ENHANCE HEALTHCARE IN THE DISTRICT'S SERVICE AREA. X 0 0 0 0 0 0 0 0 0 ROBERT SCHAPPER 0 410213 0 108377 0 0 0 0 0 0 0 518590 0 0 X 1 3531 MARKET QUOTATIONS X EXPENSES-TFHD 1 612324 ACTUAL AMOUNT PAID 0 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, PRINCIPALLY IN THE FORM OF EMPLOYEE WAGES AND BENEFITS. 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 A, LINE 2 BOARD MEMBERS TOM AND PAM HOBDAY ARE MARRIED. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD PLACES THE FORM 990 ON ITS AGENDA FOR ITS REVIEW AND APPROVAL. FORM 990, PART VI, SECTION B, LINE 15A A COMPENSATION STUDY IS USED. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST 292,053. TAHOE FOREST HOSPITAL DISTRICT 10121 PINE AVENUE TRUCKEE CA 96160 946004062 HEALTHCARE CA 115(1) N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0