MOUNTAINS COMMUNITY HOSPITAL FOUNDATION: Form 990, tax year 2011
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- Organization
- MOUNTAINS COMMUNITY HOSPITAL FOUNDATION (EIN 33-0530904)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201311359349306401
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-15T13:51:32-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390758449 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8010 | AddressLine1 |
| City | WAUSAU | City |
| State | WI | State |
| ZIP Code | 544028010 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330530904 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOUNTAINS COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MOUN | NameControl |
| Phone | 9093363651 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 70 | AddressLine1 |
| City | LAKE ARROWHEAD | City |
| State | CA | State |
| ZIP Code | 923520070 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | YVONNE WAGGENER | Name |
| Title | TREASURER | Title |
| Phone | 9093363651 | Phone |
| Date Signed | 2013-05-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KATHLEEN J LABRAKE CPA | Name |
| PTIN | P00164006 | PTIN |
| Phone | 7158453111 | Phone |
| Date Prepared | 2013-05-13 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | YVONNE WAGGENER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 70 | AddressLine1 |
| City | LAKE ARROWHEAD | City |
| State | CA | State |
| ZIP Code | 923520070 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 527029 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MCHCARES.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1991 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | MOUNTAINS COMMUNITY HOSPITAL FOUNDATION'S MISSION IS TO SECURE HEALTH CARE FOR THE MOUNTAINS COMMUNITY BY PROVIDING CONSISTENT FINANCIAL SUPPORT TO THE SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 34 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 28 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 165408 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 240702 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 39654 | InvestmentIncomePriorYear |
| Investment Income Current Year | 67161 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 205062 | TotalRevenuePriorYear |
| Total Revenue Current Year | 307863 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 210750 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 275551 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 7388 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 29346 | OtherExpensePriorYear |
| Other Expenses Current Year | 40835 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 240096 | TotalExpensesPriorYear |
| Total Expenses Current Year | 316386 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -35034 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -8523 | RevenuesLessExpensesCY |
| Total Assets BOY | 779325 | TotalAssetsBOY |
| Total Assets EOY | 771861 | TotalAssetsEOY |
| Total Liabilities BOY | 38650 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 51337 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 740675 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 720524 | NetAssetsOrFundBalancesEOY |
| Mission Description | MOUNTAINS COMMUNITY HOSPITAL FOUNDATION'S MISSION IS TO SECURE HEALTH CARE FOR THE MOUNTAINS COMMUNITY BY PROVIDING CONSISTENT FINANCIAL SUPPORT TO THE SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 275551 | Expense |
| Grants | 275551 | Grants |
| Description | CONTRIBUTIONS TO SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT FOR CAPITAL PURPOSES. | Description |
| Total Program Service Expense | 275551 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 34 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 28 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicy |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YVONNE WAGGENER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9093363651 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 70 | AddressLine1 |
| City | LAKE ARROWHEAD | City |
| State | CA | State |
| ZIP Code | 923520070 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (36 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|
| BILLIE YEAGER | |||||
| CHAIRMAN, EMERITUS | 0.10 | X | 0 | 0 | 0 |
| DON WILLERTH | |||||
| PRESIDENT | 0.10 | X | 0 | 0 | 0 |
| GLENN GOODWIN | |||||
| VICE PRESIDENT | 0.10 | X | 0 | 0 | 0 |
| NEALE PERKINS | |||||
| VICE PRESIDENT | 0.10 | X | 0 | 0 | 0 |
| CHUCK PETERS | |||||
| VICE PRESIDENT | 0.10 | X | 0 | 0 | 0 |
| GEORGE MEDAK | |||||
| VICE PRESIDENT | 0.10 | X | 0 | 0 | 0 |
| TOM BACHMAN | |||||
| SECRETARY | 0.10 | X | 0 | 0 | 0 |
| YVONNE WAGGENER | |||||
| TREASURER | 0.10 | X | 0 | 0 | 0 |
| ROSS JOHNSTONE | |||||
| PAST PRESIDENT | 0.10 | X | 0 | 0 | 0 |
| ROB ROY | |||||
| PAST PRESIDENT | 0.10 | X | 0 | 0 | 0 |
| PAT WELSH | |||||
| PAST PRESIDENT | 0.10 | X | 0 | 0 | 0 |
| CHARLIE HARRISON | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| SUSIE STUART | |||||
| STAFF | 0.10 | X | 0 | 0 | 0 |
| HARRY BRADLEY | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| JOHN BROWN | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| KIETH BURKART OD | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| KEN CAMARELLA | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| ANDY CENTER | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| BUD CRAINE DDS MS | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| BILL DAVIS | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| PAT DAVIS | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| SANDY FULTON | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| JIM GIBSON | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| JOHN GOOD | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| HARRY JOHNSON | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| AGNES KOETSIER | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| VALERIE KOMPANIEZ | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| LESLIE MARKS | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| HOWARD MILLER | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| SUE MILLER | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| HARRY SHERMAN | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| HELEN QUINN | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| LAWRENCE WALKER MD | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| IRENE WIRTENBERGER | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| ELSBETH WITTLER | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| GLORIA WOLEN | |||||
| MEMBER | 0.10 | X | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 32788 | FundraisingEvents |
| All Other Contributions | 207914 | AllOtherContributions |
| Total Contributions | 240702 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 29732 | TotalRevenueColumn |
| Exclusion | $29,732 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 246617 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 209188 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 37429 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 37429 | TotalRevenueColumn |
| Exclusion | $37,429 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 9978 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 32788 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 9978 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 307863 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $67,161 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 275551 | Total |
| Program Services | 275551 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16537 | Total |
| Management And General | 16537 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5767 | Total |
| Management And General | 5767 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8281 | Total |
| Management And General | 8281 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2862 | Total |
| Management And General | 2862 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7388 | Total |
| Fundraising | 7388 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 316386 | Total |
| Program Services | 275551 | ProgramServices |
| Management And General | 33447 | ManagementAndGeneral |
| Fundraising | 7388 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37825 | BOY |
| EOY | 15125 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77206 | BOY |
| EOY | 245412 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 585839 | BOY |
| EOY | 442263 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78455 | BOY |
| EOY | 69061 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 779325 | BOY |
| EOY | 771861 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4980 | BOY |
| EOY | 17368 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33670 | BOY |
| EOY | 33969 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38650 | BOY |
| EOY | 51337 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 695890 | BOY |
| EOY | 655282 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44785 | BOY |
| EOY | 65242 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 740675 | BOY |
| EOY | 720524 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 779325 | BOY |
| EOY | 771861 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -8523 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -11628 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 330876 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 396799 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 320246 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 165408 | CurrentTaxYearMinus1Year |
| Current Tax Year | 240702 | CurrentTaxYear |
| Total | 1454031 | Total |
Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 63836 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 68907 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 73980 | CurrentTaxYearMinus1Year |
| Current Tax Year | 78000 | CurrentTaxYear |
| Total | 284723 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 330876 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 460635 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 389153 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 239388 | CurrentTaxYearMinus1Year |
| Current Tax Year | 318702 | CurrentTaxYear |
| Total | 1738754 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 198685 | AmountsSubstContributorsTotal |
| Public Support Total170 | 1540069 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6233 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 31206 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 24578 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 19234 | CurrentTaxYearMinus1Year |
| Current Tax Year | 29732 | CurrentTaxYear |
| Total | 110983 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 1849737 | TotalSupport |
| Public Support Pertcentage170 | 0.83260 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.80310 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ASSETS HELD UNDER CHARITABLE REMAINDER TRUST | Description |
| Book Value | 69061 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 69061 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ANNUITY OBLIGATION UNDER CHARITABLE REMAINDER TRUST | $28,819 |
| DEFERRED INCOME | $5,150 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 33969 | TotalOfAmounts |
| Total Revenue | 307863 | TotalRevenue |
| Total Expenses | 316386 | TotalExpenses |
| Excess Or Deficit For Year | -8523 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -11628 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -11628 | TotalAdjustments |
| Excess Or Deficit Per FS | -20151 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 378446 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -11628 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 78000 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | 9978 | OtherRevenues |
| Revenue Not Rptd F990 | 76350 | RevenueNotRptdF990 |
| Revenue Subtotal | 302096 | RevenueSubtotal |
| Investment Expenses Not Included | 5767 | InvestmentExpensesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 5767 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 307863 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 398597 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 78000 | DonatedServicesUseOfFacilities |
| Other Expenses Included | 9978 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 87978 | ExpensesNotRptdF990 |
| Expenses Subtotal | 310619 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 5767 | InvestmentExpensesNotIncluded2 |
| Expenses Not Rptd On Fin Stmt | 5767 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 316386 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | IN ORDER TO ACCOUNT FOR ANY UNCERTAIN INCOME TAX POSITIONS, THE FOUNDATION ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION. ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE FOUNDATION RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSTIONS OR UNRECOGNIZED TAX BENEFITS IN 2012. FEDERAL RETURNS FOR YEAR JUNE 30, 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 9,978. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 9,978. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | LEGRAND PICNIC & AUCTION | NameOfEvent1 |
| Gross Receipts Event1 | 42766 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 32788 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 9978 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 9978 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 42766 | GrossReceiptsTotal |
| Charitable Contributions Total | 32788 | CharitableContributionsTotal |
| Gross Revenue Total Events | 9978 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 9978 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 9978 | DirectExpenseSummaryEvents |
| Net Income Summary | 0 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 29101 HOSPITAL ROAD | AddressLine1 |
| City | LAKE ARROWHEAD | City |
| State | CA | State |
| ZIP Code | 92352 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 262201665 | EINOfRecipient |
| IRC Section | GOVERNMENTAL | IRCSection |
| Amount Of Cash Grant | 275551 | AmountOfCashGrant |
| Purpose Of Grant | TO PROVIDE FUNDING TO THE SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE FUNDING IS PROVIDED TO MOUNTAINS COMMUNITY HOSPITAL. MONITORING IS DONE BY THE FOUNDATION'S BOARD. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MORGAN STANELY SMITH BARNEY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | KEN CAMARELLA, A MEMBER, IS SR. VP AT SMITH BARNEY, FND INVESTMENT HOLDER | Relationship |
| Amount Of Transaction | 5767 | AmountOfTransaction |
| Description Of Transaction | SMITH BARNEY CHARGES INVESTMENT MANAGEMENT FEES TO THE FOUNDATION. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 IS MADE AVAILABLE TO THE GOVERNING BODY FOR THEIR REVIEW PRIOR TO FILING THE FINAL FORM 990. | |
| NO EMPLOYEES WERE COMPENSATED BY THE FOUNDATION, THEREFORE THIS PROCESS IS NOT APPLICABLE. | ||
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, ETC. AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -11,628. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART VII, LINE 2C | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
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