COLUMBIA VALLEY COMMUNITY HEALTH: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBIA VALLEY COMMUNITY HEALTH (EIN 23-7297657)
- Tax period
- 2012-04-01 to 2013-03-31
- Filed
- 2013-08-15
- IRS object ID
- 201312279349303371
- Schema version
- 2012v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule K
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-15T18:23:10-05:00 | Timestamp |
| Tax Period End Date | 2013-03-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910189318 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 22650 | AddressLine1 |
| City | YAKIMA | City |
| State | WA | State |
| ZIP Code | 989072650 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-04-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237297657 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA VALLEY COMMUNITY HEALTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COLU | NameControl |
| Phone | 5096644575 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 ORONDO AVE SUITE 1 | AddressLine1 |
| City | WENATCHEE | City |
| State | WA | State |
| ZIP Code | 98801 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PATRICK BUCKNUM | Name |
| Title | CEO | Title |
| Phone | 5096644575 | Phone |
| Date Signed | 2013-07-25 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHRISTOPHER E RIVARD | Name |
| PTIN | P00022321 | PTIN |
| Phone | 5092487750 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | PATRICK BUCKNUM | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 ORONDO AVE SUITE 1 | AddressLine1 |
| City | WENATCHEE | City |
| State | WA | State |
| ZIP Code | 98801 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 22216941 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CVCH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1972 | YearFormation |
| State Legal Domicile | WA | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF COLUMBIA VALLEY COMMUNITY HEALTH IS TO PROVIDE ACCESS TO IMPROVED HEALTH AND WELLNESS WITH COMPASSION AND RESPECT FOR ALL. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 265 | TotalNbrEmployees |
| Total Nbr Volunteers | 14 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 4538005 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 4878203 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 16898735 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17172221 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 51630 | InvestmentIncomePriorYear |
| Investment Income Current Year | 48477 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 20112 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4053 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 21508482 | TotalRevenuePriorYear |
| Total Revenue Current Year | 22102954 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 37373 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 38133 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 14016213 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 14816601 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 5958 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 9260 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 141104 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5222226 | OtherExpensePriorYear |
| Other Expenses Current Year | 5418955 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 19281770 | TotalExpensesPriorYear |
| Total Expenses Current Year | 20282949 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2226712 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1820005 | RevenuesLessExpensesCY |
| Total Assets BOY | 24105356 | TotalAssetsBOY |
| Total Assets EOY | 26860293 | TotalAssetsEOY |
| Total Liabilities BOY | 9634433 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 10580012 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14470923 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 16280281 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF COLUMBIA VALLEY COMMUNITY HEALTH IS TO PROVIDE ACCESS TO IMPROVED HEALTH AND WELLNESS WITH COMPASSION AND RESPECT FOR ALL. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 14745784 | Expense |
| Grants | 38133 | Grants |
| Revenue | 16448356 | Revenue |
| Description | 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. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 723865 | Expense |
| Revenue | 723865 | Revenue |
| Description | 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. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 15469649 | 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 | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | 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 | 0 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 0 | 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 |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 59 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 265 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| 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 | 0 | QuidProQuoContributions |
| 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 | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | 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 | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KRISTAL ALBRECHT | NamePerson |
| Telephone Number | 5096626000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 ORONDO AVE SUITE 1 | AddressLine1 |
| City | WENATCHEE | City |
| State | WA | State |
| ZIP Code | 98801 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| RICH WATSON | |||||||
| PRESIDENT | 2.00 | X | X | 0 | 0 | 0 | |
| JOANNE HILL | |||||||
| VICE PRESIDENT | 2.00 | X | X | 0 | 0 | 0 | |
| RICHARD BLIGGENSTORFER | |||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | |
| MARGARITO RODRIGUEZ | |||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | |
| LOLY LARSON | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| ROBERT SCOTT JR | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| DOUGLAS HEAD | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| IRENE BAZAN UNTIL 71712 | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| JUAN VALLE | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| MARY HUNT | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| BERTHA SANCHEZ | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| JOAN ALWAY | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| PATRICK BUCKNUM | |||||||
| CEO | 40.00 | X | 215163 | 0 | 30759 | ||
| CAROL DIEDE | |||||||
| COO | 40.00 | X | 141234 | 0 | 27516 | ||
| KRISTAL ALBRECHT | |||||||
| CFO | 40.00 | X | 152011 | 0 | 14992 | ||
| MALCOLM BUTLER | |||||||
| MEDICAL OFFICER | 40.00 | X | 260846 | 0 | 32751 | ||
| SCOTT BIBBENS | |||||||
| DENTAL OFFICER | 40.00 | X | 199179 | 0 | 27926 | ||
| BRUCE V WILCOX | |||||||
| DENTAL OFFICER | 40.00 | X | 91991 | 0 | 12621 | ||
| LORINDA PARKS | |||||||
| PHYSICIAN | 40.00 | 235385 | 0 | 31821 | X | ||
| KENNETH SHERMER | |||||||
| PHYSICIAN | 40.00 | 214810 | 0 | 30744 | X | ||
| JOHN DAME | |||||||
| PHYSICIAN | 40.00 | 180077 | 0 | 29297 | X | ||
| JEFFERY HINCKLEY | |||||||
| DENTIST | 40.00 | 168853 | 0 | 29062 | X | ||
| BRENDA BAUMEISTER | |||||||
| PHYSICIAN | 40.00 | 155068 | 0 | 26940 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2014617 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 294429 | TotalOtherCompensation |
| Number Individuals GT100 K | 28 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| NEXTGEN HEALTHCARE | |||||
| PO BOX 511449 | LOS ANGELES | CA | 900518004 | SOFTWARE MAINTENANCE | 167782 |
| ALLIED PACIFIC BUILDERS | |||||
| 404 W ROLLING HILLS LANE | WENATCHEE | WA | 98801 | CONSTRUCTION AND REMODEL | 146990 |
| KDF ARCHITECTURE | |||||
| 1310 NORTH 16TH AVE | YAKIMA | WA | 989021354 | ARCHITECTURE FEES | 135284 |
| ALDRICH & ASSOCIATES | |||||
| 810 - 240TH ST SE | BOTHELL | WA | 98021 | CONSTRUCTION | 131329 |
| ERIC WULF LANDSCAPE CONSTRUCTION | |||||
| PO BOX 4252 | WENATCHEE | WA | 98801 | LANDSCAPING | 101821 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Fundraising Events | 7194 | FundraisingEvents |
| Government Grants | 4799508 | GovernmentGrants |
| All Other Contributions | 71501 | AllOtherContributions |
| Noncash Contributions | 76 | NoncashContributions |
| Total Contributions | 4878203 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE RE | 621400 | 12756185 | 12756185 |
| ENHANCEMENT REVENUE | 621400 | 2829574 | 2829574 |
| CAPITATION REVENUE | 621400 | 1013908 | 1013908 |
| MEANINGFUL USE INCENTIVE REVENUE | 621400 | 323000 | 323000 |
| CONTRACT SERVICES | 621400 | 228165 | 228165 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 21389 | TotalRevenueColumn |
| Related Or Exempt Function Income | 21389 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17172221 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 57991 | TotalRevenueColumn |
| Exclusion | $57,991 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 75111 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 69183 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 5928 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5928 | TotalRevenueColumn |
| Exclusion | $5,928 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 9514 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -9514 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -9514 | TotalRevenueColumn |
| Exclusion | -$9,514 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 33415 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 7194 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 35290 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1875 | TotalRevenueColumn |
| Exclusion | -$1,875 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22102954 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17172221 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $52,530 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38133 | Total |
| Program Services | 38133 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1222096 | Total |
| Program Services | 654238 | ProgramServices |
| Management And General | 567858 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10652407 | Total |
| Program Services | 8646769 | ProgramServices |
| Management And General | 1955806 | ManagementAndGeneral |
| Fundraising | 49832 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 564536 | Total |
| Program Services | 462831 | ProgramServices |
| Management And General | 101301 | ManagementAndGeneral |
| Fundraising | 404 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1442788 | Total |
| Program Services | 1215277 | ProgramServices |
| Management And General | 219367 | ManagementAndGeneral |
| Fundraising | 8144 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 934774 | Total |
| Program Services | 741368 | ProgramServices |
| Management And General | 189490 | ManagementAndGeneral |
| Fundraising | 3916 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105598 | Total |
| Management And General | 105598 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34755 | Total |
| Management And General | 34755 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9260 | Total |
| Fundraising | 9260 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 308100 | Total |
| Program Services | 176858 | ProgramServices |
| Management And General | 131242 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 122150 | Total |
| Program Services | 36366 | ProgramServices |
| Management And General | 16639 | ManagementAndGeneral |
| Fundraising | 69145 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 312632 | Total |
| Program Services | 144978 | ProgramServices |
| Management And General | 167654 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 710827 | Total |
| Program Services | 399364 | ProgramServices |
| Management And General | 311463 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 490006 | Total |
| Program Services | 340028 | ProgramServices |
| Management And General | 149978 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 249548 | Total |
| Program Services | 198658 | ProgramServices |
| Management And General | 50890 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1179309 | Total |
| Program Services | 916244 | ProgramServices |
| Management And General | 263065 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107640 | Total |
| Program Services | 70387 | ProgramServices |
| Management And General | 37253 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| PATIENT & PHARMACEUTICA | 1021764 | 1021764 | ||
| CONTINUING EDUCATION | 239770 | 118640 | 121018 | 112 |
| OTHER | 171463 | 19555 | 151908 | |
| DUES & LICENSE | 151373 | 95772 | 55601 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 214020 | Total |
| Program Services | 172419 | ProgramServices |
| Management And General | 41310 | ManagementAndGeneral |
| Fundraising | 291 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20282949 | Total |
| Program Services | 15469649 | ProgramServices |
| Management And General | 4672196 | ManagementAndGeneral |
| Fundraising | 141104 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1984145 | BOY |
| EOY | 2413780 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6396220 | BOY |
| EOY | 7844720 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 128083 | BOY |
| EOY | 467899 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1135248 | BOY |
| EOY | 1019363 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 205876 | BOY |
| EOY | 161810 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 122062 | BOY |
| EOY | 137490 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 22811459 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7996228 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14133722 | BOY |
| EOY | 14815231 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24105356 | BOY |
| EOY | 26860293 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1975178 | BOY |
| EOY | 1941930 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7070124 | BOY |
| EOY | 6670494 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 589131 | BOY |
| EOY | 1967588 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9634433 | BOY |
| EOY | 10580012 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14440789 | BOY |
| EOY | 16239533 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30134 | BOY |
| EOY | 40748 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14470923 | BOY |
| EOY | 16280281 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24105356 | BOY |
| EOY | 26860293 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 1820005 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -10647 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | 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 |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1807466 | OtherCostOrOtherBasis |
| Book Value | 1807466 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14521344 | OtherCostOrOtherBasis |
| Depreciation | 4247745 | Depreciation |
| Book Value | 10273599 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 967917 | OtherCostOrOtherBasis |
| Depreciation | 668220 | Depreciation |
| Book Value | 299697 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4297007 | OtherCostOrOtherBasis |
| Depreciation | 3015553 | Depreciation |
| Book Value | 1281454 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1217725 | OtherCostOrOtherBasis |
| Depreciation | 64710 | Depreciation |
| Book Value | 1153015 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 14815231 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER LIABILITIES | Description |
| Amount | $1,967,588 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1967588 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 22196780 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -10647 | NetUnrealizedGainsInvestments |
| Other Revenues | 104473 | OtherRevenues |
| Revenue Not Rptd F990 | 93826 | RevenueNotRptdF990 |
| Revenue Subtotal | 22102954 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 22102954 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 20387422 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 104473 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 104473 | ExpensesNotRptdF990 |
| Expenses Subtotal | 20282949 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 20282949 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | 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, 2013 AND 2012, 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: | FUNDRAISING EXPENSES 35,290. RENTAL EXPENSES 69,183. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES 35,290. RENTAL EXPENSES 69,183. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | 40TH ANNIVERSARY EVENT | NameOfEvent1 |
| Gross Receipts Event1 | 40609 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 7194 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 33415 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 4962 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 7443 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 6589 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 16296 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 40609 | GrossReceiptsTotal |
| Charitable Contributions Total | 7194 | CharitableContributionsTotal |
| Gross Revenue Total Events | 33415 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 4962 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 7443 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 6589 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 16296 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 35290 | DirectExpenseSummaryEvents |
| Net Income Summary | -1875 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | PAYMENT OF MEDICAL BILLS FOR INDIVIDUALS WHO NEED ASSISTANCE. | TypeOfGrant |
| Number Of Recipients | 256 | NumberOfRecipients |
| Amount Of Cash Grant | 38133 | AmountOfCashGrant |
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: 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. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PATRICK BUCKNUM | ||||||||||||||
| CEO | 186193 | 0 | 10000 | 0 | 18970 | 0 | 8760 | 0 | 21999 | 0 | 245922 | 0 | 0 | 0 |
| CAROL DIEDE | ||||||||||||||
| COO | 124732 | 0 | 11677 | 0 | 4825 | 0 | 5797 | 0 | 21719 | 0 | 168750 | 0 | 0 | 0 |
| KRISTAL ALBRECHT | ||||||||||||||
| CFO | 128891 | 0 | 19279 | 0 | 3841 | 0 | 6442 | 0 | 8550 | 0 | 167003 | 0 | 0 | 0 |
| MALCOLM BUTLER | ||||||||||||||
| MEDICAL OFFICER | 228326 | 0 | 26533 | 0 | 5987 | 0 | 10718 | 0 | 22033 | 0 | 293597 | 0 | 0 | 0 |
| SCOTT BIBBENS | ||||||||||||||
| DENTAL OFFICER | 151494 | 0 | 48015 | 0 | -330 | 0 | 8227 | 0 | 19699 | 0 | 227105 | 0 | 0 | 0 |
| LORINDA PARKS | ||||||||||||||
| PHYSICIAN | 142501 | 0 | 52433 | 0 | 40451 | 0 | 9788 | 0 | 22033 | 0 | 267206 | 0 | 0 | 0 |
| KENNETH SHERMER | ||||||||||||||
| PHYSICIAN | 120000 | 0 | 86093 | 0 | 8717 | 0 | 8711 | 0 | 22033 | 0 | 245554 | 0 | 0 | 0 |
| JOHN DAME | ||||||||||||||
| PHYSICIAN | 139158 | 0 | 33806 | 0 | 7113 | 0 | 7264 | 0 | 22033 | 0 | 209374 | 0 | 0 | 0 |
| JEFFERY HINCKLEY | ||||||||||||||
| DENTIST | 137753 | 0 | 15756 | 0 | 15344 | 0 | 7061 | 0 | 22001 | 0 | 197915 | 0 | 0 | 0 |
| BRENDA BAUMEISTER | ||||||||||||||
| PHYSICIAN | 157462 | 0 | 0 | 0 | -2394 | 0 | 6908 | 0 | 20032 | 0 | 182008 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 1A | ReturnReference |
| Explanation | HOUSING ALLOWANCES ARE CONSIDERED TO BE TAXABLE EARNINGS IN ACCORDANCE WITH PAYROLL LAWS. THE INTERNAL COMPENSATION POLICY GOVERNS COMPENSATION FOR AGENCY POSITIONS. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WA HEALTHCARE FACILITIES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 911108929 | IssuerEIN |
| Date Issued | 2010-12-16 | DateIssued |
| Issue Price | 7200000 | IssuePrice |
| Description Of Purpose | REMODELING & RENOVATION | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 3039859 | AmountRetired |
| Total Proceeds | 7200000 | TotalProceeds |
| Capitalized Interest | 29142 | CapitalizedInterest |
| Issuance Costs From Proceeds | 58202 | IssuanceCostsFromProceeds |
| Capital Expenditures | 4231702 | CapitalExpenditures |
| Year Of Subst Completion | 2012 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 1 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | 0 | ProcToUndertkCorrectiveAction |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| 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. 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. |
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