2013-11-15T18:39:05-06:00 2013-05-31 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2012-06-01 911349657 COMMUNITY HEALTH CARE COMM 2535974550 1019 PACIFIC AVE NO 300 TACOMA WA 98402 DAVID FLENTGE 2537221502 2013-11-07 1 PAUL MBAILEY P00292653 4252506100 2013-11-07 2012 2015-11-30 17:44:51Z DAVID FLENTGE 1019 PACIFIC AVE NO 300 TACOMA WA 98402 37778933 0 X WWW.COMMHEALTH.ORG X 1987 WA TO PROVIDE THE HIGHEST QUALITY HEALTH CARE WITH COMPASSIONATE AND ACCESSIBLE SERVICE FOR ALL. 15 15 365 20 0 0 4972679 14867928 20682576 22467821 47426 90758 867001 301367 26569682 37727874 0 0 0 0 19510042 20931711 34890 0 233918 8011453 8351232 27556385 29282943 -986703 8444931 38047999 52241806 10721229 16436950 27326770 35804856 X COMMUNITY HEALTH CARE PROVIDES COMPREHENSIVE PRIMARY MEDICAL AND DENTAL CARE THROUGH A CLINIC SYSTEM THAT INCLUDES SIX MEDICAL AND TWO DENTAL CLINICS. IN ADDITION, CARE IS ALSO PROVIDED THROUGH A WOMEN'S HEALTH CLINIC. 0 0 15135458 12001388 COMMUNITY HEALTH CARE (CHC) MEDICAL CLINICS OFFER MEDICAL SERVICES AND URGENT CARE CENTER SERVICES IN VARIOUS LOCATIONS IN PIERCE COUNTY ACCORDING TO A SLIDING FEE SCALE BASED ON INCOME AND FAMILY SIZE. DURING THE FISCAL YEAR ENDED 5/31/2013 CHC PROVIDED 30,949 PATIENTS WITH MEDICAL CARE FROM 97,522 PATIENT VISITS AT 7 MEDICAL CLINICS. 63% OF PATIENTS ARE AT POVERTY LEVEL AND 84% OF PATIENTS ARE LOW-INCOME. CHC PROVIDED $1,858,790 IN TOTAL SLIDE FEE DISCOUNTS FOR FISCAL YEAR END 5/31/13. 4838283 490193 COMMUNITY HEALTH CARE (CHC) DENTAL CLINICS OFFER PRIMARY CARE DENTAL SERVICES IN VARIOUS PIERCE COUNTY LOCATIONS ACCORDING TO THE SAME FEE STRUCTURE. DURING THE FISCAL YEAR ENDED 5/31/2013 CHC PROVIDED 35,309 DENTAL VISITS TO 13,453 PATIENTS AT TWO DENTAL CLINICS. 2631533 3776598 FOUR PHARMACIES OFFER PHARMACEUTICAL SERVICES TO PATIENTS IN VARIOUS LOCATIONS IN PIERCE COUNTY ACCORDING TO THE SAME FEE STRUCTURE NOTED ABOVE. THE PHARMACY SERVED 13,430 PATIENTS THROUGH 94,378 MEDICATION FILLS. 774056 1788642 ARNP RESIDENCY PROGRAM OFFERS MEDICAL SERVICES IN THE CITY OF TACOMA ACCORDING TO A SLIDING FEE SCALE BASED ON INCOME AND FAMILY SIZE DURING THE FISCAL YEAR STARTING IN OCT 2012 ENDING MAY 31, 2013. THE RESIDENCY PROGRAM PROVIDED 1441 ENCOUNTERS TO 941 PATIENTS. 774056 1788642 23379330 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 47 0 1 365 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X TONIA CAMPBELL 2535691510 1019 PACIFIC AVE ST 300 TACOMA WA 98402 BABULA RAY 2.00 X 0 0 0 BARBANO LYSA 4.00 X 0 0 0 BOWE RICHARD 2.00 X 0 0 0 BOWMAN LINDA 2.00 X 0 0 0 DEMPSEY PEG 4.00 X 0 0 0 GRIFFIN-STALLWORTH LADEDRIA 2.00 X 0 0 0 HOGAN NAN 2.00 X 0 0 0 JOHNSON RIA 2.00 X 0 0 0 MAGANA MARTHA 4.00 X 0 0 0 SETO PETER 2.00 X 0 0 0 SHIMAMOTO KYLE 4.00 X 0 0 0 SLOAN DAN 2.00 X 0 0 0 SWANBERG DOUG 4.00 X 0 0 0 WEISS SHELLY 2.00 X 0 0 0 YOUNG DEBRA 2.00 X 0 0 0 FLENTGE DAVID 40.00 X 146353 0 28515 SMITH JEFFREY 40.00 X 313699 0 66356 NEIGHBOR RALPH 40.00 X 188789 0 28925 SAMUELS CHUCK 40.00 X 174396 0 35321 ESHER ERICA 40.00 X 170205 0 33955 REYNOLDS THOMAS 40.00 X 145615 0 18750 PENA-BENITEZ FRIDA 40.00 X 145781 0 24048 1284838 0 235870 19 0 1 0 AMERISOURCEBERGEN PO BOX 100741 PASADENA CA 91189 PHARMACEUTICALS 669655 JOHNSON ARCHITECTURE 2124 3RD AVE STE 200 SEATTLE WA 98121 ARCHITECTURE SERVICES 542470 QUALITY SYSTEM PO BOX 511449 LOS ANGELES CA 90051 SOFTWARE/LICENSE 254315 LABCORP PO BOX 12140 BURLINGTON NC 27216 PATIENT LAB SERVICES 246838 PHYSICIAN SALES AND SVC PO BOX 1269 AUBURN WA 98071 MEDICAL INVENTORY 226761 11 53961 10997082 3816885 862476 14867928 PATIENT FEES 621400 19131521 19131521 PHARMACY REVENUE 621300 3336300 3336300 22467821 90758 90758 32750 53961 51059 -18309 -18309 MEANINGFUL USE REVENUE 711300 304229 304229 MISCELLANEOUS REVENUE 900099 15447 15447 319676 37727874 0 0 22859946 522063 324063 198000 15838704 12793911 2911353 133440 528216 408716 113263 6237 4042728 3225329 798414 18985 177903 72210 105693 54309 24 54285 1602138 1318100 221814 62224 159769 29898 128503 1368 750969 441827 299199 9943 406081 331768 74164 149 602945 401566 201319 60 262538 141632 120364 542 271744 193276 78468 1077307 937119 140088 100 110331 76381 33950 MEDICAL AND DENTAL SUPP 2244502 2242408 2094 FEES, TAXES, AND DUES 268733 155436 113294 3 REPAIRS AND MAINTENANCE 223443 193698 29602 143 MISCELLANEOUS 119429 73104 45602 723 19091 18864 226 1 29282943 23379330 5669695 233918 9175941 8690610 3202630 1328047 433962 3192816 2792823 16710910 105443 198863 121360 204756 193224 30395162 10473531 21383372 19921631 655652 1977765 38047999 52241806 6075559 7437488 35498 40381 1395000 1330000 3215172 7629081 10721229 16436950 X 26920586 35804856 406184 0 27326770 35804856 38047999 52241806 8444931 33155 0 X 0 1 X 1 1 1 X 9314479 6331802 4257171 5639201 14867928 40410581 9314479 6331802 4257171 5639201 14867928 40410581 40410581 66235 -229272 27717 47426 90758 2864 291287 -12239 4932 903624 319676 1507280 41920725 118579758 0.96400 0.95460 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 0 0 0 0 1 1459 1459 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: CEO SPENT APPROXIMATELY TEN HOURS LOBBYING. 3642530 3642530 16841286 3323997 13517289 2308465 1036586 1271879 7309157 6011674 1297483 293724 101274 192450 19921631 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS BECAUSE THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION, EXEMPT FROM INCOME TAXES UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION (ASC). THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2010. X X X X X 1 RICHARD OLDENBURG 6825 RAINER AVE GIG HARBOR WA 98335 MAJOR & PLANNED GIFT CONSULTING 0 0 71963 -71963 71963 -71963 WA ANNUAL LUNCHEON 86711 53961 32750 4000 11634 11500 23925 86711 53961 32750 4000 11634 11500 23925 51059 -18309 X X X X 0 0 0 0 0 0 0 0 0 FLENTGE DAVID 146353 0 0 0 0 0 20568 0 7947 0 174868 0 0 0 SMITH JEFFREY 280394 0 33305 0 0 0 46657 0 19699 0 380055 0 0 0 NEIGHBOR RALPH 187730 0 1059 0 0 0 16597 0 12328 0 217714 0 0 0 SAMUELS CHUCK 148964 0 25432 0 0 0 27686 0 7635 0 209717 0 0 0 ESHER ERICA 135236 0 34969 0 0 0 26320 0 7635 0 204160 0 0 0 REYNOLDS THOMAS 145338 0 277 0 0 0 5766 0 12984 0 164365 0 0 0 PENA-BENITEZ FRIDA 145781 0 0 0 0 0 14797 0 9251 0 169829 0 0 0 A WA HEALTH CARE FACILITIES AUTHORITY 911108929 93978EUWO 2003-01-23 3320000 TO FUND BUILDING 0 0 1 A 1990000 3320000 96667 185620 3088333 2003 0 0 0 0 A 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 0 X VACCINATIONS 1 578484 CDC PRICING X MEDICATIONS 1 232877 AWP X PROFESSIONAL TIME 1 33115 HOURLY RATE X EQUIPMENT MAINTENANCE 1 18000 INVOICE 0 1 0 FORM 990, PART VI, SECTION A, LINE 3 LEE PODOLL, AN EMPLOYEE OF COMMUNITY LINK CONSULTING, WAS ENGAGED AS TEMPORARY CFO. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING. THE BOARD IS GIVEN THE OPPORTUNITY TO FORWARD QUESTIONS AND OR CONCERNS TO THE FINANCE COMMITTEE SO THEY CAN BE ADDRESSED. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND MANAGEMENT TEAM MEMBERS ARE ASKED TO SIGN A CONFLICT OF INTEREST STATEMENT AT INITIAL ORIENTATION AND AGAIN ANNUALLY. EMPLOYEES SIGN STATEMENTS AT INITIAL ORIENTATION AND THEN EVERY SEVERAL YEARS. RECORDS ARE MAINTAINED BY EITHER THE HUMAN RESOURCES DIRECTOR OR THE ASSISTANT TO THE CEO. REPORTED OR POTENTIAL CONFLICTS ARE REVIEWED BY EITHER THE HUMAN RESOURCES DIRECTOR OR THE CEO. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER OR MANAGEMENT TEAM MEMBER MUST EXCUSE THEMSELVES FROM THE DISCUSSION OR VOTING. IF A CONFLICT IS PERVASIVE WITH A BOARD MEMBER THEN THE CO-CHAIRS CAN PROCEED TO REMOVE THE BOARD MEMBER. IF A CONFLICT IS PERVASIVE WITH A MANAGEMENT TEAM MEMBER THEN THEY MAY BE TERMINATED. FORM 990, PART VI, SECTION B, LINE 15 COMMUNITY HEALTH CARE USES SURVEYS OF LIKE ORGANIZATIONS TO REVIEW COMPENSATION. THE REVIEW IS COMPLETED BY THE HUMAN RESOURCES DEPARTMENT AND THEN PROVIDED TO THE CEO. THE CEO REVIEWS AND MAKES PROPOSALS TO THE PERSONNEL COMMITTEE WHO THEN MAKES PROPOSALS TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL. KEY EMPLOYEES' SALARIES HAVE BEEN REVIEWED MORE RECENTLY AS INDIVIDUALS HAVE DEPARTED FROM POSITIONS, AS PAY RATE QUESTIONS HAVE COME UP, OR AS THE MARKET HAS DETERMINED THAT A REVIEW WAS NECESSARY. COMMUNITY HEALTH CARE USES NORTHWEST REGIONAL PRIMARY CARE ASSOCIATION, NATIONAL ASSOCIATION FOR COMMUNITY HEALTH CENTERS, AND MILLIMAN SALARY SURVEYS AND DATA FROM THE PACIFIC NORTHWEST REGION AS COMPARATIVE DATA. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART VI, LINE 1A THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF COMMUNITY HEALTH CARE (CHAIRPERSON OR CO-CHAIRS, VICE CHAIRPERSON, SECRETARY AND TREASURER) AND THE CHAIRPERSONS OF EACH OF THE STANDING COMMITTEES. IT HAS THE POWERS AND AUTHORITY OF THE BOARD TO MAKE BOARD LEVEL DECISIONS WHEN THE BOARD IS NOT IN SESSION. THE COMMITTEE SHALL OVERSEE THE RECRUITMENT, HIRING, AND EVALUATION (YEARLY) OF THE PRESIDENT/CEO. THE EXECUTIVE COMMITTEE KEEPS REGULAR MINUTES OF ITS PROCEEDINGS, CAUSE THEM TO BE FILED WITH THE CORPORATE RECORDS AND REPORT THE SAME TO THE BOARD OF DIRECTORS AT THE NEXT REGULAR MEETING OF THE BOARD OF DIRECTORS. THE QUORUM FOR EXECUTIVE COMMITTEE MEETINGS IS 51%. HILLTOP REGIONAL HEALTH CENTER 1019 PACIFIC AVE TACOMA WA 98402 455494488 HEALTHCARE WA 501(C)(3) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0