SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION (EIN 91-1286274)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-15
IRS object ID
201212289349302171
Schema version
2011v1.2
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

FieldValueIRS element (for citing)
Timestamp2012-08-15T10:56:13-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DINGUS ZARECOR & ASSOCIATESBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line112015 E MAIN STE AAddressLine1
CitySPOKANE VALLEYCity
StateWAState
ZIP Code99206ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN911286274EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SUNNYSIDE COMMUNITY HOSPITALBusinessNameLine1
Business Name Line2ASSOCIATIONBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSUNNNameControl
Phone5098371500Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 719AddressLine1
CitySUNNYSIDECity
StateWAState
ZIP Code98944ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN GALLAGHERName
TitleCEOTitle
Phone5098371500Phone
Date Signed2012-08-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTHOMAS DINGUSName
Phone5092420874Phone
Date Prepared2012-08-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN GALLAGHERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 719AddressLine1
CitySUNNYSIDECity
StateWAState
ZIP Code98944ZIPCode
FieldValueIRS element (for citing)
Gross Receipts48775731GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SUNNYSIDEHOSPITAL.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE QUALITY COMPREHENSIVE HEALTHCARE SERVICES TO THE RESIDENTS OF SUNNYSIDE, GRANDVIEW, AND THE REST OF THE LOWER YAKIMA VALLEY OF WASHINGTON. THE FACILITY OFFERS SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees440TotalNbrEmployees
Total Nbr Volunteers138TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year496732ContributionsGrantsPriorYear
Contributions Grants Current Year1388689ContributionsGrantsCurrentYear
Program Service Revenue Prior Year48451182ProgramServiceRevenuePriorYear
Program Service Revenue CY47132212ProgramServiceRevenueCY
Investment Income Prior Year289102InvestmentIncomePriorYear
Investment Income Current Year15783InvestmentIncomeCurrentYear
Other Revenue Prior Year274057OtherRevenuePriorYear
Other Revenue Current Year239047OtherRevenueCurrentYear
Total Revenue Prior Year49511073TotalRevenuePriorYear
Total Revenue Current Year48775731TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year27118404SalariesEtcPriorYear
Salaries Etc Current Year30949314SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year107133TotalFundrsngExpCurrentYear
Other Expense Prior Year21532125OtherExpensePriorYear
Other Expenses Current Year21253286OtherExpensesCurrentYear
Total Expenses Prior Year48650529TotalExpensesPriorYear
Total Expenses Current Year52202600TotalExpensesCurrentYear
Revenues Less Expenses Prior Year860544RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3426869RevenuesLessExpensesCY
Total Assets BOY27545072TotalAssetsBOY
Total Assets EOY24517267TotalAssetsEOY
Total Liabilities BOY10671275TotalLiabilitiesBOY
Total Liabilities EOY11242596TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY16873797NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY13274671NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE QUALITY COMPREHENSIVE HEALTHCARE SERVICES TO THE RESIDENTS OF SUNNYSIDE, GRANDVIEW, AND THE REST OF THE LOWER YAKIMA VALLEY OF WASHINGTON. THE FACILITY OFFERS SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense44377155Expense
Revenue47132212Revenue
DescriptionSUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION IS COMPRISED OF A 25-BED CRITICAL ACCESS HOSPITAL AND A SERIES OF FIVE RURAL HEALTH CLINICS, ONE SPECIALTY CLINIC, A FAMILY BIRTH CENTER, COMPLETE SURGICAL SERVICES, LABORATORY, 4-D OBSTETRICAL ULTRASOUND, DIGITAL MAMMOGRAPHY, CARDIOPULMONARY SERVICES, REGISTERED DIETICIAN AND DIABETES EDUCATOR SERVICES. THE ASSOCIATION PROVIDED 1,363 HOSPITAL ADMISSIONS, 62,450 OUTPATIENT VISITS, 19,896 EMERGENCY ROOM VISITS, AND 512 BIRTHS DURING THE YEAR. THE ASSOCIATION PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 2,195,834 FOR CHARITY CARE, 10,562,239 FOR MEDICARE, 14,866,751 FOR MEDICAID, AND 6,630,129 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR.Description
Total Program Service Expense44377155TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109669NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees440NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementfalseRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCARY ROWANNamePerson
Telephone Number5098371500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11016 TACOMA AVEAddressLine1
CitySUNNYSIDECity
StateWAState
ZIP Code989440719ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
JONATHAN MERCER
PRESIDENT4.00XX000
CHRIS RIVAS
PRESIDENT EL4.00XX000
DAVE BALLINGER
SECRETARY/TR4.00XX000
MARY ANN BLIESNER
TRUSTEE4.00X000
PEGGY BREWER
TRUSTEE4.00X000
JESSE HERNANDEZ JR
TRUSTEE4.00X000
JIM SEWELL
TRUSTEE4.00X000
JON SMILEY
CEO40.00X000
WILLIAM ALSDURF
CFO40.00X000
MARTHA RODRIGUEZ
INTERIM CFO40.00X000
DUANE COULTER
INTERIM CFO40.00X000
DAVID OLSON
COO40.00X000
WILLIAM COMBS
CLINIC PHYSI40.00484231025597X
STEVEN LEE
CLINIC PHYSI40.00447431033813X
ROBERT COLEMAN
PHYSICIAN40.00365508018605X
STEVEN ELERDING
CLINIC PHYSI40.00351880024865X
SOPHIE ZHAO
CLINIC PHYSI40.00335607022910X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1984657TotalReportableCompFromOrg
Total Other Compensation125790TotalOtherCompensation
Number Individuals GT100 K46NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
INFORMATION RESOURCE MANAGEMENT
PO BOX 469SPOKANEWA99210IT SUPPORT1282073
HEALTHTECH MANAGEMENT SERVICES INC
405 DUKE DRIVE SUITE 210FRANKLINTN37067MANAGEMENT SERV1077055
EMCARE OF WASHINGTON INC
7032 COLLECTION CENTER DRIVECHICAGOIL60693ER PHYSICIANS1028820
CITY OF SUNNYSIDE
818 E EDISONSUNNYSIDEWA98944ONSITE SECURITY375636
QUEST DIAGNOSTICS
FILE NO 91514LOS ANGELESCA90074LAB SERVICES357906
FieldValueIRS element (for citing)
Number Of Contractors GT100 K11NumberOfContractorsGT100K
Related Organizations33314RelatedOrganizations
Government Grants1313390GovernmentGrants
All Other Contributions41985AllOtherContributions
Total Contributions1388689TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code624100BusinessCode
Total Revenue Column47132212TotalRevenueColumn
Related Or Exempt Function Income47132212RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue47132212TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column15783TotalRevenueColumn
Exclusion$15,783ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real7070Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real7070Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column7070TotalRevenueColumn
Exclusion$7,070ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
DIETARY REVENUE722210229993$229,993
OTHER REVENUE9000991984$1,984
FieldValueIRS element (for citing)
Total Other Revenue231977TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column48775731TotalRevenueColumn
Related Or Exempt Function Income47132212RelatedOrExemptFunctionIncome
Exclusion$254,830ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total24429088Total
Program Services20713036ProgramServices
Management And General3644836ManagementAndGeneral
Fundraising71216Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total689697Total
Program Services584783ProgramServices
Management And General102903ManagementAndGeneral
Fundraising2011Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3698218Total
Program Services3135660ProgramServices
Management And General551777ManagementAndGeneral
Fundraising10781Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2132311Total
Program Services1775562ProgramServices
Management And General350166ManagementAndGeneral
Fundraising6583Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1077055Total
Management And General1077055ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total81520Total
Management And General81520ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total57921Total
Management And General57921ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5677172Total
Program Services4611453ProgramServices
Management And General1063123ManagementAndGeneral
Fundraising2596Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total6240693Total
Program Services5423708ProgramServices
Management And General816319ManagementAndGeneral
Fundraising666Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total146737Total
Program Services2120ProgramServices
Management And General144492ManagementAndGeneral
Fundraising125Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total405176Total
Program Services356233ProgramServices
Management And General48220ManagementAndGeneral
Fundraising723Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total142265Total
Program Services60222ProgramServices
Management And General80433ManagementAndGeneral
Fundraising1610Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total89919Total
Program Services71857ProgramServices
Management And General17223ManagementAndGeneral
Fundraising839Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total358839Total
Program Services315625ProgramServices
Management And General42694ManagementAndGeneral
Fundraising520Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1411359Total
Program Services1217825ProgramServices
Management And General191666ManagementAndGeneral
Fundraising1868Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total847696Total
Program Services219549ProgramServices
Management And General628147ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBT EXPENSE36115383611538
REPAIR & MAINTENANCE713728571085142339304
OTHER EXPENSES3916681503012372384129
INDIRECT ALLOCATION1556598-15597603162

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total52202600Total
Program Services44377155ProgramServices
Management And General7718312ManagementAndGeneral
Fundraising107133Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY3716825EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3336828BOY
EOY1771861EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8281104BOY
EOY5482480EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1302047BOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY534556BOY
EOY641915EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY902033BOY
EOY495012EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis29778424LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec18333500LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY10692087BOY
EOY11444924EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2171782BOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY254643BOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY69992BOY
EOY964250EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY27545072BOY
EOY24517267EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4411877BOY
EOY4830305EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY5609110BOY
EOY5382464EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY650288BOY
EOY1029827EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY10671275BOY
EOY11242596EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY16873797BOY
EOY13274671EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16873797BOY
EOY13274671EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27545072BOY
EOY24517267EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-3426869ReconcilationRevenueExpenses
Reconcilation Other Changes-172257ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis447947InvestmentCostOrOtherBasis
Other Cost Or Other Basis409146OtherCostOrOtherBasis
Book Value857093BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis16623392OtherCostOrOtherBasis
Depreciation9217028Depreciation
Book Value7406364BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis11059978OtherCostOrOtherBasis
Depreciation8361612Depreciation
Book Value2698366BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1237961OtherCostOrOtherBasis
Depreciation754860Depreciation
Book Value483101BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings11444924TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
CAPITAL LEASE OBLIGATIONS$857,827
ESTIMATED MEDICAID SETTLEMENTS$172,000
FieldValueIRS element (for citing)
Total Of Amounts1029827TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierLIABILITY UNDER FIN 48 FOOTNOTEIdentifier
Return ReferenceSCHEDULE D, PAGE 3, PART XReturnReference
ExplanationTHE ASSOCIATION IS EXEMPT FROM FEDERAL INCOME TAX. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE ASSOCIATION EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2011 AND 2010, THE ASSOCIATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1317500TotalCommunityBenefitExpense
Direct Offsetting Revenue7103DirectOffsettingRevenue
Net Community Benefit Expense1310397NetCommunityBenefitExpense
Percent Of Total Expense0.02700PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense17254282TotalCommunityBenefitExpense
Direct Offsetting Revenue14447311DirectOffsettingRevenue
Net Community Benefit Expense2806971NetCommunityBenefitExpense
Percent Of Total Expense0.05780PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense18571782TotalCommunityBenefitExpense
Direct Offsetting Revenue14454414DirectOffsettingRevenue
Net Community Benefit Expense4117368NetCommunityBenefitExpense
Percent Of Total Expense0.08480PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense18571782TotalCommunityBenefitExpense
Direct Offsetting Revenue14454414DirectOffsettingRevenue
Net Community Benefit Expense4117368NetCommunityBenefitExpense
Percent Of Total Expense0.08480PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served1371PersonsServed
Total Community Building Expense3449TotalCommunityBuildingExpense
Net Community Building Expense3449NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs6NumberOfActivitiesOrPrograms
Persons Served2976PersonsServed
Total Community Building Expense221572TotalCommunityBuildingExpense
Net Community Building Expense221572NetCommunityBuildingExpense
Percent Of Total Expense0.00460PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served4347PersonsServed
Total Community Building Expense225021TotalCommunityBuildingExpense
Net Community Building Expense225021NetCommunityBuildingExpense
Percent Of Total Expense0.00470PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$2,166,923BadDebtExpenseAmount
Amount Reimbursed By Medicare11810455AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare11858113CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-47658MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SUNNYSIDE COMMUNITY HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1PO BOX 719AddressLine1
CitySUNNYSIDECity
StateWAState
ZIP Code98944ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SUNNYSIDE COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent125.0FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent125.0FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities6NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
BIRCH STREET MEDICAL CENTER
222 E SECOND STREETGRANDVIEWWA98930RHC CLINIC
GRANDVIEW MEDICAL CENTER
208 N EUCLIDGRANDVIEWWA98944RHC CLINIC
LINCOLN AVENUE FAMILY MEDICINE
803 E LINCOLNSUNNYSIDEWA98944RHC CLINIC
VALLEY INTERNAL MEDICINE
1000 E EDISONSUNNYSIDEWA98944RHC CLINIC
SUNNYSIDE PEDIATRICS
812 MILLER AVENUE SUITE CSUNNYSIDEWA98944RHC CLINIC
SUNNYSIDE EAR NOSE & THROAT
2925 ALLEN ROADSUNNYSIDEWA98944SPECIALTY CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSEPART I LINE 7 COLUMN FBAD DEBT EXPENSE INCLUDED ON FORM 990 PART IX LINE 25 COLUMN A OF 3611538 WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN PART I LINE 7 COLUMN F
COSTING METHODOLOGY EXPLANATIONPART I LINE 7THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COSTTOCHARGES FOR AMOUNTS REPORTED IN THE TABLE TOTAL OPERATING EXPENSES LESS BAD DEBT NONPATIENT CARE ACTIVITIES MEDICAID PROVIDER TAXES TOTAL COMMUNITY BENEFIT AND TOTAL COMMUNITY BUILDING EXPENSES
COMMUNITY BUILDING ACTIVITIESPART IITHE COMMUNITY BUILDING ACTIVITIES DETAILED IN PART II PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY THE HOSPITAL IN THAT THE PHARMACEUTICALS AND TRANSPORTATION FOR PATIENTS IN NEED PROGRAM ASSISTS DISCHARGED PATIENTS THAT ARE NOT ABLE TO PURCHASE MEDICATION PRESCRIBED TO THEM AND TO PROVIDE TRANSPORTATION TO PATIENTS THAT MAY NOT HAVE A WAY OF GETTING HOME AFTER BEING DISCHARGED THIS PROGRAM WORKS TO PREVENT PATIENTS FROM HAVING RELAPSES AND RETURNING TO THE HOSPITAL DUE TO NOT FOLLOWING DISCHARGE INSTRUCTIONS ANDOR BECAUSE OF THEIR INABILITY TO PURCHASE THE NECESSARY MEDICINE PRESENTATIONS ARE MADE AT LOCAL SCHOOLS TO EDUCATE THOSE ABOUT THE CARDIOPULMONARY PROFESSION AND THE CONSEQUENCES OF BAD CHOICES SUCH AS DRUG AND ALCOHOL USE DIABETES EDUCATION IS ESSENTIAL AS THE LOWER VALLEY HAS A HIGH OCCURRENCE OF THIS CONDITION A SERIES OF SCHOOL PRESENTATIONS WERE ORGANIZED DURING THE NATIONAL DIABETES AWARENESS MONTH IN MARCH IN ORDER TO RAISE AWARENESS OF YOUNG PEOPLE ON THIS SUBJECT THE DIABETES EDUCATOR AND A REGISTERED DIETICIAN PROVIDE ONE ON ONE CONSULTATIONS FOR PATIENTS REFERRED BY THEIR DOCTOR IN ORDER TO EDUCATE THEM ON THE IMPORTANCE OF A BALANCED AND NUTRITIOUS DIET ALSO A FREE COMMUNITY DIABETES SCREENING CAMPAIGN WAS STARTED DUE TO THE HIGH NUMBER OF PEOPLE IN THE COMMUNITY THAT ARE UNDIAGNOSED OR PREDIABETIC RAISING AWARENESS AND ENCOURAGING THEM TO SEEK MEDICAL ATTENTION TO CONTROL THIS DISEASE THE HOSPITAL OFFERS CHILD BIRTH CLASSES FOR ANY EXPECTING MOTHERS REGARDLESS OF THEIR ABILITY TO PAY WHICH GREATLY BENEFITS THE PATIENTS AS INCOME LEVELS ARE GENERALLY LOW A CAR SEAT SAFETY CHECK EVENT WAS ORGANIZED DURING CHILD PASSENGER SAFETY WEEK IN SEPTEMBER IN ORDER TO RAISE AWARENESS ON THIS ISSUE A DEMONSTRATION WAS GIVEN TO PARENTS AND OTHER DRIVERS ON THE CORRECT PLACEMENT OF CAR SEATS INSIDE THE VEHICLE AND PROPERLY SECURING CHILDREN IN THE CAR SEAT INSTRUCTORS CHECKED FOR EXPIRED OR RECALLED CAR SEATS AND PROVIDED CAR SEATS TO THOSE DEEMED UNSAFE TO LEAVE THE PARKING LOT SUNNYSIDE PROVIDES A FIRST AID BOOTH AT COMMUNITY DAYS PROVIDING MEDICAL KITS GIVEAWAYS AND MEDICAL INFORMATION AS WELL AS FIRST AID SERVICES
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4FOR PART III LINE 2 THE HOSPITAL USED THE COST TO CHARGE RATIO OF PATIENT CARE TO DETERMINE THE COST OF BAD DEBT EXPENSE FOR PART III LINE 3 THE HOSPITAL DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITALS CHARITY CARE POLICY BUT FOR WHOM SUFFICIENT INFORMATION WAS NOT OBTAINED TO MAKE DETERMINATION OF THEIR ELIGIBILITY DURING THE YEAR THE HOSPITAL ACCOUNTS FOR DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBTS AS FOLLOWS PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE REIMBURSED COSTS DISCOUNTED CHARGES AND PER DIEM PAYMENTS NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS THIRD PARTY PAYORS AND OTHERS FOR SERVICES RENDERED INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD PARTY PAYORS FOR PART III LINE 4 THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS READS AS FOLLOWS RECEIVABLES ARISING FROM REVENUE FROM SERVICES TO PATIENTS ARE REDUCED BY ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS AND CONTRACTUAL ADJUSTMENTS BASED ON EXPERIENCE THIRDPARTY CONTRACTUAL REIMBURSEMENT ARRANGEMENTS AND ANY UNUSUAL CIRCUMSTANCES WHICH MAY AFFECT THE ABILITY OF PATIENTS TO MEET THEIR OBLIGATIONS ACCOUNTS DEEMED UNCOLLECTIBLE ARE CHARGED AGAINST THESE ALLOWANCES
MEDICARE EXPLANATIONPART III LINE 8ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BADMITTING AND TWO SELF PAY COUNSELORS VISIT WITH PATIENTS BEFORE THEY ARE DISCHARGED TO DETERMINE IF THE PATIENT QUALIFIES FOR CHARITY CARE BASED ON THE THEIR FINANCIAL POSITION AND THE FEDERAL POVERTY GUIDELINES THE APPLICATIONS ARE REVIEWED AND EVALUATED FOR CHARITY CARE STATUS AND WRITTEN OFF WHEN APPROPRIATE
NEEDS ASSESSMENTPART VITHE HOSPITAL BOARD THROUGH ASSOCIATION WITH HEALTHTECH ANNUALLY REVIEWS COMMUNITY DEMOGRAPHICS PATIENT ORIGINS CURRENT SERVICES AND FUTURE NEEDS FROM THIS REVIEW THE BOARD ASSESSES THE COMMUNITY NEEDS
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VITHE PUBLIC WILL BE NOTIFIED BY THE POSTING OF SIGNS IN ENGLISH AND IN SPANISH IN ALL REGISTRATION AND WAITING AREAS AND THE BUSINESS OFFICE THE SIGN STATES SUNNYSIDE COMMUNITY HOSPITAL PROVIDES CHARITY CARE TO PERSONS MEETING MEDICAL INDIGENT CRITERIA CHARGES MAY BE WAIVED OR REDUCED IF ELIGIBILITY FOR CHARITY CARE IS DETERMINED
COMMUNITY INFORMATIONPART VISUNNYSIDE GRANDVIEW AND THE REST OF THE LOWER YAKIMA VALLEY IS A CULTURALLY DIVERSE REGION OF NEARLY 40000 PEOPLE LIVING BETWEEN THE CITY OF YAKIMA ON THE WEST AND TRICITIES WASHINGTON ON THE EAST
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VITHE HOSPITALS CHARITY CARE PROGRAM PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE FINANCIAL RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTHCARE THEY RECEIVE THE CHARITY CARE PROGRAM IS DESIGNED TO ENSURE THAT THE YAKIMA VALLEY IN ITS ENTIRETY HAS ACCESS TO NECESSARY HEALTHCARE SERVICES THE HOSPITAL ACCEPTS ALL PATIENTS IN NEED OF MEDICAL ASSISTANCE REGARDLESS OF ABILITY TO PAY IN ADDITION TO THE CHARITY CARE PROGRAM THE HOSPITAL PROVIDES OR PARTICIPATES IN SEVERAL OTHER PROGRAMS WHICH CONTRIBUTE TO ITS CHARITABLE MISSION THE HOSPITAL PROVIDES COMMUNITY OUTREACH PROGRAMS INCLUDING ASSISTANCE WITH THE PURCHASE OF PRESCRIBED MEDICATIONS TRANSPORTATION HOME FOR PATIENTS DISCHARGED FROM THE HOSPITAL CARDIOPULMONARY EDUCATION WITH AN EMPHASIS ON THE RISK FROM DRUGS AND ALCOHOL CHILD BIRTH CLASSES CAR SEAT SAFETY CHECKS AND A FIRST AIDE BOOTH AT AN ANNUAL COMMUNITY EVENT
SUNNYSIDE COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 21PART V LINE 21PATIENTS ARE BILLED THE GROSS CHARGE FOR ALL SERVICES RECEIVED IF THE PATIENT THEN QUALIFIES FOR FINANCIAL ASSISTANCE THE BILL IS THEN ADJUSTED AS DETERMINED BY OUR CHARITY CARE POLICY GUIDELINES

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
WILLIAM COMBS
48423125597509828
STEVEN LEE
44743133813481244
ROBERT COLEMAN
36550818605384113
STEVEN ELERDING
35188024865376745
SOPHIE ZHAO
33560722910358517

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierOTHER ADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE J, PART IIIReturnReference
ExplanationTHE CEO AND CFO ARE BOTH HIRED AND PAID THROUGH HEALTHTECH MANAGEMENT SOLUTIONS. THE SALARIES ARE ESTABLISHED AT THE TIME OF HIRE, AND PERIODICALLY THEREAFTER. IN ADDITION TO BASE SALARY, THE CEO AND CFO MAY BE ELGIBLE FOR INCENTIVE COMPENSATION BASED ON PERFORMANCE PARAMETERS OUTLINED IN THE HOSPITAL'S CONTRACT WITH HEALTHTECH MANAGEMENT SOLUTIONS AND APPROVED BY THE HOSPITAL BOARD. THE MOST RECENT YEAR IN WHICH THIS PROCESS OCCURRED WAS 2011.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONTO PROVIDE QUALITY COMPREHENSIVE HEALTHCARE SERVICES TO THE RESIDENTS OF SUNNYSIDE, GRANDVIEW, AND THE REST OF THE LOWER YAKIMA VALLEY OF WASHINGTON. THE FACILITY OFFERS SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.
FIRST ACCOMPLISHMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4AVALUE OF PROVIDING CARE TO THESE PATIENTS WAS 2,195,834 FOR CHARITY CARE, 10,562,239 FOR MEDICARE, 14,866,751 FOR MEDICAID, AND 6,630,129 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR.
MANAGEMENT DELEGATEDFORM 990, PAGE 6, PART VI, LINE 3THE HOSPITAL CONTRACTS WITH HEALTHTECH MANAGEMENT SOLUTIONS (HTMS) FOR MANAGEMENT SERVICES AND UTILIZES AN EMPLOYEE OF HTMS AS ITS CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. HTMS PROVIDES EDUCATION TO BOARD MEMBERS, HOSPITAL MANAGERS AND OTHER EMPLOYEES. THEY OFFER FINANCIAL PERFORMANCE EVALUATION, AND EDUCATIONAL AND NETWORKING OPPORTUNITIES FOR NURSING AND OTHER PROFESSIONAL STAFF. THEY ALSO OFFER PLANNING AND GROUP PURCHASING OFFERING (GPO).
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BA COPY OF THE 990 IS PROVIDED TO THE CEO AND CFO WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER PRIOR TO APPROVAL OF THE 990. A DRAFT IS ALSO DISTRIBUTED TO THE BOARD OF DIRECTORS FOR REVIEW. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO AUTHORIZES THE PREPARER TO FINALIZE THE RETURN.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE CEO AND CFO ARE BOTH HIRED AND PAID THROUGH HEALTHTECH MANAGEMENT SOLUTIONS. THE SALARIES ARE ESTABLISHED AT THE TIME OF HIRE, AND PERIODICALLY THEREAFTER, TAKING THE FOLLOWING FACTORS INTO ACCOUNT: A) QUALIFICATIONS OF THE CANDIDATE, INCLUDING NUMBER OF YEARS OF DIRECTLY- RELATED EXPERIENCE B) PREVAILING CEO AND CFO COMPENSATION RATES, AS EVIDENCED BY SALARY SURVEY DATA FOR HOSPITALS OF SIMILAR SIZE AND WITHIN THE RELEVANT GEOGRAPHIC AREA; AND C) THE HOSPITAL'S ABILITY AND WILLINGNESS TO PAY, AS AGREED BY THE HOSPITAL BOARD OR A SUBCOMMITTEE THEREOF.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BA SALARY SURVEY IS REVIEWED FOR KEY EMPLOYEES BY THE CEO AND HR DIRECTOR. THE CEO MAKES RECOMMENDATIONS TO THE BOARD WHO THEN MAKE THE FINAL DECISION ON EMPLOYMENT CONTRACTS WITH PHYSICIANS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. SUMMARY FINANCIAL STATEMENTS ARE ALSO POSTED INTERNALLY ON THE HOSPITAL INTRANET.
ADDITIONAL INFORMATIONFORM 990, PART VIISUNNYSIDE COMMUNITY HOSPITAL AND SUNNYSIDE COMMUNITY HOSPITAL FOUNDATION SHARE TOP MANAGEMENT OFFICIALS. THE CEO AND CFO EACH DEVOTE APPROXIMATELY 40 HOURS PER WEEK TO THE HOSPITAL AND 1 HOUR PER WEEK TO THE FOUNDATION.
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5LOSS ON IMPAIRMENT OF GOODWILL: 254,643 PRIOR PERIOD ADJUSTMENT - CLO: ( 82,386) ======== 172,257

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1SUNNYSIDE COMMUNITY HOSPITAL FDNBusinessNameLine1
Business Name Line2FOUNDATIONBusinessNameLine2

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 719AddressLine1
CitySUNNYSIDECity
StateWAState
ZIP Code98944ZIPCode
FieldValueIRS element (for citing)
EIN912000867EIN
Primary ActivitiesSUPPORTPrimaryActivities
Legal Domicile StateWALegalDomicileState
Exempt Code Section501C3ExemptCodeSection
Public Charity Status11APublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SUNNYSIDEBusinessNameLine1
Business Name Line2COMMUNITY HOSPITALBusinessNameLine2
FieldValueIRS element (for citing)
Controlled OrgfalseControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SUNNYSIDE MEDICAL CENTERBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 719AddressLine1
CitySUNNYSIDECity
StateWAState
ZIP Code98944ZIPCode
FieldValueIRS element (for citing)
EIN911359169EIN
Primary ActivityRE RENTALPrimaryActivity
Legal Domicile StateWALegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income19768ShareOfTotalIncome
Share Of EOY Assets198657ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnertrueGeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SUNNYSIDE PROFESSIONAL SERVICES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 719AddressLine1
CitySUNNYSIDECity
StateWAState
ZIP Code98944ZIPCode
FieldValueIRS element (for citing)
EIN911340615EIN
Primary ActivityMOB MGMTPrimaryActivity
Legal Domicile StateWALegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityC CORPTypeOfEntity
Share Of Total Income19768ShareOfTotalIncome
Share Of EOY Assets198657ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1SUNNYSIDE COMMUNITY HOSPITAL FOUNDABusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeNTransactionType
Amount Involved50546AmountInvolved
Method Of Amt DeterminationDEVELOPMENT DIRECTOR COMPMethodOfAmtDetermination

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