ISLAND HOSPITAL HEALTH FOUNDATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ISLAND HOSPITAL HEALTH FOUNDATION (EIN 91-1030686)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-07
- IRS object ID
- 201223129349301602
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-07T13:13:56-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | 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 | 2707 COLBY AVE SUITE 801 | AddressLine1 |
| City | EVERETT | City |
| State | WA | State |
| ZIP Code | 982013510 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911030686 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ISLAND HOSPITAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ISLA | NameControl |
| Phone | 3602994201 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 24TH STREET | AddressLine1 |
| City | ANACORTES | City |
| State | WA | State |
| ZIP Code | 98221 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM RABEL | Name |
| Title | TREASURER | Title |
| Phone | 3602994201 | Phone |
| Date Signed | 2012-10-29 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROBERT GRANNUM | Name |
| PTIN | P00355876 | PTIN |
| Phone | 4252597227 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DIANNE KUHN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 24TH STREET | AddressLine1 |
| City | ANACORTES | City |
| State | WA | State |
| ZIP Code | 98221 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 996620 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ISLANDHOSPITALFOUNDATION.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1978 | YearFormation |
| State Legal Domicile | WA | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF THE FOUNDATION IS TO RAISE FUNDS TO SUPPORT ISLAND HOSPITAL AND ITS COMMITMENT TO COMMUNITY HEALTH, IN AND AROUND ANACORTES, WASHINGTON. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 19 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 60 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2207577 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 830493 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 31696 | InvestmentIncomePriorYear |
| Investment Income Current Year | 35821 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -59478 | OtherRevenuePriorYear |
| Other Revenue Current Year | -94707 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 2179795 | TotalRevenuePriorYear |
| Total Revenue Current Year | 771607 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 799061 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 462836 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 121524 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 100074 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 55404 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 83210 | OtherExpensePriorYear |
| Other Expenses Current Year | 109610 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1003795 | TotalExpensesPriorYear |
| Total Expenses Current Year | 672520 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1176000 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 99087 | RevenuesLessExpensesCY |
| Total Assets BOY | 1985994 | TotalAssetsBOY |
| Total Assets EOY | 2028898 | TotalAssetsEOY |
| Total Liabilities BOY | 1091 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3887 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1984903 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2025011 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO RAISE FUNDS TO SUPPORT ISLAND HOSPITAL AND ITS COMMITMENT TO COMMUNITY HEALTH IN AND AROUND ANACORTES, WASHINGTON. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 150000 | Expense |
| Grants | 150000 | Grants |
| Description | FUND HOSPITAL RENOVATION AND EXPANSION COSTS NOT MET BY TAX REVENUE. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 397906 | Expense |
| Grants | 312836 | Grants |
| Description | FACILITATE OPERATIONAL NEEDS OF COMMUNITY PROGRAMS AND SERVICES OF LOCAL PUBLIC HOSPITAL DISTRICT. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 547906 | 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 | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 19 | 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 | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERNADETTE MOLNAR | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3602994247 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 24TH ST | AddressLine1 |
| City | ANACORTES | City |
| State | WA | State |
| ZIP Code | 98221 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| DIANNE KUHN | ||||||
| PRESIDENT | 2.00 | X | X | 0 | 0 | 0 |
| JOHN PROSSER | ||||||
| VICE PRESIDENT | 2.00 | X | X | 0 | 0 | 0 |
| DAVE MARGESON | ||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 |
| SHELLIE BOGOSIAN | ||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 |
| MARV SHELBY | ||||||
| PAST PRESIDENT | 1.00 | X | 0 | 0 | 0 | |
| BRENDA GRAHAM-APTER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DR MARK BACKMAN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JERREL BARTO | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| LANI DONOHOE | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CHRIS JENSEN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DIANA JORDAN-NEW | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BETH PRINS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BILL RABEL | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| AARON RASMUSSEN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JIM ROE | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DIANE RUSHER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| STEVE RUTZ | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ANNE SMITH | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JERALD ZAVALNEY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 242249 | FundraisingEvents |
| All Other Contributions | 588244 | AllOtherContributions |
| Noncash Contributions | 70298 | NoncashContributions |
| Total Contributions | 830493 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 35821 | TotalRevenueColumn |
| Exclusion | $35,821 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 130306 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 242249 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 225013 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -94707 | TotalRevenueColumn |
| Exclusion | -$94,707 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 771607 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$58,886 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 462836 | Total |
| Program Services | 462836 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78698 | Total |
| Program Services | 31479 | ProgramServices |
| Management And General | 19675 | ManagementAndGeneral |
| Fundraising | 27544 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21376 | Total |
| Program Services | 8550 | ProgramServices |
| Management And General | 5344 | ManagementAndGeneral |
| Fundraising | 7482 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7500 | Total |
| Program Services | 7500 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11017 | Total |
| Management And General | 11017 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11027 | Total |
| Program Services | 11027 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11467 | Total |
| Program Services | 11467 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11503 | Total |
| Program Services | 11503 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34940 | Total |
| Program Services | 189 | ProgramServices |
| Management And General | 14373 | ManagementAndGeneral |
| Fundraising | 20378 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8449 | Total |
| Management And General | 8449 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1146 | Total |
| Management And General | 1146 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| BANK FEES | 6473 | 6473 | |
| BAD DEBT EXPENSE | 3355 | 3355 | |
| MISCELLANEOUS | 2733 | 2733 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 672520 | Total |
| Program Services | 547906 | ProgramServices |
| Management And General | 69210 | ManagementAndGeneral |
| Fundraising | 55404 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100 | BOY |
| EOY | 100 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 277750 | BOY |
| EOY | 53309 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 163270 | BOY |
| EOY | 150917 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8290 | BOY |
| EOY | 30112 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21797 | BOY |
| EOY | 343 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1514787 | BOY |
| EOY | 1794117 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1985994 | BOY |
| EOY | 2028898 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1091 | BOY |
| EOY | 3887 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1091 | BOY |
| EOY | 3887 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1984903 | BOY |
| EOY | 2025011 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1984903 | BOY |
| EOY | 2025011 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1985994 | BOY |
| EOY | 2028898 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 99087 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -58979 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 1 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1827632 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 305479 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 516446 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 427076 | CurrentTaxYearMinus1Year |
| Current Tax Year | 830493 | CurrentTaxYear |
| Total | 3907126 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1827632 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 305479 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 516446 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 427076 | CurrentTaxYearMinus1Year |
| Current Tax Year | 830493 | CurrentTaxYear |
| Total | 3907126 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 763352 | AmountsSubstContributorsTotal |
| Public Support Total170 | 3143774 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 13461 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 5033 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 29458 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 31696 | CurrentTaxYearMinus1Year |
| Current Tax Year | 35821 | CurrentTaxYear |
| Total | 115469 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 4022595 | TotalSupport |
| Gross Receipts From Admissions Etc | 964491 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.78150 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.77150 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1386988 | BeginningOfYearBalance |
| Contributions | 33591 | Contributions |
| Investment Earnings Or Losses | -17903 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 27692 | GrantsOrScholarships |
| End Of Year Balance | 1374984 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 252065 | BeginningOfYearBalance |
| Contributions | 1129508 | Contributions |
| Investment Earnings Or Losses | 119052 | InvestmentEarningsOrLosses |
| Other Expenditures | 62572 | OtherExpenditures |
| Administrative Expenses | 51065 | AdministrativeExpenses |
| End Of Year Balance | 1386988 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | 250221 | Contributions |
| Investment Earnings Or Losses | 1844 | InvestmentEarningsOrLosses |
| End Of Year Balance | 252065 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.84890 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.14620 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00490 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (4 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| EQUITY FUNDS | 756321 | C |
| OTHER ASSETS | 353578 | C |
| MONEY MARKET FUNDS | 26238 | C |
| FIXED INCOME FUNDS | 657980 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 1794117 | TotalOfBookValueSecurities |
| Total Revenue | 771607 | TotalRevenue |
| Total Expenses | 672520 | TotalExpenses |
| Excess Or Deficit For Year | 99087 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -58979 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -58979 | TotalAdjustments |
| Excess Or Deficit Per FS | 40108 | ExcessOrDeficitPerFS |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE INCOME FROM THE ENDOWMENTS IS TO BE USED FOR TWO PURPOSES: HOSPITAL IDENTIFIED COMMUNITY HEALTH NEEDS AND TO PROVIDE FUNDS FOR THE BENEFIT OF THE BIRTHING CENTER. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | AS A CHARITABLE FOUNDATION, ISLAND HOSPITAL FOUNDATION IS A NOT-FOR-PROFIT CORPORATION AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A). FOR THE 2011 FINANCIAL STATEMENTS, THE FOUNDATION HAS ACCOUNTED FOR UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND WAS REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2011, THE FOUNDATION HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL OR DISCLOSURE. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GALA OF HOPE | NameOfEvent1 |
| Gross Receipts Event1 | 194962 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 130804 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 64158 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 34060 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 5997 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 36784 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 2620 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 20178 | OtherDirectExpensesEvent1 |
| Name Of Event2 | GOLF CLASSIC | NameOfEvent2 |
| Gross Receipts Event2 | 97574 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 56931 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 40643 | GrossRevenueEvent2 |
| Non Cash Prizes Event2 | 19567 | NonCashPrizesEvent2 |
| Rent Facility Costs Event2 | 30947 | RentFacilityCostsEvent2 |
| Other Direct Expenses Event2 | 17453 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 1 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 80019 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 54514 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 25505 | GrossRevenueOtherEvents |
| Non Cash Prizes Other Events | 25884 | NonCashPrizesOtherEvents |
| Rent Facility Costs Other Events | 9391 | RentFacilityCostsOtherEvents |
| Food And Beverage Other Events | 4218 | FoodAndBeverageOtherEvents |
| Entertainment Other Events | 2600 | EntertainmentOtherEvents |
| Other Direct Expenses Other Events | 15314 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 372555 | GrossReceiptsTotal |
| Charitable Contributions Total | 242249 | CharitableContributionsTotal |
| Gross Revenue Total Events | 130306 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 79511 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 46335 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 41002 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 5220 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 52945 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 225013 | DirectExpenseSummaryEvents |
| Net Income Summary | -94707 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ISLAND HOSPITAL SKAGIT COUNTY PUBLIC HOSPITAL DISTRICT NO 2 | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 24TH STREET | AddressLine1 |
| City | ANACORTES | City |
| State | WA | State |
| ZIP Code | 98221 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 910729255 | EINOfRecipient |
| IRC Section | SKAGIT COUNTY | IRCSection |
| Amount Of Cash Grant | 462486 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 350 | AmountOfNonCashAssistance |
| Method Of Valuation | FAIR MARKET VALUE | MethodOfValuation |
| Description Of Non Cash Assistance | TOYS FOR PHYSICAL THERAPY & REHABILITATION | DescriptionOfNonCashAssistance |
| Purpose Of Grant | SUPPORT OF HEALTH PROGRAMS AT HOSPITAL | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: ALL GRANTS AND ASSISTANCE ARE ONLY PROVIDED TO THE SUPPORTED ORGANIZATION ISLAND HOSPITAL AND UTILIZED ONLY FOR THE PURPOSE OF THAT GRANT (I.E. HEALTH SCREENING PROGRAM, DIABETES CARE). ISLAND HOSPITAL IS RESPONSIBLE FOR ENSURING FUNDS TRANSFERRED FROM ISLAND HOSPITAL FOUNDATION ARE DESIGNATED AND UTILIZED ONLY FOR THE PURPOSE INSTRUCTED, AND THE FOUNDATION RECEIVES REPORTS SHOWING FUNDS WERE DISBURSED TO DEPARTMENTS AS INSTRUCTED. | Explanation |
Schedule M IRS990ScheduleM
Clothing And Household Goods ClothingAndHouseholdGoods
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 40 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
Collectibles Collectibles
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 500 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
Food Inventory FoodInventory
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 12 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 2270 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
Other Non Cash Contributions Table OtherNonCashContributionsTable (3 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | CHRISTMAS DECORATIONS | 28 | 15874 | FMV |
| X | GIFT CERTIFICATES, TICKETS, PACKAGES, ETC. | 97 | 40849 | FMV |
| X | VARIOUS | 19 | 10115 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: | Identifier |
| Return Reference | PART I, COLUMN (B): | ReturnReference |
| Explanation | NUMBER OF CONTRIBUTORS IS THE ACTUAL NUMBER OF CONTRIBUTORS OF NON-CASH ITEMS, EXCLUDING CONTRIBUTORS OF SERVICES. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE BEFORE IT IS SIGNED AND FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | 1. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON: A. HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, B. HAS READ AND UNDERSTANDS THE POLICY, C. HAS AGREED TO COMPLY WITH THE POLICY, AND D. UNDERSTANDS IHF IS CHARITABLE ORGANIZATION AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. 2. EACH VOTING MEMBER OF THE BOARD SHALL ANNUALLY SIGN A STATEMENT WHICH DECLARES WHETHER SUCH PERSON IS AN INDEPENDENT DIRECTOR. 3. IF AT ANY TIME DURING THE YEAR, THE INFORMATION IN THE ANNUAL STATEMENT CHANGES MATERIALLY, THE DIRECTOR SHALL DISCLOSE SUCH CHANGES AND REVISE THE ANNUAL DISCLOSURE FORM. 4. THE EXECUTIVE COMMITTEE SHALL REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THIS POLICY BY REVIEWING ANNUAL STATEMENTS AND TAKING SUCH OTHER ACTIONS AS ARE NECESSARY FOR EFFECTIVE OVERSIGHT. | |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL ORGANIZATIONAL, FINANCIAL, AND TAX DOCUMENTS, INCLUDING FORM 990, ARE AVAILABLE UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -58,979. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C | THE METHOD BY WHICH THE FOUNDATION ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT, REVIEW, OR COMPILATION OF ITS FINANCIAL STATEMENTS AND SELECTION OF ITS INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PRIOR YEAR. | |
| FORM 990, PART VI, LINE 7A | FOR THE BOARD SELECTION, THE PRESIDENT, VICE PRESIDENT, AND PAST PRESIDENT RECRUIT AND BRING IN CANDIDATES. THE ENTIRE BOARD THEN VOTES ON ELECTING CANDIDATES TO THE BOARD. FINANCIAL, BUDGETARY AND GOVERNING DECISIONS REQUIRE A MAJORITY VOTE OF THE BOARD TO BE ADOPTED BY THE ORGANIZATION. |
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