2012-10-15T13:45:29-05:00 2012-05-31 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 980041446 990 2011-06-01 911349657 COMMUNITY HEALTH CARE COMM 2535974550 1019 PACIFIC AVE NO 300 TACOMA WA 98402 DAVID FLENTGE 2537221502 2012-10-01 1 PAUL MBAILEY P00292653 4252506100 2012-10-01 2011 2016-02-24 21:20:13Z X DAVID FLENTGE 1019 PACIFIC AVE NO 300 TACOMA WA 98402 26606305 0 X WWW.COMMHEALTH.ORG X 1987 WA TO PROVIDE THE HIGHEST QUALITY HEALTH CARE WITH COMPASSIONATE AND ACCESSIBLE SERVICE FOR ALL. 15 15 369 56 0 0 4257171 4972679 23522034 20682576 27717 47426 4932 867001 27811854 26569682 11130 0 0 0 21076469 19510042 41848 34890 299346 8403958 8011453 29533405 27556385 -1721551 -986703 36548377 38047999 8252571 10721229 28295806 27326770 X COMMUNITY HEALTH CARE PROVIDES COMPREHENSIVE PRIMARY MEDICAL AND DENTAL CARE THROUGH A CLINIC SYSTEM THAT INCLUDES FIVE MEDICAL AND TWO DENTAL CLINICS. IN ADDITION, CARE IS ALSO PROVIDED THROUGH A WOMEN'S HEALTH CLINIC. 0 0 13558658 11743325 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 5/31/2012, CHC PROVIDED 23,360 PATIENTS WITH MEDICAL CARE FROM 83,244 PATIENT VISITS AT 5 MEDICAL CLINICS. 63% OF PATIENTS ARE AT POVERTY LEVEL AND 84% OF PATIENTS ARE LOW-INCOME. CHC PROVIDED $1,505,792 IN TOTAL SLIDE FEE DISCOUNTS FOR FISCAL YEAR END 5/31/2012. 4381460 4331121 COMMUNITY HEALTH CARE (CHC) DENTAL CLINICS OFFER PRIMARY CARE DENTAL SERVICES IN TWO PIERCE COUNTY LOCATIONS ACCORDING TO THE SAME FEE STRUCTURE. DURING THE FISCAL YEAR ENDED 5/31/2012, CHC PROVIDED 32,846 DENTAL VISITS TO 13,237 PATIENTS AT TWO DENTAL CLINICS. 2451803 3307464 FOUR PHARMACIES OFFER PHARMACEUTICAL SERVICES TO PATIENTS IN TWO LOCATIONS IN PIERCE COUNTY ACCORDING TO THE SAME FEE STRUCTURE NOTED ABOVE. THE PHARMACY SERVED 13,262 PATIENTS THROUGH 93,599 MEDICATION FILLS. 1238541 1300666 COMMUNITY HEALTH CARE PROVIDES EXTENSIVE MATERNITY SUPPORT SERVICES TO HIGH RISK PREGNANT MOTHERS. THIS INCLUDES IN-OFFICE AND IN-HOME CARE BY NURSES, SOCIAL WORKERS, AND NUTRITIONISTS. THE ORGANIZATION ALSO PROVIDES SERVICES OF AN OPTHAMOLOGIST, PARTICULARLY FOR DIABETIC PATIENTS. 1238541 1300666 21630462 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 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 0 0 0 0 0 1 35 0 369 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X BRENDA JOZWIAK 2537221502 1019 PACIFIC AVE ST 300 TACOMA WA 98402 BRENDA JOZWIAK 40.00 X X 30121 0 7311 DOUG SWANBERG 4.00 X X 0 0 0 GARY WALMER 4.00 X X 0 0 0 PEG DEMPSEY 4.00 X X 0 0 0 DEBRA YOUNG 4.00 X X 0 0 0 LINDA BOWMAN 2.00 X 0 0 0 PETER SETO 2.00 X 0 0 0 DAN SLOAN 2.00 X 0 0 0 LYSA BARBANO 2.00 X 0 0 0 IRENE MAZER 2.00 X 0 0 0 KYLE SHIMAMOTO 2.00 X 0 0 0 LADEDRIA GRIFFIN- STALLWORTH 2.00 X 0 0 0 MARTHA MAGANA 2.00 X 0 0 0 NAN HOGAN 2.00 X 0 0 0 RIA JOHNSON 2.00 X 0 0 0 GEORGE TANBARA 2.00 X 0 0 0 DAVID FLENTGE 40.00 X 148259 0 29761 JEFFREY SMITH 40.00 X 234341 0 48025 RALPH NEIGHBOR 40.00 X 234882 0 46850 CHUCK SAMUELS 40.00 X 190173 0 34245 STEPHEN COOK 32.00 X 165238 0 33179 DAVID CAMERON 32.00 X 152709 0 44318 TODD CHAMBERS 40.00 X 150474 0 42504 1306197 0 286193 26 0 1 0 JOHNSON ARCHITECTURE 2124 3RD AVE STE 200 SEATTLE WA 98121 ARCHITECTURE SERVICES 686163 LABCORP PO BOX 12140 BURLINGTON NC 27216 PATIENT LAB SERVICES 216449 NEXTGEN PO BOX 511449 LOS ANGELES CA 90051 EMR SERVICES 207596 OPENWORKS 4742 N 24TH ST STE 450 PHOENIX AZ 85016 JANITORIAL SERVICES 178353 LARRY MCWILLIAMS BUILDER 21214 46TH AVE E SPANAWAY WA 98387 CONSTRUCTION SERVICES 161200 8 32023 3599683 1340973 666522 4972679 PATIENT FEES 621400 17893259 17893259 PHARMACY REVENUE 621300 2789317 2789317 20682576 47426 47426 810 0 810 810 810 0 32023 36623 -36623 -36623 MEANINGFUL USE REVENUE 711300 873021 873021 MISCELLANEOUS REVENUE 900099 29793 29793 902814 26569682 20682576 0 914427 667541 386037 281504 14688574 11686411 2862948 139215 523695 441381 75884 6430 2556442 1999372 544615 12455 1073790 838359 225602 9829 128014 33006 94304 704 58146 58146 34890 34890 1131031 1047889 83142 148450 16550 115478 16422 443490 229916 187585 25989 332835 266738 64467 1630 846578 420905 404643 21030 211415 93601 116866 948 62388 3435 35242 23711 213228 207571 5657 1304125 1041720 262281 124 102984 70141 32732 111 MEDICAL AND DENTAL SUPP 1984119 1977099 6455 565 BAD DEBT 444264 444264 0 0 FEES, TAXES, AND DUES 331014 219743 108866 2405 REPAIRS AND MAINTENANCE 210192 177451 31830 911 59180 28873 28330 1977 27556385 21630462 5626577 299346 7661709 9175941 3506554 3202630 172900 433962 2799558 2792823 226794 198863 203326 204756 30790405 9407033 20997064 21383372 980472 655652 36548377 38047999 3543604 6075559 35498 1460000 1395000 3248967 3215172 8252571 10721229 X 28295806 26920586 406184 28295806 27326770 36548377 38047999 X -986703 17667 X 0 1 1 X 1 1 X 6610272 9314479 6331802 4257171 5639201 32152925 6610272 9314479 6331802 4257171 5639201 32152925 32152925 381836 66235 -229272 27717 47426 293942 47322 291287 -12239 4932 903624 1234926 33681793 121081254 0.95460 0.96760 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 0 0 0 0 1 1146 1146 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: CEO SPENT APPROXIMATELY TEN HOURS LOBBYING. 3642530 3642530 16725531 2862028 13863503 2297428 914656 1382772 6822755 5531075 1291680 1302161 99274 1202887 21383372 26569682 27556385 -986703 17667 17667 -969036 26180048 17667 -443924 -426257 26606305 -36623 -36623 26569682 27149084 36623 36623 27112461 443924 443924 27556385 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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 2009. PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE INCLUDED IN FUNCTIONAL EXPENSES -443,924. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES RELATED TO FUNDRAISING -36,623. PART XIII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES RELATED TO FUNDRAISING 36,623. PART XIII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE INCLUDED IN REVENUE ON FINANCIAL STATEMENTS 443,924. X X X X X 1 COMMUNITY LINK CONSULTING PO BOX 276 NEWMAN LAKE WA 99025 GRANT APPLICATIONS 0 350000 14300 335700 RICHARD OLDENBURG 6825 RAINER AVE GIG HARBOR WA 98335 MAJOR & PLANNED GIFT CONSULTING 0 0 57408 -57408 350000 71708 278292 WA ANNUAL LUNCHEON 32023 32023 4000 13177 15278 4168 32023 32023 4000 13177 15278 4168 36623 -36623 X X X X 0 0 0 0 0 0 0 0 0 DAVID FLENTGE 148259 0 0 0 0 0 20524 0 9237 0 178020 0 0 0 JEFFREY SMITH 216577 0 17764 0 0 0 28280 0 19745 0 282366 0 0 0 RALPH NEIGHBOR 211143 0 23739 0 0 0 33112 0 13738 0 281732 0 0 0 CHUCK SAMUELS 165998 0 24175 0 0 0 25375 0 8870 0 224418 0 0 0 STEPHEN COOK 148014 0 17224 0 0 0 24346 0 8833 0 198417 0 0 0 DAVID CAMERON 134665 0 18044 0 0 0 23889 0 20429 0 197027 0 0 0 TODD CHAMBERS 145281 0 5193 0 0 0 24534 0 17970 0 192978 0 0 0 WA HEALTH CARE FACILITIES AUTHORITY 911108929 93978EUWO 2003-01-23 3320000 TO FUND BUILDING 0 0 1 1925000 3320000 96667 185620 3088333 2003 0 0 1 1 0 0 0 0 1 0 1 0 0 0 0 X VACCINATIONS 1 494544 CDC PRICING X MEDICATIONS 76 155979 AWP 0 0 1 0 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: DONATED SERVICES AND USE OF FACILITIES: 17,667. 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%.