FURP.ORG / PUBLIC DATA EXPLORER

MID-COLUMBIA HEALTH FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MID-COLUMBIA HEALTH FOUNDATION (EIN 93-0854433)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201233199349306033
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)
Timestamp2012-11-14T16:28:35-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN930418710EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELAP LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15885 MEADOWS ROAD NO 200AddressLine1
CityLAKE OSWEGOCity
StateORState
ZIP Code97035ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930854433EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MID-COLUMBIA HEALTH FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMID-NameControl
Phone5412961111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11700 E 19TH STREETAddressLine1
CityTHE DALLESCity
StateORState
ZIP Code97058ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDUANE FRANCISName
TitleCEOTitle
Phone5412961111Phone
Date Signed2012-11-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWESLEY B HANSENName
PTINP00226581PTIN
Phone5036974118Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDUANE FRANCISNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11700 E 19TH STREETAddressLine1
CityTHE DALLESCity
StateORState
ZIP Code97058ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2819320GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MCMC.NETWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1983YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionWORK TOGETHER WITH AND PROVIDE FINANCIAL SUPPORT TO MID-COLUMBIA MEDICAL CENTER IN ORDER TO PROVIDE ACCESS TO QUALITY HEALTHCARE FOR OUR COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees9TotalNbrEmployees
Total Nbr Volunteers94TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1023355ContributionsGrantsPriorYear
Contributions Grants Current Year940397ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year12181InvestmentIncomePriorYear
Investment Income Current Year70514InvestmentIncomeCurrentYear
Other Revenue Prior Year97594OtherRevenuePriorYear
Other Revenue Current Year72288OtherRevenueCurrentYear
Total Revenue Prior Year1133130TotalRevenuePriorYear
Total Revenue Current Year1083199TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1034364GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY467622GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year295259SalariesEtcPriorYear
Salaries Etc Current Year299992SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year155505OtherExpensePriorYear
Other Expenses Current Year163975OtherExpensesCurrentYear
Total Expenses Prior Year1485128TotalExpensesPriorYear
Total Expenses Current Year931589TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-351998RevenuesLessExpensesPriorYear
Revenues Less Expenses CY151610RevenuesLessExpensesCY
Total Assets BOY3015558TotalAssetsBOY
Total Assets EOY3075338TotalAssetsEOY
Total Liabilities BOY249058TotalLiabilitiesBOY
Total Liabilities EOY242826TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2766500NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2832512NetAssetsOrFundBalancesEOY
Mission DescriptionWORK TOGETHER WITH AND PROVIDE FINANCIAL SUPPORT TO MID-COLUMBIA MEDICAL CENTER IN ORDER TO PROVIDE ACCESS TO QUALITY HEALTHCARE FOR OUR COMMUNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense916801Expense
Grants467622Grants
Revenue1083199Revenue
DescriptionTHE PRIMARY PURPOSE OF THE FOUNDATION IS TO PROVIDE FUND RAISING FOR THE MID-COLUMBIA MEDICAL CENTER (ID# 93-0386936) AS WELL AS GRANTS / SCHOLARSHIPS TO THE GENERAL PUBLIC.Description
Total Program Service Expense916801TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees9NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MID-COLUMBIA MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5412961111TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11700 E 19TH STREETAddressLine1
CityTHE DALLESCity
StateORState
ZIP Code97058ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
PHIL KASER
DIRECTOR1.00X000
ROBERT BAILEY
TREASURER1.00X000
SHAWN CARROLL
DIRECTOR1.00X000
PAM CLAUSEN
DIRECTOR1.00X000
NAOMI GRIMSLEY
VICE-CHAIR1.00X000
DR FRANK TODA
DIRECTOR1.00X000
ROB CARNAHAN
DIRECTOR1.00X000
CYNTHIA KORTGE
DIRECTOR1.00X000
JASON COREY
DIRECTOR1.00X000
LINDA TRAUTZ
DIRECTOR1.00X000
DR PAULA LEE-VALKOV
SECRETARY1.00X000
DUANE FRANCIS
DIRECTOR1.00X0483759130991
DAVE GILDERSLEEVE
CHAIR1.00X000
BRIAN LAUTERBACH
DIRECTOR1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs483759TotalReportableCompFrmRltdOrgs
Total Other Compensation130991TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Related Organizations455625RelatedOrganizations
All Other Contributions484772AllOtherContributions
Total Contributions940397TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column34494TotalRevenueColumn
Exclusion$34,494ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1743658Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1707638Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities36020Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column36020TotalRevenueColumn
Exclusion$36,020ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events64585GrossIncomeFundraisingEvents
Fundraising Direct Expenses28483FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column36102TotalRevenueColumn
Exclusion$36,102ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCOFFEE CART FUNDDescription
Business Code722210BusinessCode
Total Revenue Column36186TotalRevenueColumn
Exclusion$36,186ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue36186TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1083199TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$142,802ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total390787Total
Program Services390787ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total76835Total
Program Services76835ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total266486Total
Program Services266486ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total33506Total
Program Services33506ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total3200Total
Program Services3200ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total7105Total
Program Services7105ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total104451Total
Program Services104451ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total16770Total
Program Services16770ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total3252Total
Program Services3252ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total500Total
Program Services500ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES19695490714788
PUBLIC RELATIONS77857785
MISCELLANEOUS12171217

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total931589Total
Program Services916801ProgramServices
Management And General14788ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY373561BOY
EOY444565EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2184105BOY
EOY661362EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY132346BOY
EOY79215EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY37166BOY
EOY113011EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY7818BOY
EOY7068EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis67378LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec63952LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3926BOY
EOY3426EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY1506912EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY276636BOY
EOY259779EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3015558BOY
EOY3075338EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5009BOY
EOY6324EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY244049BOY
EOY236502EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY249058BOY
EOY242826EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1488210BOY
EOY1572131EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY918748BOY
EOY898984EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY359542BOY
EOY361397EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2766500BOY
EOY2832512EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3015558BOY
EOY3075338EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses151610ReconcilationRevenueExpenses
Reconcilation Other Changes-85598ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years221663CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years490845CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years888476CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year590612CurrentTaxYearMinus1Year
Current Tax Year484772CurrentTaxYear
Total2676368Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years221663CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years490845CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years888476CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year590612CurrentTaxYearMinus1Year
Current Tax Year484772CurrentTaxYear
Total2676368Total
FieldValueIRS element (for citing)
Public Support Total1702676368PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years99403CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years56150CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6541CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12181CurrentTaxYearMinus1Year
Current Tax Year70514CurrentTaxYear
Total244789Total
FieldValueIRS element (for citing)
Total Support2921157TotalSupport
Gross Receipts From Admissions Etc493533GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.91620PublicSupportPertcentage170
Public Support Pertcent Prior Year0.92500PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1278290BeginningOfYearBalance
Contributions413749Contributions
Investment Earnings Or Losses6603InvestmentEarningsOrLosses
Grants Or Scholarships438261GrantsOrScholarships
End Of Year Balance1260381EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance357664BeginningOfYearBalance
Contributions32657Contributions
Investment Earnings Or Losses402InvestmentEarningsOrLosses
Grants Or Scholarships23127GrantsOrScholarships
End Of Year Balance367596EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance358543BeginningOfYearBalance
Contributions13818Contributions
Investment Earnings Or Losses890InvestmentEarningsOrLosses
Grants Or Scholarships15587GrantsOrScholarships
End Of Year Balance357664EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance347617BeginningOfYearBalance
Contributions10659Contributions
Investment Earnings Or Losses6106InvestmentEarningsOrLosses
Grants Or Scholarships5839GrantsOrScholarships
End Of Year Balance358543EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.64410BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.06920PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.28670TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis67378OtherCostOrOtherBasis
Depreciation63952Depreciation
Book Value3426BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3426TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionCHARITABLE REMAINDER TRUSTDescription
Book Value259779BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets259779TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DUE TO MID-COLUMBIA MEDICAL CENTER$74,717
LONG TERM DEBT - ANNUITIES$161,785
FieldValueIRS element (for citing)
Total Of Amounts236502TotalOfAmounts
Total Revenue1083199TotalRevenue
Total Expenses931589TotalExpenses
Excess Or Deficit For Year151610ExcessOrDeficitForYear
Net Unrealized GL On Investments-79239NetUnrealizedGLOnInvestments
Other-$6,359OtherAmount
Total Adjustments-85598TotalAdjustments
Excess Or Deficit Per FS66012ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt107345534TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-79239NetUnrealizedGainsInvestments
Other Revenues106341574OtherRevenues
Revenue Not Rptd F990106262335RevenueNotRptdF990
Revenue Subtotal1083199RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9901083199TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt103806413TotExpensesEtcAuditedFinclStmt
Other Expenses Included102874825OtherExpensesIncluded
Expenses Not Rptd F990102874825ExpensesNotRptdF990
Expenses Subtotal931588ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990931588TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierExplanationExplanation
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENT -6,359.
PART XII, LINE 2D - OTHER ADJUSTMENTS:REVENUE OF OTHER ENTITIES IN AUDITED F/S 106,347,933. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENT -6,359.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:EXPENSES OF OTHER ENTITIES IN AUDITED F/S 102,874,825.
PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE DISCLOSURE FOR UNCERTAIN TAX POSITIONS: INCOME TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AT THE LARGEST AMOUNT OF INCOME TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH INCOME TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED INCOME TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS WOULD BE CLASSIFIED AS INCOME TAXES IN THE STATEMENTS OF OPERATIONS. THERE WERE NO UNRECOGNIZED INCOME TAX BENEFITS, NOR ANY INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS, ACCRUED OR EXPENSED AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2011 AND 2010.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1TOURN OF TRADITIONNameOfEvent1
Gross Receipts Event128885GrossReceiptsEvent1
Gross Revenue Event128885GrossRevenueEvent1
Other Direct Expenses Event111338OtherDirectExpensesEvent1
Name Of Event2FESTIVAL OF TREESNameOfEvent2
Gross Receipts Event228610GrossReceiptsEvent2
Gross Revenue Event228610GrossRevenueEvent2
Other Direct Expenses Event29286OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events7090GrossReceiptsOtherEvents
Gross Revenue Other Events7090GrossRevenueOtherEvents
Other Direct Expenses Other Events7859OtherDirectExpensesOtherEvents
Gross Receipts Total64585GrossReceiptsTotal
Gross Revenue Total Events64585GrossRevenueTotalEvents
Other Direct Expenses Total Events28483OtherDirectExpensesTotalEvents
Direct Expense Summary Events28483DirectExpenseSummaryEvents
Net Income Summary36102NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
MID-COLUMBIA MEDICAL CENTER
1700 E 19TH STREETSTHE DALLESOR97058930386936501(C)(3)257799SUPPORT HOSPITAL ACTIVITIES.
MAMMOGRAPHY ASSIST FUND MID-COLUMBIA MEDICAL CENTER
1700 E 19TH STREETSTHE DALLESOR97058930386936501(C)(3)37779ASSISTING MAMMOGRAPHY PATIENTS.
CELILO CENTER FUND MID-COLUMBIA MEDICAL CENTER
1700 E 19TH STREETSTHE DALLESOR97058930386936501(C)(3)21857ASSISTING CANCER PATIENTS.
CHAPLAINS FUND MID-COLUMBIA MEDICAL CENTER
1700 E 19TH STREETSTHE DALLESOR97058930386936501(C)(3)18230EMERGENCY FUNDING FOR PATIENTS.
AREA OF GREATEST NEED FUND MID-COLUMBIA MEDICAL CENTER
1700 E 19TH STREETSTHE DALLESOR97058930386936501(C)(3)6620SUPPORT HOSPITAL ACTIVITIES
DIGITAL IMAGING FUND MID-COLUMBIA MEDICAL CENTER
1700 E 19TH STREETSTHE DALLESOR97058930386936501(C)(3)5925DIGITAL IMAGING EQUIPMENT & SERVICES
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (3 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
ROOD MEMORIAL SCHOLARSHIP3260830
VARIOUS MID-COLUMBIA MEDICAL CENTER SCHOLARSHIPS167505
VARIOUS MID-COLUMBIA MEDICAL CENTER NURSING SCHOLARSHIPS118500

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: AN INTERNAL GRANT MANAGER TRACKS ALL EXPENSES RELATED TO THE GRANT AND REPORTS THEM PERIODICALLY IN A WRITTEN REPORT TO THE GRANTOR. SOME GRANTS CONTAIN LINE-ITEM BUDGETS WHICH ALSO MUST BE MET AND ARE SUBJECT TO AUDIT BY THE GRANTOR.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonDUANE FRANCISNamePerson
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs483759CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs99572DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs31419NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs614750TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationDUANE FRANCIS - $84,872Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
PATRICK GRIMSLEY
SPOUSE OF CURRENT DIRECTOR NAOMI GRIMSLEY335361EMPLOYMENT AS ER PHYSICIAN AND MEDICAL DIRECTOR0
DESIGN STRUCTURES LLC
ENTITY IN WHICH CURRENT DIRECTOR DAVE GILDERSLEEVE SERVES AS AN OFFICER1775432VARIOUS CONSTRUCTION PROJECTS0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6HEALTHCARE FOR THE MID-COLUMBIA REGION IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11NO REVIEW WAS OR WILL BE CONDUCTED.
FORM 990, PART VI, SECTION B, LINE 12CWE ANNUALLY REQUIRE ALL EMPLOYEES AND DIRECTORS TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. IF A CONFLICT WAS DISCOVERED FOR AN EMPLOYEE OR DIRECTOR WITH A SIGNED DISCLOSURE STATEMENT, THEY WOULD BE SUBJECT TO CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION FOR VIOLATION OF OUR POLICY. IF THEY SELF-DISCLOSED A POTENTIAL CONFLICT OF INTEREST ON THE FORM, WE WOULD GATHER INFORMATION ON THE ISSUE AND MAKE A DETERMINATION ON HOW SEVERE THE CONFLICT IS AND WHETHER OR NOT THE EMPLOYEE OR DIRECTOR COULD REMAIN AN EMPLOYEE. THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY WITH EMPLOYEES AS PART OF THE PERFORMANCE REVIEW PROCESS.
FORM 990, PART VI, SECTION B, LINE 15THE CEO IS COMPENSATED BY HEALTH CARE FOR THE MID-COLUMBIA REGION, A RELATED ORGANIZATION. THE BOARD OF HEALTH CARE FOR THE MID-COLUMBIA REGION ENGAGES A PROFESSIONAL FIRM TO DO A REGIONAL AND NATIONAL SURVEY, ALONG WITH A COMPARISON OF ORGANIZATION COMPLEXITY AND STRUCTURE, AND THEN RECOMMENDS A SALARY AND BENEFITS RANGE TO THE BOARD. THIS IS ALL DONE CONFIDENTIALLY WITHOUT CEO PARTICIPATION. THE CEO THEN NEGOTIATES WITH THE BOARD, WHICH COMPARES THE COMPENSATION DISCUSSED WITH THE ANALYSIS PREVIOUSLY DESCRIBED AND VOTES ON AND APPROVES A NEW CONTRACT IN EXECUTIVE SESSION WITHOUT CEO PRESENCE OR PARTICIPATION IN THE VOTE. COMPENSATION OF THE ORGANIZATIONS OFFICERS OR KEY EMPLOYEES IS DETERMINED BY A SURVEY OF MARKET RATES FOR SIMILAR POSITIONS.
FORM 990, PART VI, SECTION C, LINE 19CURRENTLY NOT AVAILABLE.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -79,239. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENT -6,359. TOTAL TO FORM 990, PART XI, LINE 5: -85,598.CHANGES IN NET ASSETS OR FUND BALANCES:
THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THEIR FINANCIAL STATEMENTS & SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
HEALTH CARE FOR THE MID-COLUMBIA REGION
1700 E 19TH STREETTHE DALLESOR97058930847905HEALTH SERVICESOR501(C)(3)3HEALTHCARE FOR THE MID-COLUMBIA REGION0
MID-COLUMBIA MEDICAL CENTER
1700 E 19TH STREETTHE DALLESOR97058930386936ACUTE HOSPITAL CAREOR501(C)(3)3HEALTHCARE FOR THE MID-COLUMBIA REGION0

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
DRY HOLLOW INC
1700 E 19TH STREETTHE DALLESOR97058930631350RENTAL BUILDINGORHEALTHCARE FOR THE MID-COLUMBIA REGIONC
MID-COLUMBIA HEALTH SERVICES
1700 E 19TH STREETTHE DALLESOR97058930840781MEDICAL BILLINGORHEALTHCARE FOR THE MID-COLUMBIA REGIONC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MID-COLUMBIA MEDICAL CENTER
B448799GRANTS PAID
MID-COLUMBIA MEDICAL CENTER
C455625GRANT RECEIVED
MID-COLUMBIA MEDICAL CENTER
E74717LOANS FROM RELATED PARTY
MID-COLUMBIA MEDICAL CENTER
N299992EMPLOYEE GROSS PAY
MID-COLUMBIA MEDICAL CENTER
P149186ACTUAL EXPENSES