PTSO OF WASHINGTON: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
PTSO OF WASHINGTON (EIN 20-1082052)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-15
IRS object ID
201233209349308573
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)
Timestamp2012-11-15T16:45:23-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN910189318EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11301 A STREET SUITE 600AddressLine1
CityTACOMACity
StateWAState
ZIP Code984024205ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN201082052EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PTSO OF WASHINGTONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPTSONameControl
Phone2064542811Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12101 FOURTH AVENUE NO 320AddressLine1
CitySEATTLECity
StateWAState
ZIP Code98121ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROY O LA CROIXName
TitleCEOTitle
Phone2064542811Phone
Date Signed2012-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameNANCY J SCHAUERName
PTINP01326437PTIN
Phone2535724100Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Name Of Principal Officer PersonROY O LA CROIXNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12101 FOURTH AVENUE 320AddressLine1
CitySEATTLECity
StateWAState
ZIP Code98121ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3507571GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.PTSOWA.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2004YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionSEE FORM 990 PART III, QUESTION 1.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year562863ContributionsGrantsPriorYear
Contributions Grants Current Year770491ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2908936ProgramServiceRevenuePriorYear
Program Service Revenue CY2736901ProgramServiceRevenueCY
Investment Income Prior Year169InvestmentIncomePriorYear
Investment Income Current Year179InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year3471968TotalRevenuePriorYear
Total Revenue Current Year3507571TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year3367849GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2961142GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year171424SalariesEtcPriorYear
Salaries Etc Current Year169355SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year25579TotalFundrsngExpCurrentYear
Other Expense Prior Year-198997OtherExpensePriorYear
Other Expenses Current Year629809OtherExpensesCurrentYear
Total Expenses Prior Year3340276TotalExpensesPriorYear
Total Expenses Current Year3760306TotalExpensesCurrentYear
Revenues Less Expenses Prior Year131692RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-252735RevenuesLessExpensesCY
Total Assets BOY4626591TotalAssetsBOY
Total Assets EOY3805944TotalAssetsEOY
Total Liabilities BOY1811212TotalLiabilitiesBOY
Total Liabilities EOY1243300TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2815379NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2562644NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPTSO OF WASHINGTON IS ESTABLISHED TO IMPROVE ACCESS AND THE LEVEL AND QUALITY OF HEALTHCARE FOR THE MEDICALLY UNDERSERVED THROUGH THE IMPROVEMENTS OF INFORMATION TECHNOLOGY SERVICES AVAILABLE TO COMMUNITY HEALTH CENTERS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense3133168Expense
Grants2961142Grants
Revenue2736901Revenue
DescriptionSTANDARDIZED TRAINING OF NEXTGEN BEST PRACTICES, DATA CENTER TECHNOLOGY REFRESH, ENTERPRISE WIDE TEST OF THE DISASTER RECOVERY SITE, KBM 7.8 SERVICE PACKS FOR MEANINGFUL USE, NEXTGEN 5.6 SP1 UPGRADE FOR MEANINGFUL USE, EDR UPGRADE, 2010 UDS REPORTING, PREPARATION FOR 2011 UDS REPORTING, ICD 10 PREPARATION, ANALYSIS OF MEANINGFUL USE MEASURES. HRSA (ARRA) CONTRIBUTION OF GRANT TO FUND INTEGRATED HEALTHCARE HOME PROJECT, CONSISTING OF THREE INTERRELATED PHASES, CDS - CUSTOMIZED CLINICAL DECISION SUPPORT WITH SUPPORTIVE REPORTING CAPABILITIES, EDR - ELECTRONIC DENTAL RECORD AND PORTAL - AN ON LINE PATIENT PORTAL. WIREC ( ARRA ) HEALTH INFORMATION TECHNOLOGY REGIONAL EXTENSION CENTER PROGRAM FOR WASHINGTON AND IDAHO. PASSED THROUGH QUALIS HEALTH. WORKED ON MILESTONE 3 OF AGREEMENT WITH QUALIS TO MEET STAGE 1 MEANINGFUL USE REQUIREMENTS - ALL 15 CORE OBJECTIVES PLUS 5 CHOSEN OBJECTIVES FOR A TOTAL OF 20 MEANINGFUL USE OBJECTIVES. AAPCHO ( ARRA ) CREATED INTERFACE BETWEEN PTSO AND PACIFIC INNOVATION COLLABORATIVE (PIC). SUPPLIED DIABETIC, CHILDHOOD IMMUNIZATION, AND ACCESS METRICS TO PIC.Description
Total Program Service Expense3133168TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
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 Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109612NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
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
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1GRACE E GRIFFINBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2064542818TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12101 FOURTH AVENUE 320AddressLine1
CitySEATTLECity
StateWAState
ZIP Code98121ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
TOM TROMPETER
PRESIDENT1.00X000
LINDA MCVEIGH
DIRECTOR1.00X000
MIKE HASSING
SECRETARY1.00X000
ANITA MONOIAN
DIRECTOR1.00X000
MARK SECORD
TREASURER (1-11)1.00X000
KATIE BELL
TREASURER (11-12)1.00X000
ROY O LA CROIX
CEO40.00015433415021X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs154334TotalReportableCompFrmRltdOrgs
Total Other Compensation15021TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Government Grants770491GovernmentGrants
Total Contributions770491TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionSERVICE FEE REVENUEDescription
Business Code812900BusinessCode
Total Revenue Column2736901TotalRevenueColumn
Related Or Exempt Function Income2736901RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue2736901TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column179TotalRevenueColumn
Exclusion$179ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3507571TotalRevenueColumn
Related Or Exempt Function Income2736901RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$179ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2961142Total
Program Services2961142ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total169355Total
Program Services152621ProgramServices
Fundraising16734Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total102672Total
Management And General102672ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total33756Total
Management And General33756ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total38653Total
Management And General38653ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total301121Total
Program Services273301ProgramServices
Management And General18975ManagementAndGeneral
Fundraising8845Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total113457Total
Management And General113457ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total248675Total
Program Services248675ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total39010Total
Program Services5871ProgramServices
Management And General33139ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total36347Total
Program Services5413ProgramServices
Management And General30934ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total497852Total
Program Services497852ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total17973Total
Management And General17973ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONTRACT SALARIES13862961226572159724
MAINTENANCE - SOFTWARE/722863722863
TAXES5227652276
GRANTS TO SUPPORTING OR-2961142-2961142

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3760306Total
Program Services3133168ProgramServices
Management And General601559ManagementAndGeneral
Fundraising25579Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1467336BOY
EOY1587517EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY439798BOY
EOY357664EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY738808BOY
EOY76650EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY135930BOY
EOY164390EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6056715LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4500766LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1744852BOY
EOY1555949EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY99867BOY
EOY63774EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY4626591BOY
EOY3805944EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY631620BOY
EOY148493EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY11668BOY
EOY2305EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1167924BOY
EOY1092502EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1811212BOY
EOY1243300EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2815379BOY
EOY2562644EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2815379BOY
EOY2562644EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4626591BOY
EOY3805944EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-252735ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (7 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocAmountAmount
COMMUNITY HEALTH PLAN OF WASHINGTON
91172971071$0
COMMUNITY HEALTH NETWORK OF WASHINGTON
91157718471$0
COUNTRY DOCTOR COMMUNITY HEALTH CENTERS
23710086871$282,340
FAMILY HEALTH CENTERS
91127501171$268,111
CHC OF KING COUNTY DBA HEALTHPOINT
91088441271$966,500
YAKIMA NEIGHBORHOOD HEALTH SERVICES
91092881771$345,127
NEIGHBORCARE HEALTH
91089328771$1,099,604
FieldValueIRS element (for citing)
Total Number Of Supported Orgs7TotalNumberOfSupportedOrgs
Sum Of Amounts2961682SumOfAmounts

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis6056715OtherCostOrOtherBasis
Depreciation4500766Depreciation
Book Value1555949BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1555949TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO CHNW$154,236
MEMBER DEPOSITS$937,804
ACCRUED PAYABLES$462
FieldValueIRS element (for citing)
Total Of Amounts1092502TotalOfAmounts
Total Revenue3507571TotalRevenue
Total Expenses3760306TotalExpenses
Excess Or Deficit For Year-252735ExcessOrDeficitForYear
Excess Or Deficit Per FS-252735ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt3507571TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal3507571RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9903507571TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt3760306TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal3760306ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9903760306TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationTHE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE ORGANIZATION'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THE ORGANIZATION DID NOT ENGAGE IN AN ACTIVITY UNRELATED TO ITS TAX EXEMPT PURPOSE, ACCORDINGLY NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE FINANCIAL STATEMENTS. IN ACCORDANCE WITH REQUIREMENTS RELATED TO ACCOUNTING FOR UNCERTAINTIES IN INCOME TAXES, THE ORGANIZATION HAS DETERMINED THEY HAVE NO UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2011 AND 2010. THE ORGANIZATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION UNDER SECTION 170(B)(1)(A)(VIII) AND HAS BEEN FURTHER CLASSIFIED AS A SUPPORTING ORGANIZATION UNDER SECTION 509(A)(3). THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE ORGANIZATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2008.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Non Cash AssistanceAmountOfNonCashAssistanceDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
COUNTRY DOCTOR CHC
500 19TH AVE EASTSEATTLEWA98112237100868501 C (3)282340VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT.SUPPORTIVE ASSISTANCE
FAMILY HEALTH CENTERS IN OKANOGAN
PO BOX 1340OKANOGANWA98840911275011501 C (3)268111VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT.SUPPORTIVE ASSISTANCE
CHC OF KING COUNTY DBA HEALTHPOINT
955 POWELL AVE SE SUITE ARENTONWA98057910884412501 C (3)966500VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT.SUPPORTIVE ASSISTANCE
YAKIMA NEIGHBORHOOD HEALTH SERVICES
PO BOX 2605YAKIMAWA98907910928817501 C (3)345127VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT.SUPPORTIVE ASSISTANCE
NEIGHBORCARE HEALTH
905 SPRUCE STREET SUITE 300SEATTLEWA98104910893287501 C (3)1099064VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT.SUPPORTIVE ASSISTANCE
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants5TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
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 PersonROY O LA CROIXNamePerson
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs140429CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs13905BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs9511DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs5510NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs169355TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationDURING 2011, COMMUNITY HEALTH NETWORK OF WASHINGTON, A SUPPORTED ORGANIZATION, PAID SALARY OF ROY LACROIX, EXECUTIVE DIRECTOR OF PTSO OF WASHINGTON.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11THE DRAFT COPY OF THE PTSO TAX FORM 990 WILL BE SENT TO THE FINANCE COMMITTEE FOR REVIEW. AFTER REVIEW BY THE FINANCE COMMITTEE, THE PTSO TAX FORM 990 WILL GO TO THE PTSO BOARD FOR REVIEW.
FORM 990, PART VI, SECTION B, LINE 12PTSO OF WASHINGTON DOES NOT HAVE A WRITTEN CONFLICT OF INTEREST POLICY, BUT ITS SUPPORTED ORGANIZATIONS HAVE THOSE POLICIES.
FORM 990, PART VI, SECTION B, LINE 15ATHE CEO IS COMPENSATED BY A RELATED ORGANIZATION. THIS RELATED ORGANIZATION USES THE FOLLOWING METHODS TO DETERMINE THE CEO'S COMPENSATION: APPROVAL BY THE BOARD, COMPENSATION STUDY/SURVEY, AND INDEPENDENT COMPENSATION CONSULTANT.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS AND GOVERNING/ORGANIZING DOCUMENTS ARE AVAILABLE UPON REQUEST.
THE PTSO FINANCE COMMITTE MAINTAINS OVERSIGHT OF THE PTSO FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. PTSO PUT AUDIT AND TAX SERVICES OUT FOR BID FOR FY 2011.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionControlled OrgControlledOrgPublic Charity StatusPublicCharityStatus
COMMUNITY HEALTH PLAN OF WASHINGTON
720 OLIVE WAY STE 300SEATTLEWA98101911729710PROVIDE HEALTH CARE SERVICES INSURANCE COVERAGE TO WASHINGTON STATE PROGRAMSWA501 C (4)0
COMMUNITY HEALTH NETWORK OF WASHINGTON
720 OLIVE WAY STE 300SEATTLEWA98101911577184PROMOTION OF ACCESSIBLE, AFFORDABLE AND QUALITY HEALTHCARE FOR WASHINGTON.WA501 C (4)0
COUNTRY DOCTOR CHC
500 19TH AVE EASTSEATTLEWA98112237100868FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERWA501 C (3)0170(B)(1)(A)(VI)
FAMILY HEALTH CENTERS IN OKANOGAN
PO BOX 1340OKANOGANWA98840911275011FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERWA501 C (3)0170(B)(1)(A)(VI)
CHC OF KING COUNTY DBA HEALTHPOINT
955 POWELL AVE SW SUITE ARENTONWA98057910884412FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERWA501 C (3)0170(B)(1)(A)(III)
YAKIMA NEIGHBORHOOD HEALTH SERVICES
PO BOX 2605YAKIMAWA98907910928817FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERWA501 C (3)0170(B)(1)(A)(VI)
NEIGHBORCARE HEALTH
905 SPRUCCE STREET SUITE 300SEATTLEWA98104910893287FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERWA501 C (3)0170(B)(1)(A)(III)
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
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 Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
COMMUNITY HEALTH NETWORK OF WASHINGTON
I105259FMV
COMMUNITY HEALTH NETWORK OF WASHINGTON
R102672FMV
COMMUNITY HEALTH NETWORK OF WASHINGTON
N1493916FMV

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