TAHOE FOREST HEALTH SYSTEM FOUNDATION: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- TAHOE FOREST HEALTH SYSTEM FOUNDATION (EIN 94-3047869)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-03-14
- IRS object ID
- 201100739349300615
- Schema version
- 2009v1.7
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-03-14T15:25:14-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MATSON AND ISOM | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3013 CERES AVENUE | AddressLine1 |
| City | CHICO | City |
| State | CA | State |
| ZIP Code | 95973 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 943047869 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tahoe Forest Health System Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | TAHO | NameControl |
| Phone | 5305826329 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2508 | AddressLine1 |
| City | Truckee | City |
| State | CA | State |
| ZIP Code | 961602508 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Martha Simon | Name |
| Title | Chief Development Officer | Title |
| Phone | 5305826329 | Phone |
| Date Signed | 2011-02-28 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Bill Peterson | Name |
| Phone | 5308916474 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Martha Simon | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2508 | AddressLine1 |
| City | Truckee | City |
| State | CA | State |
| ZIP Code | 961602508 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1277330 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.tfhd.com/tahoeforestfoundation.asp | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1987 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | To create a culture of collaboration that results in excellence in community health care | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 459 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 919123 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 843085 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 268 | InvestmentIncomePriorYear |
| Investment Income Current Year | 107 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 160690 | OtherRevenuePriorYear |
| Other Revenue Current Year | 297456 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1080081 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1140648 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 493797 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 497812 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 402682 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 281048 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 84314 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 238015 | OtherExpensePriorYear |
| Other Expenses Current Year | 127941 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1134494 | TotalExpensesPriorYear |
| Total Expenses Current Year | 906801 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -54413 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 233847 | RevenuesLessExpensesCY |
| Total Assets BOY | 140009 | TotalAssetsBOY |
| Total Assets EOY | 336393 | TotalAssetsEOY |
| Total Liabilities BOY | 130152 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 92689 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9857 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 243704 | NetAssetsOrFundBalancesEOY |
| Mission Description | To create a culture of collaboration which facilitates the exploration of creative opportunities and solutions that result in excellence in community health care | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 447935 | Expense |
| Grants | 349326 | Grants |
| Description | Provided support to the Tahoe Forest Hospital District for the Tahoe Forest Cancer Center and cancer research. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 47085 | Expense |
| Grants | 36720 | Grants |
| Description | Provided support to the Tahoe Forest Hospital District's Hospice program. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 143317 | Expense |
| Grants | 111766 | Grants |
| Description | Provided support to a variety of services and programs at the Tahoe Forest Hospital District, including long-term care, the Children's Center, community wellness, emergency services, intensive care, home health, and the Women & Family Center. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 638337 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| 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 |
| 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 |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | 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 | 0 | ConflictOfInterestPolicy |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tahoe Forest Hospital District | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5305823489 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10121 Pine Avenue | AddressLine1 |
| City | Truckee | City |
| State | CA | State |
| ZIP Code | 96160 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (8 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| Tom Hobday | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Pam Hobday | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Robert Kennedy | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Chris Ryman | ||||||
| Vice President | 5.00 | X | 0 | 0 | 0 | X |
| Roger Wittenberg | ||||||
| President | 5.00 | X | 0 | 0 | 0 | X |
| Stuart Yount | ||||||
| Secretary | 5.00 | X | 0 | 0 | 0 | X |
| Roger Kahn | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Martha Simon | ||||||
| Chief Dev. Officer | 40.00 | 0 | 148127 | 0 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 148127 | 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 |
| Government Grants | 15973 | GovernmentGrants |
| All Other Contributions | 827112 | AllOtherContributions |
| Noncash Contributions | 401605 | NoncashContributions |
| Total Contributions | 843085 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 107 | TotalRevenueColumn |
| Exclusion | $107 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 434138 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 136682 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 297456 | TotalRevenueColumn |
| Exclusion | $297,456 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1140648 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $297,563 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 497812 | Total |
| Program Services | 497812 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148127 | Total |
| Program Services | 74064 | ProgramServices |
| Management And General | 29625 | ManagementAndGeneral |
| Fundraising | 44438 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62714 | Total |
| Program Services | 31357 | ProgramServices |
| Management And General | 12543 | ManagementAndGeneral |
| Fundraising | 18814 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70207 | Total |
| Program Services | 35104 | ProgramServices |
| Management And General | 14041 | ManagementAndGeneral |
| Fundraising | 21062 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8618 | Total |
| Management And General | 8618 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral |
|---|---|---|
| General & admin. | 62870 | 62870 |
| Professional fees | 32138 | 32138 |
| Services | 24315 | 24315 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 906801 | Total |
| Program Services | 638337 | ProgramServices |
| Management And General | 184150 | ManagementAndGeneral |
| Fundraising | 84314 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 130517 | BOY |
| EOY | 332258 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5550 | BOY |
| EOY | 193 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3942 | BOY |
| EOY | 3942 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 140009 | BOY |
| EOY | 336393 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 128025 | BOY |
| EOY | 49743 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2127 | BOY |
| EOY | 42946 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 130152 | BOY |
| EOY | 92689 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7537 | BOY |
| EOY | 19478 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2320 | BOY |
| EOY | 224226 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9857 | BOY |
| EOY | 243704 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 140009 | BOY |
| EOY | 336393 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tahoe Forest Hospital District | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 946004062 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 1 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $497,812 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 497812 | SumOfAmounts |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Held in trust for others | $1,231 |
| Due to Tahoe Forest Hospital District | $41,715 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 42946 | TotalOfAmounts |
| Total Revenue | 1140648 | TotalRevenue |
| Total Expenses | 906801 | TotalExpenses |
| Excess Or Deficit For Year | 233847 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 233847 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 1277330 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 1277330 | RevenueSubtotal |
| Other Revenues Not Included | -136682 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -136682 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 1140648 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 1043483 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 136682 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 136682 | ExpensesNotRptdF990 |
| Expenses Subtotal | 906801 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 906801 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part XII, Line 4b - Other Adjustments: | Fundraising expenses netted against fundraising revenue: -136682. |
| Part XIII, Line 2d - Other Adjustments: | Fundraising expenses netted against fundraising revenue: 136682. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Gene Upshaw Memorial Golf Classic | NameOfEvent1 |
| Gross Receipts Event1 | 225782 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 225782 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 97467 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Best of Tahoe Chefs | NameOfEvent2 |
| Gross Receipts Event2 | 208356 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 208356 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 39215 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 434138 | GrossReceiptsTotal |
| Gross Revenue Total Events | 434138 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 136682 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 136682 | DirectExpenseSummaryEvents |
| Net Income Summary | 297456 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 0 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tahoe Forest Hospital District | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10121 Pine Ave | AddressLine1 |
| City | Truckee | City |
| State | CA | State |
| ZIP Code | 96160 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 946004062 | EINOfRecipient |
| IRC Section | 115(1) | IRCSection |
| Amount Of Cash Grant | 497812 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 0 | AmountOfNonCashAssistance |
| Method Of Valuation | N/A | MethodOfValuation |
| Description Of Non Cash Assistance | N/A | DescriptionOfNonCashAssistance |
| Purpose Of Grant | To support & enhance healthcare in the District's service area. | PurposeOfGrant |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | Employee wages & benefits | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 401605 | NoncashContribsRptdF990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 2 | Tom and Pam Hobday are married. |
| Form 990, Part VI, Section A, line 4 | On June 30, 2009, the Articles of Incorportion were amended to change the name of the organization from "Tahoe Forest Hospital Foundation" to "Tahoe Forest Health System Foundation," and also further amended to provide that upon dissolution of the corporation, all assets of the corporation shall be transferred to Tahoe Forest Hospital District. If Tahoe Forest Hospital District is not then in existence, such remaining assets shall be distributed to a nonprofit fund, foundation or corporation which is organized and operated exclusively for charitable, educational or scientific purposes, and which has established its tax exempt status under IRC section 501(c)(3). |
| Form 990, Part VI, Section B, line 11 | The Board places the Form 990 on its agenda for its review and approval. |
| Form 990, Part VI, Section C, line 19 | The organization makes its governing documents, financial statements, and Form 990 available to the public upon request. |
| Form 990, Part V, Line 1a, Line 2a: The Tahoe Forest Hospital District files and reports all W-2s, 1099s, and payroll compliance for the Foundation. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TAHOE FOREST HOSPITAL DISTRICT | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10121 PINE AVENUE | AddressLine1 |
| City | TRUCKEE | City |
| State | CA | State |
| ZIP Code | 96160 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 946004062 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivities |
| Legal Domicile State | CA | LegalDomicileState |
| Exempt Code Section | 115(1) | ExemptCodeSection |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| The Tahoe Forest Hospital District | |
| B | 497812 |
| The Tahoe Forest Hospital District | |
| C | 401605 |
Comments