COMMUNITY HEALTH CARE: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH CARE (EIN 91-1349657)
- Tax period
- 2009-06-01 to 2010-05-31
- Filed
- 2011-04-18
- IRS object ID
- 201111089349300801
- 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 C
- Schedule D
- Schedule G
- Schedule J
- Schedule K
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-04-18T14:10:33-05:00 | Timestamp |
| Tax Period End Date | 2010-05-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clark Nuber PS | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10900 NE 4th Street Suite 1700 | AddressLine1 |
| City | Bellevue | City |
| State | WA | State |
| ZIP Code | 98004 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-06-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911349657 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 2535974550 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 EAST 26TH STREET No 100 | AddressLine1 |
| City | TACOMA | City |
| State | WA | State |
| ZIP Code | 984211108 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID FLENTGE | Name |
| Title | CEO AND ACTING CFO | Title |
| Phone | 2535974550 | Phone |
| Date Signed | 2011-04-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Sara Elizabeth J Hyre | Name |
| Phone | 4254544919 | 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 | DAVID FLENTGE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 EAST 26TH STREET No 100 | AddressLine1 |
| City | TACOMA | City |
| State | WA | State |
| ZIP Code | 984211108 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 31808991 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.COMMHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1987 | YearFormation |
| State Legal Domicile | WA | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE THE HIGHEST QUALITY HEALTH CARE WITH COMPASSIONATE AND ACCESSIBLE SERVICE FOR ALL. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 406 | TotalNbrEmployees |
| Total Nbr Volunteers | 60 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 9314479 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 6331802 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 26220493 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 25019678 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 66235 | InvestmentIncomePriorYear |
| Investment Income Current Year | -229272 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 291287 | OtherRevenuePriorYear |
| Other Revenue Current Year | -12239 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 35892494 | TotalRevenuePriorYear |
| Total Revenue Current Year | 31109969 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 9125 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 4603 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 22243992 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 21331213 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 39438 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 60635 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 228441 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 8722471 | OtherExpensePriorYear |
| Other Expenses Current Year | 8548619 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 31015026 | TotalExpensesPriorYear |
| Total Expenses Current Year | 29945070 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4877468 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1164899 | RevenuesLessExpensesCY |
| Total Assets BOY | 35706915 | TotalAssetsBOY |
| Total Assets EOY | 37560574 | TotalAssetsEOY |
| Total Liabilities BOY | 6854457 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7543217 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 28852458 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 30017357 | NetAssetsOrFundBalancesEOY |
| Mission Description | COMMUNITY HEALTH CARE PROVIDES COMPREHENSIVE PRIMARY MEDICAL AND DENTAL CARE THROUGH A CLINIC SYSTEM THAT INCLUDES SIX MEDICAL AND TWO DENTAL CLINICS. IN ADDITION CARE IS ALSO PROVIDED THROUGH A WOMEN'S HEALTH CLINIC. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 15791440 | Expense |
| Revenue | 15800860 | Revenue |
| Description | COMMUNITY HEALTH CARE (CHC) MEDICAL CLINICS OFFER MEDICAL SERVICES AND URGENT CARE CENTER SERVICES IN VARIOUS LOCATIONS IN PIERCE COUNTY ACCORDING TO A SLIDING FEE SCALE BASED ON INCOME AND FAMILY SIZE. DURING THE FISCAL YEAR ENDED 05/31/10, COMMUNITY HEALTH CARE PROVIDED 22,226 PATIENTS WITH MEDICAL CARE FROM 103,337 PATIENT VISITS AT 6 MEDICAL CLINICS WITH 45 MEDICAL PROVIDERS. 63% OF PATIENTS ARE AT POVERTY LEVEL OR BELOW. 85% OF PATIENTS ARE LOW-INCOME. CHC PROVIDED $1,700,023 IN TOTAL CHARITY CARE FOR FISCAL YEAR ENDING 5/31/10. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4421589 | Expense |
| Revenue | 5062994 | Revenue |
| Description | COMMUNITY HEALTH CARE DENTAL CLINICS OFFER PRIMARY CARE DENTAL SERVICES IN VARIOUS PIERCE COUNTY LOCATIONS ACCORDING TO THE SAME FEE STRUCTURE. DURING THE FISCAL YEAR ENDED 05/31/10 COMMUNITY HEALTH CARE PROVIDED 38,359 DENTAL ENCOUNTERS TO 14,388 PATIENTS AT TWO DENTAL CLINICS WITH 13 DENTAL PROVIDERS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2836724 | Expense |
| Revenue | 3276878 | Revenue |
| Description | SIX PHARMACIES OFFER PHARMACEUTICAL SERVICES TO PATIENTS IN VARIOUS LOCATIONS IN PIERCE COUNTY ACCORDING TO THE SAME FEE STRUCTURE NOTED ABOVE. THE PHARMACY SERVED 11,901 PATIENTS THROUGH 95,226 MEDICATION FILLS. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1013625 | Expense |
| Revenue | 891626 | Revenue |
| Description | COMMUNITY HEALTH CARE PROVIDES EXTENSIVE MATERNITY SUPPORT SERVICES TO HIGH RISK PREGNANT MOTHERS. THIS INCLUDES IN-OFFICE AND IN-HOME CARE BY NURSES, SOCIAL WORKERS, AND NUTRITIONISTS. THE ORGANIZATION ALSO PROVIDES SERVICES OF AN OPHTHALMOLOGIST, PARTICULARLY FOR DIABETIC PATIENTS. 1,951 PATIENTS RECEIVED 7,632 PATIENT VISITS FROM COMMUNITY HEALTH CARE'S MATERNITY SUPPORT SERVICES, NUTRITION PROGRAM, AND ANITCOAGULATION PROGRAM. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 1013625 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 891626 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 24063378 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 1 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 19 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 406 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| 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 | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID FLENTGE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2535974550 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 EAST 26TH STREET SUITE 100 | AddressLine1 |
| City | TACOMA | City |
| State | WA | State |
| ZIP Code | 98421 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| LINDA BOWMAN | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| LUIS CAIRE | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| OLGA GRIBBLE | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| FIDEL PINO | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| PETER SETO | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| ARTURO BIBLARZ | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DAN SLOAN | ||||||||
| BOARD MEMBER | 6.00 | X | 0 | 0 | 0 | |||
| GEORGE TANBARA | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| SHAMAY THOMAS | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DOUG SWANBERG | ||||||||
| BOARD MEMBER-CO CHAIR | 2.50 | X | 0 | 0 | 0 | X | ||
| DAVE KIMBERLING | ||||||||
| BOARD MEMBER-TREASURER | 2.00 | X | 0 | 0 | 0 | X | ||
| PEG DEMPSEY | ||||||||
| BOARD MEMBER-VICE CHAIR | 2.00 | X | 0 | 0 | 0 | X | ||
| GARY WALMER | ||||||||
| BOARD MEMBER-CO CHAIR | 5.00 | X | 0 | 0 | 0 | X | ||
| IRENE MAZER | ||||||||
| BOARD MEMBER | 5.00 | X | 0 | 0 | 0 | |||
| KYLE SHIMAMOTO | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DEBRA YOUNG | ||||||||
| BOARD MEMBER-SECRETARY | 1.50 | X | 0 | 0 | 0 | X | ||
| LORI ENGELKING | ||||||||
| BOARD MEMBER | 1.50 | X | 0 | 0 | 0 | |||
| LYSA BARBANO | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| THOMAS DUKE | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DAVID FLENTGE | ||||||||
| CEO/ACTING CFO | 40.00 | 154400 | 0 | 17334 | X | |||
| JEFFREY SMITH | ||||||||
| MEDICAL DIRECTOR | 40.00 | 231735 | 0 | 33040 | X | |||
| DEARL OLSEN | ||||||||
| DENTAL DIRECTOR | 40.00 | 163600 | 0 | 24296 | X | |||
| KATHRYN TONDER | ||||||||
| PHYSICIAN | 40.00 | 171709 | 0 | 26572 | X | |||
| RALPH NEIGHBOR | ||||||||
| PHYSICIAN | 40.00 | 222713 | 0 | 26922 | X | |||
| CHUCK SAMUELS | ||||||||
| DENTIST | 40.00 | 179311 | 0 | 16801 | X | |||
| ENRIQUE LEON | ||||||||
| PHYSICIAN | 40.00 | 171189 | 0 | 37578 | X | |||
| SUSAN POWELL | ||||||||
| PHYSICIAN | 40.00 | 164527 | 0 | 31095 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1459184 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 213638 | TotalOtherCompensation |
| Number Individuals GT100 K | 31 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| RUSHFORTH CONSTRUCTION | |||||
| 6021 12TH STREET | TACOMA | WA | 98424 | GENERAL CONSTRUCTION | 933211 |
| OPENWORKS | |||||
| 4742 N 24TH STREET SUITE 300 | PHOENIX | WA | 85016 | JANITORIAL SERVICES | 180901 |
| NORTHWEST CUSTOM ROOFING | |||||
| POBOX 111851 | TACOMA | WA | 98411 | GENERAL CONSTRUCTION | 167745 |
| JOHNSON ARCHITECTURE | |||||
| 2124 THIRD AVENUE SUITE 200 | SEATTLE | WA | 98121 | ARCHITECTURAL SERVICES | 143636 |
| VISTA STAFFING | |||||
| 275 EAST 200 SOUTH | SALT LAKE CITY | UT | 84111 | TEMPORARY STAFFING | 120896 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Federated Campaigns | 66885 | FederatedCampaigns |
| Fundraising Events | 59771 | FundraisingEvents |
| Government Grants | 5161607 | GovernmentGrants |
| All Other Contributions | 1043539 | AllOtherContributions |
| Noncash Contributions | 839302 | NoncashContributions |
| Total Contributions | 6331802 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT FEES | 621400 | 20070334 | 20070334 |
| PHARMACY REVENUE | 621300 | 2841054 | 2841054 |
| GOVERNMENT AGENCY FEES | 621400 | 2108290 | 2108290 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 25019678 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 79027 | TotalRevenueColumn |
| Exclusion | $79,027 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 358404 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 666703 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 358404 | Securities |
| Other | -666703 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -308299 | TotalRevenueColumn |
| Exclusion | -$308,299 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 7400 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 59771 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 32319 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -24919 | TotalRevenueColumn |
| Exclusion | -$24,919 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| REIMBURSEMENTS | 623990 | 10682 | 10682 |
| MISCELLANEOUS | 900099 | 1163 | 1163 |
| MEDICAL RECORDS | 623990 | 835 | 835 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 12680 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31109969 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25032358 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$254,191 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4603 | Total |
| Program Services | 4603 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 655008 | Total |
| Program Services | 431914 | ProgramServices |
| Management And General | 223094 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16088548 | Total |
| Program Services | 13020750 | ProgramServices |
| Management And General | 2978392 | ManagementAndGeneral |
| Fundraising | 89406 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 665598 | Total |
| Program Services | 550500 | ProgramServices |
| Management And General | 110710 | ManagementAndGeneral |
| Fundraising | 4388 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2737953 | Total |
| Program Services | 2123959 | ProgramServices |
| Management And General | 609372 | ManagementAndGeneral |
| Fundraising | 4622 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1184106 | Total |
| Program Services | 953665 | ProgramServices |
| Management And General | 223853 | ManagementAndGeneral |
| Fundraising | 6588 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16738 | Total |
| Management And General | 16738 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69368 | Total |
| Management And General | 69368 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60635 | Total |
| Fundraising | 60635 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 122697 | Total |
| Program Services | 18014 | ProgramServices |
| Management And General | 104235 | ManagementAndGeneral |
| Fundraising | 448 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1618185 | Total |
| Program Services | 1425019 | ProgramServices |
| Management And General | 175946 | ManagementAndGeneral |
| Fundraising | 17220 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 887626 | Total |
| Program Services | 486296 | ProgramServices |
| Management And General | 398580 | ManagementAndGeneral |
| Fundraising | 2750 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68380 | Total |
| Program Services | 40982 | ProgramServices |
| Management And General | 27169 | ManagementAndGeneral |
| Fundraising | 229 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44974 | Total |
| Program Services | 26954 | ProgramServices |
| Management And General | 17869 | ManagementAndGeneral |
| Fundraising | 151 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95861 | Total |
| Program Services | 79363 | ProgramServices |
| Management And General | 16498 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1430394 | Total |
| Program Services | 1267954 | ProgramServices |
| Management And General | 162440 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 129930 | Total |
| Program Services | 90783 | ProgramServices |
| Management And General | 39147 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| PHARMACY | 1306929 | 1300688 | 6241 | |
| BAD DEBT | 723785 | 714410 | 9375 | |
| CONTRACT SERVICES | 625490 | 393685 | 231805 | |
| CONTRACT PROVIDERS | 362857 | 362419 | 438 | |
| LABORATORY FEES | 205930 | 205930 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 839475 | Total |
| Program Services | 565490 | ProgramServices |
| Management And General | 241356 | ManagementAndGeneral |
| Fundraising | 32629 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29945070 | Total |
| Program Services | 24063378 | ProgramServices |
| Management And General | 5653251 | ManagementAndGeneral |
| Fundraising | 228441 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5660462 | BOY |
| EOY | 7425948 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1817201 | BOY |
| EOY | 1501424 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2830693 | BOY |
| EOY | 341406 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3158890 | BOY |
| EOY | 5425030 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 279773 | BOY |
| EOY | 263219 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 484406 | BOY |
| EOY | 251131 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 28004277 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6482786 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20754102 | BOY |
| EOY | 21521491 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 721388 | BOY |
| EOY | 830925 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35706915 | BOY |
| EOY | 37560574 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5264457 | BOY |
| EOY | 2724445 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1590000 | BOY |
| EOY | 1525000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 3293772 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6854457 | BOY |
| EOY | 7543217 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28852458 | BOY |
| EOY | 30017357 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28852458 | BOY |
| EOY | 30017357 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35706915 | BOY |
| EOY | 37560574 | 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 Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 1 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 1 | PublicationsOrBroadcast |
| Publications Or Broadcast | $0 | PublicationsOrBroadcastAmount |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $2,056 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 2056 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3423354 | OtherCostOrOtherBasis |
| Book Value | 3423354 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16014607 | OtherCostOrOtherBasis |
| Depreciation | 1554643 | Depreciation |
| Book Value | 14459964 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2113265 | OtherCostOrOtherBasis |
| Depreciation | 767506 | Depreciation |
| Book Value | 1345759 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6356777 | OtherCostOrOtherBasis |
| Depreciation | 4064897 | Depreciation |
| Book Value | 2291880 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 96274 | OtherCostOrOtherBasis |
| Depreciation | 95740 | Depreciation |
| Book Value | 534 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 21521491 | TotalOfBookValueLandBuildings |
| Total Revenue | 31109969 | TotalRevenue |
| Total Expenses | 29945070 | TotalExpenses |
| Excess Or Deficit For Year | 1164899 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 1164899 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 31158522 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 16234 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | 16234 | RevenueNotRptdF990 |
| Revenue Subtotal | 31142288 | RevenueSubtotal |
| Other Revenues Not Included | -32319 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -32319 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 31109969 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 29993623 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 16234 | DonatedServicesUseOfFacilities |
| Other Expenses Included | 32319 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 48553 | ExpensesNotRptdF990 |
| Expenses Subtotal | 29945070 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 29945070 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| ExplanationExplanation |
|---|
| PART XII, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES: $-32,319 |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES: $32,319 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | X | MailSolicitations |
| Email Solicitations | X | EmailSolicitations |
| Phone Solicitations | X | PhoneSolicitations |
| In Person Solicitations | X | InPersonSolicitations |
| Solicitation Of Non Govt Grants | X | SolicitationOfNonGovtGrants |
| Solicitation Of Govt Grants | X | SolicitationOfGovtGrants |
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | 1 | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Individual | RICHARD OLDENBURG | NameOfIndividual |
| Activity | CONSULTING | Activity |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFunds |
| Gross Receipts | 796610 | GrossReceipts |
| Amount Retained By Contractor | 60635 | AmountRetainedByContractor |
| Net To Organization | 735975 | NetToOrganization |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | 796610 | TotalGrossReceipts |
| Total Retained By Contractors | 60635 | TotalRetainedByContractors |
| Total Net To Organization | 735975 | TotalNetToOrganization |
| Licensed States | WA | LicensedStates |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | LUNCHEON | NameOfEvent1 |
| Gross Receipts Event1 | 67171 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 59771 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 7400 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 25 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 4000 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 7347 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 12201 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 8746 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 67171 | GrossReceiptsTotal |
| Charitable Contributions Total | 59771 | CharitableContributionsTotal |
| Gross Revenue Total Events | 7400 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 25 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 4000 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 7347 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 12201 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 8746 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 32319 | DirectExpenseSummaryEvents |
| Net Income Summary | -24919 | NetIncomeSummary |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID FLENTGE | |||||||||||||
| 143791 | 0 | 0 | 0 | 10609 | 0 | 7251 | 0 | 10083 | 0 | 171734 | 0 | 0 | 0 |
| JEFFREY SMITH | |||||||||||||
| 214605 | 0 | 16866 | 0 | 264 | 0 | 11049 | 0 | 21991 | 0 | 264775 | 0 | 0 | 0 |
| DEARL OLSEN | |||||||||||||
| 149712 | 0 | 12022 | 0 | 1866 | 0 | 7687 | 0 | 16609 | 0 | 187896 | 0 | 0 | 0 |
| KATHRYN TONDER | |||||||||||||
| 156595 | 0 | 14952 | 0 | 162 | 0 | 7125 | 0 | 19447 | 0 | 198281 | 0 | 0 | 0 |
| RALPH NEIGHBOR | |||||||||||||
| 189662 | 0 | 31825 | 0 | 1226 | 0 | 9698 | 0 | 17224 | 0 | 249635 | 0 | 0 | 0 |
| CHUCK SAMUELS | |||||||||||||
| 156947 | 0 | 22094 | 0 | 270 | 0 | 7868 | 0 | 8933 | 0 | 196112 | 0 | 0 | 0 |
| ENRIQUE LEON | |||||||||||||
| 138298 | 0 | 32634 | 0 | 257 | 0 | 7549 | 0 | 30029 | 0 | 208767 | 0 | 0 | 0 |
| SUSAN POWELL | |||||||||||||
| 146004 | 0 | 18259 | 0 | 264 | 0 | 2754 | 0 | 28341 | 0 | 195622 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WA HEALTH CARE FACILITIES AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 911108929 | IssuerEIN |
| CUSIP Number | 93978EUW0 | CUSIPNumber |
| Date Issued | 2003-01-23 | DateIssued |
| Issue Price | 3320000 | IssuePrice |
| Description Of Purpose | To fund building | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 3320000 | TotalProceeds |
| Amount In Reserve Fund | 96667 | AmountInReserveFund |
| Issuance Costs From Proceeds | 135000 | IssuanceCostsFromProceeds |
| Capital Expenditures | 3088333 | CapitalExpenditures |
| Year Of Subst Completion | 2003 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 0 | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTraded
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 4920 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | AVERAGE HIGH/LOW | MethodOfDeterminingRevenues |
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 50 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 834382 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | COST OR SELLING PRICE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | THE FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING. THE BOARD IS GIVEN THE OPPORTUNITY TO FORWARD QUESTIONS AND OR CONCERNS TO THE FINANCE COMMITTEE SO THEY CAN BE ADDRESSED. | |
| Form 990, Part VI, Section B, line 12c | BOARD MEMBERS AND MANAGEMENT TEAM MEMBERS ARE ASKED TO SIGN STATEMENTS AT INITIAL ORIENTATION AND AGAIN ANNUALLY. EMPLOYEES SIGN STATEMENTS AT INITIAL ORIENTATION AND THEN EVERY THREE YEARS. RECORDS ARE MAINTAINED BY EITHER THE HR DIRECTOR OR THE ASSISTANT TO THE CEO. REPORTED OR POTENTIAL CONFLICTS ARE REVIEWED BY EITHER THE HR DIRECTOR OR THE CEO. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER OR MANAGEMENT TEAM MEMBER CAN RECUSE THEMSELVES FROM THE DISCUSSION OR VOTING. IF A CONFLICT IS PERVASIVE WITH A BOARD MEMBER THEN THE CO-CHAIRS CAN PROCEED TO REMOVE THE BOARD MEMEBER. IF A CONFLICT IS PERVASIVE WITH A STAFF MEMBER THEN THEY MAY BE TERMINATED. | |
| Form 990, Part VI, Section B, line 15 | ANNUALLY THE CO-CHAIRS OF THE BOARD ASSIGN AN AD HOC COMMITTEE TO CONDUCT THE ANNUAL EVALUATION OF THE CEO, AS WELL AS DETERMINE ANY COMPENSATION CHANGES. OFTEN THE ENTIRE EXECUTIVE COMMITTEE IS INVOLVED. THE RESULTS OF THE EVALUATION WILL BE USED BY THE BOARD AS A BASIS TO DETERMINE WHETHER AN INCREASE SHOULD BE GIVEN. THE BOARD HAS DETERMINED THAT THEY WILL COMPLETE A COMPREHENSIVE SALARY COMPARISON OF COMPARABLE SIZED COMMUNITY HEALTH CENTERS IN THE NORTHWEST, USING A CONSULTANT, EVERY THREE YEARS. DURING THE OTHER TWO YEARS THE BOARD WILL REVIEW DATA MADE AVAILABLE BY THE NORTHWEST REGIONAL PRIMARY CARE ASSOCIATION AS A REFERENCE POINT IN MAKING A DETERMINATION ABOUT HOW MUCH OF AN INCREASE WOULD BE GRANTED IF ANY. SALARY RANGES FOR ALL OTHER EMPLOYEE SALARIES ARE APPROVED BY THE BOARD BASED ON SURVEY DATA PROVIDED TO THE HR DEPARTMENT AND/OR UNION NEGOTIATIONS. | |
| Form 990, Part VI, Section C, line 19 | THESE DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. | |
| FORM 990, PART I, LINE 6: | VOLUNTEERS SERVED ON COMMUNITY HEALTH CARE'S BOARD AND ITS COMMUNITY RELATIONS, EXECUTIVE, FINANCE, MEMBERSHIP, PERSONNEL, PLANNING AND QUALITY IMPROVEMENT, AND/OR FACILITIES COMMITTEES. ALSO VOLUNTEERS SERVED ON THE MARKETING ADVISORY, DEVELOPMENT ADVISORY, AND/OR THE CAPITAL CAMPAIGN COUNCILS. | |
| SCHEDULE A PART I, LINE 3: | ALTHOUGH THE ORGANIZATION IS A HOSPITAL AS DESCRIBED IN 170(B)(1)(A)(III), THE ORGANIZATION IS NOT A LICENSED HOSPITAL UNDER STATE LAW. THEREFORE, THE ORGANIZATION DID NOT COMPLETE SCHEDULE H. | REASON FOR PUBLIC CHARITY STATUS |
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