2011-11-15T12:49:52-06:00 2010-12-31 MOSS ADAMS LLP 1301 A STREET SUITE 600 TACOMA WA 984024205 990 2010-01-01 201082052 PTSO OF WASHINGTON PTSO 2066138952 720 OLIVE WAY NO 300 SEATTLE WA 98101 ROY LA CROIX 2066138952 2011-11-15 1 NANCY J SCHAUER 2535724100 2010 2016-03-07 17:11:31Z ROY LA CROIX 720 OLIVE WAY STE 300 SEATTLE WA 98101 3471968 0 X WWW.CHPW.ORG X 2004 WA SEE FORM 990 PART III, QUESTION 1. 5 0 0 0 0 0 414582 562863 2987968 2908936 161534 169 0 0 3564084 3471968 3279761 3367849 0 0 165324 171424 0 0 20425 -162471 -198997 3282614 3340276 281470 131692 3501628 4626591 817941 1811212 2683687 2815379 X PTSO 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. 0 0 2760560 3390986 2908936 STANDARDIZED TRAINING OF NEXTGEN BEST PRACTICES, DATA CENTER TECHNOLOGY REFRESH, ENTERPRISE WIDE TEST OF THE DISASTER RECOVERY SITE, KBM 7.8 UPGRADE, 2009 UDS REPORTING, PREPARATION FOR 2010 UDS REPORTING, 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. ACHIEVED MILESTONE 2 OF MEANINGFUL USE OBJECTIVES WITH LIVE CERTIFIED EMR, E-PRESCRIBING AND CAPABILITY OF SUBMITTING QUALITY REPORTING MEASURES (SUCH AS LAB REPORTS OR PQRI ). AAPCHO ( ARRA ) CREATED INTERFACE BETWEEN PTSO AND PACIFIC INNOVATION COLLABORATIVE (PIC). SUPPLIED DIABETIC, CHILDHOOD IMMUNIZATION, AND ACCESS METRICS TO PIC. 2760560 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 10 0 1 0 0 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 WA X X GRACE GRIFFIN 2066138952 720 OLIVE WAY SUITE 300 SEATTLE WA 98101 TOM TROMPETER 1.00 X 0 0 0 LINDA MCVEIGH 1.00 X 0 0 0 MIKE HASSING 1.00 X 0 0 0 MARK SECORD 1.00 X 0 0 0 ANITA MONOIAN 1.00 X 0 0 0 ROY LA CROIX 40.00 X 0 152819 9303 0 152819 9303 0 0 1 0 0 544085 18778 562863 SERVICE FEE REVENUE 812900 2908936 2908936 2908936 169 169 3471968 2908936 0 169 3367849 3367849 171424 152749 18675 92713 92713 5878 5878 33129 33129 327400 262874 62776 1750 105566 105566 245131 245131 29591 1347 28244 16401 16401 450748 450748 19675 19675 CONTRACT SALARIES 1035234 898878 136356 MAINTENANCE - SOFTWARE/ 725696 725696 TAXES 58553 58553 GRANT EXPENSE 23137 23137 GRANTS TO SUPPORTING OR -3367849 -3367849 3340276 2760560 559291 20425 1696082 1467336 439798 55704 738808 151341 135930 6118116 4373264 1456182 1744852 142319 99867 3501628 4626591 242212 631620 40779 11668 534950 1167924 817941 1811212 X 2683687 2815379 2683687 2815379 3501628 4626591 131692 0 X 0 1 0 X 0 X X X 0 0 0 COMMUNITY HEALTH PLAN OF WASHINGTON 911729710 7 1 0 COMMUNITY HEALTH NETWORK OF WASHINGTON 911577184 7 1 0 COUNTRY DOCTOR COMMUNITY HEALTH CENTERS 237100868 7 1 388393 FAMILY HEALTH CENTERS 911275011 7 1 234843 CHC OF KING COUNTY DBA HEALTHPOINT 910884412 7 1 1295809 YAKIMA NEIGHBORHOOD HEALTH SERVICES 910928817 7 1 491228 NEIGHBORCARE HEALTH 910893287 7 1 957576 7 3367849 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6118116 4373264 1744852 1744852 DUE TO CHNW 115479 MEMBER DEPOSITS 771875 ACCRUED PAYABLES 280570 1167924 3471968 3340276 131692 0 131692 3471968 0 3471968 0 3471968 3340276 0 3340276 0 3340276 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE 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. THERE WERE NO AMOUNTS PAID FOR UNRELATED BUSINESS INCOME IN 2010 OR 2009. IN ADDITION, THE ORGANIZATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS A SUPPORTING ORGANIZATION UNDER SECTION 509(A)(3). THE ORGANIZATION ADOPTED THE PROVISIONS OF FASB ACCOUNTING STANDARDS CODIFICATION (ASC) 740-10, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS ON JANUARY 1, 2009, WHICH HAD NO FINANCIAL STATEMENT IMPACT TO THE ORGANIZATION. THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN FIFTY PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2010 AND 2009. 0 COUNTRY DOCTOR CHC 500 19TH AVE EAST SEATTLE WA 98112 237100868 501 C (3) 388393 VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT. SUPPORTIVE ASSISTANCE FAMILY HEALTH CENTERS IN OKANOGAN PO BOX 1340 OKANOGAN WA 98840 911275011 501 C (3) 234843 VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT. SUPPORTIVE ASSISTANCE CHC OF KING COUNTY DBA HEALTHPOINT 955 POWELL AVE SE SUITE A RENTON WA 98057 910884412 501 C (3) 1295809 VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT. SUPPORTIVE ASSISTANCE YAKIMA NEIGHBORHOOD HEALTH SERVICES PO BOX 2605 YAKIMA WA 98907 910928817 501 C (3) 491228 VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT. SUPPORTIVE ASSISTANCE NEIGHBORCARE HEALTH 905 SPRUCE STREET SUITE 300 SEATTLE WA 98104 910893287 501 C (3) 957576 VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT. SUPPORTIVE ASSISTANCE 1 X X X 0 0 0 0 0 0 0 0 0 ROY LA CROIX 0 139050 0 8104 0 5665 0 0 0 9303 0 162122 0 0 SUPPLEMENTAL INFORMATION PART III DURING 2010, COMMUNITY HEALTH NETWORK OF WASHINGTON, A SUPPORTED ORGANIZATION, PAID SALARY OF ROY LACROIX, EXECUTIVE DIRECTOR OF PTSO OF WASHINGTON. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS INITIALLY REVIEWED BY THE FINANCE COMMITTEE. ONCE APPROVED, A COPY IS PROVIDED TO EACH BOARD MEMBER AT THE BOARD OF DIRECTORS MEETING. FORM 990, PART VI, SECTION B, LINE 12 PTSO OF WASHINGTON DOES NOT HAVE A WRITTEN CONFLICT OF INTEREST POLICY, BUT ITS SUPPORTED ORGANIZATIONS HAVE THOSE POLICIES. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 AND FORM 1023 ARE AVAILABLE UPON REQUEST AND AT GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS AND GOVERNING/ORGANIZING DOCUMENTS ARE AVAILABLE UPON REQUEST. COMMUNITY HEALTH PLAN OF WASHINGTON 720 OLIVE WAY STE 300 SEATTLE WA 98101 911729710 PROVIDE HEALTH CARE SERVICES INSURANCE COVERAGE TO WASHINGTON STATE PROGRAMS WA 501 C (4) 0 COMMUNITY HEALTH NETWORK OF WASHINGTON 720 OLIVE WAY STE 300 SEATTLE WA 98101 911577184 PROMOTION OF ACCESSIBLE, AFFORDABLE AND QUALITY HEALTHCARE FOR WASHINGTON. WA 501 C (4) 0 COUNTRY DOCTOR CHC 500 19TH AVE EAST SEATTLE WA 98112 237100868 FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER WA 501 C (3) 170(B)(1)(A)(VI) 0 FAMILY HEALTH CENTERS IN OKANOGAN PO BOX 1340 OKANOGAN WA 98840 911275011 FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER WA 501 C (3) 170(B)(1)(A)(VI) 0 CHC OF KING COUNTY DBA HEALTHPOINT 955 POWELL AVE SW SUITE A RENTON WA 98057 910884412 FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER WA 501 C (3) 170(B)(1)(A)(III) 0 YAKIMA NEIGHBORHOOD HEALTH SERVICES PO BOX 2605 YAKIMA WA 98907 910928817 FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER WA 501 C (3) 170(B)(1)(A)(VI) 0 NEIGHBORCARE HEALTH 905 SPRUCCE STREET SUITE 300 SEATTLE WA 98104 910893287 FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER WA 501 C (3) 170(B)(1)(A)(III) 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 1 COMMUNITY HEALTH NETWORK OF WASHINGTON J 102631 COMMUNITY HEALTH NETWORK OF WASHINGTON R 92713 COMMUNITY HEALTH NETWORK OF WASHINGTON N 1220631