COLUMBIA VALLEY COMMUNITY HEALTH: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBIA VALLEY COMMUNITY HEALTH (EIN 23-7297657)
- Tax period
- 2010-04-01 to 2011-03-31
- Filed
- 2011-09-22
- IRS object ID
- 201132659349300318
- Schema version
- 2010v3.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-09-22T09:57:05-07:00 | Timestamp |
| Tax Period End Date | 2011-03-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LarsonAllen LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 N 39th Avenue PO Box 2710 | AddressLine1 |
| City | Yakima | City |
| State | WA | State |
| ZIP Code | 98902 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-04-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237297657 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA VALLEY COMMUNITY HEALTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COLU | NameControl |
| Phone | 5096644575 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 ORONDO AVENUE SUITE 1 | AddressLine1 |
| City | WENATCHEE | City |
| State | WA | State |
| ZIP Code | 98801 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Patrick Bucknum | Name |
| Title | CEO | Title |
| Date Signed | 2011-09-22 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Ralph Conner CPA | Name |
| Phone | 5094530123 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 21695432 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.cvch.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1972 | YearFormation |
| State Legal Domicile | WA | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF COLUMBIA VALLEY COMMUNITY HEALTH IS TO PROVIDE ACCESS TO IMPROVED HEALTH AND WELLNESS WITH COMPASSION AND RESPECT FOR ALL. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 305 | TotalNbrEmployees |
| Total Nbr Volunteers | 13 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 4840012 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 4414911 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 17976726 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17212541 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 25106 | InvestmentIncomePriorYear |
| Investment Income Current Year | -17666 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 22841844 | TotalRevenuePriorYear |
| Total Revenue Current Year | 21609786 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 29182 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 32602 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 16540335 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 13727397 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 12611 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5586316 | OtherExpensePriorYear |
| Other Expenses Current Year | 5300311 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 22155833 | TotalExpensesPriorYear |
| Total Expenses Current Year | 19060310 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 686011 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2549476 | RevenuesLessExpensesCY |
| Total Assets BOY | 15744961 | TotalAssetsBOY |
| Total Assets EOY | 19408553 | TotalAssetsEOY |
| Total Liabilities BOY | 5959084 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7171986 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9785877 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 12236567 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF COLUMBIA VALLEY COMMUNITY HEALTH IS TO PROVIDE ACCESS TO IMPROVED HEALTH AND WELLNESS WITH COMPASSION AND RESPECT FOR ALL. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 14385688 | Expense |
| Revenue | 17212541 | Revenue |
| Description | PROVIDE COMPREHENSIVE MEDICAL, MENTAL HEALTH AND DENTAL CARE TO SEASONAL AND MIGRANT FARM WORKERS AND THE MEDICALLY UNDERSERVED POPULATION OF THE AREA. THIS INCLUDES GENERAL MEDICINE, DENTAL, PRENATAL, AND OBSTRETIC CARE ON AN OUTPATIENT BASIS. AN ON-SITE PHARMACY PROVIDES PATIENT PRESCRIPTION SERVICES TO ENSURE PATIENTS OBTAIN NEEDED MEDICATIONS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 671625 | Expense |
| Description | INTERMEDIARY FOR PROVIDING SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN. INCLUDES NUTRITION EDUCATION, REFERRAL FOR HEALTH CARE FOR LOW-INCOME WOMEN AS WELL AS INFANTS AND CHILDREN UNDER AGE FIVE. PROGRAM FOCUS IS FOR BOTH INFANTS AND CHILDREN IN THE CRITICAL PERIODS OF GROWTH AND DEVELOPMENT UNDER AGE FIVE. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 15057313 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 51 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 305 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | WA | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KRISTAL ALBRECHT CFO CVCH | NamePerson |
| Telephone Number | 5096626000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 ORONDO AVENUE SUITE 1 | AddressLine1 |
| City | WENATCHEE | City |
| State | WA | State |
| ZIP Code | 988012800 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Key EmployeeKeyEmployee | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Scott Bibbins | ||||||||
| Dental Director | 40.00 | X | 212805 | 0 | 25289 | |||
| Robert H Scott Jr | ||||||||
| Board Member | 2.00 | 0 | 0 | 0 | X | |||
| Richard Bliggenstorfer | ||||||||
| Treasurer | 2.00 | 0 | 0 | 0 | X | X | ||
| Rich Watson | ||||||||
| President | 2.00 | 0 | 0 | 0 | X | X | ||
| R Joe Palmer ended 311 | ||||||||
| BOARD MEMBER | 2.00 | 0 | 0 | 0 | X | |||
| Patrick Bucknum | ||||||||
| CEO | 40.00 | 158977 | 0 | 23715 | X | |||
| Nick Covey | ||||||||
| Board Member | 2.00 | 0 | 0 | 0 | X | X | ||
| MARIE DESIRE | ||||||||
| PSYCHIATRIST | 40.00 | 155526 | 0 | 11931 | X | |||
| Margarito Rodriguez | ||||||||
| Secretary | 2.00 | 0 | 0 | 0 | X | X | ||
| Malcolm Butler | ||||||||
| Medical Dir | 40.00 | X | 241120 | 0 | 26095 | |||
| LORINDA PARKS | ||||||||
| MD | 40.00 | 193009 | 0 | 26052 | X | |||
| Loly Larson | ||||||||
| Board Member | 2.00 | 0 | 0 | 0 | X | |||
| Kristal Albrecht | ||||||||
| CFO | 40.00 | 93798 | 0 | 8977 | X | |||
| KENNETH SHERMER | ||||||||
| MD | 40.00 | 185443 | 0 | 25586 | X | |||
| JOHN DAME | ||||||||
| MD | 40.00 | 185097 | 0 | 26209 | X | |||
| Joanne Hill | ||||||||
| Board Member | 2.00 | 0 | 0 | 0 | X | |||
| JAMES LARSEN | ||||||||
| MD | 0.00 | 161812 | 0 | 22406 | X | |||
| Irene Bazan | ||||||||
| Vice President | 2.00 | 0 | 0 | 0 | X | X | ||
| Guadalupe Vill ended 1010 | ||||||||
| BOARD MEMBER | 2.00 | 0 | 0 | 0 | X | |||
| Douglas Head | ||||||||
| Board Member | 2.00 | 0 | 0 | 0 | X | |||
| Carol Diede | ||||||||
| COO | 40.00 | 121289 | 0 | 23866 | X | |||
| C Eric Hughes | ||||||||
| BOARD MEMBER | 2.00 | 0 | 0 | 0 | X | |||
| Bertha Sanchez Began 211 | ||||||||
| BOARD MEMBER | 2.00 | 0 | 0 | 0 | X | |||
| Art Rodriguez 410-211 | ||||||||
| BOARD MEMBER | 2.00 | 0 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1708876 | TotalReportableCompFromOrg |
| Total Other Compensation | 220126 | TotalOtherCompensation |
| Number Individuals GT100 K | 19 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| KDF ARCHITECTURE | |||||
| 1310 N 16TH AVE | YAKIMA | WA | 98902 | ARCHITECT SERVICES | 414316 |
| JA JANSSEN MD | |||||
| PO BOX 1871 | WENATCHEE | WA | 98807 | PSYCH CONSULT | 105900 |
| ALLEGIANCE BENEFIT PLAN MANAGEMENT INC | |||||
| PO BOX 4346 | MISSOULA | MT | 598064346 | Cafeteria Plan Admin | 121366 |
| ALDRICH & ASSOCIATES | |||||
| 810 240TH ST SE | BOTHELL | WA | 98021 | CONSTRUCTION | 2432405 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Government Grants | 4388379 | GovernmentGrants |
| All Other Contributions | 26532 | AllOtherContributions |
| Total Contributions | 4414911 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICES | Description |
| Total Revenue Column | 17212541 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17212541 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17212541 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 60945 | TotalRevenueColumn |
| Exclusion | $60,945 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 7035 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 85646 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -78611 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -78611 | TotalRevenueColumn |
| Exclusion | -$78,611 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 21609786 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17212541 | RelatedOrExemptFunctionIncome |
| Exclusion | -$17,666 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32602 | Total |
| Program Services | 32602 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 935931 | Total |
| Program Services | 283607 | ProgramServices |
| Management And General | 652324 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10334550 | Total |
| Program Services | 8695770 | ProgramServices |
| Management And General | 1638780 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 194668 | Total |
| Program Services | 146828 | ProgramServices |
| Management And General | 47840 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1465612 | Total |
| Program Services | 1465612 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 796636 | Total |
| Program Services | 713597 | ProgramServices |
| Management And General | 83039 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47931 | Total |
| Program Services | 26362 | ProgramServices |
| Management And General | 21569 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42515 | Total |
| Program Services | 23383 | ProgramServices |
| Management And General | 19132 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 384780 | Total |
| Program Services | 212207 | ProgramServices |
| Management And General | 159962 | ManagementAndGeneral |
| Fundraising | 12611 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1188423 | Total |
| Program Services | 1028438 | ProgramServices |
| Management And General | 159985 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 586175 | Total |
| Program Services | 432073 | ProgramServices |
| Management And General | 154102 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13226 | Total |
| Program Services | 6983 | ProgramServices |
| Management And General | 6243 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 935169 | Total |
| Program Services | 671823 | ProgramServices |
| Management And General | 263346 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74612 | Total |
| Program Services | 19655 | ProgramServices |
| Management And General | 54957 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| STORAGE & EQUIPMENT LEASE | 308539 | 64153 | 244386 |
| REPAIRS, MAINTENANCE AND EQUIP | 203931 | 102673 | 101258 |
| OTHER EXPENSES | 423786 | 193845 | 229941 |
| CONTINUING EDUCATION | 180530 | 109696 | 70834 |
| BAD DEBT | 701924 | 701924 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 208770 | Total |
| Program Services | 126082 | ProgramServices |
| Management And General | 82688 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19060310 | Total |
| Program Services | 15057313 | ProgramServices |
| Management And General | 3990386 | ManagementAndGeneral |
| Fundraising | 12611 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1144058 | BOY |
| EOY | 2623455 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5561481 | BOY |
| EOY | 5458381 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 182230 | BOY |
| EOY | 214759 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1381782 | BOY |
| EOY | 1017064 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 131208 | BOY |
| EOY | 84496 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 118513 | BOY |
| EOY | 72741 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 11803750 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5909451 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6403703 | BOY |
| EOY | 5894299 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 86569 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 821986 | BOY |
| EOY | 3956789 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15744961 | BOY |
| EOY | 19408553 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2476420 | BOY |
| EOY | 3636210 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 272958 | BOY |
| EOY | 125382 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 2968298 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3209706 | BOY |
| EOY | 84542 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 357554 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5959084 | BOY |
| EOY | 7171986 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9743070 | BOY |
| EOY | 12199830 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42807 | BOY |
| EOY | 36737 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9785877 | BOY |
| EOY | 12236567 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15744961 | BOY |
| EOY | 19408553 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2549476 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -98786 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | 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 D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 460000 | OtherCostOrOtherBasis |
| Book Value | 460000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6840776 | OtherCostOrOtherBasis |
| Depreciation | 5909451 | Depreciation |
| Book Value | 931325 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1024881 | OtherCostOrOtherBasis |
| Book Value | 1024881 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 64710 | OtherCostOrOtherBasis |
| Book Value | 64710 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3413383 | OtherCostOrOtherBasis |
| Book Value | 3413383 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5894299 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CONSTRUCTION IN PROGRESS | Description |
| Book Value | 3123227 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3956789 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Rounding | $1 |
| OTHER LONG TERM LIABILITIES | $357,553 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 357554 | TotalOfAmounts |
| Total Revenue | 21609786 | TotalRevenue |
| Total Expenses | 19060310 | TotalExpenses |
| Excess Or Deficit For Year | 2549476 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -98786 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -98786 | TotalAdjustments |
| Excess Or Deficit Per FS | 2450690 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 21531940 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -98786 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 20940 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | -77846 | RevenueNotRptdF990 |
| Revenue Subtotal | 21609786 | RevenueSubtotal |
| Total Revenue Per Form990 | 21609786 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 19081250 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 20940 | DonatedServicesUseOfFacilities |
| Expenses Not Rptd F990 | 20940 | ExpensesNotRptdF990 |
| Expenses Subtotal | 19060310 | ExpensesSubtotal |
| Total Expenses Per Form990 | 19060310 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part X | Identifier |
| Return Reference | Part X : FIN48 Footnote | ReturnReference |
| Explanation | Uncertainty in income tax - No provision for income taxes is shown in the financial statements because the Organization is a nonprofit organization. As such, the Organization is exempt from federal income tax.The Organization has not identified any uncertainty in income tax positions that would jeopardize the entity's status as a nonprofit entity. The Organization's income tax returns are subject to review and examination by federal authorities for the years 2008 and later. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
| No Grant More Than5000 | X | NoGrantMoreThan5000 |
| Total Nbr Of501 C3 And Govt Grants | 0 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | Payment of medical bills for individuals who need assistance | TypeOfGrant |
| Number Of Recipients | 152 | NumberOfRecipients |
| Amount Of Cash Grant | 32602 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Grantmaker's Description of How Grants are Used | Identifier |
| Explanation | Per the clients funding policy: To be considered for the Helping Hands Fund, the patient's household income should not exceed two hundred percent (200%) of the poverty guidelines. As the Helping Hands Fund is the payer of last resort, all outside funding sources (including, but not limited to, grants, government assistance, private foundations, and patient assistance programs) will be reviewed and utilized before determining Helping Hands Fund eligibility. The Committee will review and vote on eligible applications on a case by case basis. For applicants referred by providers, an Urgent Need Request form will be completed by the provider and signed by a Committee member. If the estimated cost is between $200 and $299, a Management Team Member's signature is also required.Urgent Need Requests equal to or greater than $300 must be approved by the Committee via email vote before funding can occur. Non Urgent Need Applications will be reviewed at monthly Committee meetings. In addition to the application, further information may be obtained by the Committee to aid with eligibility determination.If the need dictates, the Committee may consider an application prior to the monthly meeting. Applicants requesting relief on CVCH accounts will generally receive a decision and notification by a Committee representative within 60 days of Committee review. In making a determination of eligibility, the Committee may consider whether the patient has negotiated in good faith with the CVCH Billing Department, kept Patient Service appointments, made payments, and/or demonstrated interest in clearing his/her account. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| 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 | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|
| Scott Bibbins | ||||
| 141714 | 51571 | 19520 | 25289 | 238094 |
| Patrick Bucknum | ||||
| 153860 | 5117 | 23715 | 182692 | |
| MARIE DESIRE | ||||
| 155526 | 11931 | 167457 | ||
| Malcolm Butler | ||||
| 186573 | 41697 | 12850 | 26095 | 267215 |
| LORINDA PARKS | ||||
| 132640 | 49066 | 11303 | 26052 | 219061 |
| KENNETH SHERMER | ||||
| 110001 | 77040 | -1598 | 25586 | 211029 |
| JOHN DAME | ||||
| 140005 | 31764 | 13328 | 26209 | 211306 |
| JAMES LARSEN | ||||
| 109009 | 47688 | 5115 | 22406 | 184218 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Sch J, Part I, Line 1a | Identifier |
| Return Reference | Part I, Line 1a: Relevant information in regards to selections on 1a. | ReturnReference |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WA HEALTHCARE FACILITIES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 911108929 | IssuerEIN |
| Date Issued | 2010-12-16 | DateIssued |
| Issue Price | 7200000 | IssuePrice |
| Description Of Purpose | REMODELING AND RENOVATION | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 2910096 | AmountRetired |
| Total Proceeds | 7200000 | TotalProceeds |
| Issuance Costs From Proceeds | 58202 | IssuanceCostsFromProceeds |
| Capital Expenditures | 2968298 | CapitalExpenditures |
| Amount Unspent | 4231702 | AmountUnspent |
| Current Refunding | true | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | false | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | false | Form8038TFiled |
| Variable Rate Issue | false | VariableRateIssue |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
| Superintegrated Hedge | false | SuperintegratedHedge |
| Hedge Terminated | false | HedgeTerminated |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Regulatory Safe Harbor Satisfied | false | RegulatorySafeHarborSatisfied |
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Exception To Rebate | false | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MALCOLM BUTLER | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | BOARD MEMBER CHPW | Relationship |
| Description Of Transaction | SEE SCHEDULE O. | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| INTERESTED PERSON PER SCHEDULE L | CVCH IS A MEMBER OF COMMUNITY HEALTH PLAN OF WASHINGTON (THE PLAN), A MANAGED CARE PLAN FORMED BY COMMUNITY AND MIGRANT HEALTH CLINICS THROUGHOUT THE STATE OF WASHINGTON TO PARTICIPATE IN THE MANAGED CARE MARKETPLACE. THE PLAN IS A NONPROFIT CORPORATION. EACH CLINIC IS REPRESENTED BY A MEMBER ON THE BOARD OF DIRECTORS OF THE PLAN. | |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Conflict of interest policy is available upon request but not published externally. Governing documents are not shared. Financial statements can be viewed on site. The organizations's Form 990 is avaliable on Guide Star. | Form 990, Part VI, Line 19 |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Data pulled from 1) NACHC Health Center Compensation & Benefits Report, 2) Milliman Northwest Health Care Industry Salary Survey, and 3) Independent Salary Surveys Conducted through HR. Information is then reviewed by the CEO who makes recommendation to Board for final approval. | Form 990, Part VI, Line 15b |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Compliance is updated annually for Board Members. For staff members:The process for evaluating conflict of interest issues is outlined in Policy ADM-CC-02, Employee Conflict of Interest. Employees submit their request for review of outside employment to the Human Resources (HR) Director; generally via email. The HR Director reviews the request with the employee's immediate supervisor and appropriate manager and/or director up to the Management Team Member. If approved via this chain of command, the request is submitted to the CEO for final approval. A written response is provided the employee outlining any guidelines. In the case of highly sensitive conflict of interest issues, employees may consult with the CEO directly. | Form 990, Part VI, Line 12c |
| Form 990, Part VI, Line 11: Form 990 Review Process | Form 990 is reviewed by either the Board or finance committee prior to filing. | Form 990, Part VI, Line 11 |
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