LEWIS COUNTY COMMUNITY HEALTH SERVICES: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- LEWIS COUNTY COMMUNITY HEALTH SERVICES (EIN 42-1599749)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-02
- IRS object ID
- 202313069349301681
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-02T11:46:02-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10700 NORTHUP WAY SUITE 200 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421599749 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LEWIS COUNTY COMMUNITY HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LEWI | BusinessNameControlTxt |
| Phone | 3603309595 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2690 NE KRESKY AVENUE | AddressLine1Txt |
| City | CHEHALIS | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98532 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HOLLY SLIVA | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3603309595 | PhoneNum |
| Signature | 2023-10-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | HOLLY | PersonFirstNm |
| Person Last | SLIVA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KURT BENNION CPA | PreparerPersonNm |
| PTIN | P01469618 | PTIN |
| Phone | 4252506100 | PhoneNum |
| Preparation | 2023-10-31 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VALLEY VIEW HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GAELON SPRADLEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2690 NE KRESKY AVENUE | AddressLine1Txt |
| City | CHEHALIS | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98532 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $32,110,132 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.VVHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY BY PROVIDING QUALITY AND COMPASSIONATE HEALTH CARE SERVICES IN A PATIENT-CENTERED ATMOSPHERE, RESPECTING INDIVIDUAL AND CULTURAL DIVERSITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 292 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $8,245,161 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,182,246 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $23,840,953 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $25,539,992 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$17,202 | PYInvestmentIncomeAmt |
| CY Investment Income | $138,524 | CYInvestmentIncomeAmt |
| PY Other Revenue | $263,169 | PYOtherRevenueAmt |
| CY Other Revenue | $176,888 | CYOtherRevenueAmt |
| PY Total Revenue | $32,332,081 | PYTotalRevenueAmt |
| CY Total Revenue | $32,037,650 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $13,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,737,261 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $19,388,087 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,167,155 | PYOtherExpensesAmt |
| CY Other Expenses | $7,948,092 | CYOtherExpensesAmt |
| PY Total Expenses | $24,917,416 | PYTotalExpensesAmt |
| CY Total Expenses | $27,337,179 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,414,665 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,700,471 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,600,058 | TotalAssetsBOYAmt |
| Total Assets EOY | $33,793,494 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,017,332 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,638,607 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,582,726 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $27,154,887 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY BY PROVIDING QUALITY AND COMPASSIONATE HEALTH CARE SERVICES IN A PATIENT-CENTERED ATMOSPHERE, RESPECTING INDIVIDUAL AND CULTURAL DIVERSITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,205,182 | ExpenseAmt |
| Grant | $1,000 | GrantAmt |
| Revenue | $14,491,460 | RevenueAmt |
| Desc | VALLEY VIEW HEALTH CENTER (THE CENTER) PROVIDES MEDICAL SERVICES, PRIMARILY TO LOW-INCOME INDIVIDUALS. IN 2022, THE CENTER PROVIDED 43,826 MEDICAL ENCOUNTERS TO 24,025 PATIENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,958,020 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $6,538,373 | RevenueAmt |
| Desc | THE CENTER PROVIDES DENTAL-RELATED SERVICES, PRIMARILY TO LOW-INCOME INDIVIDUALS. IN 2022, THE CENTER PROVIDED 17,631 DENTAL ENCOUNTERS TO 7,204 PATIENTS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,836,412 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,112,699 | RevenueAmt |
| Desc | THE CENTER PROVIDES PHARMACY-RELATED SERVICES, PRIMARILY TO LOW-INCOME INDIVIDUALS. IN 2022, THE CENTER'S PHARMACY FILLED 77,144 PRESCRIPTIONS AND CONDUCTED 266 CLINICAL ENCOUNTERS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,273,421 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,397,460 | RevenueAmt |
| Desc | THE CENTER PROVIDES BEHAVIORAL HEALTH AND RELATED SERVICES, PRIMARILY TO LOW-INCOME INDIVIDUALS. IN 2022, THE CENTER PROVIDED 3,148 BEHAVIORAL HEALTH ENCOUNTERS TO 619 PATIENTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,273,421 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $1,397,460 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $23,273,035 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 36 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 292 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HOLLY SLIVA | PersonNm |
| Phone | 3603309595 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2690 NE KRESKY AVENUE | AddressLine1Txt |
| City | CHEHALIS | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98532 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| GARETT GODFREY | ||||||||
| DENTIST | 40.00 | Yes (X) | $263,282 | $0 | $22,851 | |||
| DAVID LITTLE | ||||||||
| MEDICAL DIRECTOR | 40.00 | $256,960 | $0 | $26,236 | Yes (X) | |||
| SARAH LANDRUM | ||||||||
| ASSISTANT MEDICAL DIRECTOR | 40.00 | Yes (X) | $254,869 | $0 | $25,820 | |||
| STEPHEN HENNESSEY | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $254,231 | $0 | $21,043 | |||
| GAELON SPRADLEY | ||||||||
| CEO | 40.00 | $253,461 | $0 | $20,386 | Yes (X) | |||
| LOU ANN MERCIER | ||||||||
| CCIO / DENTAL DIRECTOR | 40.00 | $239,652 | $0 | $23,576 | Yes (X) | |||
| THOMAS DONOVAN | ||||||||
| COO | 40.00 | $187,799 | $0 | $18,410 | Yes (X) | |||
| JON WILEY | ||||||||
| PHARMACIST | 40.00 | Yes (X) | $186,054 | $0 | $18,316 | |||
| KEITH DOYLE | ||||||||
| DENTIST | 40.00 | Yes (X) | $180,575 | $0 | $18,097 | |||
| HOLLY SLIVA | ||||||||
| CFO | 40.00 | $185,463 | $0 | $12,804 | Yes (X) | |||
| SARAH BAGBY | ||||||||
| PHARMACY DIRECTOR | 40.00 | $187,658 | $0 | $8,242 | Yes (X) | |||
| HEIDI ZIPPERER | ||||||||
| CAO | 40.00 | $127,518 | $0 | $15,975 | Yes (X) | |||
| LESLIE WOHLD | ||||||||
| CHRO | 40.00 | $115,163 | $0 | $15,495 | Yes (X) | |||
| GREG MARTIN | ||||||||
| PRESIDENT | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| RACHEL WOOD | ||||||||
| VICE PRESIDENT | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| DANIEL STUSSER | ||||||||
| SECRETARY | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| KIANDRE BRASHER | ||||||||
| TREASURER (THROUGH OCTOBER 2022) | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| BOBBY BURGER | ||||||||
| BOARD MEMBER & TREASURER | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| JOHN BURTON | ||||||||
| PAST PRESIDENT | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| TONI GWIN | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| MARY BETH HARRINGTON | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| ROBERT MOHRBACHER | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| ROBERT CHRIS RUST | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| TAMRA RUYMANN | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| GRICELDA SANCHEZ | ||||||||
| BOARD MEMBER (THROUGH JULY 2022) | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,692,685 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $247,251 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 43 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BLUENOVO INC | |||||
| 8455 COLESVILLE RD SUITE 1525 | SILVER SPRING | MD | 20910 | IT SERVICES | $274,084 |
| UNIVERSITY OF WASHINGTON | |||||
| 1959 NE PACIFIC STREET | SEATTLE | WA | 98195 | PSYCHIATRIC SERVICES | $177,469 |
| LAKESIDE INDUSTRIES | |||||
| PO BOX 7016 | ISSAQUAH | WA | 980277016 | CONSTRUCTION | $165,075 |
| YOUNGS JANITORIAL | |||||
| PO BOX 599 | ONALASKA | WA | 98570 | CLEANING SERVICES | $130,650 |
| FIRST RULE GROUP | |||||
| 1001 COOPER POINT ROAD SW SUITE 14 | OLYMPIA | WA | 98502 | PROJECT CONSULTING | $111,265 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,160,494 | GovernmentGrantsAmt |
| All Other Contributions | $21,752 | AllOtherContributionsAmt |
| Noncash Contributions | $203,759 | NoncashContributionsAmt |
| Total Contributions | $6,182,246 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 624100 | $23,755,303 | $23,755,303 |
| CAPITATION REVENUE | 624100 | $1,784,689 | $1,784,689 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $25,539,992 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $51,006 | TotalRevenueColumnAmt |
| Exclusion | $51,006 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $43,859 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $43,859 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,859 | TotalRevenueColumnAmt |
| Exclusion | $43,859 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $160,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $72,482 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $87,518 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $87,518 | TotalRevenueColumnAmt |
| Exclusion | $87,518 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| OTHER INCOME | 900099 | $110,411 | $110,411 |
| MEDICAL RECORDS REVENUE | 900099 | $22,618 | $22,618 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $133,029 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,037,650 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,539,992 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $315,412 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Program Services | $1,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,694,795 | TotalAmt |
| Program Services | $742,325 | ProgramServicesAmt |
| Management And General | $952,470 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,024,285 | TotalAmt |
| Program Services | $13,462,505 | ProgramServicesAmt |
| Management And General | $561,780 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,377 | TotalAmt |
| Program Services | $321,130 | ProgramServicesAmt |
| Management And General | $12,247 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,235,933 | TotalAmt |
| Program Services | $2,236,551 | ProgramServicesAmt |
| Management And General | -$618 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,099,697 | TotalAmt |
| Program Services | $882,826 | ProgramServicesAmt |
| Management And General | $216,871 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,824,684 | TotalAmt |
| Program Services | $1,008,004 | ProgramServicesAmt |
| Management And General | $816,680 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,604 | TotalAmt |
| Program Services | $60,603 | ProgramServicesAmt |
| Management And General | $13,001 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $398,917 | TotalAmt |
| Program Services | $341,642 | ProgramServicesAmt |
| Management And General | $57,275 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $738,310 | TotalAmt |
| Program Services | $609,528 | ProgramServicesAmt |
| Management And General | $128,782 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,935 | TotalAmt |
| Program Services | $125,490 | ProgramServicesAmt |
| Management And General | $35,445 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,408 | TotalAmt |
| Program Services | $6,178 | ProgramServicesAmt |
| Management And General | $6,230 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,376 | TotalAmt |
| Program Services | $167,337 | ProgramServicesAmt |
| Management And General | $39 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $660,222 | TotalAmt |
| Program Services | $625,503 | ProgramServicesAmt |
| Management And General | $34,719 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,525 | TotalAmt |
| Program Services | $467 | ProgramServicesAmt |
| Management And General | $94,058 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $2,351,999 | $1,608,752 | $743,247 |
| DUES & SUBSCRIPTIONS | $584,172 | $429,432 | $154,740 |
| MINOR EQUIPMENT | $273,925 | $205,292 | $68,633 |
| BAD DEBT EXPENSE | $219,897 | $219,897 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $387,118 | TotalAmt |
| Program Services | $218,573 | ProgramServicesAmt |
| Management And General | $168,545 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,337,179 | TotalAmt |
| Program Services | $23,273,035 | ProgramServicesAmt |
| Management And General | $4,064,144 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,298,548 | BOYAmt |
| EOY | $5,714,723 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,401,668 | BOYAmt |
| EOY | $4,163,706 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $325,795 | BOYAmt |
| EOY | $633,998 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,420,440 | BOYAmt |
| EOY | $1,877,296 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $269,046 | BOYAmt |
| EOY | $345,055 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $259,943 | BOYAmt |
| EOY | $241,770 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,749,609 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,334,424 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,153,407 | BOYAmt |
| EOY | $8,415,185 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,465,357 | BOYAmt |
| EOY | $12,395,907 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,854 | BOYAmt |
| EOY | $5,854 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,600,058 | BOYAmt |
| EOY | $33,793,494 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,109,996 | BOYAmt |
| EOY | $2,301,527 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $684,264 | BOYAmt |
| EOY | $281,901 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,854 | BOYAmt |
| EOY | $5,854 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,067,059 | BOYAmt |
| EOY | $3,900,431 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,159 | BOYAmt |
| EOY | $148,894 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,017,332 | BOYAmt |
| EOY | $6,638,607 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,582,726 | BOYAmt |
| EOY | $27,154,887 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,582,726 | BOYAmt |
| EOY | $27,154,887 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,600,058 | BOYAmt |
| EOY | $33,793,494 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,700,471 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$110,853 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$17,457 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,051,793 | OtherCostOrOtherBasisAmt |
| Book Value | $1,051,793 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,538,536 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,447,538 | DepreciationAmt |
| Book Value | $4,090,998 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,469,564 | OtherCostOrOtherBasisAmt |
| Depreciation | $120,536 | DepreciationAmt |
| Book Value | $2,349,028 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,398,341 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,766,350 | DepreciationAmt |
| Book Value | $631,991 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $291,375 | OtherCostOrOtherBasisAmt |
| Book Value | $291,375 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,415,185 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RISK POOL | Desc |
| Amt | $148,894 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $148,894 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $31,393,871 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$110,853 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $21,973 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | -$88,880 | RevenueNotReportedAmt |
| Revenue Subtotal | $31,482,751 | RevenueSubtotalAmt |
| Other Revenues Not Included | $554,899 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $554,899 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $32,037,650 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $27,139,255 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $21,973 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $21,973 | ExpensesNotReportedAmt |
| Expenses Subtotal | $27,117,282 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $219,897 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $219,897 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $27,337,179 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE ORGANIZATION HOLDS SECURITY DEPOSITS FOR TENANTS OF LEASED SPACE. THE FUNDS WILL BE REFUNDED, LESS ANY REPAIRS FOR DAMAGES, WHEN THE LEASE IS TERMINATED. |
| PART X, LINE 2: | THE CENTER IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE CENTER EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2022 AND 2021, THE CENTER HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTIONS 247,484. GAIN ON DISPOSAL OF ASSETS 87,518. BAD DEBT EXPENSE 219,897. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 219,897. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GARETT GODFREY | ||||||||||||||
| DENTIST | $263,282 | $0 | $0 | $0 | $0 | $0 | $10,430 | $0 | $12,421 | $0 | $286,133 | $0 | $0 | $0 |
| DAVID LITTLE | ||||||||||||||
| MEDICAL DIRECTOR | $256,960 | $0 | $0 | $0 | $0 | $0 | $9,388 | $0 | $16,848 | $0 | $283,196 | $0 | $0 | $0 |
| SARAH LANDRUM | ||||||||||||||
| ASSISTANT MEDICAL DIRECTOR | $254,869 | $0 | $0 | $0 | $0 | $0 | $10,179 | $0 | $15,641 | $0 | $280,689 | $0 | $0 | $0 |
| STEPHEN HENNESSEY | ||||||||||||||
| PHYSICIAN | $251,731 | $0 | $2,500 | $0 | $0 | $0 | $10,169 | $0 | $10,874 | $0 | $275,274 | $0 | $0 | $0 |
| GAELON SPRADLEY | ||||||||||||||
| CEO | $253,461 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,386 | $0 | $273,847 | $0 | $0 | $0 |
| LOU ANN MERCIER | ||||||||||||||
| CCIO / DENTAL DIRECTOR | $239,652 | $0 | $0 | $0 | $0 | $0 | $9,586 | $0 | $13,990 | $0 | $263,228 | $0 | $0 | $0 |
| THOMAS DONOVAN | ||||||||||||||
| COO | $187,799 | $0 | $0 | $0 | $0 | $0 | $7,512 | $0 | $10,898 | $0 | $206,209 | $0 | $0 | $0 |
| JON WILEY | ||||||||||||||
| PHARMACIST | $186,054 | $0 | $0 | $0 | $0 | $0 | $7,442 | $0 | $10,874 | $0 | $204,370 | $0 | $0 | $0 |
| KEITH DOYLE | ||||||||||||||
| DENTIST | $180,575 | $0 | $0 | $0 | $0 | $0 | $7,223 | $0 | $10,874 | $0 | $198,672 | $0 | $0 | $0 |
| HOLLY SLIVA | ||||||||||||||
| CFO | $185,463 | $0 | $0 | $0 | $0 | $0 | $1,855 | $0 | $10,949 | $0 | $198,267 | $0 | $0 | $0 |
| SARAH BAGBY | ||||||||||||||
| PHARMACY DIRECTOR | $187,658 | $0 | $0 | $0 | $0 | $0 | $7,506 | $0 | $736 | $0 | $195,900 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1826 | ContributionCnt |
| Noncash Contributions Rpt F990 | $203,759 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | INVOICE PRICE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE NUMBERS REPORTED IN PART I, COLUMN B REPRESENT THE NUMBER OF DONATED ITEMS RECEIVED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF FORM 990 WAS PROVIDED TO THE CEO AND CFO WHO REVIEWED THE FORM AND SCHEDULES. ALL COMMENTS OR QUESTIONS WERE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT WAS PRESENTED TO THE FINANCE COMMITTEE. A COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS. ONCE APPROVED, THE CEO SIGNED THE FORM 8879-TE, AUTHORIZING THE PREPARER TO E-FILE THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | IT IS THE POLICY OF THE CENTER TO ENSURE TRANSPARENCY REGARDING ANY CONFLICTS OF INTEREST AND PREVENT ANY REAL OR PERCEIVED CONFLICTS FO INTEREST FROM OCCURRING WITH RESPECT OT HEALTH CENTER EMPLOYEES, OFFICERS, GOVERNING BOARD MEMBERS, AND AGENTS. ALL INDIVIDUALS AFFILIATED WITH VVHC MUST READ AND SIGN THE STANDARDS OF CONDUCT POLICY WITH THE CONFLICT OF INTEREST DISCLOSURE FORM AND DISCLOSE ALL CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS OF INTEREST UPON INITIAL AFILIATION WITH VVHC, AND ANNUALLY THEREAFTER. IF A PERSON HAS A POTENTIAL CONFLICT OF INTEREST, THEY ARE REQUIRED TO DISCLOSE THE RELEVANT FACTS AND ANSWER QUESTIONS, AFTER WHICH THEY LEAVE THE MEETING FOR REMAINING DISCUSSIONS AND VOTING. IF A CONFLICT EXISTS, THE BOARD EVALUATES WHETHER ANOTHER TRANSACTION CAN BE IDENTIFIED THAT WOULD NOT INVOLVE A CONFLICT OF INTEREST. IF AN INDIVIDUAL FAILS TO DISCLOSE A POTENTIAL CONFLICT OF INTEREST, APPROPRIATE CORRECTIVE AND DISCIPLINARY ACTIONS ARE TAKEN. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS' EXECUTIVE COMMITTEE SETS THE COMPENSATION OF THE CEO. IN 2022, A COMPENSATION CONSULTANT ANALYZED THE COMPENSATION STRUCTURES OF ALL OFFICERS AND EMPLOYEES, UTILIZING THE CURRENT WASHINGTON STATE RANGES IN THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AS WELL AS OTHER REGIONAL BENCHMARKS. THE CEO'S PAY FOR PERFORMANCE IS SET BASED ON THE DIFFERENCE BETWEEN THE BASE SALARY AND 100TH PERCENTILE. THE COMPENSATION REVIEW FOR OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED USING NATIONAL SALARY SURVEYS OBTAINED BY HUMAN RESOURCES. THE SALARIES ARE REVIEWED AND UPDATED ANNUALLY OR ON THE EMPLOYEE'S CONTRACT TERMS. THIS PROCESS MOST RECENTLY INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION IN 2022. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CENTER MAKES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | RISK POOL SETTLEMENT -17,457. |