2020-11-16T19:51:34-06:00 2020-03-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2019-04-01 237297657 COLUMBIA VALLEY COMMUNITY HEALTH COLU 5096626000 600 ORONDO AVENUE NO 1 WENATCHEE WA 98801 DAVID OLSON CEO 5096626000 2020-10-30 1 KURT BENNION CPA P01469618 4252506100 2020-10-30 67.137.57.251 2020-10-30 16:26:47 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B236117B9166D2F893B54FD65EE150CAF84F9165 2019 2021-01-29 14:40:06Z DAVID OLSON 600 ORONDO AVENUE NO 1 WENATCHEE WA 98801 44635798 0 X WWW.CVCH.ORG X 1972 WA PARTNERING TO ACHIEVE OPTIMAL HEALTH AND WELLNESS WITH COMPASSION AND RESPECT FOR ALL. 9 9 389 10 0 0 9264751 9082241 32158662 34884235 275309 322634 92191 346688 41790913 44635798 7723 31681 0 0 24320585 26526096 0 0 0 12108684 12537182 36436992 39094959 5353921 5540839 56567792 61216299 13585514 13082291 42982278 48134008 THE MISSION OF COLUMBIA VALLEY COMMUNITY HEALTH IS PARTNERING TO ACHIEVE OPTIMAL HEALTH AND WELLNESS WITH COMPASSION AND RESPECT FOR ALL. 0 0 31101223 31681 34884235 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 OBSTETRIC CARE ON AN OUTPATIENT BASIS. AN ON SITE PHARMACY PROVIDES PATIENT PRESCRIPTION SERVICES TO ENSURE PATIENTS OBTAIN NEEDED MEDICATIONS. 528341 0 0 INTERMEDIARY FOR PROVIDING SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN. INCLUDES NUTRITION EDUCATION, REFERRAL FOR HEALTH CARE FOR LOWINCOME 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. 31629564 1 1 0 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 1 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 69 0 389 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X MIKE ROMINE 5096626000 600 ORONDO AVENUE NO 1 WENATCHEE WA 98801 MALCOLM BUTLER CMO 40.00 X 326934 0 37638 KENNETH SHERMER MEDICAL DIRECTOR 40.00 X 312002 0 37638 DAVID OLSON CEO 40.00 X 307119 0 37638 JENNIFER SNYDER PHYSICIAN 40.00 X 306276 0 35967 KERI BERGESON MEDICAL DIRECTOR 40.00 X 268674 0 37285 CAROL DIEDE COO (THROUGH JULY 2019) 40.00 X 265071 0 22833 JEFFERY HINCKLEY DENTIST & DENTAL DIRECTOR 40.00 X 250223 0 36840 NATHAN SCHREIBER PHYSICIAN 40.00 X 233440 0 35970 LAUREN KENDALL PHYSICIAN 40.00 X 232689 0 29247 MICHAEL ROMINE CFO 40.00 X 174280 0 29849 MANUEL NAVARRO COO 40.00 X 144933 0 31629 BLAKE EDWARDS BEHAVIORAL HEALTH DIRECTOR 40.00 X 113658 0 30036 KRISTINA STEPPER PRESIDENT 2.00 X X 0 0 0 MICHAEL MACHADO VICE PRESIDENT 2.00 X X 0 0 0 LOLY LARSON SECRETARY 2.00 X X 0 0 0 SHAUN KOOS TREASURER (THROUGH MARCH 2020) 2.00 X X 0 0 0 JOAN ALWAY BOARD MEMBER 2.00 X 0 0 0 DUSTY MAHONEY BOARD MEMBER 2.00 X 0 0 0 ALFREDO ORTIZ BOARD MEMBER 2.00 X 0 0 0 ROBERT SCOTT JR BOARD MEMBER 2.00 X 0 0 0 JOHN SWENSON BOARD MEMBER 2.00 X 0 0 0 TERESA ZEPEDA BOARD MEMBER 2.00 X 0 0 0 2935299 0 402570 48 0 1 0 ATHENAHEALTH PO BOX 415615 BOSTON MA 02241 BILLING & COLLECTION SERVICES 573163 RIMMER & ROETER CONSTRUCTION INC PO BOX 262 CASHMERE WA 98815 CONSTRUCTION SERVICES 452143 ABM JANITORIAL SERVICES PO BOX 951864 DALLAS TX 75395 JANITORIAL SERVICES 302018 CLIFTONLARSONALLEN LLP PO BOX 31001-2443 PASADENA CA 91110 ACCOUNTING/ PROFESSIONAL SVCS 214832 COMMUNITY CLINIC CONTRACTING NETWORK 18 S MISSION ST 300 WENATCHEE WA 98801 DATA WAREHOUSING SERVICES 163696 6 9008590 73651 1163152 9082241 PATIENT SERVICE REVENUE 621400 21546779 21546779 ENHANCEMENTS REVENUE 621400 11495845 11495845 CAPITATION REVENUE 621400 1738049 1738049 MEANINGFUL USE REVENUE 621400 85000 85000 MEDICAL RECORD REVENUE 621400 18562 18562 34884235 137096 137096 81918 103620 0 0 81918 103620 185538 185538 MISCELLANEOUS INCOME 900099 346688 346688 346688 44635798 34884235 0 669322 20000 20000 11681 11681 1747487 214194 1533293 19699524 17476050 2223474 713848 656446 57402 2902259 2518568 383691 1462978 1229101 233877 74204 74204 28795 28795 8036 8036 849099 325150 523949 72003 61375 10628 606860 470557 136303 1910234 1244749 665485 1000090 866052 134038 25802 18049 7753 288232 222483 65749 2169463 1593545 575918 58030 58030 MEDICAL SUPPLIES 4062253 4049583 12670 MISCELLANEOUS EXPENSES 557808 139845 417963 CONTINUING EDUCATION 333942 138067 195875 BAD DEBT EXPENSE 263561 263561 228770 110508 118262 39094959 31629564 7465395 0 10066110 11890441 4617348 9241001 282210 340220 4016419 2253241 192662 173969 674528 666558 49451976 17362095 32139212 32089881 3158479 3199051 1200000 1200000 220824 161937 56567792 61216299 3324272 3914915 356550 28125 9209679 8620280 695013 518971 13585514 13082291 X 42926501 48044567 55777 89441 42982278 48134008 56567792 61216299 5540839 -389109 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3957504 3957504 37437052 11979018 25458034 129171 113942 15229 7320540 5269135 2051405 607709 607709 32089881 OTHER LIABILITIES 518971 518971 X 44330537 15699 15699 44314838 8036 312924 320960 44635798 38823362 0 38823362 8036 263561 271597 39094959 PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS USING A STANDARD THAT PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. AS OF MARCH 31, 2020 AND 2019, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS 15,699. PART XI, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS 49,363. PROVISION FOR BAD DEBT 263,561. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 263,561. 1 THE TRUST FOR PUBLIC LAND 101 MONTGOMERY STREET SUITE 900 SAN FRANCISCO CA 94104 237222333 501(C)(3) 20000 RENOVATION OF A LOCAL PARK 1 0 HELPING HANDS FUND 63 11681 PART I, LINE 2: FOR THE GRANT TO AN ORGANIZATION, SUBSEQUENT REPORTING WAS CONDUCTED BY THE RECIPIENT TO ENSURE APPROPRIATE USE OF THE FUNDS. 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. THE COMMITTEE WILL REVIEW AND VOTE ON ELIGIBLE APPLICATIONS ON A CASE BY CASE BASIS. FOR APPLICATIONS 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 REQUEST 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. PAYMENTS ARE MADE DIRECTLY TO CREDITORS TO ENSURE PROPER USE OF ALL FUNDS. X 1 1 X X X X X 1 0 0 0 0 1 0 0 0 MALCOLM BUTLER CMO 284919 0 40951 0 1064 0 12600 0 25038 0 364572 0 0 0 KENNETH SHERMER MEDICAL DIRECTOR 287493 0 11574 0 12935 0 12600 0 25038 0 349640 0 0 0 DAVID OLSON CEO 240846 0 48350 0 17923 0 12600 0 25038 0 344757 0 0 0 JENNIFER SNYDER PHYSICIAN 282972 0 3679 0 19625 0 10929 0 25038 0 342243 0 0 0 KERI BERGESON MEDICAL DIRECTOR 245226 0 5735 0 17713 0 12512 0 24773 0 305959 0 0 0 CAROL DIEDE COO (THROUGH JULY 2019) 74540 0 23707 0 166824 0 12032 0 10801 0 287904 0 0 0 JEFFERY HINCKLEY DENTIST & DENTAL DIRECTOR 208465 0 23228 0 18530 0 11808 0 25032 0 287063 0 0 0 NATHAN SCHREIBER PHYSICIAN 233765 0 2192 0 -2517 0 10932 0 25038 0 269410 0 0 0 LAUREN KENDALL PHYSICIAN 227094 0 5079 0 516 0 10649 0 18598 0 261936 0 0 0 MICHAEL ROMINE CFO 153872 0 19611 0 797 0 8086 0 21763 0 204129 0 0 0 MANUEL NAVARRO COO 124808 0 20000 0 125 0 6830 0 24799 0 176562 0 0 0 PART I, LINE 1A THE ORGANIZATION PROVIDES HEALTH CLUB MEMBERSHIPS FOR ALL EMPLOYEES, INCLUDING THE INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A. THIS AMOUNT IS NOT INCLUDED IN EMPLOYEES' TAXABLE COMPENSATION. PART I, LINE 4A DURING 2019, CAROL DIEDE RECEIVED A SEVERANCE PAYMENT OF $142,242. PART I, LINE 6 THE ORGANIZATION'S LEADERSHIP TEAM PARTICIPATES IN AN INCENTIVE-BASED PROGRAM WITH SIX PILLARS, INCLUDING FINANCIAL SUSTAINABILITY (I.E. OPERATING MARGIN), COMMUNITY, GROWTH, PATIENT EXPERIENCE, QUALITY, AND WORKFORCE. EACH PILLAR IS EQUALLY WEIGHTED. A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 2017-06-22 9911965 NEW CONSTRUCTION AND REFINANCE SERIES 2010 BONDS 0 0 0 A 1173382 9911965 5080906 4831059 2017 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 MICHELLE NAVARRO SPOUSE OF MANUEL NAVARRO, THE ORGANIZATION'S COO 80515 EMPLOYEE COMPENSATION 0 X 15847 1163152 INVOICE PRICE 0 0 0 0 PART I, COLUMN (B): THE NUMBER REPORTED IN PART I, COLUMN B IS THE NUMBER OF DONATED ITEMS RECEIVED DURING THE FISCAL YEAR. FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE OFFICERS OF THE BOARD AND ONE AT-LARGE BOARD MEMBER. THE EXECUTIVE COMMITTEE IS AUTHORIZED TO REVIEW AND TAKE ANY NECESSARY ACTION THAT, IN THE OPINION OF A MAJORITY OF THE COMMITTEE, CANNOT WAIT FOR THE NEXT REGULARLY SCHEDULED BOARD MEETING OR WHERE THE CALLING OF A SPECIAL BOARD MEETING IS NOT PRACTICAL. THE EXECUTIVE COMMITTEE CHAIR MUST REPORT TO THE BOARD AT ITS NEXT REGULAR MEETING ALL ACTIONS TAKEN BY THE COMMITTEE. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION'S BYLAWS WERE AMENDED IN MAY 2019 TO CHANGE THE MISSION STATEMENT TO THE ONE NOW SHOWN IN FORM 990, PART I, LINE 1 AND PART III, LINE 1; TO ADD A VISION STATEMENT; AND TO ALLOW THE BOARD PRESIDENT TO ADD AD HOC VOTING MEMBERS TO ANY COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE FORM 990 WAS PROVIDED BY THE EXTERNAL TAX PRACTITIONER AND PRESENTED TO THE FINANCE COMMITTEE, A SUBCOMMITTEE OF THE BOARD. THE FINANCE COMMITTEE REVIEWED THE FORM 990 AND THEN PRESENTED ITS RECOMMENDATION TO THE BOARD OF DIRECTORS TO FILE. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER SIGNS THE CONFLICT OF INTEREST STATEMENT WHEN THEY JOIN THE BOARD. IN ADDITION, AT THE ANNUAL BOARD MEETING IN MARCH ALL BOARD MEMBERS SIGN THE STATEMENT AGAIN TO ENSURE NOTHING HAS CHANGED FROM THE PRIOR YEAR OR TO BRING ATTENTION TO SOMETHING THAT HAS. ALSO, BOARD MEMBERS ARE ENCOURAGED TO DISCLOSE NEW INFORMATION THAT MIGHT COME UP AFTER THE STATEMENT WAS SIGNED. IF A CONFLICT EXISTS, THAT BOARD MEMBER DOES NOT VOTE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15A SALARY DATA IS PULLED FROM MULTIPLE SALARY SURVEY SOURCES, IN ADDITION TO INDEPENDENT SALARY SURVEYS CONDUCTED THROUGH HR. THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE CEO'S COMPENSATION. THE CEO REVIEWS AND APPROVES ALL OTHER EMPLOYEES' COMPENSATION. THE PROCESS WAS LAST COMPLETED IN 2019. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, BUT THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC.