2020-02-11T12:17:38-06:00 2019-03-31 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1400 BELLEVUE WA 98004 990 2018-04-01 911537371 MOSES LAKE COMMUNITY HEALTH CENTER MOSE 5097650674 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 AMANDA BARTA CHIEF FINANCIAL OFFICER 5097650674 2020-02-06 1 KATHRYN J OKIMOTO P00746598 4254544919 2020-01-29 65.158.230.202 2020-02-06 13:26:16 PS P DE1D2BBAE0F1147E7A7EA18DABEA7E867F199504 C070BA3AF7F6D7D87E83B9D9DF9412DF7C2C6F3F 2018 2020-09-22 18:59:49Z SHEILA CHILSON 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 33411565 0 X WWW.MLCHC.ORG X 1991 WA TO PROVIDE HIGH QUALITY, COMPASSIONATE AND COMPREHENSIVE PRIMARY HEALTH SERVICES FOR THE ENTIRE FAMILY, WITH A SPECIAL FOCUS ON THE UNDERSERVED AND MIGRANT FARM-WORKERS IN THE COMMUNITY. 10 10 348 11 0 0 6194688 6916220 25794627 26156022 268752 333323 1350 6000 32259417 33411565 0 854 0 0 21093937 22733103 0 0 0 7780793 8108897 28874730 30842854 3384687 2568711 37133034 39280254 9177714 7854439 27955320 31425815 TO PROVIDE HIGH QUALITY, COMPASSIONATE AND COMPREHENSIVE PRIMARY HEALTH SERVICES FOR THE ENTIRE FAMILY, WITH A SPECIAL FOCUS ON THE UNDERSERVED AND MIGRANT FARM-WORKERS IN THE COMMUNITY. 0 0 15238412 854 19813471 MEDICAL SERVICES - THIS PROGRAM INCLUDES MEDICAL, BEHAVIORAL HEALTH AND PHARMACY SERVICES PROVIDED TO PATIENTS OF THE HEALTH CENTER. MOSES LAKE COMMUNITY HEALTH CENTER (MLCHC) PROVIDES PRIMARY CARE SERVICES INCLUDING OBSTETRICS CARE WITH 8 PHYSICIANS AND 15 MID-LEVEL PHYSICIANS ON STAFF. IN 2018, 22,684 MEDICAL PATIENTS WERE SEEN WITH A TOTAL OF 76,477 VISITS. 5611356 5615523 DENTAL SERVICES - MLCHC HAS 10 DENTISTS AND 5 DENTAL HYGIENISTS ON STAFF TO PROVIDE PREVENTATIVE, RESTORATIVE AND EMERGENCY CARE TO THE HEALTH CENTER'S INSURED AND UNINSURED PATIENTS. IN 2018, 12,909 PATIENTS WERE SEEN IN THE DENTAL DEPARTMENT WITH A TOTAL OF 37,744 VISITS PROVIDED. 1816960 727028 OTHER HEALTH PROGRAMS - MLCHC PROVIDES MATERNITY SUPPORT SERVICES, WIC, INFANT TODDLER EARLY INTERVENTION AND DEVELOPMENTAL DISABILITY PARENT TRAINING PROGRAMS. THE MATERNITY SUPPORT SERVICES DEPARTMENT PROVIDED 6,421 VISITS TO APPROXIMATELY 1,222 PATIENTS. THE WIC PROGRAM SERVICES ELIGIBLE CLIENTS THROUGHOUT GRANT COUNTY IN MULTIPLE LOCATIONS. 22666728 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 53 0 1 348 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X AMANDA BARTA 5097650674 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 MATTHEW BENSON BOARD CHAIR 2.00 1.00 X X 0 0 0 DAVE CAMPBELL VICE CHAIR 2.00 0.00 X X 0 0 0 EVA HIDALGO SECRETARY 2.00 0.00 X X 0 0 0 MICHAEL HOMER TREASURER 2.00 0.00 X X 0 0 0 SHERRY DELGADO DIRECTOR 1.00 1.00 X 0 0 0 SHARON LANGE DIRECTOR 1.00 0.00 X 0 0 0 AMY RAYMOND THRU 1118 DIRECTOR 1.00 0.00 X 0 0 0 CAROL SCHIMKE DIRECTOR 1.00 0.00 X 0 0 0 AMELIA CAMPOS DIRECTOR 1.00 0.00 X 0 0 0 DAYANA RUIZ DIRECTOR 1.00 0.00 X 0 0 0 JOSE AGUINAGA JR DIRECTOR 1.00 0.00 X 0 0 0 LARRY VERHAGE CHIEF MEDICAL OFFICER 40.00 0.00 X 357510 0 31720 BRETT PACK CHIEF DENTAL OFFICER 40.00 0.00 X 294494 0 26058 SHEILA CHILSON CEO 40.00 1.00 X 254269 0 26315 AMANDA BARTA CFO 40.00 1.00 X 164141 0 21725 KIM FRICKE COO 40.00 0.00 X 157525 0 22002 MICHAEL TOLLEY PHYSICIAN 40.00 0.00 X 311540 0 31920 CARLINA MENJIVAR PHYSICIAN 40.00 0.00 X 283880 0 29323 COLE HEMMERLING PHYSICIAN 40.00 0.00 X 270761 0 31714 JILL SIMON PHYSICIAN 40.00 0.00 X 244487 0 27809 MORGAN FIFE PHYSICIAN 40.00 0.00 X 231807 0 30156 2570414 0 278742 46 0 1 0 ALDRICH & ASSOCIATES 810-240TH STREET SE BOTHELL WA 98021 CONSTRUCTION CONTRACTOR 3639972 NUVODIA 801 S STEVENS ST SPOKANE VALLEY WA 99204 INFORMATION TECHNOLOGY SERVICES 1123694 NORTHWEST JANITORIAL 11523 E MISSION AVE SPOKANE VALLEY WA 99206 JANITORIAL SERVICES 315942 INTERPATH LABORATORY PO BOX 1208 PENDLETON WA 97801 OUTSIDE LAB FEES 250588 STAFF CARE INC PO BOX 281923 ATLANTA GA 30384 LOCUM STAFFING AGENCY 158086 5 6318653 597567 6916220 PATIENT SERVICES 624100 17348870 17348870 MANAGED CARE 624100 8592137 8592137 CONTRACT SERVICES 624100 215015 215015 26156022 329728 329728 3595 0 3595 3595 3595 PRECEPTOR PROGRAM 900099 6000 6000 6000 33411565 26156022 0 339323 854 854 1330822 362314 968508 17670272 14373606 3296666 453500 352887 100613 1856074 1438870 417204 1422435 1101239 321196 23351 8225 15126 101798 15210 86588 1000 1000 329351 246626 82725 69864 7438 62426 245028 111103 133925 1256493 324318 932175 481577 113452 368125 121769 85923 35846 78432 59685 18747 16185 16176 9 839687 316103 523584 94913 36891 58022 MED & PHARM SUPPLIES 1887269 1887269 PURCHASED SERVICES 744374 587268 157106 BAD DEBT EXPENSE 721690 721690 UBIT 337 337 1095779 499581 596198 30842854 22666728 8176126 0 1984677 2045947 4684326 3774636 753317 159359 1650039 2467089 6314900 6314900 351486 365382 311391 451915 22913956 8398124 9358576 14515832 11724322 9185194 37133034 39280254 8340895 7648694 836819 205745 9177714 7854439 X 27955320 31425815 27955320 31425815 37133034 39280254 2568711 113800 787984 0 X 0 1 X 1 1 1 X 5254443 5783143 6682929 6194688 6916220 30831423 5254443 5783143 6682929 6194688 6916220 30831423 30831423 249322 257284 260909 265126 329728 1362369 9313 4859 6584 20756 6000 6000 32220548 114311808 0.95690 0.95540 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: PRECEPTOR - 2018 AMOUNT: $ 6,000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1000 1000 0 PART II-B, LINE 1: A PORTION OF THE ASSOCIATION MEMBERSHIP DUES THE ORGANIZATION PAYS ARE EARMARKED FOR LOBBYING EFFORTS. 1821855 1821855 7779937 2566680 5213257 2974673 2015154 959519 5372372 3816290 1556082 4965119 4965119 14515832 33525365 113800 113800 33411565 0 33411565 31140221 297367 297367 30842854 0 30842854 PART XII, LINE 2D - OTHER ADJUSTMENTS: NET INCOME OF SUBSIDIARY 297,367. X X X 0 0 0 0 0 0 0 0 0 LARRY VERHAGE CHIEF MEDICAL OFFICER 321560 0 35950 0 0 0 10800 0 20920 0 389230 0 0 0 BRETT PACK CHIEF DENTAL OFFICER 273544 0 20950 0 0 0 10865 0 15193 0 320552 0 0 0 SHEILA CHILSON CEO 253319 0 950 0 0 0 9833 0 16482 0 280584 0 0 0 AMANDA BARTA CFO 163191 0 950 0 0 0 6530 0 15195 0 185866 0 0 0 KIM FRICKE COO 156575 0 950 0 0 0 5295 0 16707 0 179527 0 0 0 MICHAEL TOLLEY PHYSICIAN 305490 0 6050 0 0 0 11000 0 20920 0 343460 0 0 0 CARLINA MENJIVAR PHYSICIAN 282810 0 1070 0 0 0 8403 0 20920 0 313203 0 0 0 COLE HEMMERLING PHYSICIAN 261510 0 9251 0 0 0 10794 0 20920 0 302475 0 0 0 JILL SIMON PHYSICIAN 243537 0 950 0 0 0 9744 0 18065 0 272296 0 0 0 MORGAN FIFE PHYSICIAN 220787 0 11020 0 0 0 9236 0 20920 0 261963 0 0 0 FORM 990, PART I, LINE 6: THE BOARD OF DIRECTORS PER MLCHC BYLAWS REQUIRES A BOARD COMPOSITION OF 9 TO 15 MEMBERS. ALL VOLUNTEER POSITIONS ARE RELATED TO INVOLVEMENT ON THE BOARD, EITHER AS AN ELECTED MEMBER OR ADVISORY MEMBER. THESE INDIVIDUALS CONTRIBUTE A MINIMUM OF 3 HOURS A MONTH IN THIS CAPACITY. FORM 990, PART VI, SECTION B, LINE 11B UPON COMPLETION OF THE FORM 990, THE RETURN WILL BE REVIEWED IN DETAIL WITH THE BOARD FINANCE COMMITTEE AND THEN IN SUMMARY WITH THE BOARD OF DIRECTORS. UPON APPROVAL BY THE BOARD OF DIRECTORS, THE FINAL FORM 990 WILL BE SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS, OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED ON A CONTINUOUS BASIS TO COMPLY WITH THE CONFLICT OF INTEREST POLICY AND ARE REQUIRED TO DISCLOSE TO THE BOARD OF DIRECTORS OR COMPLIANCE OFFICER ANY ISSUES OR CONCERNS. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING AND REPORTING ANY CONFLICTS OF INTEREST BROUGHT TO THE ATTENTION OF THE ORGANIZATION. A BOARD MEMBER WHO HAS A CONFLICT OF INTEREST, IN ANY MATTER BROUGHT BEFORE THE BOARD, SHALL DECLARE SUCH CONFLICT AND MAY BE INCLUDED IN, OR OFFER INFORMATION TO THE DISCUSSION, BUT SHALL ABSTAIN FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 FOR THE CEO, THE BOARD OF DIRECTORS REVIEWS SALARY SURVEYS AND REGIONAL MARKET COMPARISONS TO DETERMINE APPROPRIATE COMPENSATION LEVELS. THE CONTRACT IS REVIEWED BY THE BOARD OF DIRECTORS EVERY THREE YEARS AND APPROVED BY THE ENTIRE BOARD. OTHER OFFICERS AND KEY EMPLOYEES ARE REVIEWED UTILIZING SALARY SURVEYS AND REGIONAL MARKET COMPARISONS AS WELL. THIS PROCESS IS LED BY THE CEO WITH THE ASSISTANCE OF THE HR DIRECTOR. COMPENSATION INFORMATION IS REVIEWED WITH THE BOARD CHAIR BY THE CEO. THE LAST COMPENSATION REVIEW WAS PERFORMED IN JUNE 2019. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE FOR VIEWING UPON REQUEST AT THE ORGANIZATION'S MAIN BUSINESS OFFICE IN THE PRESENCE OF THE CFO OR CEO. MLCHC COMMUNITY SERVICES 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 463517778 CLINIC EXPANSION WA 501(C)(3) LINE 12A, I MOSES LAKE COMMUNITY HEALTH CENTER 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 MLCHC COMMUNITY SERVICES K 133200 COST