COLUMBIA VALLEY COMMUNITY HEALTH: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBIA VALLEY COMMUNITY HEALTH (EIN 23-7297657)
- Tax period
- 2016-04-01 to 2017-03-31
- Filed
- 2018-01-22
- IRS object ID
- 201830229349300133
- Schema version
- 2016v3.0
- 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 | 2018-01-22T18:44:42-06:00 | ReturnTs |
| Tax Period End | 2017-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Moss Adams LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 22650 | AddressLine1Txt |
| City | Yakima | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 989072650 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237297657 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Columbia Valley Community Health | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COLU | BusinessNameControlTxt |
| Phone | 5096643528 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Orondo Ave Suite 1 | AddressLine1Txt |
| City | Wenatchee | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98801 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | David Olson | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5096643528 | PhoneNum |
| Signature | 2017-10-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Wendy Campos | PreparerPersonNm |
| PTIN | P00448102 | PTIN |
| Phone | 5092487750 | PhoneNum |
| Preparation | 2017-10-27 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 12.129.7.100 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-10-27 | IPDt |
| IP Tm | 16:23:32 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D983BCCB14F58FEA2964ADA2E2BA40929A762B4D | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | David Olson | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Orondo Ave Suite 1 | AddressLine1Txt |
| City | Wenatchee | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $29,592,948 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cvch.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE ACCESS TO IMPROVED HEALTH AND WELLNESS WITH COMPASSION AND RESPECT FOR ALL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 348 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,573,085 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,797,611 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $24,557,122 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,732,748 | CYProgramServiceRevenueAmt |
| PY Investment Income | $105,295 | PYInvestmentIncomeAmt |
| CY Investment Income | -$464,625 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $31,235,502 | PYTotalRevenueAmt |
| CY Total Revenue | $29,065,734 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $18,657 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $50,340 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,396,276 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $19,614,799 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $36,738 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $8,502 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $166,121 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,472,064 | PYOtherExpensesAmt |
| CY Other Expenses | $7,929,540 | CYOtherExpensesAmt |
| PY Total Expenses | $24,923,735 | PYTotalExpensesAmt |
| CY Total Expenses | $27,603,181 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,311,767 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,462,553 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,847,198 | TotalAssetsBOYAmt |
| Total Assets EOY | $47,922,519 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,250,256 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,571,154 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $31,596,942 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $33,351,365 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of Columbia Valley Community Health is to provide access to improved health and wellness with compassion and respect for all. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $19,904,130 | ExpenseAmt |
| Grant | $50,340 | GrantAmt |
| Revenue | $21,072,246 | RevenueAmt |
| Desc | 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. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $606,724 | ExpenseAmt |
| Revenue | $660,502 | RevenueAmt |
| Desc | 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. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $20,510,854 | 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 | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | 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 | 68 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 348 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | 0 | LocalChaptersInd |
| 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mike Romine | PersonNm |
| Phone | 5096626000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Orondo Ave Suite 1 | AddressLine1Txt |
| City | Wenatchee | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98801 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Ruth Cabrera de Alpire | |||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Joanne Hill | |||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Shaun Koos | |||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Loly Larson | |||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Michael Machado | |||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Robert Scott Jr | |||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| John Swenson | |||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Joan Alway | |||||||
| President | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Kristina Stepper | |||||||
| Vice President | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Teresa Zepeda | |||||||
| Secretary | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| RICH WATSON | |||||||
| Treasurer | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| David Olson | |||||||
| CEO - as of 6/30/2016 | 40.00 | $92,728 | $0 | $13,854 | Yes (X) | ||
| Patrick Bucknum | |||||||
| Former CEO - Through 8/1/2016 | 40.00 | $174,546 | $0 | $18,792 | Yes (X) | ||
| Michael Romine | |||||||
| CFO | 40.00 | $112,926 | $0 | $18,823 | Yes (X) | ||
| Carol Diede | |||||||
| COO | 40.00 | $161,044 | $0 | $22,223 | Yes (X) | ||
| Malcolm Butler | |||||||
| Chief Medical Officer | 40.00 | $306,677 | $0 | $30,367 | Yes (X) | ||
| Bruce V Wilcox | |||||||
| Dental Director | 40.00 | $230,047 | $0 | $29,171 | Yes (X) | ||
| Jennifer Snyder | |||||||
| Physician | 40.00 | $264,279 | $0 | $28,893 | Yes (X) | ||
| Kenneth Shermer | |||||||
| Medical Director | 40.00 | $262,726 | $0 | $30,312 | Yes (X) | ||
| Keri Bergeson | |||||||
| Medical Director | 40.00 | $260,823 | $0 | $21,720 | Yes (X) | ||
| Jeffery Hinckley | |||||||
| Dentist | 40.00 | $211,558 | $0 | $27,965 | Yes (X) | ||
| Brenda Baumeister | |||||||
| Physician | 40.00 | $189,414 | $0 | $26,254 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,266,768 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $268,374 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 32 | 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 |
|---|---|---|---|---|---|
| Aldrich & Associates | |||||
| 810 240th St SE | Bothell | WA | 98021 | Construction | $6,286,530 |
| Athenahealth Inc | |||||
| PO Box 415615 | Boston | MA | 02241 | Billing and collection service | $452,506 |
| KDF Architecture | |||||
| 1310 North 16th Ave | Yakima | WA | 98902 | Architecture | $312,171 |
| ABM Janitorial Services | |||||
| PO Box 951864 | Dallas | TX | 75395 | Janitorial Services | $171,766 |
| Environments East Inc | |||||
| 1250 N Wenatchee Ave H130 | Wenatchee | WA | 98801 | Landscape architecture | $161,932 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $7,747,807 | GovernmentGrantsAmt |
| All Other Contributions | $49,804 | AllOtherContributionsAmt |
| Total Contributions | $7,797,611 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Service Revenue | 621400 | $14,275,223 | $14,275,223 |
| Enhancement Revenue | 621400 | $4,832,554 | $4,832,554 |
| Capitation Revenue | 621400 | $1,734,820 | $1,734,820 |
| Contract Services | 621400 | $705,870 | $705,870 |
| Misc. Income | 900099 | $99,281 | $99,281 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $85,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $85,000 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,732,748 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $62,589 | TotalRevenueColumnAmt |
| Exclusion | $62,589 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $527,214 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$527,214 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$527,214 | TotalRevenueColumnAmt |
| Exclusion | -$527,214 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,065,734 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,732,748 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$464,625 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,340 | TotalAmt |
| Program Services | $50,340 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,260,434 | TotalAmt |
| Program Services | $333,873 | ProgramServicesAmt |
| Management And General | $926,561 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,804,267 | TotalAmt |
| Program Services | $12,082,508 | ProgramServicesAmt |
| Management And General | $2,663,361 | ManagementAndGeneralAmt |
| Fundraising | $58,398 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $578,325 | TotalAmt |
| Program Services | $454,871 | ProgramServicesAmt |
| Management And General | $120,725 | ManagementAndGeneralAmt |
| Fundraising | $2,729 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,689,360 | TotalAmt |
| Program Services | $1,389,625 | ProgramServicesAmt |
| Management And General | $288,905 | ManagementAndGeneralAmt |
| Fundraising | $10,830 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,282,413 | TotalAmt |
| Program Services | $997,187 | ProgramServicesAmt |
| Management And General | $280,339 | ManagementAndGeneralAmt |
| Fundraising | $4,887 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,566 | TotalAmt |
| Management And General | $24,566 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,600 | TotalAmt |
| Management And General | $42,600 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,502 | TotalAmt |
| Fundraising | $8,502 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $579,535 | TotalAmt |
| Program Services | $146,438 | ProgramServicesAmt |
| Management And General | $433,097 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,374 | TotalAmt |
| Program Services | $79,180 | ProgramServicesAmt |
| Management And General | $20,825 | ManagementAndGeneralAmt |
| Fundraising | $80,369 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $276,037 | TotalAmt |
| Program Services | $149,323 | ProgramServicesAmt |
| Management And General | $126,592 | ManagementAndGeneralAmt |
| Fundraising | $122 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,242,218 | TotalAmt |
| Program Services | $799,020 | ProgramServicesAmt |
| Management And General | $443,198 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $759,306 | TotalAmt |
| Program Services | $563,668 | ProgramServicesAmt |
| Management And General | $195,638 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,455 | TotalAmt |
| Program Services | $23,123 | ProgramServicesAmt |
| Management And General | $7,332 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $376,937 | TotalAmt |
| Program Services | $189,423 | ProgramServicesAmt |
| Management And General | $187,230 | ManagementAndGeneralAmt |
| Fundraising | $284 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,027 | TotalAmt |
| Program Services | $124,750 | ProgramServicesAmt |
| Management And General | $70,277 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,456,263 | TotalAmt |
| Program Services | $881,024 | ProgramServicesAmt |
| Management And General | $575,239 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,724 | TotalAmt |
| Program Services | $68,059 | ProgramServicesAmt |
| Management And General | $50,665 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Patient & Pharmaceutica | $1,759,120 | $1,758,063 | $1,057 |
| Other Equipment | $349,166 | $208,220 | $140,946 |
| Staff Recruiting | $125,637 | $108,266 | $17,371 |
| Dues & License | $51,696 | $45,833 | $5,863 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $361,879 | TotalAmt |
| Program Services | $58,060 | ProgramServicesAmt |
| Management And General | $303,819 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,603,181 | TotalAmt |
| Program Services | $20,510,854 | ProgramServicesAmt |
| Management And General | $6,926,206 | ManagementAndGeneralAmt |
| Fundraising | $166,121 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,250,550 | BOYAmt |
| EOY | $5,517,611 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,036,745 | BOYAmt |
| EOY | $5,022,858 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,710 | BOYAmt |
| EOY | $672,528 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,461,177 | BOYAmt |
| EOY | $2,839,387 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,916 | BOYAmt |
| EOY | $115,760 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $221,843 | BOYAmt |
| EOY | $272,765 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $41,397,952 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,964,786 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,648,056 | BOYAmt |
| EOY | $29,433,166 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,791,201 | BOYAmt |
| EOY | $2,848,444 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,200,000 | BOYAmt |
| EOY | $1,200,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,847,198 | BOYAmt |
| EOY | $47,922,519 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,666,613 | BOYAmt |
| EOY | $3,996,777 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $275,533 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,375,240 | BOYAmt |
| EOY | $4,909,953 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,208,403 | BOYAmt |
| EOY | $5,388,891 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,250,256 | BOYAmt |
| EOY | $14,571,154 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,513,093 | BOYAmt |
| EOY | $33,295,814 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,849 | BOYAmt |
| EOY | $55,551 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,596,942 | BOYAmt |
| EOY | $33,351,365 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,847,198 | BOYAmt |
| EOY | $47,922,519 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,462,553 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $291,870 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,691,939 | OtherCostOrOtherBasisAmt |
| Book Value | $3,691,939 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,226,087 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,399,599 | DepreciationAmt |
| Book Value | $18,826,488 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,144,769 | OtherCostOrOtherBasisAmt |
| Depreciation | $981,804 | DepreciationAmt |
| Book Value | $162,965 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,069,117 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,475,190 | DepreciationAmt |
| Book Value | $1,593,927 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,266,040 | OtherCostOrOtherBasisAmt |
| Depreciation | $108,193 | DepreciationAmt |
| Book Value | $5,157,847 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $29,433,166 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| Managed Care Reconciliation | $2,448,101 |
| Behavioral Health FFS Takebacks | $76,057 |
| Bhealth Overpayments | $2,252,132 |
| Construction Retainages | $499,556 |
| Other Liabilities | $113,045 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,388,891 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $29,357,604 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $291,870 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $291,870 | RevenueNotReportedAmt |
| Revenue Subtotal | $29,065,734 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $29,065,734 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $27,603,181 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $27,603,181 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $27,603,181 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Organization is a not-for-profit corporation and has been recognized as tax-exempt pursuant to Section 501(c)(3) of the Internal Revenue Code. The Organization is exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code 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, 2017 and 2016, the Organization had no uncertain tax positions requiring accrual. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
| Total501c3 Org | 0 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Payment of medical bills for individuals who need assistance - helping hands | GrantTypeTxt |
| Recipient | 192 | RecipientCnt |
| Cash Grant | $50,340 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| 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 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. 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patrick Bucknum | ||||||||||||||
| Former CEO - Through 8/1/2016 | $123,543 | $0 | $50,858 | $0 | $145 | $0 | $8,034 | $0 | $10,758 | $0 | $193,338 | $0 | $0 | $0 |
| Carol Diede | ||||||||||||||
| COO | $143,653 | $0 | $16,942 | $0 | $449 | $0 | $7,424 | $0 | $14,799 | $0 | $183,267 | $0 | $0 | $0 |
| Malcolm Butler | ||||||||||||||
| Chief Medical Officer | $258,858 | $0 | $46,737 | $0 | $1,082 | $0 | $11,925 | $0 | $18,442 | $0 | $337,044 | $0 | $0 | $0 |
| Bruce V Wilcox | ||||||||||||||
| Dental Director | $187,176 | $0 | $31,991 | $0 | $10,880 | $0 | $10,750 | $0 | $18,421 | $0 | $259,218 | $0 | $0 | $0 |
| Jennifer Snyder | ||||||||||||||
| Physician | $174,000 | $0 | $80,429 | $0 | $9,850 | $0 | $10,491 | $0 | $18,402 | $0 | $293,172 | $0 | $0 | $0 |
| Kenneth Shermer | ||||||||||||||
| Medical Director | $164,000 | $0 | $86,220 | $0 | $12,506 | $0 | $11,925 | $0 | $18,387 | $0 | $293,038 | $0 | $0 | $0 |
| Keri Bergeson | ||||||||||||||
| Medical Director | $157,692 | $0 | $83,298 | $0 | $19,833 | $0 | $11,737 | $0 | $9,983 | $0 | $282,543 | $0 | $0 | $0 |
| Jeffery Hinckley | ||||||||||||||
| Dentist | $156,846 | $0 | $39,693 | $0 | $15,019 | $0 | $9,587 | $0 | $18,378 | $0 | $239,523 | $0 | $0 | $0 |
| Brenda Baumeister | ||||||||||||||
| Physician | $187,000 | $0 | $0 | $0 | $2,414 | $0 | $8,832 | $0 | $17,422 | $0 | $215,668 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WA Healthcare Facilities | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 911108929 | BondIssuerEIN |
| Bond Issued | 2010-12-16 | BondIssuedDt |
| Issue Price | $7,200,000 | IssuePriceAmt |
| Purpose | Remodeling & renovation | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $4,768,285 | RetiredAmt |
| Total Proceeds | $7,200,000 | TotalProceedsAmt |
| Capitalized Interest | $29,142 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $58,202 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $4,231,702 | CapitalExpendituresAmt |
| Substantial Completion | 2012 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | 0 | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | A draft of the 990 IS provided by the external tax practitioner and presented to THE FINANCE COMMITTEE, A SUBCOMMITTEE OF THE BOARD. The Finance Committee reviews the 990 and then presents it's 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 ARE ONBOARDED. 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(S) DOES NOT VOTE ON THE MATTER. |
| Form 990, Part VI, Section B, line 15 | 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 REVIEWED BY THE CEO, WHO MAKES RECOMMENDATIONS TO THE BOARD FOR FINAL APPROVAL. |
| Form 990, Part VI, Section C, line 19 | CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST, BUT NOT PUBLISHED EXTERNALLY. GOVERNING DOCUMENTS ARE NOT SHARED. AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, AND THE FORM 990 IS AVAILABLE ON GUIDESTAR. |