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CTS HEALTH: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CTS HEALTH (EIN 91-1266346)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-15
IRS object ID
201203209349308105
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-15T16:01:16-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN910189318EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 22650AddressLine1
CityYAKIMACity
StateWAState
ZIP Code989072650ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN911266346EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1KADLEC HEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlKADLNameControl
Phone5099464611Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1888 SWIFT BLVDAddressLine1
CityRICHLANDCity
StateWAState
ZIP Code993523583ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJULIE MEEKName
TitleVP FINANCE/ CFOTitle
Phone5099464611Phone
Date Signed2012-11-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCATHY STERBENZName
PTINP00737078PTIN
Phone5092487750Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJULIE MEEKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1888 SWIFT BLVDAddressLine1
CityRICHLANDCity
StateWAState
ZIP Code993523583ZIPCode
FieldValueIRS element (for citing)
Gross Receipts57152264GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.KADLECMED.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1984YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE QUALITY HEALTHCARE FOR EVERY PATIENT.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees390TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI7800TotalGrossUBI
Net Unrelated Business Txbl Income4400NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year39212414ProgramServiceRevenuePriorYear
Program Service Revenue CY41865461ProgramServiceRevenueCY
Investment Income Prior Year142InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year140309OtherRevenuePriorYear
Other Revenue Current Year15232699OtherRevenueCurrentYear
Total Revenue Prior Year39352865TotalRevenuePriorYear
Total Revenue Current Year57098160TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year32610162SalariesEtcPriorYear
Salaries Etc Current Year39838899SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year18758869OtherExpensePriorYear
Other Expenses Current Year21695897OtherExpensesCurrentYear
Total Expenses Prior Year51369031TotalExpensesPriorYear
Total Expenses Current Year61534796TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-12016166RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-4436636RevenuesLessExpensesCY
Total Assets BOY17209514TotalAssetsBOY
Total Assets EOY14344913TotalAssetsEOY
Total Liabilities BOY5782915TotalLiabilitiesBOY
Total Liabilities EOY7332402TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY11426599NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7012511NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE QUALITY HEALTHCARE FOR EVERY PATIENT. THROUGH THE SUPPORT OF KADLEC REGIONAL MEDICAL CENTER (KRMC), KADLEC MEDICAL ASSOCIATES IS DEDICATED TO INPATIENT CARE, DEFINED BY QUALITY AND COMPASSION.THROUGH THE SUPPORT OF KADLEC HEALTH SYSTEM, KADLEC CLINIC SEEKS TO DELIVER EXCEPTIONAL, PATIENT-CENTERED CARE, TO PROVIDE A SUPERIOR PRACTICE ENVIRONMENT FOR ITS PHYSICIANS, AND TO ENSURE THE AVAILABILITY OF COMPREHENSIVE MEDICAL SERVICES FOR OUR COMMUNITIES. THROUGH THE SUPPORT OF KADLEC HEALTH SYSTEM, KADLEC NEUROSCIENCE CENTER PROVIDES EXCEPTIONAL PATIENT-CENTERED NEUROLOGICAL CARE FOR OUR COMMUNITIES AND A SUPERIOR PRACTICE ENVIRONMENT FOR OUR PHYSICIANS AND PROVIDERS.THROUGH THE SUPPORT OF KADLEC HEALTH SYSTEM, TRICITIES NEPHROLOGY PROVIDES EXCEPTIONAL PATIENT-CENTERED NEPHROLOGY CARE FOR OUR COMMUNITIES AND A SUPERIOR PRACTICE ENVIRONMENT FOR OUR PHYSICIANS AND PROVIDERS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense12316888Expense
Revenue12922927Revenue
DescriptionKADLEC MEDICAL ASSOCIATES LLC (KMA) IS A DISREGARDED ENTITY WITHIN KHS WHICH PROVIDES HOSPITAL-BASED PHYSICIAN SERVICES TO KADLEC REGIONAL MEDICAL CENTER. THIS SERVICE ALLOWS PHYSICIANS IN THE COMMUNITY TO REMAIN IN THEIR OFFICE AND SERVICE MORE PATIENTS IN THE OUTPATIENT SETTING.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense24934609Expense
Revenue20506694Revenue
DescriptionKADLEC CLINIC LLC (KC) IS A DISREGARDED ENTITY PROVIDING PHYSICIAN SERVICES AT LOCATIONS THROUGHOUT THE COMMUNITY. BRING PRIMARY CARE PHYSICIANS AND SPECIALISTS TO UNDERSERVED AREAS IRREGARDLESS OF ABILITY TO PAY.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense11194685Expense
Revenue7729811Revenue
DescriptionKADLEC NEUROSCIENCE CENTER LLC (KNC) IS A DISREGARDED ENTITY AND WAS STARTED IN APRIL OF 2008 TO BRING A RANGE OF NEUROSCIENCE RELATED PHYSICIANS AND SERVICES TO THE AREA IN ORDER TO SERVE THIS PATIENT POPULATION.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense835404Expense
Revenue15897964Revenue
DescriptionTRICITIES NEPHROLOGY LLC (TCN) IS A DISREGARDED ENTITY AND WAS ACQUIRED IN FEBRUARY OF 2009 TO BRING A NEPHROLOGY PHYSICIAN AND SERVICES TO THE AREA IN ORDER TO SERVE THIS PATIENT POPULATION. KHS IS A HEALTHCARE SYSTEM PROVIDING HOSPITAL AND PHYSICIANS SERVICES TO THE SURROUNDING COMMUNITY.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp835404TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev15897964TotalOfOtherProgramServiceRev
Total Program Service Expense49281586TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109639NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees390NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledWAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJULIE L MEEKNamePerson
Telephone Number5099464611TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1888 SWIFT BLVDAddressLine1
CityRICHLANDCity
StateWAState
ZIP Code99352ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
TOM COWAN
KHS - VICE CHAIR2.00XX000
SANDRA GAMBLE
KHS - TREASURER2.00XX000
SUSAN KREID
KHS - CHAIR2.00XX000
DAVID LIPPES
KHS - MEMBER2.00X000
WAYNE MARTIN PHD
KHS - MEMBER2.00X000
DAVID MERKLEY MD
KHS - SECRETARY2.00XX000
THOMAS RADO MD
KHS - MEMBER2.00X000
NEIL RAWLINS MD
KHS - MEMBER2.00X15007408397
JOHN T SAMSELL MD
KHS - MEMBER2.00X000
RONALD SCHWARTZ MD
KHS - MEMBER2.00X000
SAM VOLPENTIST
KHS-MEMBER;KC,KMA,KNC-JOINT OP. COMMITTE4.00X000
STEVE KING
KHS - MEMBER2.00X000
RAND WORTMAN
KHS-PRES/CEO; KNC-V.CHAIR; KC-MEMBER;TCN-SEC/TREAS56.00XX0445123318311
JULIE MEEK
KHS - VP FINANCE/CFO50.00X031937427823
DAVID R ROACH
VICE PRESIDENT50.00X024724320097
JEFFREY A CLARK
VICE PRESIDENT50.00X024196224372
WILLIAM T WINGO
VICE PRESIDENT50.00X027949121720
MELVIN WAHL MD
KNC - PHYSICIAN50.001124962012197X
BRIAN O'GRADY MD
KNC - PHYSICIAN50.0078999104938X
CHEERAG UPADHYAYA
KNC - PHYSICIAN50.00654818987503173X
DEBRA STEELE
KNC - PHYSICIAN50.00636628820004069X
MATTHEW FEWEL MD
KNC - PHYSICIAN50.007397819200012440X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4096254TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1805943TotalReportableCompFrmRltdOrgs
Total Other Compensation457537TotalOtherCompensation
Number Individuals GT100 K77NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
DELTA LOCUM TENENS
PO BOX 202940DALLASTX753202056PHYSICAN LOCUM SERVICES2368120
COMPHEALTH
PO BOX 972651DALLASTX753972651PHYSICAN LOCUM SERVICES645409
D&Y
P O BOX 635715CINCINNATIOH452635715PHYSICAN LOCUM SERVICES617086
PRAXIS MEDICAL MANAGEMENT
5825 CALLAGAHAN 203SAN ANTONIOTX78228BILLING SERVICES FOR KMA311527
WEATHERBY LOCUMS
PO BOX 972633DALLASTX753972633PHYSICAN LOCUM SERVICES203453
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE6214003418440634184406
PROFESSIONAL FEES FOR62140076677777667777
MSO INCOME6241001327813278
FieldValueIRS element (for citing)
Total Program Service Revenue41865461TotalProgramServiceRevenue

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real80305Real
Personal6763Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real51702Real
Personal2402Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real28603Real
Personal4361Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column32964TotalRevenueColumn
Exclusion$32,964ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
SUBSIDY FROM KRMC9000991510107315101073
MEDICAL DIRECTOR FEES9000997903179031
MISC. INCOME9000991546476647800

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column4167TotalRevenueColumn
Related Or Exempt Function Income4167RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue15199735TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column57098160TotalRevenueColumn
Related Or Exempt Function Income57057396RelatedOrExemptFunctionIncome
Unrelated Business Revenue7800UnrelatedBusinessRevenue
Exclusion$32,964ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total158471Total
Program Services158471ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total35761824Total
Program Services31202779ProgramServices
Management And General4559045ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total297068Total
Program Services130042ProgramServices
Management And General167026ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2083571Total
Program Services1814982ProgramServices
Management And General268589ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1537965Total
Program Services1303976ProgramServices
Management And General233989ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total34697Total
Management And General34697ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total133954Total
Management And General133954ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total7892523Total
Program Services4998122ProgramServices
Management And General2894401ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total189913Total
Program Services80166ProgramServices
Management And General109747ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3791286Total
Program Services3304743ProgramServices
Management And General486543ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1150839Total
Program Services7132ProgramServices
Management And General1143707ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3589263Total
Program Services2290196ProgramServices
Management And General1299067ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total411189Total
Program Services340275ProgramServices
Management And General70914ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total303659Total
Management And General303659ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total721706Total
Program Services305309ProgramServices
Management And General416397ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total920328Total
Program Services920328ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
UBI TAXES12091209
BAD DEBT16423771642377
TAXES83038292109738273
RENTAL/LEASE EQUIPMENT617562340238354

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total20816Total
Program Services6061ProgramServices
Management And General14755ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total61534796Total
Program Services49281586ProgramServices
Management And General12253210ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY659657BOY
EOY788131EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4999775BOY
EOY4466009EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY17301BOY
EOY41431EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY16350EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis11594416LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2608571LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY9581811BOY
EOY8985845EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1950970BOY
EOY47147EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY17209514BOY
EOY14344913EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1446181BOY
EOY3118297EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4334302BOY
EOY4211673EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2432BOY
EOY2432EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5782915BOY
EOY7332402EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY11426599BOY
EOY7012511EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11426599BOY
EOY7012511EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY17209514BOY
EOY14344913EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-4436636ReconcilationRevenueExpenses
Reconcilation Other Changes22548ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis885486OtherCostOrOtherBasis
Book Value885486BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6478555OtherCostOrOtherBasis
Depreciation545835Depreciation
Book Value5932720BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1798070OtherCostOrOtherBasis
Depreciation581023Depreciation
Book Value1217047BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2432305OtherCostOrOtherBasis
Depreciation1481713Depreciation
Book Value950592BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings8985845TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionSECURITY DEPOSITDescription
Amount$2,432Amount
FieldValueIRS element (for citing)
Total Of Amounts2432TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationEFFECTIVE JANUARY 1, 2009, THESE ENTITIES ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. AS OF DECEMBER 31, 2011 AND 2010, THERE WERE NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
NEIL RAWLINS MD
1499990007505250031470158471000
RAND WORTMAN
033548701023760726001798390138472076343400
JULIE MEEK
03005810171760161702205005773034719700
DAVID R ROACH
0232887014356000191560941026734000
JEFFREY A CLARK
02234010185610001945404918026633400
WILLIAM T WINGO
02578940215970001896702753030121100
MELVIN WAHL MD
799992032497000089050329201137159000
BRIAN O'GRADY MD
789991000000049380794929000
CHEERAG UPADHYAYA
65481800009875000317306579919875000
DEBRA STEELE
63662800008200000406906406978200000
MATTHEW FEWEL MD
73978100009200075180492207522219200000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ATHE BOARD IS ALLOWED TO TAKE THEIR COMPANION ON THE ANNUAL BOARD RETREAT. RAND WORTMAN KHS PRESIDENT & CEO, KRMC CEO; WILLIAM WINGO, VP, CORPORATE COUNSEL FOR KRMC AND KHS; THEIR MEADOW SPRINGS COUNTRY CLUB DUES ARE PAID BY THE MEDICAL CENTER.
PART I, LINE 4ATHE KADLEC CLINIC PRESIDENT (HUGH MALONEY - $85,023.54) AND EXECUTIVE DIRECTOR (MICHAEL HUPPE - $61,404) BOTH RECEIVED SEVERANCE PAY IN 2011.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3THE BOARD OF DIRECTORS HIRED QUORUM HEALTH RESOURCES AS A MANAGEMENT COMPANY TO OVERSEE DAY TO DAY OPERATIONS OF THE HEALTH SYSTEM. THE PRESIDENT AND CEO IS AN EMPLOYEE OF QUORUM HEALTH RESOURCES.
FORM 990, PART VI, SECTION B, LINE 11ONCE THE 990 IS PREPARED BY A THIRD PARTY, ACCOUNTING STAFF REVIEWS THE DOCUMENTS TO VERIFY INFORMATION HAS BEEN PROVIDED AND INPUT ACCURATELY. ONCE THIS PROCESS HAS BEEN COMPLETED, THE 990 IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD. THE 990 IS ALSO UPLOADED TO THE BOARD WEBSITE AND IS AVAILABLE FOR ALL BOARD MEMBERS TO REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CIF SOMEONE IS SUSPECTED OF VIOLATING THE POLICY, THE COMPLIANCE OFFICER IS NOTIFIED AND RESEARCHES THE ISSUE. APPROPRIATE ACTIONS ARE TAKEN IF A VIOLATION OCCURS. EMPLOYEES MUST ANNUALLY ANSWER A NUMBER OF QUESTIONS REGARDING CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 1515A - SALARY SURVEYS WERE USED AND FINAL COMP AMOUNTS ARE APPROVED BY THE EXECUTIVE TEAM. 15B - SALARY SURVEYS WERE USED AND MGMA PHYSICIAN COMP GUIDELINES WERE ALSO USED.
FORM 990, PART VI, SECTION C, LINE 19FORMS 990, FORMS 1023,GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE KEPT IN THE ACCOUNTING OFFICE AT KADLEC REGIONAL MEDICAL CENTER AND ARE AVAILABLE TO ANYONE UPON REQUEST. AUDITED FINANCIAL STATEMENTS ARE ALSO SENT OUT TO WHOEVER REQUESTS THEM.
FORM 990, PART VII, RELATED ORGANIZATION(1) TOM COWAN; KRMC - MEMBER; 2.00 (2) SANDRA GAMBLE; KRMC - TREASURER; 2.00 (3) SUSAN KREID; KRMC - CHAIR; 2.00 (5) WAYNE MARTIN, PHD; KRMC - MEMBER; 2.00 (6) DAVID MERKLEY, MD; KRMC - SECRETARY; 2.00 (9) JOHN T. SAMSELL, MD; KRMC - MEMBER; 2.00 (12) STEVE KING; KRMC - MEMBER; 2.00
FORM 990, PART XI, LINE 5:DISTRIBUTION TO RELATED ENTITY NOT REPORTED ON 990 22,548. TOTAL TO FORM 990, PART XI, LINE 5: 22,548.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CNO CHANGES HAVE BEEN MADE IN THE PAST YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
KADLEC CLINIC LLC
945 GOETHALS SUITE 220RICHLANDWA99352204265899PRIMARY CARE PHYSICIAN SERVICESWA229287224607725KADLEC HEALTH SYSTEM
KADLEC MEDICAL ASSOCIATES LLC
888 SWIFT BLVDRICHLANDWA993523583203980865INPATIENT HOSPITALISTS SERVICESWA129220291211186KADLEC HEALTH SYSTEM
KADLEC NEUROSCIENCE CENTER LLC
800 SWIFT BLVD SUITE 300RICHLANDWA993523583201613946NEUROLOGICAL RELATED PHYSICIAN SERVICESWA80281791417174KADLEC HEALTH SYSTEM
TRICITIES NEPHROLOGY LLC
309 BRADLEY SUITE 109RICHLANDWA99352271041915NEPHROLOGY PHYSICIAN SERVICESWA1008291177489KADLEC HEALTH SYSTEM

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
KADLEC REGIONAL MEDICAL CENTER
888 SWIFT BLVDRICHLANDWA99352910655392ACUTE CARE HOSPITALWA501(C)(3)LINE 3KADLEC HEALTH SYSTEM0
KADLEC FOUNDATION
800 SWIFT BLVDRICHLANDWA99352237005501FUNDRAISINGWA501(C)(3)LINE 11A, IKADLEC HEALTH SYSTEM0
KADLEC NEUROLOGICAL RESOURCE CENTER
712 SWIFT BLVD SUITE 1RICHLANDWA99352911266345EDUCATION ON NEUROLOGICAL DISORDERSWA501(C)(3)LINE 7KADLEC HEALTH SYSTEM0

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityPercentage OwnershipPercentageOwnershipShare Of EOY AssetsShareOfEOYAssets
MID COLUMBIA MEDICAL ASSOCIATES
510 N COLORADO SUITE AKENNEWICKWA99336911987844INFECTIOUS DISEASE AND NEPHROLOGY PHYSICIANSWAKADLEC HEALTH SYSTEMC1.00000
KADLEC ENTERPRISES INC
888 SWIFT BOULEVARDRICHLANDWA99352911323736ENGAGE IN BUSINESS RELATED TO HEALTHCARE AND TO SUPPORT KHS & AFFILIATESWAKADLEC HEALTH SYSTEMC1.00000353
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
KRMC
J1278894
KRMC
N794326
KRMC
R15101073
KRMC
K7378760