SUMMIT MEDICAL FITNESS CENTER: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- SUMMIT MEDICAL FITNESS CENTER (EIN 20-3752312)
- Tax period
- 2010-04-01 to 2011-03-31
- Filed
- 2012-03-28
- IRS object ID
- 201230889349300323
- Schema version
- 2010v3.4
- 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) |
|---|---|---|
| Timestamp | 2012-03-28T12:11:28-05:00 | Timestamp |
| Tax Period End Date | 2011-03-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JORDAHL & SLITER PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8600 | AddressLine1 |
| City | KALISPELL | City |
| State | MT | State |
| ZIP Code | 599041600 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-04-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 203752312 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE SUMMIT MEDICAL FITNESS CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SUMM | NameControl |
| Phone | 4067564707 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 310 SUNNYVIEW LANE | AddressLine1 |
| City | KALISPELL | City |
| State | MT | State |
| ZIP Code | 59901 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHARLES PEARCE | Name |
| Title | CFO | Title |
| Phone | 4067564707 | Phone |
| Date Signed | 2012-03-23 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JUSTIN P SLITER | Name |
| Phone | 4067521040 | Phone |
| Date Prepared | 2012-03-23 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CHARLES PEARCE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 310 SUNNYVIEW LANE | AddressLine1 |
| City | KALISPELL | City |
| State | MT | State |
| ZIP Code | 59901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 3923489 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.NWHC.ORG/SUMMIT | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2005 | YearFormation |
| State Legal Domicile | MT | StateLegalDomicile |
| Activity Or Mission Description | COMMUNITY HEALTH AND WELLNESS EDUCATION AND PRIMARY AND SECONDARY PREVENTION OF CHRONIC DISEASE | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 183 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 66335 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 19002 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 6175 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3514806 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3763014 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 69469 | InvestmentIncomePriorYear |
| Investment Income Current Year | 21931 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 153589 | OtherRevenuePriorYear |
| Other Revenue Current Year | 131122 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 3737864 | TotalRevenuePriorYear |
| Total Revenue Current Year | 3922242 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2437614 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2669688 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1421313 | OtherExpensePriorYear |
| Other Expenses Current Year | 1535860 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 3858927 | TotalExpensesPriorYear |
| Total Expenses Current Year | 4205548 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -121063 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -283306 | RevenuesLessExpensesCY |
| Total Assets BOY | 5905134 | TotalAssetsBOY |
| Total Assets EOY | 5737530 | TotalAssetsEOY |
| Total Liabilities BOY | 1513502 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1629204 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4391632 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4108326 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROMOTED COMMUNITY HEALTH AND SAFETY THROUGH COMMUNITY ACTIVITIES AND SCHOOL BASED PROGRAMS, INCLUDING EDUCATIONAL SEMINARS, HEALTH SCREENINGS, SAFETY ACTIVITIES, THERAPEUTIC LIFE-STYLE PROGRAMS, AND ATHLETIC PHYSICALS AND TRAINING ACTIVITIES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 3823217 | Expense |
| Revenue | 3702281 | Revenue |
| Description | PROMOTED COMMUNITY HEALTH AND SAFETY THROUGH COMMUNITY ACTIVITIES AND SCHOOL BASED PROGRAMS, INCLUDING EDUCATIONAL SEMINARS, HEALTH SCREENINGS, SAFETY ACTIVITIES, THERAPEUTIC LIFE-STYLE PROGRAMS, AND ATHLETIC PHYSICALS AND TRAINING ACTIVITIES. | Description |
| Total Program Service Expense | 3823217 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 183 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES PEARCE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4067521724 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 310 SUNNYVIEW LANE | AddressLine1 |
| City | KALISPELL | City |
| State | MT | State |
| ZIP Code | 59901 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (10 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| JEANNIE LUCKEY | ||||||
| TRUSTEE | 1.00 | X | 0 | 1100 | 0 | |
| WILSON HIGGS MD | ||||||
| TRUSTEE | 1.00 | X | 0 | 1100 | 0 | |
| DAVE MEREDITH | ||||||
| TRUSTEE | 1.00 | X | 0 | 1100 | 0 | |
| VELINDA STEVENS | ||||||
| PRESIDENT | 0.00 | X | 0 | 580833 | 41022 | X |
| BRAD ROY | ||||||
| ED SMFC & HOME CARE | 17.50 | X | 0 | 324736 | 24158 | X |
| CHARLES PEARCE | ||||||
| CHIEF FINANCIAL OFFICER | 0.00 | 0 | 380705 | 24330 | X | |
| FRANCIS LAUKAITIS | ||||||
| CHIEF OPERATING OFFICER | 0.00 | 0 | 298179 | 12104 | X | |
| KAREN LEE | ||||||
| CHIEF NURSING OFFICER | 0.00 | 0 | 252101 | 33820 | X | |
| DEB WILSON | ||||||
| CHIEF HUMAN RESOURCES | 0.00 | 0 | 207932 | 39776 | X | |
| AC EDDY | ||||||
| CHIEF MEDICAL OFFICER | 0.00 | 0 | 199610 | 420 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2247396 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 175630 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Related Organizations | 1675 | RelatedOrganizations |
| All Other Contributions | 4500 | AllOtherContributions |
| Noncash Contributions | 1675 | NoncashContributions |
| Total Contributions | 6175 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| MEMBERSHIP DUES | 713940 | 2624059 | 2624059 | |
| PROGRAM ACTIVITIES | 900099 | 1138955 | 1078222 | 60733 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3763014 | TotalProgramServiceRevenue |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 96849 | Real |
| Personal | 4320 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 96849 | Real |
| Personal | 4320 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 101169 | TotalRevenueColumn |
| Exclusion | $101,169 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 23178 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1247 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 21931 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 21931 | TotalRevenueColumn |
| Exclusion | $21,931 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| DAY CARE | 624410 | 20572 | $20,572 |
| CAFETERIA/VENDING | 722210 | 2824 | $2,824 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6557 | TotalRevenueColumn |
| Unrelated Business Revenue | 5602 | UnrelatedBusinessRevenue |
| Exclusion | $955 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 29953 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3922242 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3702281 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 66335 | UnrelatedBusinessRevenue |
| Exclusion | $147,451 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74223 | Total |
| Management And General | 74223 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1909442 | Total |
| Program Services | 1714443 | ProgramServices |
| Management And General | 194999 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61010 | Total |
| Program Services | 56519 | ProgramServices |
| Management And General | 4491 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 490143 | Total |
| Program Services | 431446 | ProgramServices |
| Management And General | 58697 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 134870 | Total |
| Program Services | 117183 | ProgramServices |
| Management And General | 17687 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3040 | Total |
| Management And General | 3040 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7807 | Total |
| Management And General | 7807 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3850 | Total |
| Program Services | 3850 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 103609 | Total |
| Program Services | 103609 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 213868 | Total |
| Program Services | 192481 | ProgramServices |
| Management And General | 21387 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 232102 | Total |
| Program Services | 232102 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20963 | Total |
| Program Services | 20963 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27580 | Total |
| Program Services | 27580 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 503879 | Total |
| Program Services | 503879 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15155 | Total |
| Program Services | 15155 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| REPAIRS & MAINTENANCE | 182488 | 182488 |
| OTHER EXPENSE | 141236 | 141236 |
| PURCHASED SERVICES | 73131 | 73131 |
| BAD DEBTS | 7152 | 7152 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4205548 | Total |
| Program Services | 3823217 | ProgramServices |
| Management And General | 382331 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23458 | BOY |
| EOY | 44610 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 219494 | BOY |
| EOY | 242818 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6812 | BOY |
| EOY | 5332 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 12199546 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6754776 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5655370 | BOY |
| EOY | 5444770 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5905134 | BOY |
| EOY | 5737530 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 175008 | BOY |
| EOY | 214438 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 313395 | BOY |
| EOY | 334235 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 630879 | BOY |
| EOY | 40641 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 394220 | BOY |
| EOY | 1039890 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1513502 | BOY |
| EOY | 1629204 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4391632 | BOY |
| EOY | 4108326 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4391632 | BOY |
| EOY | 4108326 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5905134 | BOY |
| EOY | 5737530 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -283306 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 2711235 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2791143 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2631453 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2633086 | CurrentTaxYear |
| Total | 10766917 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 789625 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 830160 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 917268 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1127465 | CurrentTaxYear |
| Total | 3664518 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 3500860 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3621303 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3548721 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3760551 | CurrentTaxYear |
| Total | 14431435 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 14431435 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 99081 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 98069 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 119675 | CurrentTaxYearMinus1Year |
| Current Tax Year | 101169 | CurrentTaxYear |
| Total | 417994 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 99081 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 98069 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 119675 | CurrentTaxYearMinus1Year |
| Current Tax Year | 101169 | CurrentTaxYear |
| Total | 417994 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 3599941 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3719372 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3668396 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3861720 | CurrentTaxYear |
| Total | 14849429 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.97190 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.97120 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.02810 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.02880 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 541728 | OtherCostOrOtherBasis |
| Book Value | 541728 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6291881 | OtherCostOrOtherBasis |
| Depreciation | 3082325 | Depreciation |
| Book Value | 3209556 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3863755 | OtherCostOrOtherBasis |
| Depreciation | 2694947 | Depreciation |
| Book Value | 1168808 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 913711 | OtherCostOrOtherBasis |
| Depreciation | 529486 | Depreciation |
| Book Value | 384225 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 588471 | OtherCostOrOtherBasis |
| Depreciation | 448018 | Depreciation |
| Book Value | 140453 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5444770 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO AFFILIATES | Description |
| Amount | $1,039,890 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1039890 | TotalOfAmounts |
| Total Revenue | 3922242 | TotalRevenue |
| Total Expenses | 4205548 | TotalExpenses |
| Excess Or Deficit For Year | -283306 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | -283306 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 3881976 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 3881976 | RevenueSubtotal |
| Other Revenues Not Included | 40266 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 40266 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 3922242 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 4166957 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 4166957 | ExpensesSubtotal |
| Other Expenses Not Included | 38591 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 38591 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 4205548 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE CORPORATION ADOPTED THE PROVISIONS OF ASC 740, INCOME TAXES. ASC 740 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE ASC AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT STANDARD FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF AN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE CORPORATION HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN TAX YEARS AND HAS CONCLUDED NO RESERVES ARE REQUIRED. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTION FOR CAPITAL ASSET PURCHASE BOOKED TO EQUITY 1,675. EXPENSES NET AGAINST REVENUE 38,591. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | EXPENSES NET AGAINST REVENUE 38,591. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | X | FirstClassOrCharterTravel |
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VELINDA STEVENS | |||||||||||||
| 0 | 458638 | 0 | 87542 | 0 | 34653 | 0 | 25407 | 0 | 15615 | 0 | 621855 | 0 | 0 |
| BRAD ROY | |||||||||||||
| 0 | 147066 | 0 | 29224 | 0 | 148446 | 0 | 8980 | 0 | 15178 | 0 | 348894 | 0 | 40060 |
| CHARLES PEARCE | |||||||||||||
| 0 | 287042 | 0 | 60789 | 0 | 32874 | 0 | 8761 | 0 | 15569 | 0 | 405035 | 0 | 0 |
| FRANCIS LAUKAITIS | |||||||||||||
| 0 | 145895 | 0 | 52615 | 0 | 99669 | 0 | 4457 | 0 | 7647 | 0 | 310283 | 0 | 0 |
| KAREN LEE | |||||||||||||
| 0 | 204544 | 0 | 43426 | 0 | 4131 | 0 | 26781 | 0 | 7039 | 0 | 285921 | 0 | 0 |
| DEB WILSON | |||||||||||||
| 0 | 168178 | 0 | 37503 | 0 | 2251 | 0 | 26831 | 0 | 12945 | 0 | 247708 | 0 | 0 |
| AC EDDY | |||||||||||||
| 0 | 181242 | 0 | 15000 | 0 | 3368 | 0 | 0 | 0 | 420 | 0 | 200030 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 1A | FIRST CLASS OR CHARTER TRAVEL - SMFC DOES NOT PROVIDE FIRST CLASS TRAVEL. CHARTER TRAVEL IS UTILIZED FOR THESE INDIVIDUALS WHEN A GROUP IS FLYING TOGETHER TO A CONFERENCE OR MEETING AND IT IS LESS EXPENSIVE THAN FLYING COMMERCIAL OR NO COMMERCIAL FLIGHT IS AVAILABLE. THIS WAS NOT INCLUDED AS TAXABLE COMPENSATION AS IT WAS BUSINESS RELATED. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - THE MEMBERS OF THE ADMINISTRATIVE TEAM RECEIVE A 457 PLAN CONTRIBUTION OF $16,500 FOR 2010. THIS AMOUNT IS GROSSED UP TO TAKE CARE OF THE APPLICABLE TAXES. THE MEMBERS INCLUDE: PRESIDENT, CFO, CEO, COO, CMO, VICE PRESIDENT OF HUMAN RESOURCES, SUMMIT ADMINISTRATOR, VICE PRESIDENT OF COMMUNITY RELATIONS, TREASURER, ADMINISTRATOR REGIONAL OUTREACH, AND THE FOUNDATION EXECUTIVE VICE PRESIDENT. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES - ALL ADMINISTRATIVE TEAM MEMBERS RECEIVE A FREE MEMBERSHIP TO THE SUMMIT. | |
| PART I, LINE 4B | THE MEMBERS OF THE ADMINISTRATIVE TEAM RECEIVED A 457 PLAN CONTRIBUTION OF $16,500 FOR 2010. THE MEMBERS INCLUDE: PRESIDENT, CFO, CEO, COO, CMO, VICE PRESIDENT OF HUMAN RESOURCES, SUMMIT ADMINISTRATOR, VICE PRESIDENT OF COMMUNITY RELATIONS AND THE FOUNDATION EXECUTIVE VICE PRESIDENT. | |
| PART I, LINE 7 | BONUS PLANS ADMIN AND MGMT-BASED ON A NUMBER OF FACTORS INCLUDING BUT NOT LIMITED TO: QUALITY AND FINANCIAL INDICATORS INCLUDING DEPARTMENT SPECIFIC GOALS AND INITIATIVES, PATIENT SATISFACTION, PRODUCTIVITY, EMPLOYEE SATISFACTION, AND EMPLOYEE EVALUATION TIMELINESS. SUCCESSFUL IMPLEMENTATION OF COMPANY FISCAL YEAR ACTION PLANS AND THE OVERALL FINANCIAL HEALTH AND STABILITY OF THE ORGANIZATION. | |
| PART III | PART I, QUESTION 3 - THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT IS DETERMINED BY THE COMPENSATION COMMITTEE OF ITS PARENT ORGANIZATION, NORTHWEST HEALTHCARE CORPORATION, AND APPROVED BY ITS BOARD OF TRUSTEES. THE COMPENSATION COMMITTEE UTILIZES VARIOUS RESOURCES IN ESTABLISHING THE COMPENSATION OF THE PRESIDENT, INCLUDING FORM 990 OF OTHER ORGANIZATIONS, A WRITTEN EMPLOYMENT CONTRACT, AND REVIEW OF COMPENSATION SURVEYS OR STUDIES. | SUPPLEMENTAL INFORMATION |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SUMMIT MEDICAL FITNESS CENTER HAS ONE MEMBER, NORTHWEST HEALTHCARE CORPORATION. | |
| FORM 990, PART VI, SECTION A, LINE 7B | TO BE EFFECTIVE, SIGNIFICANT DECISIONS OF THE GOVERNING BOARD MUST BE APPROVED BY ITS MEMBER, NORTHWEST HEALTHCARE CORPORATION. SIGNIFICANT DECISIONS INCLUDE CHANGES TO THE BOARD OF DIRECTORS, CONFIRMATION OF THE ANNUAL BUDGETS, ENTERING INTO LARGE CONTRACTS, AND REORGANIZATION OF THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS MAILED TO ALL BOARD MEMBERS WITH THE FEBRUARY BOARD PACKET. THE BOARD MEMBERS HAVE A CHANCE TO REVIEW THE FORM BEFORE THE BOARD MEETING WHERE A PRESENTATION ON THE FORM 990 IS DONE AND A QUESTION AND ANSWER SESSION HELD. | |
| THE CONFLICT OF INTEREST POLICY COVERS ALL TRUSTEES, DIRECTORS, OFFICERS, AND KEY EMPLOYEES. THE COMPLIANCE OFFICE REVIEWS THEM, IDENTIFIES POTENTIAL CONFLICTS, AND FORWARDS TO THE ADMINISTRATIVE TEAM IF A POTENTIAL CONFLICT EXISTS, AS OUTLINED IN THE ORGANIZATIONAL POLICY. | FORM 990, PART VI, SECTION B, LINE 12C | |
| NORTHWEST HEALTHCARE HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL ITS EMPLOYEES, INCLUDING THE SENIOR EXECUTIVES. SALARY AND BENEFITS FOR THE PRESIDENT/CHIEF EXECUTIVE OFFICER ARE DETERMINED BY THE NORTHWEST HEALTHCARE BOARD OF DIRECTORS EXECUTIVE COMPENSATION COMMITTEE AND REPORTED TO THE NORTHWEST HEALTHCARE BOARD. THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD REVIEWS BASE SALARY AND TOTAL COMPENSATION DATA FROM AN ARRAY OF COMPENSATION SURVEYS OF HOSPITALS THAT ARE SIMILAR IN SIZE AND COMPLEXITY TO NORTHWEST HEALTHCARE. THESE REPORTS ARE CONSIDERED BY THE COMMITTEE, AND A DETERMINATION IS MADE AS TO THE STATUS OF THE BASE SALARY, BENEFITS, AND TOTAL COMPENSATION FOR THE PRESIDENT/CEO. THE BOARD AND EXECUTIVE COMPENSATION COMMITTEE EMBRACE THE PHILOSOPHY OF MAINTAINING A COMPENSATION LEVEL WHICH WILL FAVOR RETENTION OF KEY LEADERSHIP IN ORDER TO MAINTAIN STABILITY IN KEY INITIATIVES. ADDITIONALLY, THE PRESIDENT/CEO UTILIZES THE PERIODIC RETENTION OF A COMPENSATION CONSULTANT AND MARKET INFORMATION PROVIDED TO DETERMINE RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES AND ENGAGES IN AN ANALYSIS THROUGH USE OF INDEPENDENT SURVEY RESULTS. THE BOARD COMMITTEE ALSO INCLUDES A REVIEW OF PERFORMANCE TARGETS WHICH ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION. THESE MEASURES INCLUDE ORGANIZATIONAL AND INDIVIDUAL GOALS, EFFORTS TO FURTHER THE MISSION AND VISION OF NORTHWEST HEALTHCARE, QUALITY INDICATORS, CUSTOMER/PATIENT SATISFACTION, AND FINANCIAL PERFORMANCE OBJECTIVES. THE BOARD COMMITTEE REVIEWS BENEFIT LEVELS AND TOTAL COMPENSATION TO ENSURE APPROPRIATENESS IN THE NOT-FOR-PROFIT HEALTH CARE SECTOR. THE BOARD EXECUTIVE COMPENSATION COMMITTEE MAKES ITS REPORT TO THE NORTHWEST HEALTHCARE BOARD OF DIRECTORS. | FORM 990, PART VI, SECTION B, LINE 15 | |
| ONLY FORM 990 IS AVAILABLE. | FORM 990, PART VI, SECTION C, LINE 19 | |
| AVERAGE HOURS PER WEEK | THE OFFICERS OF THE SUMMIT MEDICAL FITNESS CENTER DIVIDE THEIR TIME AMONG THE OTHER RELATED ENTITIES FOR WHICH THEY ARE ALSO OFFICERS. THEIR TOTAL AVERAGE WEEKLY HOURS DEVOTED TO ALL OF THE ENTITIES IS IN EXCESS OF 50 HOURS. | FORM 990, PART VII, SECTION A, COLUMN (B) |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTHWEST HEALTHCARE CORPORATION | |||||||||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | 810406485 | SUPPORT SUBSIDIARY TAX EXEMPT ORGANIZATIONS | MT | 501(C)(3) | 11, TYPE II | N/A | 0 | |
| NORTHWEST HEALTHCARE FOUNDATION INC | |||||||||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | 311703013 | SUPPORTING ORGANIZATION | MT | 501(C)(3) | 11, TYPE I | 1 | KALISPELL REGIONAL MEDICAL CENTER | |
| KALISPELL REGIONAL MEDICAL CENTER INC | |||||||||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | 237293874 | OPERATE ACCUTE CARE HOSPITAL | MT | 501(C)(3) | 3 | 1 | NORTHWEST HEALTHCARE CORPORATION | |
| NORTHWEST HORIZONS INC | |||||||||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | 810420653 | OPERATE LONG TERM AMBULATORY FACILITY | MT | 501(C)(3) | 9 | 1 | NORTHWEST HEALTHCARE CORPORATION | |
| KALISPELL REGIONAL MEDICAL CENTER VOLUNTEERS INC | |||||||||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | 273866474 | SUPPORTING ORGANIZATION | MT | 501(C)(3) | APPLIED FOR | 1 | KALISPELL REGIONAL MEDICAL CENTER | |
Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|
| MRICT JOINT OPERATING AGREEMENT | ||||||||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | 205010390 | DIAGNOSTIC SCREENING | MT | N/A | N/A | 0 | 0 |
| HEALTHCENTER NORTHWEST LLC | ||||||||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | 810540517 | ACUTE CARE | MT | N/A | N/A | 0 | 0 |
| FLATHEAD HOSPITAL DEVELOPMENT COMPANY LLC | ||||||||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | 810541707 | COMMERCIAL BUILDING RENTAL | MT | N/A | N/A | 0 | 0 |
| NORTHWEST ORTHOPEDICS & SPORTS MEDICINE LLC | ||||||||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | 371518772 | ORTHOPEDIC MEDICINE | MT | N/A | N/A | 0 | 0 |
| ORTHOPEDICS ONE LLC | ||||||||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | 800346984 | ORTHOPEDIC MEDICINE | MT | N/A | N/A | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | APPLIED HEALTH SERVICES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 310 SUNNYVIEW LANE | AddressLine1 |
| City | KALISPELL | City |
| State | MT | State |
| ZIP Code | 59901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810413632 | EIN |
| Primary Activity | HEALTH RELATED | PrimaryActivity |
| Legal Domicile State | MT | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| KALISPELL REGIONAL MEDICAL CENTER | ||
| A | 250092 | ACTUAL PAYMENT |
| APPLIED HEALTH SERVICES INC | ||
| A | 89172 | ACTUAL PAYMENT |
| KALISPELL REGIONAL MEDICAL CENTER | ||
| K | 453724 | ACTUAL PAYMENT |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | THIS RETURN IS BEING FILED BETWEEN MARCH 1, 2012 AND MARCH 30, 2012, AS DIRECTED BY THE IRS IN NOTICE 2012-4, BECAUSE ELECTRONIC FILING WAS NOT AVAILABLE JANUARY 1, 2012 THROUGH FEBRUARY 29, 2012. WE REQUEST THAT PENALTIES BE WAIVED BECAUSE IT WOULD BE INEQUITABLE TO IMPOSE A PENALTY ON US DUE TO THE UNUSUAL CIRCUMSTANCES REQUIRING US TO DELAY THE FILING OF THE RETURN. | Explanation |