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COMMONSPIRIT WASHINGTON COMMUNITY CARE: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
COMMONSPIRIT WASHINGTON COMMUNITY CARE (EIN 91-0565546)
Tax period
2009-05-01 to 2010-04-30
Filed
2011-03-09
IRS object ID
201100689349300850
Schema version
2009v1.7
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)
Timestamp2011-03-09T21:51:58-06:00Timestamp
Tax Period End Date2010-04-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Clark Nuber PSBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110900 NE 4th Street Suite 1700AddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN910565546EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HARRISON MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHARRNameControl
Phone3607446507Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12520 CHERRY AVENUEAddressLine1
CityBREMERTONCity
StateWAState
ZIP Code983104270ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFORREST G EHLINGERName
TitleVICE PRESIDENT & CFOTitle
Phone3607446507Phone
Date Signed2011-03-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSara Elizabeth J HyreName
Phone4254544919Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSCOTT BOSCHNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12520 CHERRY AVENUEAddressLine1
CityBREMERTONCity
StateWAState
ZIP Code983104270ZIPCode
FieldValueIRS element (for citing)
Gross Receipts423560021GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.HARRISONMEDICAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1918YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionHARRISON MAKES A POSITIVE DIFFERENCE IN PEOPLE'S LIVES THROUGH EXCEPTIONAL HEALTH CARE. THE RESIDENTS OF KITSAP PENINSULA AND ADJACENT AREAS HAVE ACCESS TO ACUTE MEDICAL AND SURGICAL SERVICES INCLUDING EMERGENCY, ONCOLOGY AND CARDIO VASCULAR SERVICES. ADDITIONALLY, HARRISON PROVIDES OUTPATIENT SERVICES IN HOME HEALTH AND PEDIATRIC REHABILITATION AND OPERATES URGENT CARE AND PRIMARY CARE FACILITIES IN BOTH PORT ORCHARD AND BELFAIR.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees2754TotalNbrEmployees
Total Nbr Volunteers400TotalNbrVolunteers
Total Gross UBI834777TotalGrossUBI
Net Unrelated Business Txbl Income749274NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year257329ContributionsGrantsPriorYear
Contributions Grants Current Year412969ContributionsGrantsCurrentYear
Program Service Revenue Prior Year300068279ProgramServiceRevenuePriorYear
Program Service Revenue CY343132894ProgramServiceRevenueCY
Investment Income Prior Year-1403477InvestmentIncomePriorYear
Investment Income Current Year2836136InvestmentIncomeCurrentYear
Other Revenue Prior Year67452OtherRevenuePriorYear
Other Revenue Current Year70046OtherRevenueCurrentYear
Total Revenue Prior Year298989583TotalRevenuePriorYear
Total Revenue Current Year346452045TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year313414GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY422191GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year151002365SalariesEtcPriorYear
Salaries Etc Current Year164037248SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year137641771OtherExpensePriorYear
Other Expenses Current Year161587274OtherExpensesCurrentYear
Total Expenses Prior Year288957550TotalExpensesPriorYear
Total Expenses Current Year326046713TotalExpensesCurrentYear
Revenues Less Expenses Prior Year10032033RevenuesLessExpensesPriorYear
Revenues Less Expenses CY20405332RevenuesLessExpensesCY
Total Assets BOY265694851TotalAssetsBOY
Total Assets EOY346441290TotalAssetsEOY
Total Liabilities BOY122838199TotalLiabilitiesBOY
Total Liabilities EOY166037468TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY142856652NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY180403822NetAssetsOrFundBalancesEOY
Mission DescriptionHARRISON MEDICAL CENTER PROVIDES ACUTE MEDICAL AND SURGICAL SERVICES, EMERGENCY SERVICES AND A RANGE OF GENERAL AND SPECIALIZED SERVICES TO RESIDENTS OF THE KITSAP PENINSULA AND ADJACENT AREAS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense269941984Expense
Grants422310Grants
Revenue343132894Revenue
DescriptionDURING THE FISCAL YEAR ENDED APRIL 30, 2010, THE MEDICAL CENTER EXPERIENCED 15,376 HOSPITAL INPATIENT ADMISSIONS REPRESENTING 59,815 DAYS OF CARE TO ADULTS AND PEDIATRIC PATIENTS. SERVICES PROVIDED INCLUDED, 74,050 EMERGENCY ROOM VISITS, 12,461 SURGERY PATIENTS INCLUDING 218 OPEN HEART CASES, 1,889 BIRTHS INCLUDING 3,488 DAYS OF CARE, 25,433 HOME HEALTH VISITS, 35,550 URGENT CARE VISITS, 11,724 PRIMARY CARE VISITS AND 41,490 OUTPATIENT VISITS. HARRISON PROVIDES NEEDED MEDICAL CARE TO INDIGENT PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE MEDICAL CENTER HAS ESTABLISHED CRITERIA FOR DETERMINING WHETHER A PATIENT IS ELIGIBLE FOR CHARITY CARE. THE AMOUNT OF PATIENT REVENUES FOREGONE FOR CHARITY CARE PROVIDED BY HARRISON FOR THE FISCAL YEAR ENDED APRIL 30, 2010 AMOUNTED TO $14,851,579.ALL FINANCIAL SURPLUSES FROM OPERATIONS ARE USED TO FURTHER THE CHARITABLE PURPOSES OF THE MEDICAL CENTER. THESE SURPLUSES ARE USED TO HELP FUND NEW HEALTH SERVICE PROGRAMS IN THE FUTURE AND FUND NEW AND REPLACEMENT EQUIPMENT AND FACILITIES.COMMUNITY HEALTH EDUCATION:HARRISON MEDICAL CENTER HAS A LONG-STANDING COMMITMENT TO PROMOTE COMMUNITY EDUCATION IN THE HEALTH CARE AREA. THE COMMITMENT IS DEMONSTRATED THROUGH AN ACTIVE PROGRAM OF CLASSES DIRECTED AT THE COMMUNITY-AT-LARGE AND SPECIALIZED CLASSES DIRECTED AT PERSONS WITH SPECIAL NEEDS. THESE COMMUNITY EDUCATIONAL SERVICES ARE PROVIDED BY STAFF OR TRAINED PROFESSIONALS WHO ARE EMPLOYEES OF THE MEDICAL CENTER. HARRISON MEDICAL CENTER VALUES THE RELATIONSHIPS WE MAINTAIN WITH THE COMMUNITY AND COMMUNITY ORGANIZATIONS. THERE ARE NUMEROUS COMMUNITY BASED SUPPORT GROUPS, WHICH MEET AT HARRISON ON A REGULAR BASIS USING THE MEDICAL CENTER'S MEETING ROOMS AT NO CHARGE. THE FACILITATORS OF THESE GROUPS ARE OFTEN STAFF AND TRAINED PROFESSIONALS OF THE MEDICAL CENTER. HEALTH-RELATED VOLUNTEER SERVICE OF HARRISON MEDICAL CENTER EMPLOYEES:MANY OF HARRISON'S EMPLOYEES SERVE AS COMMUNITY SOCIAL SERVICE ORGANIZATION BOARD MEMBERS AS WELL AS DONATING THEIR TIME TO INDIVIDUAL HEALTH AGENCY PROJECTS. EMPLOYEES OF HARRISON REGULARLY CONTRIBUTE THEIR OWN TIME TO SUPPORT VARIOUS COMMUNITY FUND RAISING EVENTS SUCH AS MARCH OF DIMES WALK-A-THON, MS WALK-A-THON, ALZHEIMER'S MEMORY WALK, AMERICAN CANCER SOCIETY RELAY FOR LIFE, CYSTIC FIBROSIS GREAT STRIDES WALK, KITSAP COUNTY AIDS WALK AND UNITED WAY DAY OF CARING. THE MEDICAL CENTER ALSO CONTRIBUTES TO THESE CAUSES BY PROVIDING EVENT MEALS FOR THE VOLUNTEERS, AND PAID TIME FOR EMPLOYEES DURING REGULAR WORKING HOURS TO ORGANIZE THE EVENTS. HEALTH-RELATED SERVICE OF HARRISON MEDICAL CENTER VOLUNTEERS:HARRISON'S VOLUNTEERS ARE INVOLVED IN A PROGRAM THAT PROVIDES PATIENTS AND THEIR FAMILIES WITH COMPLEMENTARY THERAPIES DURING THEIR STAY AT THE MEDICAL CENTER. THESE THERAPIES INCLUDE HAND MASSAGE, THERAPEUTIC MUSIC, SUCH AS HARP, ACOUSTIC GUITAR, FLUTE AND PIANO, THERAPEUTIC ART, BOOK AND BEVERAGE CART SERVICE AND SERVICE PET ROUNDING.TRAINING AND EDUCATION FOR HEALTHCARE PROFESSIONALS:HARRISON MEDICAL CENTER CONTINUES TO SERVE AS A CLINICAL SITE FOR STUDENTS IN NURSING, PHYSICAL THERAPY, MEDICAL RECORDS, RADIOLOGY, PHARMACY, SOCIAL WORK, AND DIETARY PROGRAMS AND A NON-CLINICAL SITE FOR STUDENTS IN MATERIALS MANAGEMENT. STUDENTS ARE ON-SITE AND UNDER HARRISON'S DIRECTION FOR SERVICE FOR SEVERAL THOUSAND HOURS EACH YEAR.COMMUNITY HEALTHCARE INFORMATION:HARRISON MEDICAL CENTER HAS DEVELOPED AN INTERNET WEB SITE AND PROVIDES THE COMMUNITY WITH AREAS TO LOOK UP HOSPITAL PROGRAMS AND SERVICES, COMMUNITY AND HEALTHCARE NEWS. IT ALSO CONTAINS A PHYSICIAN DATABASE THAT IS USEFUL TO INDIVIDUALS WHO ARE CHOOSING A PHYSICIAN. THE MEDICAL AND HEALTHCARE CONSUMER LIBRARIES MAINTAINED BY HARRISON MEDICAL CENTER ARE RESOURCES FOR HEALTH PROFESSIONALS AND THE PUBLIC IN OUR COMMUNITY. OUR MEDICAL LIBRARY WORKS IN COOPERATION WITH THE REGIONAL PUBLIC LIBRARY, NAVY HOSPITAL AND COMMUNITY COLLEGE LIBRARY TO PROVIDE HEALTHCARE INFORMATION FOR AREA RESIDENTS.Description
Total Program Service Expense269941984TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
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 Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096194NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2754NumberOfEmployees
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
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
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 Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledWAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RICHARD SMITHBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3607446507TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12520 CHERRY AVENUEAddressLine1
CityBREMERTONCity
StateWAState
ZIP Code98310ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (32 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JOHN WALLEN
CHAIR2.00XX000
JAMES CIVILLA
VICE CHAIR2.00XX000
DAVID VETERANE
SECRETARY / TREASURER2.00XX000
NANCY BOHANNON MD
CHIEF OF STAFF5.00XX5520100
GRIFFITH BLACKMON MD
DIRECTOR3.00X214400
CARL CRAMER
DIRECTOR2.00X000
JAMES SMALLEY
DIRECTOR2.00X000
MARY GARGUILE
DIRECTOR2.00X000
RUTH HANSTEN
DIRECTOR2.00X000
GREGORY S HENDERSON MD
DIRECTOR2.00X000
RALPH LINTZ
DIRECTOR2.00X000
KELLY NELSON
DIRECTOR2.00X000
RON MUHLEMAN
DIRECTOR2.00X000
JOAN SORIANO
DIRECTOR2.00X000
RICK TIFT
DIRECTOR2.00X000
SCOTT BOSCH
PRESIDENT & CEO50.00X5770880189001
PATRICIA COCHRELL
EXECUTIVE VP & COO50.00X330637049085
CYNTHIA MAY
CNO/DIR NURSING PRACTICE,50.00X221519034632
RONALD MORRIS
VP QUALITY & CMO50.00X23731804669
ADAR PALIS
VP ADMINISTRATION & CIO50.00X306670045707
ANDREW STEFO
VP OPERATIONS & CFO50.00X179842045486
RICHARD SMITH
INTERIM CFO50.00X148288029175
MARIAL KAGAN
VP & CHIEF LEGAL OFFICER50.00271800040759X
REBECCA KELLY
VP-HUMAN RESOURCES50.00193005029748X
THOMAS KRUSE
VP/CHIEF STRATEGY OFFCR50.00293857049344X
RAPIN CHAI KANITHANON
PHYSICIAN40.00405478024645X
ROBERT C KING
PHYSICIAN40.00495262042313X
RONALD ROBERT REIMER
PHYSICIAN40.0042752709745X
DENNIS M WILLERFORD
PHYSICIAN40.00472642011135X
MALCOM W WINTER
PHYSICIAN40.00471217011135X
JAMES ROWSON
FORMER VP OPERATIONS/CFO0.00341028020704X
MARLA BRADY
FORMER VP-SRVC EXCELL/OP0.00233228013835X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5663751TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation651118TotalOtherCompensation
Number Individuals GT100 K157NumberIndividualsGT100K
Formers Listed1FormersListed
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
DYNACARE NORTHWEST INC
550 17TH AVENUE STE 300SEATTLEWA98122LABORATORY2021187
SOUND PHYSICIANS
1123 PACIFIC AVENUETACOMAWA98402PHYSICIAN1915170
ADVANCED MEDICAL IMAGING LLC
1780 NW MYHRE RD STE 1220SILVERDALEWA98383IMAGING1820291
S & S SECURITY SERVICE
PO BOX 459BELFAIRWA98528SECURITY1519688
PATHOLOGY ASSOCIATES OF KITSAP COUNTY
PO BOX 2171BREMERTONWA98310PHYSICIAN892359
FieldValueIRS element (for citing)
Number Of Contractors GT100 K22NumberOfContractorsGT100K
Related Organizations336458RelatedOrganizations
Government Grants59016GovernmentGrants
All Other Contributions17495AllOtherContributions
Noncash Contributions69413NoncashContributions
Total Contributions412969TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT REVENUE621110192199187192199187
MEDICARE/MEDICAID621110150933707150933707
FieldValueIRS element (for citing)
Total Program Service Revenue343132894TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2985617TotalRevenueColumn
Unrelated Business Revenue834777UnrelatedBusinessRevenue
Exclusion$2,150,840ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real66328Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real-3718Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real70046Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column70046TotalRevenueColumn
Exclusion$70,046ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities76654560Securities
Other307653Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities76773815Securities
Other337879Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-119255Securities
Other-30226Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-149481TotalRevenueColumn
Exclusion-$149,481ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column346452045TotalRevenueColumn
Related Or Exempt Function Income343132894RelatedOrExemptFunctionIncome
Unrelated Business Revenue834777UnrelatedBusinessRevenue
Exclusion$2,071,405ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total422191Total
Program Services422191ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3355191Total
Management And General3355191ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total124187388Total
Program Services105422579ProgramServices
Management And General18764809ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total5585594Total
Program Services4970891ProgramServices
Management And General614703ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total17984791Total
Program Services14944068ProgramServices
Management And General3040723ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total12924284Total
Program Services10726327ProgramServices
Management And General2197957ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total393673Total
Management And General393673ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total72713Total
Management And General72713ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total39577Total
Management And General39577ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total25081772Total
Program Services18039072ProgramServices
Management And General7042700ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1280719Total
Program Services16289ProgramServices
Management And General1264430ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2755879Total
Program Services946465ProgramServices
Management And General1809414ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3809940Total
Program Services777873ProgramServices
Management And General3032067ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2627557Total
Program Services1929077ProgramServices
Management And General698480ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total861630Total
Program Services443664ProgramServices
Management And General417966ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3316370Total
Program Services3316370ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total15212937Total
Program Services10211856ProgramServices
Management And General5001081ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2399110Total
Program Services2212336ProgramServices
Management And General186774ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES67780864659790371801827
BAD DEBT PROVISION2494160624941606
EQUIP RENT/MAINTENANCE773584144718513263990
BUSINESS TAXES21835946072182987
UNRELATED BUS INC TAXES299000299000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total794492Total
Program Services169825ProgramServices
Management And General624667ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total326046713Total
Program Services269941984ProgramServices
Management And General56104729ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3014887BOY
EOY20917298EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1138241BOY
EOY2234942EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY42978393BOY
EOY44600307EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2308516BOY
EOY2909014EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2415654BOY
EOY2391084EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis249323295LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec131882112LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY107401805BOY
EOY117441183EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY66211262BOY
EOY103461188EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY32151780BOY
EOY42455593EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8074313BOY
EOY10030681EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY265694851BOY
EOY346441290EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY30351777BOY
EOY36486129EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY62123808BOY
EOY90291615EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY30362614BOY
EOY39259724EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY122838199BOY
EOY166037468EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY138100397BOY
EOY174915979EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2922803BOY
EOY3548838EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1833452BOY
EOY1939005EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY142856652BOY
EOY180403822EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY265694851BOY
EOY346441290EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$39,577OtherActivitiesAmount
Total Lobbying Expenditures IIB39577TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1i:Identifier
Return ReferenceExplanation of Other Lobbying Activities:ReturnReference
ExplanationPROFESSIONAL LOBBYIST WAS PAID FOR ASSISTANCE ON THE "NO ON 1033" CAMPAIGN. WASHINGTON INITIATIVE 1033 WOULD HAVE LIMITED PROPERTY TAX INCREASES TO THE RATE OF INFLATION AND POPULATION GROWTH. A PORTION OF THE MEMBERSHIP DUES PAID TO WASHINGTON SATE HOSPITAL ASSOCIATION AND AMERICAN HEART ASSOCIATION WERE EXPENDED FOR LOBBYING ACTIVITIES AS WELL.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis8287756InvestmentCostOrOtherBasis
Other Cost Or Other Basis6832354OtherCostOrOtherBasis
Book Value15120110BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis59190571OtherCostOrOtherBasis
Depreciation28250811Depreciation
Book Value30939760BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis155008906OtherCostOrOtherBasis
Depreciation99719611Depreciation
Book Value55289295BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis20003708OtherCostOrOtherBasis
Depreciation3911690Depreciation
Book Value16092018BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings117441183TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVESTMENT IN JOINT VENTURES1137110F
ALTERNATIVE INVESTMENTS41318483F
FieldValueIRS element (for citing)
Total Of Book Value Securities42455593TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ACCRUED PENSION LIABILITY$27,351,376
RESERVE FOR PROFESSIONAL LIABILITY CLAIMS$11,096,410
DEFERRED GAIN FROM SALE OF FACILITIES$811,938
FieldValueIRS element (for citing)
Total Of Amounts39259724TotalOfAmounts
Total Revenue346452045TotalRevenue
Total Expenses326046713TotalExpenses
Excess Or Deficit For Year20405332ExcessOrDeficitForYear
Net Unrealized GL On Investments23894292NetUnrealizedGLOnInvestments
Other-$6,752,454OtherAmount
Total Adjustments17141838TotalAdjustments
Excess Or Deficit Per FS37547170ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt362915625TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments23894292NetUnrealizedGainsInvestments
Other Revenues-7430712OtherRevenues
Revenue Not Rptd F99016463580RevenueNotRptdF990
Revenue Subtotal346452045RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990346452045TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt325368455TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal325368455ExpensesSubtotal
Other Expenses Not Included678258OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt678258ExpensesNotRptdOnFinStmt
Total Expenses Per Form990326046713TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierExplanationExplanation
Part XI, Line 8 - Other Adjustments:CHANGE IN OBLIGATIONS UNDER PENSION PLAN: -8025420. CHANGE IN INTEREST IN HARRISON MEDICAL CENTER FOUNDATION: 1272966.
Part XII, Line 2d - Other Adjustments:EXPENSES GROUPED WITH REVENUES ON FINANCIAL STATEMENTS: -678258. CHANGE IN OBLIGATIONS UNDER PENSION PLAN: -8025420. CHANGE IN INTEREST IN HARRISON MEDICAL CENTER FOUNDATION: 1272966.
Part XIII, Line 4b - Other Adjustments:EXPENSES GROUPED WITH REVENUES ON FINANCIAL STATEMENTS: 678258.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage100.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense5044238TotalCommunityBenefitExpense
Net Community Benefit Expense5044238NetCommunityBenefitExpense
Percent Of Total Expense0.01550PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense37487116TotalCommunityBenefitExpense
Direct Offsetting Revenue24218980DirectOffsettingRevenue
Net Community Benefit Expense13268136NetCommunityBenefitExpense
Percent Of Total Expense0.04070PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense12257276TotalCommunityBenefitExpense
Direct Offsetting Revenue11707776DirectOffsettingRevenue
Net Community Benefit Expense549500NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense54788630TotalCommunityBenefitExpense
Direct Offsetting Revenue35926756DirectOffsettingRevenue
Net Community Benefit Expense18861874NetCommunityBenefitExpense
Percent Of Total Expense0.05790PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense503973TotalCommunityBenefitExpense
Net Community Benefit Expense503973NetCommunityBenefitExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense49520TotalCommunityBenefitExpense
Net Community Benefit Expense49520NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense41979TotalCommunityBenefitExpense
Net Community Benefit Expense41979NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense595472TotalCommunityBenefitExpense
Net Community Benefit Expense595472NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense55384102TotalCommunityBenefitExpense
Direct Offsetting Revenue35926756DirectOffsettingRevenue
Net Community Benefit Expense19457346NetCommunityBenefitExpense
Percent Of Total Expense0.05970PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense11500TotalCommunityBuildingExpense
Net Community Building Expense11500NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense137230TotalCommunityBuildingExpense
Net Community Building Expense137230NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense445123TotalCommunityBuildingExpense
Net Community Building Expense445123NetCommunityBuildingExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense593853TotalCommunityBuildingExpense
Net Community Building Expense593853NetCommunityBuildingExpense
Percent Of Total Expense0.00180PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$8,471,247BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare108260010AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare120065779CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-11805769MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy0WrittenDebtCollectionPolicy

Form990 Schedule H Part V Form990ScheduleHPartV (4 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursEr OtherErOtherOtherOther
HARRISON MEDICAL CENTER
2520 CHERRY AVENUEBREMERTONWA98310XXX
HARRISON MEDICAL CENTER
1800 NW MYHRE ROADSILVERDALEWA98383XXX
HARRISON BELFAIR URGENT CARE
21 NE ROMANCE HILL ROADBELFAIRWA98528XPRIMARY & URGENT CARE
HARRISON PORT ORCHARD URGENT CARE
450 S KITSAP BLVDPORT ORCHARDWA98366XPRIMARY & URGENT CARE

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Bad Debt FootnotePart III, Line 4: THE MEDICAL CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA, UNDER ITS CHARITY CARE POLICY, WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE MEDICAL CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE AMOUNT OF CHARGES FORGONE FOR CHARITY CARE PROVIDED BY THE MEDICAL CENTER FOR THE YEARS ENDED APRIL 30, 2010 AND 2009, WAS $14,851,580 AND $14,778,329, RESPECTIVELY.BAD DEBT EXPENSE IS RECORDED BASED ON A REVIEW OF OUTSTANDING ACCOUNTS RECEIVABLE BALANCES BY AGE AND FINANCIAL CLASS. BASED ON HISTORICAL CLOSED CASE DATA, AN ESTIMATED WRITE OFF AMOUNT IS CALCULATED AND A RESERVE IS ESTABLISHED ON THE BALANCE SHEET FOR THIS ESTIMATE. THE RESERVE IS COMPARED WITH THE PRIOR PERIOD RESERVE AND THE NECESSARY INCREASE IS BOOKED AS EXPENSE FOR THE PERIOD. BALANCES FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE HANDLED SEPARATELY.CHARITY CARE (FINANCIAL ASSISTANCE) EXPENSE IS RECORDED AT THE TIME THE FINANCIAL ASSISTANCE APPLICATION IS PROCESSED. THE AMOUNT RECORDED AS CHARITY CARE IS DETERMINED BY THE LEVEL OF FINANCIAL ASSISTANCE THAT IS APPROVED BASED ON INCOME CRITERIA ESTABLISHED IN THE POLICY. THIS AMOUNT IS IDENTIFIED AS CHARITY EXPENSE AND REPAYMENT IS NOT PURSUED FROM THE APPLICANT/PATIENT.THE MISSION OF HARRISON MEDICAL CENTER IS "TO MAKE A POSITIVE DIFFERENCE IN PEOPLE'S LIVES THROUGH EXCEPTIONAL HEALTH CARE." IN ORDER TO ENSURE THE FUTURE OF THIS MISSION WITHIN OUR COMMUNITY WE MUST REMAIN FINANCIALLY HEALTHY BY RECEIVING APPROPRIATE PAYMENT FOR THE SERVICES WE PROVIDE. IN ADDITION, OUR FINANCIAL ASSISTANCE PRACTICES WILL ALWAYS COMPLY WITH WASHINGTON STATE LAWS AND REGULATIONS AND BE CONSISTENT WITH BEST PRACTICES OF OTHER MEDICAL CENTERS. TO OBTAIN CURRENT FINANCIAL ASSISTANCE GUIDELINES THE WEBSITE USED IS HTTP://WWW.ASPE.HHS.GOV/POVERTY/08POVERTY.SHTMLIT IS THE GOAL THAT EACH PATIENT WHO INDICATES FINANCIAL DIFFICULTY IN PAYING FOR HEALTHCARE SERVICES IS FULLY AND FAIRLY EVALUATED AND OFFERED APPROPRIATE FINANCIAL ASSISTANCE. HARRISON IS ALSO OBLIGATED TO PURSUE OUTSTANDING BALANCES FOR THE DEDUCTIBLES OR CO-INSURANCE AMOUNTS REQUIRED BY A THIRD PARTY PAYER ON PATIENT ACCOUNTS FAIRLY AND CONSISTENTLY.1. HARRISON IS COMMITTED TO NEVER DENY NECESSARY MEDICAL CARE BASED ON THE INABILITY TO PAY.2. HARRISON WILL PROVIDE A WRITTEN NOTICE TO ALL PATIENTS INFORMING THEM ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.3. HARRISON WILL ACTIVELY SUPPORT PATIENTS IN THEIR EFFORTS TO OBTAIN APPROPRIATE FINANCIAL ASSISTANCE.4. UNCOMPENSATED HEALTHCARE WILL NEVER BE DENIED BASED UPON RACE, CREED, COLOR, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION, DISABILITY, AGE OR SOURCE OF INCOME.5. UNDER ALL CIRCUMSTANCES THE COLLECTION PRACTICES OF HARRISON ENTITIES WILL BE PERFORMED PROFESSIONALLY AND CONSISTENT WITH OUR MISSION AND THE FEDERAL FAIR DEBT COLLECTION PRACTICES ACT.6. HARRISON WILL COMPLY WITH OR EXCEED THE STATE OF WASHINGTON LEGISLATIVE DIRECTIVES ENACTED BY RCW 70.170.060 AND ANY UPDATES.7. HARRISON WILL ABIDE BY AND COMPLY WITH THE RULES AND MONITORING OF THE DEPARTMENT OF HEALTH.8. HARRISON WILL MAINTAIN A COLLECTION PROCEDURE WHICH DEFINES ACCOUNT PARAMETERS FOR REFERRAL TO COLLECTIONS BASED ON ALPHA PREFIX AND PLACEMENT OF LIENS.9. THE FINANCE COMMITTEE OF THE BOARD WILL RECEIVE AN ANNUAL REPORT SUMMARIZING OUR COLLECTION ACTIVITY.PROCEDURE CRITERIA:1. HARRISON WILL COMPLY WITH THE STATE DEPARTMENT OF HEALTH ACCOUNTING RULES OF UNIFORM PROCEDURES, DATA REQUIREMENTS AND CRITERIA FOR IDENTIFYING PATIENTS RECEIVING FINANCIAL ASSISTANCE.2. ASSISTANCE WILL BE PROVIDED IN ACCESSING ENTITLEMENT PROGRAMS SUCH AS STATE MEDICAL ASSISTANCE AND CRIME VICTIMS.3. THE AMOUNT OF DISCOUNT RELATED TO THE INDIGENT CARE AFTER MEDICARE PAYMENT WILL BE IDENTIFIED.4. PROCEDURES WILL BE IN PLACE TO INFORM THE PUBLIC ABOUT AVAILABLE FINANCIAL ASSISTANCE.5. HARRISON WILL SUBMIT ANNUAL REPORTS REQUESTED BY THE DEPARTMENT OF HEALTH.6. APPLICATION FOR FINANCIAL ASSISTANCE WILL BE WRITTEN WITH SUPPORTING DOCUMENTATION.7. FAILURE TO COMPLY WITH OUTREACH SERVICES PROTOCOL WILL RESULT IN THE DENIAL OF FINANCIAL ASSISTANCE.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: HARRISON USES THE MEDICARE COST REPORT TO ALIGN REVENUE WITH EXPENSES FOR EACH ESTABLISHED MEDICARE DEFINED COST CENTER BY USING THE STEP-DOWN METHOD OF COST ALLOCATION. HOSPITAL GENERAL LEDGER DEPARTMENTS ARE GROUPED INTO MEDICARE-DEFINED COST CENTERS. EXPENSES ARE OFFSET BY OTHER OPERATING REVENUES TO EXCLUDE SERVICES UNRELATED TO PATIENT CARE. KEY STATISTICS ARE USED TO ALLOCATE THE COSTS TO THE MAJOR FUNCTION SERVICES. ADJUSTMENTS TO CREATE A BETTER MATCHING OF REVENUES AND COSTS ARE PERFORMED AS NEEDED. NON-PATIENT INCOME IS OFFSET AGAINST THE ASSOCIATED NON-PATIENT CARE EXPENSES ASSOCIATED WITH THE SERVICES. IN ADDITION, PROFESSIONAL SERVICES PROVIDED BY PHYSICIANS ARE EXCLUDED. ONCE THE GENERAL LEDGER HAS BEEN ADJUSTED FOR THE RECLASSIFICATIONS AND INCOME OFFSETS, THE EXPENSES ARE ALLOCATED USING THE STEP-DOWN METHOD. THE STEP-DOWN METHOD ALLOCATES THE COST OF EACH COST CENTER, AS WELL AS THE COSTS STEPPED DOWN TO IT, TO THE MAJOR FUNCTIONAL SERVICES.OVERHEAD, CAPITAL COSTS, DEPRECIATION, AND INTEREST ARE ALLOCATED BASED ON COST CENTER KEY STATISTICS. IN THE STEP-DOWN ALLOCATION PROCESS, COSTS WILL ACCUMULATE FROM PREVIOUSLY STEPPED DOWN COST CENTERS. THE ACCUMULATED COST FOR EACH COST CENTER WILL BE STEPPED DOWN USING ITS SPECIFIC STATISTIC. THE NEXT GROUP OF COST CENTERS TO BE ALLOCATED IS THE ANCILLARY COST CENTERS, WHICH ARE STEPPED DOWN BASED ON GROSS CHARGES PROVIDED TO EACH FUNCTIONAL SERVICE. THE FINAL RESULT PROVIDES FULLY ALLOCATED COSTS TO THE MAJOR FUNCTIONAL SERVICES, SUCH AS MEDICAL SURGICAL INPATIENTS, OBSTETRICS AND EMERGENCY DEPARTMENTS.HARRISON MEDICAL CENTER PROVIDES UNCOMPENSATED CARE OR CHARITY CARE TO PATIENTS WHO HAVE QUALIFIED FOR FINANCIAL ASSISTANCE AT NO CHARGE OR AT SUBSTANTIALLY REDUCED RATES. $14,851,979 OF GROSS CHARGES WERE RELATED TO CHARITY CARE PATIENTS IN FISCAL YEAR 2010. IN AGGREGATE, HARRISON MEDICAL CENTER'S PATIENT CARE RELATED COSTS ARE APPROXIMATELY 33.96 % OF TOTAL PATIENT CHARGES. THE COST TO CHARGE METHODOLOGY WAS USED TO CALCULATE THE COST OF THESE UNCOMPENSATED SERVICES, RESULTING IN OVER $5 MILLION OF COMMUNITY BENEFIT PROVIDED BY HARRISON MEDICAL CENTER IN FISCAL YEAR 2010.ShortfallAsCommunityBenefit
Number Of Facility Type ExplnPart V: HARRISON MEDICAL CENTER HAS THE FOLLOWING ADDITIONAL FACILITIES THAT ARE NOT RECOGNIZED AS HOSPITALS FOR STATE PURPOSES: ONE OUTPATIENT REHAB CLINIC, ONE PEDIATRIC REHAB CLINIC, ONE IV OPTIMUM CLINIC, ONE THORACIC AND VASCULAR CENTER, AND TWO MEDICAL ONCOLOGY FACILITIES.NumberOfFacilityTypeExpln
Needs AssessmentPart VI, Line 2: HARRISON MEDICAL CENTER'S ASSESSMENT OF THE COMMUNITY'S HEALTH CARE NEEDS IS DATA DRIVEN, FACTORING IN A NUMBER OF CONSIDERATIONS. THE ORGANIZATION REVIEWS MARKET SHARE DATA BY VARIOUS CLINICAL DEFINITIONS TO UNDERSTAND WHY PATIENTS MAY BE LEAVING THE COMMUNITY FOR CARE AND DETERMINE IF THERE IS AN UNMET NEED WITHIN THE COMMUNITY. DEMOGRAPHIC DATA IS ANALYZED ALONG WITH HISTORICAL USE RATES TO DETERMINE FUTURE CHANGES IN HEALTH CARE NEEDS. ALSO, DATA FROM THE CDC'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) IS REVIEWED TO UNDERSTAND CHANGES IN THE OVERALL HEALTH STATUS AND RISK FACTORS FOR VARIOUS DISEASES SUCH AS SMOKING AND OBESITY. ANALYSIS OF THE NUMBER AND TYPE OF PHYSICIANS AND MID-LEVEL PROVIDERS IS USED TO EVALUATE ACCESS TO PRIMARY AND SPECIALTY CARE PROVIDERS IN THE COMMUNITY.NeedsAssessment
Patient Education AssistancePart VI, Line 3: FINANCIAL ASSISTANCE APPLICATIONS ARE LOCATED AT EACH HARRISON MEDICAL CENTER LOCATION. PATIENTS THAT PRESENT FOR SERVICES AS SELF PAY OR INSURED ARE OFFERED A FINANCIAL ASSISTANCE APPLICATION. APPLICATIONS ARE AVAILABLE IN ENGLISH AND IN SPANISH. INTERPRETERS HELP PROVIDE INFORMATION TO OTHER NON- ENGLISH SPEAKING FAMILIES. THIS INFORMATION IS ALSO AVAILABLE ON THE HOSPITAL'S WEB SITE. HARRISON MEDICAL CENTER PRODUCED 10,000 APPLICATIONS TO MAKE AVAILABLE TO OUR PATIENTS. ONCE AN APPLICATION IS RECEIVED OUR FINANCIAL ASSISTANCE SPECIALIST WILL REVIEW THE APPLICATION AND CONTACT THE PATIENT FOR ADDITIONAL INFORMATION IF NEEDED. WHEN REVIEWING THE APPLICATION, IF THE FINANCIAL ASSISTANCE SPECIALIST DETERMINES THAT THEY MAY QUALIFY FOR ANY STATE PROGRAMS THEN THEY WILL REFER THE ACCOUNT TO OUR OUTREACH SERVICES DEPARTMENT TO BE SCREENED FOR SUCH PROGRAMS. PATIENT ACCOUNTS SPECIALISTS ARE ALSO AVAILABLE TO MEET WITH PATIENTS AND OR THEIR FAMILIES TO HELP COMPLETE THE APPLICATION IF NEEDED. IF THE APPLICATION RECEIVED IS COMPLETE AND THE PATIENT DOES NOT QUALIFY FOR OTHER STATE PROGRAMS, THEN THE APPLICATION WILL BE PROCESSED AND OR APPROVED BASED ON THE FEDERAL POVERTY GUIDELINES.PatientEducationAssistance
Community InformationPart VI, Line 4: HARRISON MEDICAL CENTER ACCEPTS ALL PATIENTS REGARDLESS OF ABILITY TO PAY. HARRISON'S PRIMARY MARKET AREA, KITSAP COUNTY, HAS A POPULATION OVER 240,000. OVER 13 PERCENT OF THE COUNTY'S RESIDENTS ARE OVER THE AGE OF 65. HARRISON'S SECONDARY MARKET IS CLALLAM, JEFFERSON, AND NORTH MASON COUNTIES.CommunityInformation
Community Building ActivitiesPart VI, Line 5: HARRISON MEDICAL CENTER VALUES THE RELATIONSHIPS IT MAINTAINS WITH THE COMMUNITY AND COMMUNITY ORGANIZATIONS. THERE ARE NUMEROUS COMMUNITY BASED SUPPORT GROUPS, WHICH MEET AT HARRISON ON A REGULAR BASIS USING THE MEDICAL CENTER'S MEETING ROOMS AT NO CHARGE. THE FACILITATORS OF THESE GROUPS ARE OFTEN STAFF AND TRAINED PROFESSIONALS OF THE MEDICAL CENTER. THESE GROUPS INCLUDE DIABETES SUPPORT FOR CHILDREN AND PARENTS, STOP SMOKING SUPPORT, AMPUTEE SUPPORT, LUPUS SUPPORT, WOMEN'S CARDIAC HEALTH & CANCER PROGRAM, CANCER EDUCATION SUPPORT, LOOK GOOD AND FEEL BETTER SUPPORT, SLEEP APNEA SUPPORT, BETTER BREATHERS CLUB, PARKINSON'S, OVARIAN/GYNECOLOGICAL CANCER SUPPORT, BARIATRIC SURGERY SUPPORT, COMPASSIONATE FRIENDS SUPPORT, STROKE SUPPORT, BREAST CANCER SUPPORT, TRAUMATIC BRAIN INJURY SUPPORT, WOMEN WITH CANCER SUPPORT, HEART AND VASCULAR SUPPORT, KIDS CARE SUPPORT, LAP-BAND SUPPORT, ANCHOR SENIOR SUPPORT, AND ORTHOPEDIC SUPPORT.HARRISON MEDICAL CENTER'S SOCIAL WORKERS PROVIDE OVER 250 HOURS PER YEAR OF ASSISTANCE TO COMMUNITY MEMBERS WITH QUESTIONS REGARDING SERVICES OUTSIDE OF HMC AND ANOTHER 300 HOURS PER YEAR OF ASSISTANCE WITH ACCESS TO THESE SERVICES. SOCIAL WORKERS FREQUENTLY ARRANGE TRANSPORTATION FOR PATIENTS AND THEIR FAMILIES WHO LACK RESOURCES, PROCURE URGENTLY REQUIRED DISCHARGE MEDICATIONS TO LOW INCOME PATIENTS, PROVIDE 1.2 FTE'S OF SOCIAL WORK SERVICES FOR UNBILLED OUTPATIENT COUNSELING FOR RADIATION ONCOLOGY AND REHAB PATIENTS, AND THE SOCIAL WORK DIRECTOR SPENDS 15-20 HOURS EACH MONTH WORKING WITH COMMUNITY GROUPS ON MUTUAL PROJECTS AND SERVING ON VARIOUS COMMUNITY BOARDS.HARRISON MEDICAL CENTER RECRUITS PHYSICIANS TO FILL UNMET NEEDS IN THE COMMUNITY. ANALYSIS OF THE NUMBER AND TYPE OF PHYSICIANS AND MID-LEVEL PROVIDERS IS USED TO EVALUATE ACCESS TO PRIMARY AND SPECIALTY CARE PROVIDERS IN THE COMMUNITY. WHERE GAPS EXIST, HARRISON WORKS WITH OUR PHYSICIAN PARTNERS TO RECRUIT NEW PROVIDERS TO MEET THE GAPS IDENTIFIED BY THE ANALYSIS.CommunityBuildingActivities
Other InformationPart VI, Line 6: HARRISON MEDICAL CENTER PROMOTES THE HEALTH OF THE COMMUNITY IN MANY WAYS. HARRISON'S OPEN MEDICAL STAFF PRACTICE IN FIVE LOCATIONS THROUGHOUT KITSAP COUNTY AND NORTH MASON COUNTY, PROVIDING PRIMARY AND URGENT CARE AS WELL AS ADVANCED SPECIALTY CARE. FOR THE PAST SIX YEARS, HARRISON HAS SPONSORED THE KITSAP COUNTY MEDICAL SOCIETY FOUNDATION'S FAMILY FUN RUN. THE EVENT MARKS THE CULMINATION OF A TWO-MONTH PROGRAM, ENCOURAGING SCHOOL CHILDREN TO EXERCISE AND MAKE HEALTHY NUTRITION CHOICES. OUR DIETARY DEPARTMENT HAS CREATED AN ONGOING WELLNESS PROGRAM FOR EMPLOYEES. THE PROGRAM OFFERS GROUP EXERCISE CLASSES, PERSONALIZED DIET AND ACTIVITY PLANS, ONLINE COMMUNITY FORUMS, AND HEALTH SCREENINGS ALL MEANT TO ENABLE EMPLOYEES TO LEAD HEALTHIER LIVES. HARRISON OFFERS A NURSING RESIDENCY PROGRAM DESIGNED TO AID THE TRANSITION OF NURSING STUDENTS TO STAFF NURSES PROVIDING CARE FOR PATIENTS AT THE BEDSIDE. HARRISON ALSO OFFERS A MULTITUDE OF CLASSES FROM SMOKING CESSATION TO DIABETES EDUCATION.THE HARRISON MEDICAL CENTER BOARD OF DIRECTORS CONSISTS OF BUSINESS AND COMMUNITY LEADERS FROM WITHIN OUR PRIMARY AND SECONDARY MARKET AREAS. BOARD MEMBERS BRING RICH AND DIVERSE SKILL SETS TO THE GOVERNANCE ROLE THROUGH BACKGROUNDS INCLUDING, BUT NOT LIMITED TO, PUBLIC ACCOUNTING, EDUCATION, MEDICINE, MEDIA, AND MANUFACTURING.HARRISON MEDICAL CENTER PROVIDES URGENT AND EMERGENT PATIENT CARE IN THREE LOCATIONS, 24 HOURS A DAY, SEVEN DAYS A WEEK, OPERATING TWO HOSPITAL BASED EMERGENCY ROOMS AND AN URGENT CARE CLINIC. HARRISON ALSO PROVIDES URGENT CARE AT A SECOND LOCATION, 12 HOURS A DAY, EVERY DAY. NO PATIENT IS EVER TURNED AWAY FROM HARRISON MEDICAL CENTER BECAUSE OF AN INABILITY TO PAY. IT MAINTAINS AN OPEN MEDICAL STAFF CONSISTING OF COMMUNITY PHYSICIANS WHO HAVE MET THE CREDENTIALING REQUIREMENTS OF THE ORGANIZATION.OtherInformation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
HARRISON MEDICAL CENTER FOUNDATION
2520 CHERRY AVENUEBREMERTONWA98310911197626501(C)(3)271956N/AN/APROVIDE SALARIES AND BENEFITS FOR FOUNDATION STAFF
AMERICAN CANCER SOCIETY
718 LEBO BLVDBREMERTONWA98310131788491501(C)(3)12000N/AN/ARELAY FOR LIFE SPONSORSHIP
BOYS & GIRLS CLUB
11875 NW SILVERDALE WAY SUITE 205SILVERDALEWA98383261550879501(C)(3)5500N/AN/ABARN DANCE AND BBQ SPONSORSHIP
KITSAP COUNTY MEDICAL SOCIETY
PO BOX 339BREMERTONWA98383237087265501(C)(6)23000N/AN/AMULTIPLE EVENT SPONSORSHIP
MARCH OF DIMES
1904 3RD AVENUE SUITE 230SEATTLEWA98101999999999501(C)(3)9000N/AN/AMARCH FOR BABIES 2010 SPONSORSHIP
KIDS DISCOVERY MUSEUM
305 MADISON AVE SUITE CBAINBRIDGE ISLANDWA98110300167480501(C)(3)10000N/AN/AMEDICAL CLINIC EXHIBIT SPONSORSHIP
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants5TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: SUPPORT IS PROVIDED TO HARRISON MEDICAL CENTER FOUNDATION IN THE FORM OF SALARIES AND BENEFITS FOR SEVERAL STAFF MEMBERS. HARRISON MEDICAL CENTER REVIEWS THE RECORDS AND PREPARES THE FINANCIAL STATEMENTS OF THE FOUNDATION. WHEN CONSIDERING FINANCIAL DONATIONS TO OTHER ORGANIZATIONS, HARRISON MEDICAL CENTER FOCUSES ON THREE AREAS: HEALTH AND WELLNESS PROGRAMS THAT ENHANCE OPPORTUNITIES FOR FAMILIES IN KITSAP COUNTY; SPORTS PROGRAMS THAT SUPPORT HEALTHY, ACTIVE LIFESTYLES; AND BUSINESS DEVELOPMENT OPPORTUNITIES THAT EXPAND THE WELLNESS COMPONENT OF OUR SERVICES. WE BELIEVE OUR EMPLOYEES ARE THE BEST RESOURCE WE CAN OFFER OUR COMMUNITIES AND THEREFORE WE ALSO SUPPORT ORGANIZATIONS IN WHICH THEY ARE ACTIVE VOLUNTEERS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
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 (17 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
SCOTT BOSCH
4792580894600837001709720180290766089000
PATRICIA COCHRELL
28983203982509800358500132350379722000
CYNTHIA MAY
19374502700007740197600148720256151000
RONALD MORRIS
13369103240007122700046690241987000
ADAR PALIS
232224031050043396037330083770352377000
ANDREW STEFO
16327000016572037407080790225328000
RICHARD SMITH
13879200094960148970142780177463000
MARIAL KAGAN
23728803240002112031220095390312559000
REBECCA KELLY
1697670229500288022114076340222753000
THOMAS KRUSE
22546303105003734403434401500003432010224120
RAPIN CHAI KANITHANON
39759800078800122500123950430123000
ROBERT C KING
465134000301280273500149630537575000
RONALD ROBERT REIMER
42672500080204900048450437272000
DENNIS M WILLERFORD
47242300021904900062350483777000
MALCOM W WINTER
47099800021904900062350482352000
JAMES ROWSON
13337402250001851540139210678303617320307210
MARLA BRADY
607500218700150608062450759002470630138270

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 1aKITSAP GOLF & COUNTRY CLUB MEMBERSHIP DUES IN THE AMOUNT OF $4,794 FOR SCOTT BOSCH, CEO, ARE PAID FOR BY THE MEDICAL CENTER AND ARE A NON-TAXABLE BENEFIT TO THE INDIVIDUAL BECAUSE THE MEMBERSHIP IS ONLY USED FOR BUSINESS PURPOSES. HOUSING COST IN THE AMOUNT OF $16,000 FOR ANDREW STEFO, CFO, IS PAID FOR BY THE MEDICAL CENTER AND IS A TAXABLE BENEFIT.
Part I, Line 4aTHE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS: MARLA BRADY = $101,250, RONALD MORRIS = $54,167. THESE PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN (B)(III) AS OTHER REPORTABLE COMPENSATION. THE FOLLOWING INDIVIDUALS PARTICIPATED IN OR RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: SCOTT BOSCH = $153,822, PATRICIA COCHRELL = $23,600, MARIEL KAGAN = $19,200, REBECCA KELLY = $13,600, THOMAS KRUSE = $22,825, CINDY MAY = $16,000, ADAR PALIS = $21,055, ANDREW STEFO = $33,600
Part I, Line 6DEFERRED COMPENSATION: AS PART OF THE EXECUTIVE BENEFITS PACKAGE AVAILABLE TO SENIOR PERSONNEL, VICE PRESIDENT LEVEL STAFF ARE PROVIDED A NET PERCENTAGE OF THEIR ANNUAL BASE COMPENSATION TO BE USED FOR THE PURCHASE OF ADDITIONAL BENEFITS (E.G., LIFE INSURANCE, LONG TERM CARE INSURANCE, ETC.) OR TO BE DEFERRED AS AN AT RISK (SUBJECT TO RISK RULES, AS DEFINED) INVESTMENT TO BE PAID OUT ONLY UPON TERMINATION / RETIREMENT OF THE INDIVIDUAL. NO PART OF THIS ADDITIONAL BENEFIT IS PREDICATED ON THE EARNINGS OF HARRISON MEDICAL CENTER. INCENTIVE COMPENSATION: AN INCENTIVE COMPENSATION PLAN IS ALSO IN PLACE FOR SENIOR EXECUTIVES (VICE PRESIDENT LEVEL AND THE CEO). THIS PLAN, WHICH PLACES A PORTION OF EACH EXECUTIVE'S OVERALL COMPENSATION AT RISK, IS PREMISED ON A SERIES OF GOALS THAT RANGE FROM QUALITY TO FINANCIAL PERFORMANCE. WHILE A TRIGGER DOES EXIST IN THE PLAN THAT THE OPERATING BUDGET FOR THE FISCAL YEAR MUST BE MET, NO PART OF THE INCENTIVE IS COMPUTED AS A PERCENTAGE OF OPERATING INCOME. THE TARGETS ARE ADJUSTED EACH YEAR BY THE BOARD OF DIRECTORS, DEPENDENT ON THE ORGANIZATIONAL OBJECTIVES FOR THE YEAR.
Part IIIPART II, COLUMN (B)(III): THE MAJORITY OF THE AMOUNT REPORTED AS OTHER REPORTABLE COMPENSATION FOR JAMES ROWSON INCLUDES FUNDS RECEIVED FROM THE EXECUTIVE CAPITAL ACCUMULATION ACCOUNT.Supplemental Information

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WASHINGTON HEALTH CARE FACILITIES AUTHORITY 2010 SERIESBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN911108929IssuerEIN
Date Issued2010-04-29DateIssued
Issue Price30000000IssuePrice
Description Of PurposeCONSTRUCT, REMODEL & EQUIP CARDIOVASCULAR CENTER & CAMPUS IMPROVEMENTSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds30000000TotalProceeds
Amount Unspent21288758AmountUnspent
Issuance Costs From Proceeds600000IssuanceCostsFromProceeds
Capital Expenditures8111242CapitalExpenditures
Year Of Subst Completion2012YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made0FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Counsel Routinely Engaged1BondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed1Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
PATHOLOGY ASSOICATES OF KITSAP COUNTY
PARTNERSHIP MORE THAN 5% OWNED BY GREGORY S. HENDERSON, MD, TRUSTEE892359ANATOMIC PATHOLOGY SERVICES AGREEMENT AND LAB DIRECTOR SERVICES0
KITSAP CHEST CONSULTANTS
PARTNERSHIP MORE THAN 5% OWNED BY GRIFFITH BLACKMON, MD, TRUSTEE659759MANAGEMENT FEES AND ICU CALL COVERAGE CONTRACT0

Schedule M IRS990ScheduleM

Books And Publications BooksAndPublications

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F9902563NoncashContribsRptdF990
Method Of Determining RevenuesCOSTMethodOfDeterminingRevenues

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9901734NoncashContribsRptdF990
Method Of Determining RevenuesCOSTMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable (4 entries)

Non Cash CheckboxNonCashCheckboxDescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
XSURGICAL NAV149000DONOR FMV
XEMULATOR11261COST
XNON-MED SUPPLIES41406COST
XMISCELLANEOUS113449COST
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierMethod for Determining Number of Contributors:Identifier
Return ReferencePart I, Column (b):ReturnReference
ExplanationTHE NUMBER OF CONTRIBUTIONS REPORTED IN COLUMN B IS BASED ON THE NUMBER OF CONTRIBUTIONS RECEIVED.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11THE FORM 990 IS REVIEWED BY THE DIRECTOR OF FINANCE AND THE CHIEF FINANCIAL OFFICER TO ENSURE ACCURACY AND COMPLETENESS OF DATA. ONCE THEIR REVIEW IS COMPLETE, THE 990 IS SHARED WITH THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS RECEIVES AN ELECTRONIC COPY OF THE FORM PRIOR TO FILING.
Form 990, Part VI, Section B, line 12cBOARD MEMBERS ARE ANNUALLY REQUIRED TO ACKNOWLEDGE RECEIPT OF THE MEDICAL CENTER'S CURRENT POLICY AND COMPLETE AND SUBMIT PROVIDED QUESTIONNAIRES. MEDICAL CENTER COUNSEL REVIEWS THE SUBMITTED QUESTIONNAIRES AND PROVIDES A FORMAL REPORT BACK TO THE BOARD.
Form 990, Part VI, Section B, line 15CONSULTANTS ARE RETAINED BY THE CHAIRMAN OF THE BOARD FOR THE EXPRESS PURPOSE OF SETTING EXECUTIVE COMPENSATION AND OPINING AS TO ITS COMPARABILITY AND REASONABLENESS. CONSULTANTS MAY USE A VARIETY OF RESOURCES TO MAKE THIS DETERMINATION INCLUDING SURVEYS, INFORMATION FROM OTHER ORGANIZATIONS' FORM 990, AND VARIOUS COMPARATIVE DATA. THIS REVIEW PROCESS IS DONE ANNUALLY FOR THE EXECUTIVE STAFF AND KEY EMPLOYEES.
Form 990, Part VI, Section C, line 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, PART I, LINE 6VOLUNTEER RESOURCES RECRUITS, ORIENTS, PLACES, TRAINS AND SUPPORTS VOLUNTEERS FROM 14 TO OVER 90 YEARS OF AGE. PEOPLE VOLUNTEER BECAUSE THEY VALUE SERVICE, TO GAIN WORK EXPERIENCE, MEET JUNIOR/HIGH SCHOOL REQUIREMENTS, MEET CRITERIA FOR COLLEGE APPLICATIONS OR PROGRAMS, OR FOR CAREER EXPLORATION. WE COORDINATE WITH SCHOOLS AND LOCAL ORGANIZATIONS IN ORDER TO PROVIDE OPPORTUNITIES FOR THEIR CLIENTS AND FOR THOSE WITH SPECIAL NEEDS. DURING THE FISCAL YEAR, MAY 1, 2009 THROUGH APRIL 30 2010, VOLUNTEER RESOURCES SUPPORTED OVER 400 VOLUNTEERS AND JOB SHADOWS WITH ABOUT 180 ACTIVE VOLUNTEERS EACH MONTH. CURRENTLY, ALMOST ONE HALF OF NEW VOLUNTEERS ARE VOLUNTEERING TO MEET SCHOOL REQUIREMENTS OR TO ENHANCE THEIR WORK EXPERIENCE. IN-VOLUNTEERS DONATED 37,060 HOURS OF SERVICE THROUGHOUT HARRISON AND HEALTH PARTNERS. VOLUNTEERS WERE PLACED AND/OR COMPLETED WORK ORDERS FOR OVER 40 DEPARTMENTS OR LOCATIONS: BELFAIR PRIMARY CARE, BUSINESS/COMMUNITY DEVELOPMENT, COMMUNICATIONS, COMPLEMENTARY THERAPIES, DIABETES CENTER, DIETARY, EDUCATION SERVICES, EMPLOYEE HEALTH, ENVIRONMENTAL SERVICES, FACILITIES, FOUNDATION, GIFT SHOPS, INFORMATION TECHNOLOGY, SOUTH KITSAP URGENT CARE AND PRIMARY CARE, HOME HEALTH, HUMAN RESOURCES, INFECTION PREVENTION, MARKETING, MEDICAL AFFAIRS, MEDICAL IMAGING NURSING ADMINISTRATION, NURSING UNITS (ALL), PATIENT ACCOUNTS, PUBLIC RELATIONS, PRE ADMIT, RADIATION ONCOLOGY, REGISTRATION, REHABILITATION (ALL AREAS), SERVICE EXCELLENCE, SLEEP CLINIC, SOCIAL WORK, SPIRITUAL CARE (ALL INPATIENT AREAS), SURGERY (INPATIENT AND SAME DAY), PHARMACY, TELECOMMUNICATIONS. EXAMPLES OF VOLUNTEER TASKS INCLUDE PROVIDING CUSTOMER SERVICE BY GREETING AND ESCORTING PATIENTS AND VISITORS, BEING COMMUNICATION LIAISONS, STAFFING RECEPTION DESKS, MAKING PHONE CALLS, PROVIDING CLERICAL AND COMPUTER ASSISTANCE, STAFFING SPECIAL EVENTS, ASSISTING NURSES IN CLINICAL AREAS, STOCKING SUPPLIES, GIVING TOURS, AND PROVIDING COMPLEMENTARY THERAPIES INCLUDING HAND RUBS, MUSIC, DOG THERAPY, AND ART THERAPY. VOLUNTEERS ALSO COMPLETE THOUSANDS OF WORK ORDERS WHICH INCLUDE COPYING, COLLATING, ART PROJECTS, AND SPECIAL PROJECTS. THE INDEPENDENT SECTOR ESTIMATES THE AVERAGE DOLLAR VALUE OF VOLUNTEER TIME AT $20.85 PER HOUR FOR 2009 ($18.35 WITHOUT FRINGE BENEFITS OF 12%). NOTE MINIMUM WAGE PLUS 15% INCREASE SUGGESTED BY HUMAN RESOURCES EQUALS CLOSE TO A $400,000 SAVINGS IN LABOR COST. BY ANY COUNT, THESE FIGURES HELP US MEASURE THE BROADER CONTRIBUTION OF VOLUNTEERS WHO DEDICATE THEIR TIME, TALENTS AND ENERGY TO MAKING A POSITIVE DIFFERENCE AT HARRISON.
FORM 990, PART VII, SECTION A: COMPENSATIONJIM ROWSEN, CHIEF FINANCIAL OFFICER, RETIRED FROM HARRISON MEDICAL CENTER ON DECEMBER 31, 2008. RICK SMITH, THE CURRENT DIRECTOR OF FINANCE, SERVED AS THE INTERIM CFO WHILE THE HOSPITAL SEARCHED FOR A REPLACEMENT. ANDREW STEFO WAS HIRED AS THE NEW CHIEF FINANCIAL OFFICER AS OF MARCH 30, 2009. ANDREW STEFO RESIGNED FROM THE HOSPITAL AS THE CHIEF FINANCIAL OFFICER AS OF JUNE 30, 2010. RICK SMITH IS SERVING AS THE INTERIM CHIEF FINANCIAL OFFICER AGAIN WHILE THE HOSPITAL SEARCHES FOR A REPLACEMENT FOR THE POSITION.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1HARRISON MEDICAL CENTER FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12520 CHERRY AVENUEAddressLine1
CityBREMERTONCity
StateWAState
ZIP Code98310ZIPCode
FieldValueIRS element (for citing)
EIN911197626EIN
Primary ActivitiesRAISES & MANAGES CHARITABLE GIFTS FOR HARRISON MEDICAL CENTERPrimaryActivities
Legal Domicile StateWALegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLINE 7PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
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 Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
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 Org0OtherTransferFromOtherOrg