2019-04-15T18:36:19-05:00 2018-05-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2017-06-01 911349657 COMMUNITY HEALTH CARE COMM 2535974550 1148 BROADWAY NO 100 TACOMA WA 98402 DAVID FLENTGE CEO 2537221502 2019-04-15 1 KURT BENNION CPA P01469618 4252506100 2019-04-15 67.137.57.251 2019-04-15 04:55:16 PD P 8AB1EF77DE18A0C4413B49866C7FB8A65B600F09 3C05182BCE949607266F40F8D21D5C2A178D6925 2017 2019-02-21 02:37:17Z DAVID FLENTGE 1148 BROADWAY NO 100 TACOMA WA 98402 63725138 0 X WWW.COMMHEALTH.ORG X 1987 WA TO PROVIDE THE HIGHEST QUALITY HEALTH CARE WITH COMPASSIONATE AND ACCESSIBLE SERVICE FOR ALL. 12 12 575 21 0 28197 8685597 8192256 41764716 55235209 202159 207198 123086 46864 50775558 63681527 22780 17650 0 0 33512995 37028848 61050 66852 79037 16358373 19008547 49955198 56121897 820360 7559630 52990893 58697019 15810654 13957150 37180239 44739869 X COMMUNITY HEALTH CARE PROVIDES COMPREHENSIVE PRIMARY MEDICAL AND DENTAL CARE THROUGH A CLINIC SYSTEM THAT INCLUDES SEVEN MEDICAL AND THREE DENTAL CLINICS. IN ADDITION, CARE IS ALSO PROVIDED THROUGH A WOMEN'S HEALTH CLINIC. 0 0 26549979 17650 22965633 COMMUNITY HEALTH CARE (CHC) MEDICAL CLINICS OFFER MEDICAL SERVICES AND URGENT CARE CENTER SERVICES IN VARIOUS LOCATIONS IN PIERCE COUNTY ACCORDING TO A SLIDING FEE SCALE BASED ON INCOME AND FAMILY SIZE. CHC CONTINUES TO SUPPORT TWO RESIDENCY PROGRAMS: 1. A FAMILY PHYSICIAN RESIDENCY PROGRAM THAT ACCEPTS 6 RESIDENTS EACH YEAR FOR A TOTAL OF 18 RESIDENTS DURING A 3 YEAR PROGRAM; AND 2. A FAMILY ADVANCED REGISTERED NURSE PRACTIONER RESIDENCY PROGRAM. DURING THE FISCAL YEAR ENDED 5/31/18, CHC PROVIDED 27,891 PATIENTS WITH MEDICAL CARE FROM 114,702 PATIENT VISITS AT 5 MEDICAL CLINICS. 10990329 0 14941921 COMMUNITY HEALTH CARE (CHC) DENTAL CLINICS OFFER PRIMARY CARE DENTAL SERVICES IN VARIOUS PIERCE COUNTY LOCATIONS ACCORDING TO THE SAME FEE STRUCTURE. CHC DENTAL CLINICS INCLUDE A DENTAL RESIDENCY PROGRAM THAT LAUNCHED IN JULY 2013. DURING THE FISCAL YEAR ENDED 5/31/18, CHC PROVIDED 22,923 PATIENTS WITH DENTAL CARE FROM 65,747 DENTAL VISITS PATIENTS AT 3 DENTAL CLINICS. 8858456 0 14875678 COMMUNITY HEALTH CARE (CHC) PHARMACIES OFFER PHARMACEUTICAL SERVICES TO PATIENTS IN VARIOUS LOCATIONS IN PIERCE COUNTY ACCORDING TO THE SAME FEE STRUCTURE NOTED ABOVE. DURING THE FISCAL YEAR ENDED 5/31/18, CHC'S PHARMACIES SERVED 15,322 PATIENTS THROUGH 153,839 MEDICATION FILLS AT 4 CLINICS. 2308260 0 2451977 COMMUNITY HEALTH CARE (CHC) OFFERS NUTRITION, VISION, MATERNITY, AND BEHAVIORAL HEALTH SERVICES THROUGH THE CHC CLINICS IN PIERCE COUNTY.DURING THE FISCAL YEAR ENDED 5/31/18, CHC PROVIDED 4,609 PATIENTS WITH 16,861 VISITS. 2308260 0 2451977 48707024 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 32 0 575 1 1 1 0 0 0 0 1 1 0 0 0 0 X 12 12 0 0 1 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X TONIA CAMPBELL 2535691510 1148 BROADWAY NO 100 TACOMA WA 98402 GARY WALMER CHAIR 2.00 2.00 X X 0 0 0 RICHARD BOWER VICE CHAIR (THROUGH NOV 2017) 2.00 0.00 X X 0 0 0 MARCO VINIEGRA BOARD MEMBER & VICE CHAIR 2.00 0.00 X X 0 0 0 DAN SLOAN SECRETARY 2.00 2.00 X X 0 0 0 LES CATHERSAL TREASURER 2.00 0.00 X X 0 0 0 LINDA BOWMAN BOARD MEMBER 2.00 0.00 X 0 0 0 JACK CVITANOVIC BOARD MEMBER 2.00 0.00 X 0 0 0 LADEDRIA GRIFFIN STALLWORTH BOARD MEMBER 2.00 0.00 X 0 0 0 PAUL HANSEN BOARD MEMBER 2.00 0.00 X 0 0 0 RIA JOHNSON BOARD MEMBER 2.00 0.00 X 0 0 0 CHAD MCMILLAN BOARD MEMBER (THROUGH APRIL 2018) 2.00 0.00 X 0 0 0 KEN REPP BOARD MEMBER 2.00 0.00 X 0 0 0 DOUG SWANBERG BOARD MEMBER 2.00 2.00 X 0 0 0 ANTHONY VELEZ BOARD MEMBER 2.00 0.00 X 0 0 0 SHELLY WEISS BOARD MEMBER (THROUGH OCT 2017) 2.00 0.00 X 0 0 0 DAVID FLENTGE CEO 40.00 2.00 X 253718 0 23272 TONIA CAMPBELL CFO 40.00 2.00 X 146886 0 26621 JEFFREY SMITH RESIDENCY DIRECTOR 40.00 0.00 X 309184 0 26843 GARY REICHARD MD/DO & ASSISTANT RESIDENCY DIRECTOR 40.00 0.00 X 220591 0 41743 ELIZABETH FRIESEMA MEDICAL DIRECTOR 40.00 0.00 X 264763 0 29355 DANIEL KREBS ASSISTANT MEDICAL DIRECTOR (THROUGH JULY 2017) 40.00 0.00 X 160169 0 22467 JEFF REYNOLDS DENTAL DIRECTOR 40.00 0.00 X 168310 0 21984 JOHNNY ERKINS MD OBGYN 40.00 0.00 X 309770 0 38062 JAMES LENHART MD FP W/OB 40.00 0.00 X 282826 0 22947 SANDRA WERNER MD FP W/OB 40.00 0.00 X 279278 0 26088 DAVID LAR MD PEDIATRICIAN 40.00 0.00 X 249821 0 29123 ERIN LONGLEY MD FP W/OB 40.00 0.00 X 241066 0 19622 2886382 0 328127 63 0 1 0 SCRIBE-X NORTHWEST LLC 931 SW KING AVENUE PORTLAND OR 97205 MEDICAL SCRIBES 440647 ABM JANITORIAL SERVICES PO BOX 419860 BOSTON MA 02241 JANITORIAL 341391 NUWEST GROUP HOLDINGS LLC PO BOX 40285 BELLEVUE WA 98015 TEMPORARY STAFFING 311898 PATTERSON DENTAL SUPPLY INC 22522 29TH DRIVE SE BOTHELL WA 98021 DENTAL REPAIRS & SUPPLIES 288077 FASPSYCH LLC 8687 E VIA DE VENTURA SCOTTSDALE AZ 85258 MENTAL HEALTH SERVICES 224770 8 127999 7665266 398991 481859 8192256 PATIENT FEES 621400 42719152 42719152 PHARMACY REVENUE 621300 12516057 12516057 55235209 207198 207198 36345 0 36345 36345 36345 0 127999 43611 -43611 -43611 MISCELLANEOUS REVENUE 900099 54130 54130 54130 63681527 55235209 0 254062 17650 17650 1515012 1515012 27874599 25295250 2575225 4124 1094935 928143 166638 154 4549912 3998355 550893 664 1994390 1690583 303526 281 59017 6285 52724 8 72225 7692 64523 10 2199 2199 66852 66852 3007036 2604882 396891 5263 90700 8481 82219 910633 541766 368848 19 877544 739014 136958 1572 1110102 590270 519813 19 432677 240181 192450 46 369422 245031 124390 1 1011943 926816 85117 10 142547 94233 48308 6 UBI TAXES 4930 4930 MEDICAL/DENTAL SUPPLIES 7968800 7963812 4988 0 BAD DEBT 1792317 1792317 0 0 MISCELLANEOUS 496617 446292 50317 8 659838 569971 89867 56121897 48707024 7335836 79037 4009064 8090579 2850685 4702478 783679 287635 4696863 5166769 187585 198087 2469002 1197027 36054329 16176434 18817466 19877895 19176549 19176549 52990893 58697019 7920623 6637574 95791 102944 3148540 3025076 4645700 4191556 15810654 13957150 X 37180239 44739869 37180239 44739869 52990893 58697019 7559630 0 X 0 1 X 1 1 1 X 7267521 4976893 6040011 8685597 8192256 35162278 7267521 4976893 6040011 8685597 8192256 35162278 35162278 212177 244377 234721 237793 243543 1172611 100948 30053 96865 130875 54130 412871 36747760 197475429 0.95690 0.96700 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE SPECIAL FUNDRAISING EVENT REVENUES 1 1 0 0 0 0 1 2199 0 0 2199 0 PART II-B, LINE 1: THE ORGANIZATION'S EMPLOYEES, INCLUDING THE CEO AND HUMAN RESOURCES DIRECTOR, SPENT APPROXIMATELY 24 HOURS LOBBYING. TWO OF THE ORGANIZATION'S BOARD MEMBERS SPENT APPROXIMATELY 10 HOURS LOBBYING. 4282892 4282892 17435649 5260015 12175634 2431980 1600011 831969 11903808 9316408 2587400 19877895 RECEIVABLE FROM HILLTOP CHC INVESTMENT FUND, LLC 19176549 19176549 X 61208423 62199 43611 105810 61102613 2578914 2578914 63681527 54435390 62199 43611 105810 54329580 1792317 1792317 56121897 PART X, LINE 2: NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS BECAUSE THE ORGANIZATION IS A NONPROFIT ORGANIZATION, EXEMPT FROM INCOME TAXES UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION (ASC). PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 43,611. PART XI, LINE 4B - OTHER ADJUSTMENTS: CAPITAL GRANT 149,919. OTHER INCOME 243,544. CAPITAL CAMPAIGN CONTRIBUTIONS 393,134. BAD DEBT EXPENSE 1,792,317. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 43,611. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,792,317. X X X X X X X 1 RICHARD OLDENBURG 6825 RAINIER AVE GIG HARBOR WA 98335 MAJOR & PLANNED GIFT CONSULTING 0 524112 66852 457260 524112 66852 457260 WA ANNUAL LUNCHEON 127999 127999 16265 1000 26346 127999 127999 16265 1000 26346 43611 -43611 1 PART I, LINE 2: CHC DONATES TO LOCAL CHARITIES AND GOVERNMENT ENTITIES. CHC DOES NOT CONDUCT ANY SPECIAL FOLLOW-UP TO ENSURE FUNDS ARE USED FOR A CHARITABLE PURPOSE. X 1 1 X X X X X 0 0 0 0 0 1 0 0 0 DAVID FLENTGE CEO 241028 0 12690 0 0 0 12717 0 10555 0 276990 0 0 0 TONIA CAMPBELL CFO 140541 0 6345 0 0 0 5200 0 21421 0 173507 0 0 0 JEFFREY SMITH RESIDENCY DIRECTOR 270767 0 38417 0 0 0 10000 0 16843 0 336027 0 0 0 GARY REICHARD MD/DO & ASSISTANT RESIDENCY DIRECTOR 220566 0 25 0 0 0 24000 0 17743 0 262334 0 0 0 ELIZABETH FRIESEMA MEDICAL DIRECTOR 214466 0 50297 0 0 0 18000 0 11355 0 294118 0 0 0 DANIEL KREBS ASSISTANT MEDICAL DIRECTOR (THROUGH JULY 2017) 112689 0 47480 0 0 0 17388 0 5079 0 182636 0 0 0 JEFF REYNOLDS DENTAL DIRECTOR 148334 0 19976 0 0 0 5766 0 16218 0 190294 0 0 0 JOHNNY ERKINS MD OBGYN 255717 0 54053 0 0 0 24000 0 14062 0 347832 0 0 0 JAMES LENHART MD FP W/OB 231352 0 51474 0 0 0 6500 0 16447 0 305773 0 0 0 SANDRA WERNER MD FP W/OB 238436 0 40842 0 0 0 15600 0 10488 0 305366 0 0 0 DAVID LAR MD PEDIATRICIAN 234473 0 15348 0 0 0 2473 0 26650 0 278944 0 0 0 ERIN LONGLEY MD FP W/OB 197404 0 43662 0 0 0 17992 0 1630 0 260688 0 0 0 PART I, LINE 1A DURING 2017, COMMUNITY HEALTH CARE PAID ROTARY CLUB DUES OF $450 FOR DAVID FLENTGE, THE CEO. THIS AMOUNT WAS NOT INCLUDED IN HIS TAXABLE COMPENSATION. PART I, LINE 6 THE EXECUTIVE MANAGEMENT TEAM RECEIVES A BONUS THAT IS PRIMARILY BASED ON ACHIEVING BOARD-APPROVED OPERATING SURPLUS/DEFICIT GOALS, AS WELL AS FOUR OTHER STRATEGIC GOALS SUCH AS PATIENT SATISFACTION AND NUMBER OF PATIENTS SERVED. A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 2016-08-19 3285000 TO FUND A FACILITY RENOVATION AND REFUND SERIES 2003 BONDS 0 0 0 A 218132 3285000 2311710 927290 2017 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 X 21 466714 CDC PRICING X SUPPLIES 2 8299 DONOR VALUED X FURNITURE 1 6845 DONOR VALUED 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF BOARD (CHAIR OR CO-CHAIRS, VICE CHAIR, SECRETARY AND TREASURER) AND THE CHAIRS OF EACH STANDING COMMITTEE. THE EXECUTIVE COMMITTEE HAS THE POWERS AND AUTHORITY OF THE BOARD TO MAKE DECISIONS WHEN THE BOARD IS NOT IN SESSION. THE EXECUTIVE COMMITTEE ALSO OVERSEES THE RECRUITMENT AND HIRING OF THE CEO. THE COMMITTEE OVERSEES THE COMPENSATION PROCESS OF THE CEO. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION'S BYLAWS WERE AMENDED IN MARCH 2018 TO UPDATE THE RESPONSIBILITIES OF THE BOARD'S OFFICERS AND COMMITTEES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CFO, BY THE EXECUTIVE COMMITTEE AND BY THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND MANAGEMENT TEAM MEMBERS ARE ASKED TO SIGN A CONFLICT OF INTEREST STATEMENT AT INITIAL ORIENTATION AND AGAIN ANNUALLY. RECORDS ARE MAINTAINED BY EITHER THE HUMAN RESOURCES DIRECTOR OR THE ASSISTANT TO THE CEO. REPORTED OR POTENTIAL CONFLICTS ARE REVIEWED BY EITHER THE HUMAN RESOURCES DIRECTOR OR THE CEO. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER OR MANAGEMENT TEAM MEMBER MUST EXCUSE THEMSELVES FROM THE DISCUSSION OR VOTING. IF A CONFLICT IS PERVASIVE WITH A BOARD MEMBER THEN THE CO-CHAIRS CAN PROCEED TO REMOVE THE BOARD MEMBER. IF A CONFLICT IS PERVASIVE WITH A MANAGEMENT TEAM MEMBER THEN THEY MAY BE TERMINATED. FORM 990, PART VI, SECTION B, LINE 15 COMMUNITY HEALTH CARE USES NORTHWEST REGIONAL PRIMARY CARE ASSOCIATION, NATIONAL ASSOCIATION FOR COMMUNITY HEALTH CENTERS, AND MILLIMAN SALARY SURVEYS AND DATA FROM THE PACIFIC NORTHWEST REGION AS COMPARATIVE DATA. AN OUTSOURCED INDEPENDENT CONSULTANT IS ALSO USED TO DETERMINE SALARY EXPECTATION. THE BOARD REVIEWS THE CEO'S COMPENSATION AND APPROVES. THIS PROCESS WAS LAST COMPLETED IN 2018. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS REVIEWED BY THE CEO AND THEN THE BOARD OF DIRECTORS FOR FINAL APPROVAL. THIS PROCESS WAS LAST COMPLETED IN 2018. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. HILLTOP REGIONAL HEALTH CENTER 1148 BROADWAY SUITE 100 TACOMA WA 98402 455494488 HEALTHCARE WA 501(C)(3) LINE 12D, III-O COMMUNITY HEALTH CARE 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 HILLTOP REGIONAL HEALTH CENTER K 231001 FMV BASED ON LOW-COST FINANCING