2020-03-24T20:40:19-05:00 2019-05-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2018-06-01 911349657 COMMUNITY HEALTH CARE COMM 2535974550 1148 BROADWAY NO 100 TACOMA WA 98402 DAVID FLENTGE CEO 2537221502 2019-10-30 1 KURT BENNION CPA P01469618 4252506100 2019-10-30 67.137.57.251 2019-10-30 17:49:28 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 0A137849BC389FB7B51D6FC2D6742665ACC5CBED 2018 2020-09-23 17:36:50Z DAVID FLENTGE 1148 BROADWAY NO 100 TACOMA WA 98402 65135222 0 X WWW.COMMHEALTH.ORG X 1987 WA TO PROVIDE THE HIGHEST QUALITY HEALTH CARE WITH COMPASSIONATE AND ACCESSIBLE SERVICE FOR ALL. 13 13 651 21 0 62544 8192256 8691602 55235209 56075520 207198 227772 46864 104599 63681527 65099493 17650 13200 0 0 37028848 41849743 66852 77591 124159 19008547 19747793 56121897 61688327 7559630 3411166 58697019 61063021 13957150 12911986 44739869 48151035 X COMMUNITY HEALTH CARE PROVIDES COMPREHENSIVE PRIMARY MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE THROUGH A CLINIC SYSTEM THAT INCLUDES FIVE MEDICAL CLINICS, FOUR DENTAL CLINICS, AND FIVE PHARMACY LOCATIONS. IN ADDITION, CARE IS ALSO PROVIDED THROUGH A WOMEN'S HEALTH CLINIC. 0 0 29490436 13200 23367362 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 MEDICAL 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 1-YEAR FAMILY ADVANCED REGISTERED NURSE PRACTIONER RESIDENCY PROGRAM WITH TWO RESIDENTS.DURING THE FISCAL YEAR ENDED 5/31/19, CHC PROVIDED 27,617 PATIENTS WITH MEDICAL CARE FROM 110,362 PATIENT VISITS AT 5 MEDICAL CLINICS. 11533305 0 13694542 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 1-YEAR DENTAL RESIDENCY PROGRAM.DURING THE FISCAL YEAR ENDED 5/31/19, CHC PROVIDED 23,751 PATIENTS WITH DENTAL CARE FROM 68,317 PATIENT VISITS AT 4 DENTAL CLINICS. 9969214 0 16470616 COMMUNITY HEALTH CARE (CHC) PHARMACIES OFFER PHARMACEUTICAL SERVICES TO PATIENTS IN VARIOUS LOCATIONS IN PIERCE COUNTY ACCORDING TO THE SAME FEE STRUCTURE NOTED ABOVE. THE CHC PHARMACY PROGRAM INCLUDES A 1-YEAR PHARMACY RESIDENCY PROGRAM.DURING THE FISCAL YEAR ENDED 5/31/19, CHC'S PHARMACIES SERVED 14,982 PATIENTS THROUGH 154,299 MEDICATION FILLS AT 5 CLINICS. 2681198 0 2543000 COMMUNITY HEALTH CARE (CHC) OFFERS MATERNITY SUPPORT, BEHAVIORAL HEALTH SERVICES, NUTRITION AND VISION SERVICES THROUGH THE CHC CLINICS IN PIERCE COUNTY.DURING THE FISCAL YEAR ENDED 5/31/19, CHC PROVIDED 4,995 PATIENTS WITH 16,868 VISITS. 2681198 0 2543000 53674153 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 40 0 651 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 13 13 0 0 1 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X TONIA CAMPBELL 2535974550 1148 BROADWAY NO 100 TACOMA WA 98402 GARY WALMER CHAIR 2.00 2.00 X X 0 0 0 MARCO VINIEGRA 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 (THROUGH DEC 2018) 2.00 0.00 X X 0 0 0 LADEDRIA GRIFFIN STALLWORTH BOARD MEMBER & 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 (THROUGH DEC 2018) 2.00 0.00 X 0 0 0 DORIS GARCIA BOARD MEMBER (THROUGH DEC 2018) 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 MEI YUN LOYA BOARD MEMBER 2.00 0.00 X 0 0 0 ALMA PRICE BOARD MEMBER 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 ANNIE TUSTISON BOARD MEMBER 2.00 0.00 X 0 0 0 ANTHONY VELEZ BOARD MEMBER 2.00 0.00 X 0 0 0 DAVID FLENTGE MSW CEO 40.00 2.00 X 267958 0 30036 TONIA CAMPBELL CPA CFO 40.00 2.00 X 174555 0 38715 JEFFREY SMITH MD CMO 40.00 0.00 X 403392 0 41551 CARRIE JO TIMMER DO RESIDENCY DIRECTOR 40.00 0.00 X 261763 0 50480 GARY REICHARD MD ASSISTANT RESIDENCY DIRECTOR 40.00 0.00 X 265250 0 42176 JEFF REYNOLDS DMD DENTAL DIRECTOR 40.00 0.00 X 218220 0 34963 GODWIN ASEMOTA PHARMD PHARMACY DIRECTOR 40.00 0.00 X 170638 0 35857 JOHNNY ERKINS MD MEDICAL PROVIDER 40.00 0.00 X 303062 0 55231 SANDRA WERNER MD MEDICAL PROVIDER 40.00 0.00 X 278716 0 27012 JAMES LENHART MD PHD MEDICAL PROVIDER 40.00 0.00 X 271574 0 39568 ELIZABETH FRIESEMA MD PEDIATRICIAN 40.00 0.00 X 267388 0 13975 DAVID LAR MD PEDIATRICIAN 40.00 0.00 X 266933 0 50779 3149449 0 460343 61 0 1 0 SCRIBE-X NORTHWEST LLC 931 SW KING AVENUE PORTLAND OR 97205 MEDICAL SCRIBES 482059 ABM JANITORIAL SERVICES PO BOX 742049 LOS ANGELES CA 90074 JANITORIAL 314421 NUWEST GROUP HOLDINGS LLC PO BOX 40285 BELLEVUE WA 98015 TEMPORARY STAFFING 265494 FASPSYCH LLC 8687 E VIA DE VENTURA SCOTTSDALE AZ 85258 MENTAL HEALTH SERVICES 257232 CHI FRANCISCAN HEALTH 1145 BROADWAY TACOMA WA 98402 OB DELIVERIES 139200 19 44348 8390095 257159 493231 8691602 PATIENT FEES 621400 41445468 41445468 PHARMACY REVENUE 621300 14477052 14477052 MEANINGFUL USE REVENUE 621400 153000 153000 56075520 227672 227672 22097 0 22097 22097 22097 100 0 100 100 100 32004 44348 35729 -3725 -3725 MISCELLANEOUS REVENUE 900099 86227 86227 86227 65099493 56075520 0 332371 13200 13200 2179281 1602918 542369 33994 30900595 27005745 3891881 2969 1022537 871662 150768 107 5482109 4644142 832300 5667 2265221 1911794 350494 2933 78893 78893 66024 66024 3626 3626 77591 77591 3783552 3032791 750643 118 196650 131255 65395 983220 655873 326943 404 1039834 782511 257314 9 464027 300577 163207 243 305174 204453 100713 8 1193910 1031371 162437 102 154442 106217 48216 9 UBI TAXES 13134 13134 MEDICAL/DENTAL SUPPLIES 9173235 9170627 2608 BAD DEBT EXPENSE 1228006 1228006 MISCELLANEOUS 434403 423926 10472 5 629663 557085 72578 61688327 53674153 7890015 124159 8090579 8184569 4702478 4218073 287635 312456 5166769 8149662 198087 169728 1197027 1292201 36973474 17413691 19877895 19559783 19176549 19176549 58697019 61063021 6637574 5573223 102944 269481 3025076 2887332 4191556 4181950 13957150 12911986 X 44739869 48151035 44739869 48151035 58697019 61063021 3411166 0 X 0 1 X 1 1 1 X 4976893 6040011 8685597 8192256 8691602 36586359 4976893 6040011 8685597 8192256 8691602 36586359 36586359 244377 234721 237793 243543 249769 1210203 30053 96865 130875 54130 118231 430154 38226716 227295718 0.95710 0.95690 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE SPECIAL FUNDRAISING EVENT REVENUES RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 3626 0 0 3626 0 PART II-B, LINE 1: THE ORGANIZATION'S EMPLOYEES, INCLUDING THE CEO AND AND 2 ARNP RESIDENTS, SPENT APPROXIMATELY 45 HOURS LOBBYING. FOUR OF THE ORGANIZATION'S BOARD MEMBERS SPENT APPROXIMATELY 20 HOURS LOBBYING. IN ADDITION, A PORTION OF THE MEMBERSHIP DUES PAID TO CERTAIN ASSOCIATIONS ARE USED BY THOSE ASSOCIATIONS TO LOBBY ON BEHALF OF THEIR MEMBERS. 4282892 4282892 17516887 5750111 11766776 2431980 1688832 743148 12741715 9974748 2766967 19559783 RECEIVABLE FROM HILLTOP CHC INVESTMENT FUND, LLC 19176549 19176549 X 63434448 46835 35729 82564 63351884 1747609 1747609 65099493 60542785 46835 35729 82564 60460221 1228106 1228106 61688327 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 35,729. PART XI, LINE 4B - OTHER ADJUSTMENTS: CAPITAL GRANT 12,575. OTHER INCOME 249,769. CAPITAL CAMPAIGN CONTRIBUTIONS 257,159. BAD DEBT EXPENSE 1,228,006. GAIN ON DISPOSAL OF FIXED ASSETS 100. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 35,729. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,228,006. GAIN ON DISPOSAL OF FIXED ASSETS 100. X X X X X X X 1 RICHARD OLDENBURG 6825 RAINIER AVE GIG HARBOR WA 98335 MAJOR & PLANNED GIFT CONSULTING 0 453422 77591 375831 453422 77591 375831 WA ANNUAL LUNCHEON 73777 44348 29429 9820 13371 2000 10538 73777 44348 29429 9820 13371 2000 10538 35729 -6300 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 MSW CEO 267958 0 0 0 0 0 13284 0 16752 0 297994 0 0 0 TONIA CAMPBELL CPA CFO 153810 0 20745 0 0 0 8805 0 29910 0 213270 0 0 0 JEFFREY SMITH MD CMO 358012 0 45380 0 0 0 19429 0 22122 0 444943 0 0 0 CARRIE JO TIMMER DO RESIDENCY DIRECTOR 211609 0 50154 0 0 0 13893 0 36587 0 312243 0 0 0 GARY REICHARD MD ASSISTANT RESIDENCY DIRECTOR 220672 0 44578 0 0 0 13239 0 28937 0 307426 0 0 0 JEFF REYNOLDS DMD DENTAL DIRECTOR 184778 0 33442 0 0 0 9013 0 25950 0 253183 0 0 0 GODWIN ASEMOTA PHARMD PHARMACY DIRECTOR 149893 0 20745 0 0 0 8376 0 27481 0 206495 0 0 0 JOHNNY ERKINS MD MEDICAL PROVIDER 256776 0 46286 0 0 0 15251 0 39980 0 358293 0 0 0 SANDRA WERNER MD MEDICAL PROVIDER 245354 0 33362 0 0 0 13658 0 13354 0 305728 0 0 0 JAMES LENHART MD PHD MEDICAL PROVIDER 235701 0 35873 0 0 0 13575 0 25993 0 311142 0 0 0 ELIZABETH FRIESEMA MD PEDIATRICIAN 221675 0 45713 0 0 0 13369 0 606 0 281363 0 0 0 DAVID LAR MD PEDIATRICIAN 240188 0 26745 0 0 0 13701 0 37078 0 317712 0 0 0 PART I, LINE 1A DURING 2018, 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 359553 3285000 2311710 927290 2017 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 X 6 493231 CDC PRICING 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 BYLAWS WERE AMENDED IN MAY 2019 TO MAKE THE FOLLOWING SIGNIFICANT CHANGES: 1. TO CLARIFY THE SITUATIONS IN WHICH A BOARD MEMBER MAY BE REMOVED FOR FAILURE TO SUFFICIENTLY PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE; AND 2. TO CLARIFY WHEN A BOARD MEMBER MAY BE EXCUSED FROM SERVING ON A COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CFO AND BY THE FINANCE COMMITTEE, AND A COPY WAS PROVIDED TO 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 231000 FMV BASED ON LOW-COST FINANCING