2022-05-12T18:23:56-05:00 2021-06-30 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2020-07-01 911255170 COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY COMM 4257893700 8609 EVERGREEN WAY EVERETT WA 98208 JOSEPH VESSEY CHIEF EXECUTIVE OFFICER 4257893700 2022-05-12 1 JOSEPH VESSEY 999009999 COLLEEN RAMIRES P01251320 4252597227 2022-05-12 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z NA JOSEPH VESSEY 8609 EVERGREEN WAY EVERETT WA 98208 71429241 0 X WWW.CHCSNO.ORG X 1986 WA TO PROVIDE OUR DIVERSE COMMUNITY WITH ACCESS TO HIGH QUALITY, AFFORDABLE PRIMARY HEALTH CARE 12 12 679 0 0 0 10177919 9681740 45495484 49673497 656189 567971 2482295 2817541 58811887 62740749 0 0 0 0 42022051 44758343 0 0 0 15171643 14800223 57193694 59558566 1618193 3182183 83410001 91248127 12865253 17283642 70544748 73964485 X COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY ("CHC") PROVIDES MEDICAL AND DENTAL CARE TO LOW-INCOME/HOMELESS INDIVIDUALS WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES ON A SLIDING FEE BASIS. ALL PATIENTS ARE REQUIRED TO PAY A MINIMUM FEE, AND NO PATIENT IS DENIED SERVICES DUE TO AN INABILITY TO PAY. SINCE MANAGEMENT DOES NOT EXPECT PAYMENT FOR THE DISCOUNTED PORTION OF CARE, THE DISCOUNTED SERVICES ARE EXCLUDED FROM REVENUE. DURING THE YEAR ENDED JUNE 30, 2021, CHC PROVIDED $ 4,071,491 OF CHARITY CARE OF UNDER THIS POLICY. 0 0 31604992 31822686 MEDICAL CARE - TO PROVIDE MEDICAL SERVICES IN PEDIATRICS, ACUTE GENERAL CARE AND OBSTETRICAL CARE TO LOW-INCOME/ HOMELESS PEOPLE AT FIVE DIFFERENT CLINIC LOCATIONS. COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY ALSO OFFERS PRENATAL CARE, BEHAVIORAL HEALTH SERVICES, IMMUNIZATIONS, AND CHRONIC DISEASE MANAGEMENT TO INDIVIDUALS AND FAMILIES FROM A WIDE VARIETY OF ETHNIC AND CULTURAL BACKGROUNDS. COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY EMPLOYS A MULTILINGUAL STAFF, PROVIDES EXTENDED HOURS AND SAME-DAY APPOINTMENTS FOR COMMUNITY RESIDENTS. FEES ARE PAID ON A SLIDING FEE SCALE AND BY THIRD-PARTY INSURANCE, MEDICARE AND MEDICAID. THERE WAS A TOTAL OF 157,674 PATIENT ENCOUNTERS FOR THIS FISCAL YEAR. CHARITY CARE SERVICES FOR THE YEAR TOTALED $2,975,847. IN ADDITION, CHC PROVIDED PRIMARY CARE OUTREACH SERVICES FOR HOMELESS INDIVIDUALS AND FAMILIES AT THREE TRANSITIONAL HOUSING AGENCIES IN SNOHOMISH COUNTY. 14199344 14975381 DENTAL CARE - TO PROVIDE DENTAL SERVICES TO LOW-INCOME/HOMELESS PEOPLE ON A SLIDING FEE BASIS AND BY THIRD-PARTY INSURANCE AND MEDICAID AT FIVE DIFFERENT CLINICS. THERE WAS A TOTAL OF 64,620 PATIENT ENCOUNTERS FOR THIS FISCAL YEAR. CHARITY CARE SERVICES FOR THE YEAR TOTALED $1,095,644. 2875430 5594050 PHARMACY SERVICES - TO PROVIDE PHARMACY SERVICES TO LOW-INCOME PEOPLE ON A SLIDING FEE BASIS AND BY THIRD-PARTY INSURANCE AND MEDICAID AT FIVE DIFFERENT CLINICS. 146,668 TOTAL PRESCRIPTIONS WERE FILLED FOR THIS FISCAL YEAR. BEHAVIORAL HEALTH ENCOUNTERS WERE 10,548 FOR THIS FISCAL YEAR. 48679766 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 38 0 1 679 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JOSEPH VESSEY 4257893700 8609 EVERGREEN WAY EVERETT WA 98208 ED ROGAN CHAIR (THRU 4/21), TREASURER 2.00 X X 0 0 0 OLIVIA MATHISEN-HOLLOMAN RDN CD VICE CHAIR (THRU 4/21), CHAIR 2.00 X X 0 0 0 ANGELICA MONTANARI BOARD MEMBER(THRU 4/21), VICE CHAIR 2.00 X X 0 0 0 COURTNEY MILLER BOARD MEMBER (THRU 4/21), SECRETARY 2.00 X X 0 0 0 BICH-NGA NGUYEN BOARD MEMBER 2.00 X 0 0 0 CHARLES MISTER BOARD MEMBER 2.00 X 0 0 0 JESSICA ENICK BOARD MEMBER 2.00 X 0 0 0 LENORA ROSE BOARD MEMBER 2.00 X 0 0 0 MIKE SHAW BOARD MEMBER 2.00 X 0 0 0 ROBERT MAX MAXWELL BOARD MEMBER 2.00 X 0 0 0 ROBIN FENN BOARD MEMBER 2.00 X 0 0 0 TRACY CUAJAO BOARD MEMBER 2.00 X 0 0 0 SAM HOLTZMAN BOARD MEMBER (DEPARTED 8.20) 2.00 X 0 0 0 THOMAS M TOCHER CHIEF CLINICAL OFFICER 45.00 X 344003 0 22167 JOSEPH E VESSEY CHIEF EXECUTIVE OFFICER 45.00 X 265148 0 21452 DION C KAPETANOV CHIEF ADMINISTRATIVE OFFICER 45.00 X 231508 0 19951 SUE M YOON CHIEF DENTAL OFFICER 45.00 X 225082 0 19912 TOVE R DOYLE - SKAFTUN CHIEF NURSING OFFICER 45.00 X 204460 0 18801 ADAM HEATH CHIEF OPERATING OFFICER 45.00 X 80402 0 6788 BENJAMIN LUETY CHIEF FINANCIAL OFFICER 45.00 X 44434 0 1830 SCOTT R MCAFEE CLINICAL DIRECTOR MEDICAL 45.00 X 266230 0 19219 CARMEN S OPREA PHYSICIAN WITH OB 45.00 X 251403 0 20717 DAVID GORDON PHYSICIAN 45.00 X 242740 0 18755 SUZANNE H POWELL PHYSICIAN WITH OB 45.00 X 237561 0 20525 ANDREW K PERRY PHYSICIAN 45.00 X 227650 0 20215 2620621 0 210332 108 0 1 0 JR ABBOTT CONSTRUCTION INC 3408 1ST AVE SOUTH SUITE 101 SEATTLE WA 981248448 CONSTRUCTION OF FACILITIES 5058718 LANGUAGE LINE SERVICES PO BOX 202564 DALLAS TX 753202572 TRANSLATION SERVICES 335176 TECHHEAD INC 7070 FIR LOOP PORTLAND OR 97223 CONSTRUCTION OF FACILITIES 314276 COMPHEALTH INC PO BOX 972670 DALLAS TX 753972670 TEMP HEALTHCARE STAFFING 255625 COMMUNITY CLINIC CONTRACTING NETWORK LL 18 S MISSION ST STE 300 WENATCHEE WA 98801 CONSULTING SERVICES 217696 26 224 9304339 377177 1577066 9681740 MEDICARE/MEDICAID 621400 22065093 22065093 CAPITATED REVENUE 621110 20372825 20372825 PATIENT FEES 621110 7036337 7036337 RESEARCH & CLINICAL STUDIES INCOM 621110 199242 199242 49673497 425304 425304 5955729 5715116 97946 240613 -97946 142667 142667 5594050 2875430 2718620 2718620 PATIENT RECORD 561000 55979 55979 MISCELLANEOUS INCOME 561000 42942 42942 98921 62740749 52392117 0 666892 1781830 178183 1603647 35376030 30805777 4570253 1025546 872323 153223 3876884 3270393 606491 2698053 2228230 469823 67417 67417 127139 127139 69271 69271 2520685 1038006 1482679 7967 7967 742715 593643 149072 714510 458858 255652 1173675 997071 176604 32266 16110 16156 242215 182565 59650 187748 187748 3157092 2712085 445007 169702 111979 57723 CLINICAL SUPPLIES 3590100 3590100 MINOR EQUIPMENT 482816 452208 30608 BAD DEBT 436690 436690 EQUIP. RENTAL & MAINT. 396093 371808 24285 682122 363737 318385 59558566 48679766 10878800 0 9895227 14223301 2385171 3184718 657722 470222 2533636 4109265 821400 1119141 362700 441194 76521944 29453956 46232340 47067988 20521805 20632298 83410001 91248127 7641814 9867858 1390675 31159 3832764 7384625 12865253 17283642 X 70544748 73964485 70544748 73964485 83410001 91248127 3182183 237554 0 X 0 1 X 1 1 1 X 6130235 6025147 6911782 10177919 9681740 38926823 45564578 45732883 54485411 51580144 55267547 252630563 24554 47812 26195 37692 55979 192232 51719367 51805842 61423388 61795755 65005266 291749618 0 0 0 291749618 421776 413617 441192 501549 425304 2203438 421776 413617 441192 501549 425304 2203438 5493 43097 58761 51241 42942 201534 52146636 52262556 61923341 62348545 65473512 294154590 0.99180 0.99120 0.00750 0.00810 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 100456 6436883 6537339 57350757 19916958 37433799 23453 23453 10677632 9534132 1143500 1932763 2866 1929897 47067988 X 65365767 237554 2893425 3130979 62234788 69271 436690 505961 62740749 61946030 2893425 2893425 59052605 69271 436690 505961 59558566 PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT CHC IS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN AND RECOGNIZE A TAX LIABILITY IF CHC HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE U.S. GOVERNMENT. CHC HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF JUNE 30, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RECLASS COST OF GOODS SOLD 2,893,425. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASS BAD DEBT 436,690. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASS COST OF GOODS SOLD 2,893,425. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS BAD DEBT 436,690. X X X X 0 0 0 0 0 0 0 0 0 THOMAS M TOCHER CHIEF CLINICAL OFFICER 331725 0 12278 0 0 0 11400 0 10767 0 366170 0 0 0 JOSEPH E VESSEY CHIEF EXECUTIVE OFFICER 265148 0 0 0 0 0 10722 0 10730 0 286600 0 0 0 DION C KAPETANOV CHIEF ADMINISTRATIVE OFFICER 231508 0 0 0 0 0 9264 0 10687 0 251459 0 0 0 SUE M YOON CHIEF DENTAL OFFICER 220987 0 4095 0 0 0 9191 0 10721 0 244994 0 0 0 TOVE R DOYLE - SKAFTUN CHIEF NURSING OFFICER 204460 0 0 0 0 0 8155 0 10646 0 223261 0 0 0 SCOTT R MCAFEE CLINICAL DIRECTOR MEDICAL 262593 0 3637 0 0 0 10596 0 8623 0 285449 0 0 0 CARMEN S OPREA PHYSICIAN WITH OB 240609 0 10794 0 0 0 10036 0 10681 0 272120 0 0 0 DAVID GORDON PHYSICIAN 234932 0 7808 0 0 0 9688 0 9067 0 261495 0 0 0 SUZANNE H POWELL PHYSICIAN WITH OB 222318 0 15243 0 0 0 9831 0 10694 0 258086 0 0 0 ANDREW K PERRY PHYSICIAN 223208 0 4442 0 0 0 9558 0 10657 0 247865 0 0 0 A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 2020-09-16 7960000 BUILDING CONSTRUCTION AND REFUND OF 2013 BOND 0 0 0 A 512124 7960000 65857 4032368 3861775 2020 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 A 1 X 29681 1577066 COST 0 1 0 PART I, COLUMN (B): THE NUMBER IN COLUMN (B) IS BASED ON THE NUMBER OF ITEMS RECEIVED. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEWS AND APPROVES CHC'S FORM 990 AND SCHEDULE B PRIOR TO ITS FILING WITH THE IRS. THE APPROVAL PROCESS IS AS FOLLOWS: THE BOARD OF DIRECTORS RECEIVE A COPY OF FORM 990 AND SCHEDULE B TO MAKE A MOTION AND VOTE TO APPROVE THE FORM 990. UPON THE BOARD OF DIRECTORS' APPROVAL, THE FORM 990 AND SCHEDULE B IS ELECTRONICALLY FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CHC OF SNOHOMISH COUNTY EMPLOYEE HANDBOOK CONTAINS THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. EACH EMPLOYEE AND BOARD MEMBER IS REQUIRED TO SIGN OFF AS HAVING READ THE HANDBOOK AND HAVING UNDERSTOOD THIS CONFLICT OF INTEREST POLICY. PER THIS POLICY, ALL EMPLOYEES AND BOARD MEMBERS ARE REQUIRED TO AVOID AND REPORT SITUATIONS THAT COULD CREATE OR RESULT IN A REAL OR PERCEIVED CONFLICT OF INTEREST BY DISCLOSING THE RELATIONSHIP, ACTIVITY OR ASSOCIATION TO THEIR MANAGER OR HUMAN RESOURCES. BOARD MEMBERS WHO BELIEVE THAT A CONFLICT OF INTEREST EXISTS NEED TO INFORM THE CHAIR OF THE BOARD, WHO WOULD WORK WITH THE CEO TO INQUIRE INTO THE FACTS AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. WHERE A CONFLICT OF INTEREST OCCURS, THE INDIVIDUAL IS RECUSED FROM ANY DECISION MAKING PROCESS OR MEETINGS RELATED TO THAT SITUATION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE CHIEF EXECUTIVE OFFICER'S COMPENSATION AND PERFORMS A PERFORMANCE EVALUATION TO SET COMPENSATION. THE HUMAN RESOURCES MANAGER MAY ASSIST AS NECESSARY. ALL OTHER OFFICERS' COMPENSATION IS SET BY HUMAN RESOURCES. THE SALARY RANGE IS BASED ON COMMUNITY COMPENSATION DATA AND YEARS OF PROFESSIONAL EXPERIENCE AND QUALIFICATIONS. ANNUAL REVIEWS OF COMPENSATION WERE LAST PERFORMED IN MARCH 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST ONLY.