2023-05-11T15:22:23-05:00 2022-06-30 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2021-07-01 911255170 COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY COMM 4257893700 8609 EVERGREEN WAY EVERETT WA 98208 JOSEPH VESSEY CHIEF EXECUTIVE OFFICER 4257893700 2023-05-10 1 JOSEPH VESSEY 999009999 COLLEEN RAMIRES P01251320 4252597227 2023-05-10 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z NA JOSEPH VESSEY 8609 EVERGREEN WAY EVERETT WA 98208 77090470 0 X WWW.CHCSNO.ORG X 1986 WA TO PROVIDE OUR DIVERSE COMMUNITY WITH ACCESS TO HIGH QUALITY, AFFORDABLE PRIMARY HEALTH CARE 12 12 628 12 0 0 9681740 13663039 49673497 54899226 567971 678380 2817541 3195014 62740749 72435659 0 0 0 0 44758343 48866497 0 0 0 14800223 20472427 59558566 69338924 3182183 3096735 91248127 92563819 17283642 17496778 73964485 75067041 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, 2022, CHC PROVIDED $4,590,736 OF CHARITY CARE OF UNDER THIS POLICY. 0 0 32974567 35612435 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 102,915 PATIENT ENCOUNTERS FOR THIS FISCAL YEAR. BEHAVIORAL HEALTH ENCOUNTERS WERE 8,055 FOR THIS FISCAL YEAR. CHARITY CARE SERVICES FOR THE YEAR TOTALED $3,355,362 . IN ADDITION, CHC PROVIDED PRIMARY CARE OUTREACH SERVICES FOR HOMELESS INDIVIDUALS AND FAMILIES AT THREE TRANSITIONAL HOUSING AGENCIES IN SNOHOMISH COUNTY. 14814661 16758793 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 43,414 PATIENT ENCOUNTERS FOR THIS FISCAL YEAR. CHARITY CARE SERVICES FOR THE YEAR TOTALED $1,235,374. 2527998 5480493 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. 146,092 TOTAL PRESCRIPTIONS WERE FILLED FOR THIS FISCAL YEAR. 50317226 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 45 0 1 628 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 THOMAS M TOCHER CHIEF CLINICAL OFFICER 45.00 X 339257 0 20448 JOSEPH E VESSEY CHIEF EXECUTIVE OFFICER 45.00 X 287859 0 20497 SCOTT R MCAFEE CLINICAL DIRECTOR MEDICAL 45.00 X 265801 0 15900 SUZANNE H POWELL PHYSICIAN WITH OB 45.00 X 242796 0 18432 DAVID GORDON PHYSICIAN 45.00 X 235830 0 19721 DION C KAPETANOV CHIEF ADMINISTRATIVE OFFICER 45.00 X 235813 0 17796 AMY RODRIGUEZ CLINICAL DIRECTOR 45.00 X 233791 0 17359 DOUGLAS MCMILLEN CMO 45.00 X 228542 0 21003 SUE M YOON CHIEF DENTAL OFFICER 45.00 X 230517 0 15723 STEVEN GRANT PHYSICIAN 45.00 X 227854 0 18363 TOVE R DOYLE-SKAFTUN CHIEF NURSING OFFICER 45.00 X 209426 0 19649 ADAM HEATH CHIEF OPERATING OFFICER 45.00 X 189461 0 19340 BENJAMIN LUETY CHIEF FINANCIAL OFFICER 45.00 X 189958 0 16070 OLIVIA MATHISEN-HOLLOMAN RDN CD CHAIR 2.00 X X 0 0 0 ANGELICA MONTANARI VICE-CHAIR 2.00 X X 0 0 0 ED ROGAN TREASURER 2.00 X X 0 0 0 COURTNEY MILLER 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 (THRU 6/22) 2.00 X 0 0 0 ROBERT MAX MAXWELL BOARD MEMBER 2.00 X 0 0 0 ROBIN FENN BOARD MEMBER (THRU 6/22) 2.00 X 0 0 0 TRACY CUAJAO BOARD MEMBER (THRU 6/22) 2.00 X 0 0 0 3116905 0 240301 101 0 1 0 JEAN-PAUL CREUSAT 850 PIMLICON PLACE SUWANEE GA 30034 CONSULTANT SERVICES 291960 COMMUNITY CLINIC CONTRACTING NETWORK LL 18 S MISSION ST STE 300 WENATCHEE WA 98801 CONSULTING SERVICES 213838 JKR LLC PO BOX 957 RENTON WA 98057 LAUNDRY SERVICES 131009 MOSS ADAMS LLP PO BOX 101822 PASADENA CA 91189 ACCOUNTING SERVICES 121224 THREE THRITY-SIX CONSULTING 3193 HEATHCHASE LAN SUWANEE GA 30034 CONSULTANT SERVICES 112904 6 188 13633026 29825 1569978 13663039 CAPITATED REVENUE 621110 24200021 24200021 MEDICARE/MEDICAID 621400 22670452 22670452 PATIENT FEES 621110 7899839 7899839 RESEARCH & CLINICAL STUDIES INCOM 621110 128914 128914 54899226 470890 470890 2334303 2126813 207490 207490 207490 5480493 2527998 2952495 2952495 MISCELLANEOUS INCOME 561000 176845 176845 PATIENT RECORD 561000 65674 65674 242519 72435659 57851721 0 920899 2005464 51172 1954292 38168596 32005073 6163523 1243398 994899 248499 4523382 3586953 936429 2925657 2292436 633221 132014 132014 117359 117359 71350 71350 4072020 1186706 2885314 5896 327 5569 794310 447497 346813 2990830 75541 2915289 1357586 1094661 262925 258116 179379 78737 190587 190587 3939950 2760746 1179204 210832 133764 77068 PATIENT SUPPLIES 3306989 3306989 0 BAD DEBT 1065931 1065931 EMPLOYEE SUPPLIES 691127 192122 499005 MINOR EQUIPMENT 445688 389525 56163 821842 553505 268337 69338924 50317226 19021698 0 14223301 14156614 3184718 2357682 470222 380665 4109265 5443291 1119141 1220598 441194 674111 81583392 33394878 47067988 48188514 20632298 20142344 91248127 92563819 9867858 10723241 31159 105744 7384625 6667793 17283642 17496778 X 73964485 75067041 73964485 75067041 91248127 92563819 3096735 -1994179 0 X 0 1 X 1 1 1 X 6025147 6911782 10177919 9681740 13663039 46459627 45732883 54485411 51580144 55267547 60379719 267445704 47812 26195 37692 55979 65674 233352 51805842 61423388 61795755 65005266 74108432 314138683 0 0 0 314138683 413617 441192 501549 425304 470890 2252552 413617 441192 501549 425304 470890 2252552 43097 58761 51241 42942 176845 372886 52262556 61923341 62348545 65473512 74756167 316764121 0.99170 0.99180 0.00710 0.00750 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 100456 6436883 6537339 57675119 22504107 35171012 29948 974 28974 14786266 10885367 3900899 2554720 4430 2550290 48188514 X 71832197 -1994179 2527998 533819 71298378 71350 1065931 1137281 72435659 70729641 2527998 2527998 68201643 71350 1065931 1137281 69338924 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, 2022 AND 2021, 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 2,527,998. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASS BAD DEBT 1,065,931. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASS COST OF GOODS SOLD 2,527,998. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS BAD DEBT 1,065,931. X X X X 0 0 0 0 0 0 0 0 0 THOMAS M TOCHER CHIEF CLINICAL OFFICER 322271 0 16986 0 0 0 9839 0 10609 0 359705 0 0 0 JOSEPH E VESSEY CHIEF EXECUTIVE OFFICER 283109 0 4750 0 0 0 9914 0 10583 0 308356 0 0 0 SCOTT R MCAFEE CLINICAL DIRECTOR MEDICAL 248501 0 17300 0 0 0 7445 0 8455 0 281701 0 0 0 SUZANNE H POWELL PHYSICIAN WITH OB 223567 0 19229 0 0 0 7872 0 10560 0 261228 0 0 0 DAVID GORDON PHYSICIAN 229463 0 6367 0 0 0 10163 0 9558 0 255551 0 0 0 DION C KAPETANOV CHIEF ADMINISTRATIVE OFFICER 231063 0 4750 0 0 0 7240 0 10556 0 253609 0 0 0 AMY RODRIGUEZ CLINICAL DIRECTOR 218791 0 15000 0 0 0 6811 0 10548 0 251150 0 0 0 DOUGLAS MCMILLEN CMO 224520 0 4022 0 0 0 10441 0 10562 0 249545 0 0 0 SUE M YOON CHIEF DENTAL OFFICER 225767 0 4750 0 0 0 7918 0 7805 0 246240 0 0 0 STEVEN GRANT PHYSICIAN 222649 0 5205 0 0 0 8843 0 9520 0 246217 0 0 0 TOVE R DOYLE-SKAFTUN CHIEF NURSING OFFICER 204676 0 4750 0 0 0 9120 0 10529 0 229075 0 0 0 ADAM HEATH CHIEF OPERATING OFFICER 186586 0 2875 0 0 0 8812 0 10528 0 208801 0 0 0 BENJAMIN LUETY CHIEF FINANCIAL OFFICER 187083 0 2875 0 0 0 5578 0 10492 0 206028 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 1230876 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 29391 1569978 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 JULY 2022. 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.