2023-04-18T11:49:24-05:00 2022-05-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2021-06-01 911349657 COMMUNITY HEALTH CARE COMM 2535974550 1148 BROADWAY 100 TACOMA WA 98402 DAVID FLENTGE CEO 2537221502 2023-04-12 1 DAVID FLENTGE 999009999 KURT BENNION CPA P01469618 4252506100 2023-04-12 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DAVID FLENTGE 1148 BROADWAY 100 TACOMA WA 98402 88812928 0 X WWW.COMMHEALTH.ORG X 1987 WA TO PROVIDE THE HIGHEST QUALITY HEALTH CARE WITH COMPASSIONATE AND ACCESSIBLE SERVICE FOR ALL. 15 15 709 10 0 0 13552668 11314143 62024092 77437790 1531 16240 79225 -957 75657516 88767216 9356 16122 0 0 45852481 49356531 0 0 89977 23659679 27136907 69521516 76509560 6136000 12257656 68534516 86446193 16343977 21494446 52190539 64951747 X COMMUNITY HEALTH CARE PROVIDES COMPREHENSIVE PRIMARY MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE THROUGH A CLINIC SYSTEM THAT INCLUDES SEVEN MEDICAL CLINICS, FIVE DENTAL CLINICS, AND FIVE PHARMACY LOCATIONS. IN ADDITION, CARE IS ALSO PROVIDED THROUGH A WOMEN'S HEALTH CLINIC. 1 0 36215742 16122 35612728 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 TO 8 RESIDENTS EACH YEAR FOR A TOTAL OF 20 RESIDENTS DURING A 3 YEAR PROGRAM; AND2. A 1-YEAR FAMILY ADVANCED REGISTERED NURSE PRACTIONER RESIDENCY PROGRAM WITH TWO RESIDENTS.DURING THE FISCAL YEAR ENDED 5/31/22, CHC PROVIDED 34,564 PATIENTS WITH MEDICAL CARE FROM 107,814 PATIENT VISITS AT 10 MEDICAL CLINICS. 12520906 0 21687000 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 5/31/22, CHC'S PHARMACIES SERVED 13,907 PATIENTS THROUGH 132,317 MEDICATION FILLS AT 5 CLINICS. 13446877 0 16153353 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 5/31/22, CHC PROVIDED 19,795 PATIENTS WITH DENTAL CARE FROM 53,044 PATIENT VISITS AT 8 DENTAL CLINICS. 3088774 0 3984709 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 5/31/22, CHC PROVIDED 4,324 PATIENTS WITH 18,079 VISITS. 3088774 0 3984709 65272299 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 37 0 709 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X KAREN PARK 2535974550 1148 BROADWAY SUITE 100 TACOMA WA 98402 JEFFREY SMITH MD CMO 40.00 X 499094 0 26571 JOHNNY ERKINS MD MEDICAL PROVIDER 40.00 X 379777 0 57035 DAVID FLENTGE MSW CEO 40.00 X 346943 0 40896 JAMES LENHART MD PHD MEDICAL PROVIDER 40.00 X 333455 0 44781 TONIA CAMPBELL CPA CFO (THROUGH NOV 2021) 40.00 X 296181 0 41465 CARRIE JO TIMMER DO RESIDENCY DIRECTOR 40.00 X 289535 0 47999 PARTHA GONAVARAM MEDICAL PROVIDER (THROUGH DEC 2021) 40.00 X 307786 0 22490 GAYLE MATTHEWS MD OBGYN MEDICAL PROVIDER 40.00 X 310954 0 10440 CONSTANCE CAMPBELL MD MEDICAL PROVIDER 40.00 X 291424 0 11826 JEFF REYNOLDS DMD DENTAL DIRECTOR 40.00 X 249182 0 26738 GODWIN ASEMOTA PHARMACY DIRECTOR 40.00 X 204881 0 54000 GARY REICHARD MD ASSISTANT RESIDENCY DIRECTOR 32.00 X 210731 0 39397 CALLIE GARD COMPLIANCE OFFICER 40.00 X 201389 0 39114 COREY HATFIELD OPERATIONS DIRECTOR 40.00 X 199365 0 27947 KAREN PARK MBA INTERIM CFO & CFO 40.00 X 69113 0 7184 MARCO VINIEGRA CHAIR 2.00 X X 0 0 0 WILL SPEAKER VICE CHAIR 2.00 X X 0 0 0 KATIE PARKER SECRETERY 2.00 X X 0 0 0 GARY WALMER TREASURER & BOARD MEMBER 2.00 X X 0 0 0 KEN REPP BOARD MEMBER & TREASURER 2.00 X X 0 0 0 LINDA BOWMAN BOARD MEMBER 2.00 X 0 0 0 LYNESE CAMMACK BOARD MEMBER 2.00 X 0 0 0 LADEDRIA GRIFFITH STALLWORTH BOARD MEMBER 2.00 X 0 0 0 RIA JOHNSON BOARD MEMBER 2.00 X 0 0 0 BOAZ KEALY BOARD MEMBER 2.00 X 0 0 0 ALMA PRICE BOARD MEMBER 2.00 X 0 0 0 JIM SATT BOARD MEMBER 2.00 X 0 0 0 DAN SLOAN BOARD MEMBER 2.00 X 0 0 0 ANNIE TUSTISON BOARD MEMBER 2.00 X 0 0 0 BARBARA WASHINGTON BOARD MEMBER 2.00 X 0 0 0 4189810 0 497883 85 0 1 0 NEXTGEN HEALTHCARE PO BOX 511449 LOS ANGELES CA 90051 EHR SOFTWARE SERVICES 856651 NUWEST GROUP HOLDINGS LLC 325 118TH AVENUE SE 300 BELLEVUE WA 98005 STAFFING SERVICES 655422 MARROTT DENTAL 4493 RUSSELL ROAD F MUKILTEO WA 98275 DENTAL EQUIPMENT & REPAIRS 606865 ABM JANITORIAL SERVICES PO BOX 419860 BOSTON MA 02241 JANITORIAL 499715 SCRIBE-X NORTHWEST LLC 931 SW KING AVENUE PORTLAND OR 97205 MEDICAL TRANSCRIPTION 209460 14 36250 11004887 273006 404377 11314143 PATIENT FEES 621400 60407393 60407393 PHARMACY REVENUE 621300 17030397 17030397 77437790 17322 17322 39363 0 39363 39363 39363 1082 -1082 -1082 -1082 0 36250 44630 -44630 -44630 MISCELLANEOUS REVENUE 900099 47547 47547 RISK POOL REVENUE 900099 -43237 -43237 4310 88767216 77437790 0 15283 16122 16122 2761808 1599213 1123621 38974 36707407 31715142 4990496 1769 1374131 1140092 233724 315 5764255 4721151 1036743 6361 2748930 2236591 508682 3657 205886 205886 76478 76478 26500 26500 5300578 4119135 1144660 36783 295329 156236 139025 68 1820095 1481722 338363 10 731823 595430 136120 273 494193 289614 204579 454007 237906 215228 873 3034648 2611806 422819 23 226103 160781 64823 499 MEDICAL/DENTAL SUPPLIES 11120688 11063552 56882 254 BAD DEBT EXPENSE 1973366 1973366 MISCELLANEOUS 599027 560755 38272 REPAIRS & MAINTENANCE 511915 394058 117739 118 266271 199627 66644 76509560 65272299 11147284 89977 18832253 32099960 3653397 3653945 649460 711280 7821995 7020910 267298 226869 992224 1187338 75611804 34569465 36317889 41042339 503552 68534516 86446193 7114894 6023850 615668 329765 2603092 9648150 6010323 5492681 16343977 21494446 X 52190539 64951747 52190539 64951747 68534516 86446193 X 12257656 503552 X 0 1 X 1 1 1 X 8192256 8691602 28341845 13552668 11314143 70092514 8192256 8691602 28341845 13552668 11314143 70092514 70092514 243543 249769 207248 4554 56685 761799 54130 118231 7749870 76202 4310 8002743 78857056 307218555 0.88890 0.88150 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE SPECIAL FUNDRAISING EVENT REVENUES GAIN ON NMTC TERMINATION RISK POOL REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 26500 0 0 26500 0 PART II-B, LINE 1: THE ORGANIZATION'S EMPLOYEES, INCLUDING THE CEO AND 2 ARNP RESIDENTS, SPENT APPROXIMATELY 35 HOURS LOBBYING. FOUR OF THE ORGANIZATION'S BOARD MEMBERS SPENT APPROXIMATELY 15 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. 55000 55000 1.00000 0.00000 0.00000 0 0 6014491 6014491 50732774 19749371 30983403 3034537 2019986 1014551 15334364 12800108 2534256 495638 495638 41042339 X 86801395 19600 44630 64230 86737165 2030051 2030051 88767216 74600424 19600 44630 64230 74536194 1973366 1973366 76509560 PART V, LINE 4: DURING THE FISCAL YEAR, THE ORGANIZATION RECEIVED AN ENDOWMENT. THE FUNDS ARE BEING INVESTED WITH THE GOAL OF USING FUTURE EARNINGS TO EXPAND SERVICES TO PATIENTS IN THE FUTURE. 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 44,630. PART XI, LINE 4B - OTHER ADJUSTMENTS: OTHER NONOPERATING INCOME 56,685. BAD DEBT EXPENSE 1,973,366. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 44,630. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,973,366. LUNCH & LAUGHTER 36250 36250 44630 36250 36250 44630 44630 -44630 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 1 0 JEFFREY SMITH MD CMO 456597 0 42497 0 0 0 5025 0 21546 0 525665 0 0 0 JOHNNY ERKINS MD MEDICAL PROVIDER 327854 0 51923 0 0 0 26000 0 31035 0 436812 0 0 0 DAVID FLENTGE MSW CEO 346943 0 0 0 0 0 25000 0 15896 0 387839 0 0 0 JAMES LENHART MD PHD MEDICAL PROVIDER 330255 0 3200 0 0 0 19500 0 25281 0 378236 0 0 0 TONIA CAMPBELL CPA CFO (THROUGH NOV 2021) 265691 0 30490 0 0 0 19036 0 22429 0 337646 0 0 0 CARRIE JO TIMMER DO RESIDENCY DIRECTOR 281218 0 8317 0 0 0 19500 0 28499 0 337534 0 0 0 PARTHA GONAVARAM MEDICAL PROVIDER (THROUGH DEC 2021) 303827 0 3959 0 0 0 0 0 22490 0 330276 0 0 0 GAYLE MATTHEWS MD OBGYN MEDICAL PROVIDER 306954 0 4000 0 0 0 10056 0 384 0 321394 0 0 0 CONSTANCE CAMPBELL MD MEDICAL PROVIDER 287500 0 3924 0 0 0 0 0 11826 0 303250 0 0 0 JEFF REYNOLDS DMD DENTAL DIRECTOR 227606 0 21576 0 0 0 0 0 26738 0 275920 0 0 0 GODWIN ASEMOTA PHARMACY DIRECTOR 174391 0 30490 0 0 0 26000 0 28000 0 258881 0 0 0 GARY REICHARD MD ASSISTANT RESIDENCY DIRECTOR 208164 0 2567 0 0 0 24000 0 15397 0 250128 0 0 0 CALLIE GARD COMPLIANCE OFFICER 171221 0 30168 0 0 0 26000 0 13114 0 240503 0 0 0 COREY HATFIELD OPERATIONS DIRECTOR 182620 0 16745 0 0 0 12616 0 15331 0 227312 0 0 0 PART I, LINE 1A DURING 2021, COMMUNITY HEALTH CARE PAID ROTARY CLUB DUES OF $32 FOR DAVID FLENTGE, THE CEO. THIS AMOUNT WAS NOT INCLUDED IN HIS TAXABLE COMPENSATION. PART I, LINE 6 THE EXECUTIVE MANAGEMENT TEAM, OTHER THAN THE CEO, 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. PART I, LINE 7 IN MAY 2021, THE ORGANIZATION GAVE EMPLOYEES A ONE-TIME PAYMENT AS A THANK-YOU FOR THEIR SERVICES DURING THE COVID PANDEMIC. A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 910882971 2022-02-04 23000000 SEE PART VI 0 0 0 A 10000006 309832 9158004 532169 1 1 0 0 A 0 1 0 0 0.02000 0.00000 0.02000 0 0 1 A 0 1 1 0 0 1 US BANK NA 6.580000000000 0 0 0 0 1 A 1 PART I, COLUMN E AND PART II, LINES 3 AND 12: THE BONDS ARE DRAW-DOWN BONDS AND THE ISSUE PRICE, TOTAL PROCEEDS AND USES OF PROCEEDS ASSUME ALL EXPECTED DRAWS TO BE MADE. PART I, COLUMN F: THE BONDS WERE ISSUED TO FINANCE CONSTRUCTION AND EQUIPPING OF CERTAIN HEALTH CARE FACILITIES, TO REFINANCE A PROMISSORY NOTE WITH U.S. BANK NATIONAL ASSOCIATION DATED OCTOBER 28, 2021, AND TO REFUND THE SERIES 2016 BONDS ISSUED ON AUGUST 19, 2016. PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINE 2B: THE BONDS HAVE A CURRENT REFUNDING PORTION THAT MET THE 6-MONTH EXCEPTION TO THE REBATE REQUIREMENT. PART IV, LINE 4C: THE EXECUTION DATE WAS 2/24/2022 AND THE TERMINATION DATE OF THE SWAP IS 2/1/2029. X 7484 404377 CDC PRICING 0 0 1 0 FORM 990, PART III, LINE 2 DURING THE FISCAL YEAR ENDED MAY 31, 2022, COMMUNITY HEALTH CARE ACQUIRED A PUYALLUP LOCATION AND BEGAN RENOVATIONS IN ANTICIPATION OF OPENING AN INTEGRATED LOCATION IN EARLY 2024. ADDITIONALLY, THE KEY CENTER LOCATION IS BEING RENOVATED TO ADD A PHARMACY. FORM 990, PART VI, SECTION A, LINE 1A 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 B, LINE 11B THE FORM 990 WAS REVIEWED AND APPROVED BY THE CFO, THEN BY THE FINANCE COMMITTEE, THEN 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 THE HUMAN RESOURCES FOR THE MANAGEMENT TEAM AND THE ASSISTANT TO THE CEO FOR THE BOARD. THE COMPLIANCE OFFICER REVIEWS AND SIGNS EACH CONFLICT OF INTEREST FORM. REPORTED OR POTENTIAL CONFLICTS ARE REVIEWED BY THE COMPLIANCE OFFICER AND THE HUMAN RESOURCES DIRECTOR FOR MANAGEMENT TEAM AND CEO FOR THE BOARD. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER OR MANAGEMENT TEAM MEMBER MUST EXCUSE THEMSELVES FROM DISCUSSION OR VOTES THAT INVOLVE THE SUBJECT OF THEIR CONFLICT. 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, 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 2022. 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 2021. 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. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 503,552.