2024-11-07T14:20:16-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2023-01-01 911230237 SAMARITAN HEALTHCARE FOUNDATION SAMA 5097939647 801 EAST WHEELER ROAD MOSES LAKE WA 98837 PJ DEBENEDETTI PRESIDENT 5097939647 2024-11-06 1 1 KURT BENNION CPA P01469618 4252506100 2024-10-31 2023 2024-10-15 13:58:12Z SAMARITAN FOUNDATION GRETCHEN YOUNGREN 801 EAST WHEELER ROAD MOSES LAKE WA 98837 257696 0 X WWW.SAMARITANHEALTHCARE.COM/FOUNDATION X 1984 WA TO ENSURE THE CONTINUED AVAILABILITY OF QUALITY HEALTH CARE THROUGH SAMARITAN HEALTHCARE. 10 7 0 75 0 0 309540 185933 0 0 20531 25858 -2571 16758 327500 228549 15500 57398 0 0 0 0 0 0 5221 5108 15591 20608 72989 306892 155560 1944811 2276868 0 0 1944811 2276868 THE SOLE MISSION OF THE FOUNDATION AS A NON-PROFIT FUNDRAISING ORGANIZATION IS TO ENSURE THE CONTINUED AVAILABILITY OF QUALITY HEALTH CARE SERVICES AND PROGRAMS THROUGH PUBLIC HOSPITAL DISTRICT NO. 1, GRANT COUNTY, WASHINGTON (DBA: SAMARITAN HEALTHCARE). 0 0 29398 29398 0 PROGRAM AND PROJECT GRANTS TO PUBLIC HOSPITAL DISTRICT NO. 1, GRANT COUNTY, WASHINGTON (DBA: SAMARITAN HEALTHCARE): SUPPORT IN 2023 WAS FOR THE #BUILDCOMMUNITY CAMPAIGN FOR A NEW MEDICAL CAMPUS, AS WELL AS SUPPORT FOR THE HOSPITAL'S PATIENT PRESCRIPTION ASSISTANCE PROGRAM AND TAXI CAB VOUCHER PROGRAM. DISTRIBUTION OF #BUILDCOMMUNITY FUNDS TO SAMARITAN HEALTHCARE IS PROJECTED TO OCCUR THROUGHOUT THE YEARS 2024-2027. 28000 28000 0 SCHOLARSHIPS TO EMPLOYEES OF SAMARITAN HEALTHCARE:SCHOLARSHIP AWARDS ARE PROVIDED TO EMPLOYEES CHOOSING TO FURTHER THEIR WORK-RELATED EDUCATION THROUGH COLLEGE LEVEL COURSEWORK. SCHOLARSHIP AWARDS ARE FORWARDED TO THE INSTITUTE OF HIGHER LEARNING, OR TO THE EMPLOYEE ON A REIMBURSEMENT BASIS. 57398 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 7 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X GRETCHEN YOUNGREN 5097939647 801 E WHEELER ROAD MOSES LAKE WA 98837 THERESA SULLIVAN DIRECTOR 0.50 54.00 X 0 394307 87745 GRETCHEN YOUNGREN EXECUTIVE DIRECTOR 20.00 30.00 X 0 146751 72137 NICOLE JACKSON DIRECTOR 0.50 39.50 X 0 44960 17114 RYAN CARPENTER DIRECTOR 0.50 39.00 X 0 32144 0 DALE PARIS DIRECTOR 0.50 1.00 X 0 9766 0 SUSAN CARBON DIRECTOR 0.50 1.00 X 0 8654 0 PJ DEBENEDETTI PRESIDENT 1.00 0.00 X X 0 0 0 CHERA ANDERSON SECRETARY 1.00 0.00 X X 0 0 0 JEROME BROTHERTON DIRECTOR 0.50 0.00 X 0 0 0 WALLY FARRIS DIRECTOR 0.50 0.00 X 0 0 0 JIM SPERRY DIRECTOR 0.50 0.00 X 0 0 0 AMANDA WALKER DIRECTOR (THROUGH JANUARY 2023) 0.50 0.00 X 0 0 0 0 636582 176996 0 0 1 0 0 29350 156583 500 185933 25858 25858 3925 0 3925 3925 3925 11100 29350 14359 -3259 -3259 29664 14788 14876 14876 MISCELLANEOUS INCOME 900099 1216 1216 1216 228549 0 0 42616 29398 29398 28000 28000 1945 1945 EVENT EXPENSES 5221 5221 MISCELLANEOUS 4939 4939 TAXES 3486 3486 72989 57398 10370 5221 790299 688790 1154512 1588078 1944811 2276868 0 0 X 997360 921893 947451 1354975 1944811 2276868 1944811 2276868 155560 176497 0 X 0 0 0 X 222264 195337 333402 309540 185933 1246476 3000 3000 3000 3000 3000 15000 225264 198337 336402 312540 188933 1261476 329629 931847 15177 8361 12479 25981 29783 91781 25100 9221 12801 74320 12316 133758 1487015 136326 0.62670 0.60690 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: FUNDRAISING EVENT REVENUES OTHER INCOME CHARITABLE GAMING REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1138990 183563 1322553 1389080 765 -250855 1138990 419822 857156 115815 3713 1389080 370292 74840 25310 419822 322013 48279 370292 0.66700 0.33300 0.00000 1 0 0 PART V, LINE 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO HELP ACHIEVE THE ORGANIZATION'S MISSION. GOLF TOURNAMENT 40450 29350 11100 1248 3192 6030 3699 190 40450 29350 11100 1248 3192 6030 3699 190 14359 -3259 1 FRIENDS OF HEALTHCARE PO BOX 2292 MOSES LAKE WA 98837 922310289 527 29398 0 SUPPORT ADVOCACY FOR A BOND BALLOT MEASURE 0 1 EMPLOYEE SCHOLARSHIPS 12 27000 EMPLOYEE CRISIS FUND 2 1000 PART I, LINE 2: GRANTS TO OTHER ORGANIZATIONS WERE APPROVED FROM UNRESTRICTED ASSETS. GRANTS FROM UNRESTRICTED ASSETS ARE USED FOR SPECIFIC PROGRAM NEEDS. WE TRACK TO ASSURE THESE PROGRAMS NEEDS ARE ACTUALLY CARRIED OUT WITH THE FUNDS PROVIDED FOR THE SPECIFIC PURPOSE. FUNDS FOR SCHOLARSHIPS ARE EITHER PROVIDED DIRECTLY TO THE SCHOOL OR ARE PROVIDED TO THE INDIVIDUAL AS A REIMBURSEMENT AFTER THEY HAVE SUBMITTED ADEQUATE DOCUMENTATION, SUCH AS A RECEIPT FOR A QUALIFIED EXPENSE. 0 0 0 1 0 0 0 0 0 THERESA SULLIVAN DIRECTOR 0 354204 0 40103 0 0 0 58245 0 29500 0 482052 0 0 GRETCHEN YOUNGREN EXECUTIVE DIRECTOR 0 146751 0 0 0 0 0 36084 0 36053 0 218888 0 0 PART I, LINE 3 THE FOLLOWING WERE USED BY PUBLIC HOSPITAL DISTRICT NO. 1, GRANT COUNTY, WASHINGTON (DBA: SAMARITAN HEALTHCARE) TO DETERMINE THE EXECUTIVE DIRECTOR'S COMPENSATION: 1. WRITTEN EMPLOYMENT CONTRACT 2. COMPENSATION SURVEY OR STUDY PART I, LINE 5 PUBLIC HOSPITAL DISTRICT NO. 1, GRANT COUNT, WASHINGTON (DBA: SAMARITAN HEALTHCARE) HAS AN INCENTIVE COMPENSATION PLAN THAT APPLIES TO ALL FULL-TIME EMPLOYEES. IN 2023, BONUS COMPENSATION WAS BASED ON THE ORGANIZATION'S BALANCED SCORECARD PERFORMANCE WHICH INCLUDED METRICS FOCUSED ON QUALITY, PATIENT EXPERIENCE, FINANCIAL PERFORMANCE, AND COMMUNITY ENGAGEMENT INCLUDING FOUNDATION TOTAL GIVING. IN 2023, 5% OF THE POSSIBLE INCENTIVE COMPENSATION WAS BASED ON THE FOUNDATION'S FINANCIAL PERFORMANCE. FORM 990, PART VI, SECTION A, LINE 1A THE BOARD OF DIRECTORS MAY APPOINT AN EXECUTIVE COMMITTEE CONSISTING OF AT LEAST THREE DIRECTORS, INCLUDING THE BOARD PRESIDENT. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE FOUNDATION DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF DIRECTORS. ALL MATTERS OF MAJOR IMPORTANCE AND POLICIES OF SIGNIFICANCE ARE REFERRED PROMPTLY TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 3 ALL MANAGEMENT SERVICES ARE PROVIDED BY PUBLIC HOSPITAL DISTRICT NO. 1, GRANT COUNTY, WASHINGTON (DBA: SAMARITAN HEALTHCARE). FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF COMMISSIONERS OF SAMARITAN HEALTHCARE APPOINTS A MAJORITY OF THE BOARD MEMBERS OF SAMARITAN HEALTHCARE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE EXECUTIVE DIRECTOR, THEN BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS, THEN BY THE FULL BOARD OF DIRECTORS PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS, COMMITTEE MEMBERS WITH BOARD-DESIGNATED POWERS, AND OFFICERS. IF AN INDIVIDUAL HAS AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THEY ARE REQUIRED TO DISCLOSE IT TO THE BOARD OR COMMITTEE, ALONG WITH ANY MATERIAL FACTS. AFTER THIS DISCLOSURE, THE INDIVIDUAL LEAVES THE ROOM WHILE THE REMAINING BOARD OR COMMITTEE MEMBERS VOTE ON WHETHER A CONFLICT EXISTS. IF A CONFLICT EXISTS, THE INDIVIDUAL LEAVES THE ROOM FOR ALL DISCUSSIONS OF THE TRANSACTION AND FOR ANY VOTES ON THE MATTER. THE REMAINING BOARD OR COMMITTEE MEMBERS EXERCISE DUE DILIGENCE TO DETERMINE WHETHER A MORE FAVORABLE TRANSACTION IS AVAILABLE WITHOUT A CONFLICT OF INTEREST. IF A MORE FAVORABLE TRANSACTION IS NOT FOUND, THE REMAINING BOARD OR COMMITTEE MEMBERS VOTE ON WHETHER TO ENTER THE TRANSACTION CAUSING THE CONFLICT. IF THE BOARD OR A COMMITTEE BELIEVES A PERSON HAS FAILED TO DISCLOSE A CONFLICT, THE INDIVIDUAL IS GIVEN THE OPPORTUNITY TO EXPLAIN THE SITUATION. THE BOARD OR COMMITTE THEN DETERMINES WHETHER A FAILURE TO DISCLOSE HAS OCCURRED. IF A FAILURE HAS OCCURRED, THE BOARD OR COMMITTEE TAKE APPROPRIATE DISCPLINARY AND CORRECTIVE STEPS. ALL BOARD MEMBERS ARE REQUIRED TO SIGN AND RETURN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. ALL BOARD MEMBERS ARE ASKED TO REVIEW AND DISCLOSE POTENTIAL CONFLICTS AT THE BEGINNING OF ALL BOARD MEETINGS UPON REVIEW OF THE AGENDA. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR IS PAID BY SAMARITAN HEALTHCARE. THE EXECUTIVE DIRECTOR'S COMPENSATION IS BASED ON MARKET CONDITIONS AND SURVEYS BY HUMAN RESOURCES AND IS REVIEWED BY THE HOSPITAL'S CEO AND CHRO. THIS PROCESS WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 SAMARITAN HEALTHCARE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. PUBLIC HOSPITAL DISTRICT NO 1 801 E WHEELER ROAD MOSES LAKE WA 98837 916001698 HOSPITAL WA 115 N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0