2024-04-18T12:59:52-05:00 2023-06-30 930623286 ALDRICH CPAS AND ADVISORS LLP 1903 WRIGHT PLACE 180 CARLSBAD CA 92008 990 2022-07-01 911538852 PEACEHEALTH ST JOHN MEDICAL CENTER FOUNDATION PEAC 3604316789 1615 DELAWARE LONGVIEW WA 98632 JOEL HANSON PRESIDENT 3604316789 2024-03-15 1 JOEL HANSON 999009999 0 DEBRA D SMITH CPA P00646873 7604318440 2024-03-15 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JOEL HANSON 1615 DELAWARE LONGVIEW WA 98632 2832691 0 X WWW.PEACEHEALTH.ORG/FOUNDATION/ST-JOHN/ X 1986 WA SUPPORT OF PEACEHEALTH ST. JOHN MEDICAL CENTER BY BUILDING SOCIAL AND FINANCIAL RESOURCES. 22 20 0 0 0 0 933089 2154360 0 0 91730 76660 40977 23166 1065796 2254186 607933 1595750 0 0 0 0 0 0 119782 35062 147589 642995 1743339 422801 510847 5233562 6168603 111319 74037 5122243 6094566 THE MISSION OF THE FOUNDATION IS TO SUPPORT PEACEHEALTH ST. JOHN MEDICAL CENTER, LOCATED IN LONGVIEW, WASHINGTON, BY SOLICITING, RECEIVING, MANAGING, ADMINISTERING AND DISTRIBUTING FUNDS OR OTHER GIFTS TO OR FOR THE BENEFIT OF PEACEHEALTH ST. JOHN MEDICAL CENTER. 0 0 1595750 1595750 TRANSFERS TO PEACEHEALTH ST. JOHN MEDICAL CENTER TO SUPPORT THEIR PROGRAM SERVICES. 1595750 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 22 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 WA X SACRED HEART MEDICAL CENTER FOUNDATION 5412227112 123 INTERNATIONAL WAY SPRINGFIELD OR 97477 CHERELLE MONTANYE DIRECTOR, CAO ST. JOHN MED. CENTER 1.00 40.00 X 0 391957 67578 CAL LANTZ VICE PRESIDENT 1.00 X X 0 0 0 PJ PETERSON SECRETARY 1.00 X X 0 0 0 JOEL HANSON PRESIDENT 1.00 X X 0 0 0 JACKIE K EVANS DIRECTOR 1.00 X 0 0 0 JORDAN BURNS DIRECTOR 1.00 X 0 0 0 FRANCENA DODD DIRECTOR 1.00 X 0 0 0 SANDY JUNKER DIRECTOR 1.00 X 0 0 0 DON CIANCI DIRECTOR 1.00 X 0 0 0 CINDY FAUBION DIRECTOR 1.00 X 0 0 0 JEANE CONRAD DIRECTOR 1.00 X 0 0 0 ELIZABETH A LAUFER DIRECTOR 1.00 X 0 0 0 GERALDINE L BOOTH DIRECTOR 1.00 X 0 0 0 ANNE HAYES DIRECTOR 1.00 X 0 0 0 ANN WRIGHT DIRECTOR 1.00 X 0 0 0 WILLIAM C BOEHM DIRECTOR 1.00 X 0 0 0 KEN CRAVEN DIRECTOR 1.00 X 0 0 0 DAVID MINTHORN DIRECTOR 1.00 X 0 0 0 BYRON W HANSON DIRECTOR 1.00 X 0 0 0 MICHAEL I MCNELLIS MD DIRECTOR 1.00 40.00 X 0 464948 61238 JONATHAN P RODMAN DIRECTOR 1.00 X 0 0 0 ARLEEN HUBBLE DIRECTOR 1.00 X 0 0 0 AMY LEGGIO - START 042023 EXECUTIVE DIRECTOR 40.00 X 0 0 0 0 856905 128816 0 0 1 0 0 206068 1948292 40650 2154360 87323 87323 450000 460663 -10663 -10663 -10663 124632 206068 117842 6790 6790 16376 0 16376 16376 2254186 0 0 99826 1595750 1595750 5094 5094 9875 9875 FUNDRAISING EXPENSE 119782 0 0 119782 OTHER EXPENSES 12838 0 12838 0 1743339 1595750 27807 119782 338896 220952 2654719 2170900 296306 214159 1487580 3125687 456061 436905 5233562 6168603 0 90 40325 45498 70994 28449 111319 74037 X 1285535 1558525 3836708 4536041 5122243 6094566 5233562 6168603 X 510847 272838 188638 X 0 1 X 1 0 X 840709 795424 835025 933089 2154360 5558607 840709 795424 835025 933089 2154360 5558607 1408030 4150577 115186 95911 77200 75362 87323 450982 44641 35374 40977 23166 144158 6153747 0.67450 0.81080 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1725352 25225 145105 100072 1795610 1965271 21003 -198996 61926 1725352 1616639 66946 302553 20867 1965271 1594641 2302 25607 5911 1616639 1521419 88944 51130 66852 1594641 0.13000 0.87000 0 0 0 CASH VALUE OF LIFE INSURANCE 238738 CONTRIBUTION RECEIVABLE FROM REMAINDER TRUST 47775 BENEFICIAL INTEREST IN ASSETS HELD BY PEACEHEALTH 150392 436905 OBLIGATIONS ON ASSETS HELD BY PEACEHEALTH 28449 28449 X 3493407 272838 782839 188638 1244315 2249092 5094 5094 2254186 2521084 782839 782839 1738245 5094 5094 1743339 PART V, LINE 4: THE ENDOWMENT FUNDS ARE FOR PROGRAM ACTIVITIES. PART X, LINE 2: FOR THE YEARS ENDED JUNE 30, 2023 AND 2022, MANAGEMENT OF THE FOUNDATION BELIEVES THERE HAS BEEN NO ACTIVITY THAT WOULD JEOPARDIZE THE TAX POSITION, BEING A TAX EXEMPT ORGANIZATION, AND THAT IT IS MORE LIKELY THAN NOT, BASED ON THE TECHNICAL MERITS, THAT THIS POSITION WOULD BE SUSTAINED UPON EXAMINATION. THE FOUNDATION RECOGNIZES INTEREST AND PENALTIES, IF ANY, RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE. THERE WERE NONE FOR THE YEARS ENDED JUNE 30, 2023 AND 2022. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 188,893. CHANGE IN VALUE OF CONTRIBUTIONS RECEIVABLE FROM REMAINDER TRUSTS -255. GALA 253602 149993 103609 10351 250 5000 9400 56023 GOLF 77098 56075 21023 14798 16455 5565 330700 206068 124632 25149 250 21455 9400 61588 117842 6790 16376 1 1.00000 16376 16376 WA 1 0 1 0 1.00000 SACRED HEART MEDICAL CENTER FOUNDATION 123 INTERNATIONAL WAY SPRINGFIELD OR 97477 0 1 16376 1 PEACEHEALTH 1115 SE 164TH AVE SUITE 332 VANCOUVER WA 98683 910939479 501(C)(3) 1555100 40650 FMV MATERIALS GENERAL SUPPORT FOR PEACEHEALTH ST. JOHN MEDICAL CENTER 1 0 PART I, LINE 2: OUR FINANCE COMMITTEE AWARDS AND MONITORS THE DISTRIBUTION AND USE OF THE FUNDS ACCORDING TO DONOR INTENT. FUNDS ARE DISTRIBUTED TO THE HOSPITAL DEPARTMENTS ONLY AFTER RECEIPT OF AN INVOICE AND ONLY FUNDED FOR THE EXACT AMOUNT. X X X X 1 1 0 1 0 0 0 0 0 0 0 MICHAEL I MCNELLIS MD DIRECTOR 0 421681 0 38474 0 4793 0 48347 0 12891 0 526186 0 38474 CHERELLE MONTANYE DIRECTOR, CAO ST. JOHN MED. CENTER 0 332805 0 59152 0 0 0 41128 0 26450 0 459535 0 0 PART I, LINE 1A PEACEHEALTH (A RELATED ORGANIZATION) HAS POLICES REGARDING THE ELIGIBILITY OF EXECUTIVES FOR THESE ITEMS. FOR EXAMPLE TRAVEL FOR COMPANIONS AND HOUSING ALLOWANCES ARE RELATED TO RELOCATION BENEFITS OR FIRST CLASS TRAVEL FOR FLIGHTS EXCEEDING SIX HOURS IN DURATION. THESE BENEFITS WERE REPORTED AND TREATED AS TAXABLE. PART I, LINE 3 THE FOUNDATION EXECUTIVE DIRECTOR IS COMPENSATED BY PEACE HEALTH (A RELATED ORGANIZATION ) WHICH USES A MARKET BASED COMPENSATION PROGRAM UTILIZING SEVERAL INDEPENDENT THIRD PARTY COMPENSATION MARKET SURVEYS TO ESTABLISH PAY RANGES FOR THE POSITION. PEACE HEALTH THEN ESTABLISHES THE INDIVIDUAL RATE OF PAY WITHIN THE PAY RANGE BASED ON RELEVANT EXPERIENCE / SKILLS / COMPETENCE TO DO THE JOB. THIS RATE, OFFERED TO THE EXECUTIVE DIRECTOR AT TIME OF HIRE, WAS DETERMINED THROUGH A DISCUSSION BETWEEN THE REGIONAL CEO, REGIONAL DIRECTOR OF HUMAN RESOURCES AND THE ADMINISTRATIVE DIRECTOR OF HUMAN RESOURCES. THE RANGES AND RATE OF PAY ARE REVIEWED ON AN ANNUAL BASIS. PART I, LINE 4B PEACEHEALTH (A RELATED ORGANIZATION) HAS POLICES REGARDING THE ELIGIBILITY OF EXECUTIVES FOR THESE ITEMS. BOARD MEMBERS LISTED ON SCHEDULE J ARE EMPLOYEES OF PEACEHEALTH (A RELATED ORGANIZATION) AND PEACEHEALTH'S CEO, EXECUTIVE VICE PRESIDENT, SENIOR VICE PRESIDENT, CERTAIN PHYSICIANS AND OTHER HIGHLY COMPENSATED EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN VARIOUS NONQUALIFIED RETIREMENT PLANS. CONTRIBUTIONS TO THESE PLANS AND RELATED INVESTMENT RETURNS ARE DISCLOSED ON SCHEDULE J AS DEFERRED COMPENSATION AND AS BONUS COMPENSATION WHEN PAID TO THE INDIVIDUAL. X OTHER NON-CASH ITEMS 11 16375 FAIR MARKET VALUE X QUILTS 17 14275 FAIR MARKET VALUE X 2,000 BUNCHES OF TULIPS 1 10000 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B ONCE THE FORM 990 IS COMPLETED BY OUR INDEPENDENT ACCOUNTING FIRM IT IS REVIEWED BY THE GOVERNANCE COMMITTEE. EVERY MEMBER OF THE BOARD WILL RECEIVE A COPY OF THE FORM 990 BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE GOVERNANCE COMMITTEE IN CONSULTATION WITH THE BOARD PRESIDENT AND EXECUTIVE DIRECTOR ARE RESPONSIBLE FOR ENSURING THAT ALL TOPICS BROUGHT BEFORE THE BOARD ARE FREE FROM CONFLICT. DETERMINATIONS OF WHETHER A CONFLICT EXISTS AND REVIEW OF ANY CONFLICTS ARE MADE AT THIS LEVEL. IF A CONFLICT ARISES, THE INDIVIDUAL AT RISK IS CONTACTED AND ASKED TO EXCUSE HIM OR HER FROM THE ROOM DURING DISCUSSION AND VOTING. ALL MEMBERS OF THE BOARD, AS WELL AS STAFF, ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE FOUNDATION EXECUTIVE DIRECTOR IS COMPENSATED BY PEACE HEALTH (A RELATED ORGANIZATION) WHICH USES A MARKET BASED COMPENSATION PROGRAM UTILIZING SEVERAL INDEPENDENT THIRD PARTY COMPENSATION MARKET SURVEYS TO ESTABLISH PAY RANGES FOR THE POSITION. PEACE HEALTH THEN ESTABLISHES THE INDIVIDUAL RATE OF PAY WITHIN THE PAY RANGE BASED ON RELEVANT EXPERIENCE/ SKILLS/ COMPETENCE TO DO THE JOB. THIS RATE, OFFERED TO THE EXECUTIVE DIRECTOR AT TIME OF HIRE, WAS DETERMINED THROUGH A DISCUSSION BETWEEN THE REGIONAL CEO, REGIONAL DIRECTOR OF HUMAN RESOURCES AND THE ADMINISTRATIVE DIRECTOR OF HUMAN RESOURCES. THE RANGES AND RATE OF PAY ARE REVIEWED ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE ONLINE THROUGH GUIDESTAR AND UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THE FORM 990 IS AVAILABLE ONLINE THROUGH GUIDESTAR AND UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 188,893. CHANGE IN VALUE OF CONTRIBUTIONS RECEIVABLE FROM REMAINDER TRUSTS -255. PEACEHEALTH 1115 SE 164TH AVE SUITE 332 VANCOUVER WA 98683 910939479 HOSPITAL WA 501(C)(3) LINE 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0