Klickitat Valley Health Memorial Foundation in Goldendale, Washington (WA)

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Klickitat Valley Health Memorial Foundation
Employer Identification Number (EIN)911503247
Name of OrganizationKlickitat Valley Health Memorial Foundation
In Care of NameGREGORY SMITH
Address310 South Roosevelt, Goldendale, WA 98620
Websitehttp://www.kvhmf.weebly.com
ActivitiesGifts, grants, or loans to other organizations
SubsectionCharitable Organization
Ruling Date12/1991
DeductibilityContributions are deductible
FoundationOrganization which receives a substantial part of its support from a governmental unit or the general public
OrganizationCorporation
Exempt Organization StatusUnconditional Exemption
Tax Period2014
Assets$0
Income$0
Filing Requirement990 - Required to file Form 990-N - Income less than $25,000 per year
Asset Amount$-1,400,636
Amount of Income$760,299
Form 990 Revenue Amount$760,299
National Taxonomy of Exempt Entities (NTEE)Health - General and Rehabilitative: Single Organization Support


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Amount of income in 2014: $760,299
Klickitat Valley Health Memorial Foundation: 

 $760,299
Other organizations performing similar types of work: 

 $6,088,020

Assets in 2014: $-1,400,636
This organization: 

 $-1,400,636
Other organizations performing similar types of work: 

 $26,323,448

Expenses in 2010: $2,038
This organization: 

 $2,038
Other organizations performing similar types of work: 

 $1,941,347

Income to expenses ratio in 2010: 373.1
Klickitat Valley Health Memorial Foundation: 

 373.1
Other organizations performing similar types of work: 

 2.7

Expenses allocated to program services in 2006: 92.2%
Klickitat Valley Health Memorial Foundation: 

 92.2%
Other organizations performing similar types of work: 

 84.3%

Employees paid over $50,000 in 2006: 0.0%
This organization: 

 0.0%
Other organizations performing similar types of work: 

 40.0%

Grants share in income in 2010: 14.2%
This organization: 

 14.2%
Other organizations performing similar types of work: 

 18.7%

Financial snapshot ($)

Revenue for 2010

Revenue, Expenses, and Changes in Net Assets or Fund Balances (for 2010)
Total revenue$12,338
Contributions, gifts, grants, and similar amounts received$1,750
Program service revenue including government fees and contracts$0
Membership dues and assessments$0
Investment income$0
Gain from sale of assets other than inventory$0
Net income from gaming and fundraising events$10,588
Gross income from gaming$0
Gross income from fundraising events$10,588
Less: direct expenses from gaming and fundraising events$0
Gross profit from sales of inventory$0
Other revenue$0
Total expenses$2,038
Total net assets$17,800
Excess for the year$10,300
Net assets or fund balances at beginning of year$7,500
Other changes in net assets or fund balances$0
Balance Sheets (for 2010)
Total assets$17,800
Total liabilities$0
Net assets or fund balances$17,800
Other Information (for 2010)
Did the organization have unrelated business gross income of $1,000 or more during the year from business activitiesNo
Initiation fees and capital contributions$0
Gross receipts for public use of club facilities$0
Reason for Public Charity Status (for 2010)
The organization is not a private foundation because it is:Not provided
Revenue, Expenses, and Changes in Net Assets or Fund Balances
2000200120022003200420052006
Total revenue$680,616$783,537$715,897$710,993$758,404$792,244$760,299
Contributions, gifts, grants, and similar amounts received$2,618$2,251$0$0$0$1,575$13,361
Contributions to donor advised funds$0
Direct public support$2,618$2,251$0$0$0$1,575$13,361
Indirect public support$0$0$0$0$0$0$0
Government contributions (grants)$0$0$0$0$0$0$0
Program service revenue including government fees and contracts$672,751$774,315$710,571$708,214$756,234$787,096$744,190
Membership dues and assessments$0$0$0$0$0$0$0
Interest on savings and temporary cash investments$5,247$0$5,326$2,778$2,169$2,833$2,748
Dividends and interest from securities$0$6,971$0$0$0$0$0
Net rental income or (loss)$0$0$0$0$0$0$0
Gross rents$0$0$0$0$0$0$0
Less: rental expenses$0$0$0$0$0$0$0
Other investment income$0$0$0$0$0$0$0
Gain or (loss) from sales of assets other than inventory$0$0$0$0$0$0$0
Gross amount from sales of assets other than inventory$0$0$0$0$0$0$0
Less: cost or other basis and sales expenses$0$0$0$0$0$0$0
Net income or (loss) from special events and activities$0$0$0$0$0$0$0
Gross revenue$0$0$0$0$0$0$0
Less: direct expenses other than fundraising expenses$0$0$0$0$0$0$0
Gross profit or (loss) from sales of inventory$0$0$0$0$0$0$0
Gross sales of inventory, less returns and allowances$0$0$0$0$0$0$0
Less: cost of goods sold$0$0$0$0$0$0$0
Other revenue$0$0$0$0$0$740$0
Total expenses$666,460$864,942$963,947$906,072$819,089$942,090$936,985
Program services$388,599$864,942$963,947$859,550$749,224$857,145$863,988
Management and general$277,861$0$0$46,522$69,865$84,945$72,997
Fundraising$0$0$0$0$0$0$0
Payments to affiliates$0$0$0$0$0$0$0
Net assets or fund balances at end of year$-748,754$-772,498$-688,590$-860,133$-495,260$-1,223,950$-1,400,636
Excess or (deficit) for the year$14,156$-81,405$-248,050$-195,079$-60,684$-149,846$-176,686
Net assets or fund balances at beginning of year$-1,288,499$-759,021$-431,337$-688,590$-860,133$-1,074,104$-1,223,950
Other changes in net assets or fund balances$525,589$67,928$-9,203$23,536$425,557$0$0
Statement of Functional Expenses (for 2006)
TotalProgram servicesManagement and generalFundraising
Total functional expenses$936,985$863,988$72,997$0
Grants paid from donor advised funds$0
Other grants and allocations$0
Specific assistance to individuals$0
Benefits paid to or for members$0
Compensation of current officers, directors, key employees, etc.$0$0$0$0
Compensation of former officers, directors, key employees, etc.$0$0$0$0
Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)$0$0$0$0
Salaries and wages of employees not included above$208,372$183,837$24,535$0
Pension plan contributions not included above$0$0$0$0
Employee benefits not included above$34,309$30,275$4,034$0
Payroll taxes$26,148$23,073$3,075$0
Professional fundraising fees$0$0$0$0
Accounting fees$10,124$0$10,124$0
Legal fees$0$0$0$0
Supplies$85,531$82,715$2,816$0
Telephone$3,752$3,752$0$0
Postage and shipping$277$0$277$0
Occupancy$332,479$332,479$0$0
Equipment rental and maintenance$10,202$10,202$0$0
Printing and publications$0$0$0$0
Travel$5,189$5,189$0$0
Conferences, conventions, and meetings$1,333$1,333$0$0
Interest$0$0$0$0
Depreciation, depletion, etc.$172,642$172,642$0$0
Other expenses not covered above$46,627$18,491$28,136$0
Balance Sheets
2000200120022003200420052006
Total assets$3,405,054$3,310,932$3,594,916$3,431,241$3,565,103$3,016,613$2,894,547
Cash - non-interest-bearing$59,127$150,527$76,233$99,809$31,322$42,593$59,024
Savings and temporary cash investments$192,231$109,701$145,975$145,401$196,528$129,340$156,044
Accounts receivable less allowance for doubtful accounts$0$0$14,639$14,370$0$17,714$23,276
Pledges receivable less allowance for doubtful accounts$0$0$0$0$0$0$0
Grants receivable$0$0$0$0$0$0$0
Receivables from current and former officers, directors, trustees, and key employees$0$0$0$0$0$0$0
Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)$0
Other notes and loans receivable less allowance for doubtful accounts$0$0$0$0$0$0$0
Inventories for sale or use$0$0$0$0$0$0$0
Prepaid expenses and deferred charges$4,811$8,494$20,202$12,110$0$10,873$12,752
Investments - publicly-traded securities$0
Investments - other securities$0$0$0$0$0$0$0
Investments - land, buildings, and equipment less accumulated depreciation$3,148,885$3,042,210$3,337,867$0$0$0$0
Investments - other$0$0$0$0$0$0$0
Land, buildings, and equipment less accumulated depreciation$0$0$0$3,159,550$3,337,251$2,816,093$2,643,451
Other assets, including program-related investments$0$0$0$0$0$0$0
Total liabilities$4,153,808$4,083,430$4,283,506$4,291,375$4,060,363$4,240,563$4,295,183
Accounts payable and accrued expenses$6,636$21,600$291,616$235,234$9,222$297,429$352,049
Grants payable$0$0$0$0$0$0$0
Deferred revenue$55,644$0$0$0$0$0$0
Loans from officers, directors, trustees, and key employees$0$0$0$0$0$0$0
Tax-exempt bond liabilities$0$3,215,000$3,215,000$3,215,000$3,215,000$3,115,000$3,115,000
Mortgages and other notes payable$4,091,528$846,830$776,890$841,141$836,141$828,134$828,134
Other liabilities$0$0$0$0$0$0$0
Total liabilities and net assets/fund balances$3,405,054$3,310,932$3,594,916$3,431,241$3,565,103$3,016,613$2,894,547
Total net assets or fund balances$-748,754$-772,498$-688,590$-860,134$-495,260$-1,223,950$-1,400,636
Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
2000200120022003200420052006
Total revenue$680,616$0$0$0$0$792,244$760,299
Total revenue, gains, and other support per audited financial statements$680,616$0$0$0$0$792,244$760,299
Other expenses$0$0$0$0$0$0$0
Net unrealized gains on investments$0$0$0$0$0$0$0
Donated services and use of facilities$0$0$0$0$0$0$0
Recoveries of prior year grants$0$0$0$0$0$0$0
Other$0$0$0$0$0$0$0
Other revenue$0$0$0$0$0$0$0
Investment expenses$0$0$0$0$0$0$0
Other$0$0$0$0$0$0$0
Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
2000200120022003200420052006
Total expenses$666,460$0$0$0$0$942,090$936,985
Total expenses and losses per audited financial statements$666,460$0$0$0$0$942,090$936,985
Other revenue$0$0$0$0$0$0$0
Donated services and use of facilities$0$0$0$0$0$0$0
Prior year adjustments$0$0$0$0$0$0$0
Losses$0$0$0$0$0$0$0
Other$0$0$0$0$0$0$0
Other expenses$0$0$0$0$0$0$0
Investment expenses$0$0$0$0$0$0$0
Other$0$0$0$0$0$0$0
Current Officers, Directors, Trustees, and Key Employees
Total number of officers, directors, and trustees permitted to vote on organization business at board meetings7
Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, related to each other through family or business relationships?No
Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization?Yes
Does the organization have a written conflict of interest policy?No
Other Information
Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return, and has it filed a tax return on Form 990-T for this year?No
Was there a liquidation, dissolution, termination, or substantial contraction during the year?No
Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization?Yes
Direct and indirect political expenditures$0
Did the organization file Form 1120-POL for this year?No
Were substantially all dues nondeductible by members?
Did the organization make only in-house lobbying expenditures of $2,000 or less?
Dues, assessments, and similar amounts from members$0
Section 162(e) lobbying and political expenditures$0
Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices$0
Taxable amount of lobbying and political expenditures$0
Does the organization elect to pay the section 6033(e) tax on the amount above?
If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount above to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?
Initiation fees and capital contributions$0
Gross receipts for public use of club facilities$0
At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)?No
Amount of tax imposed on the organization during the year under: section 4911$0
Amount of tax imposed on the organization during the year under: section 4912$0
Amount of tax imposed on the organization during the year under: section 4955$0
Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year?No
Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958$0
Amount of tax above, reimbursed by the organization$0
At any time during the tax year, was the organization a party to a prohibited tax shelter transaction?No
Did the organization acquire a direct or indirect interest in any applicable insurance contract?No
Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year?No
Number of employees employed in the pay period that includes March 12, 200614
Analysis of Income-Producing Activities (for 2006)
Unrelated business incomeExcluded by section 512, 513, or 514Related or exempt function income
Business codeAmountExclusion codeAmount
Total$0$2,748$744,190
Program service revenue
Program service revenue 1000000$000$0$737,715
Program service revenue 2000000$000$0$1,200
Program service revenue 3000000$000$0$5,275
Program service revenue 4000000$000$0$0
Program service revenue 5000000$000$0$0
Medicare/Medicaid payments000000$000$0$0
Fees and contracts from government agencies000000$000$0$0
Membership dues and assessments000000$000$0$0
Interest on savings and temporary cash investments000000$0Dividends, interest, payments with respect to securities loans, annuities, income from notional principal contracts, loan commitment fees, and other substantially similar income from ordinary and routine investments excluded by section 512(b)(1)$2,748$0
Dividends and interest from securities000000$000$0$0
Net rental income or (loss) from real estate
debt-financed property000000$000$0$0
not debt-financed property000000$000$0$0
Net rental income or (loss) from personal property000000$000$0$0
Other investment income000000$000$0$0
Gain or (loss) from sales of assets other than inventory000000$000$0$0
Net income or (loss) from special events000000$000$0$0
Gross profit or (loss) from sales of inventory000000$000$0$0
Other revenue000000$000$0$0
Information Regarding Taxable Subsidiaries and Disregarded Entities (for 2006)
EIN of corporation, partnership, or disregarded entityPercentage of ownership interestTotal incomeEnd-of-year assets
0%$0$0
0%$0$0
0%$0$0
0%$0$0
Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (for 2006)
CompensationContributions to employee benefit plans & deferred compensationExpense account and other allowances
$0$0$0
$0$0$0
$0$0$0
$0$0$0
$0$0$0
Total number of other employees paid over $50,0000
Statements About Activities (for 2006)
Expenses paid or incurred in connection with the lobbying activities$0
Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures?No
Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services?No
Did the organization maintain any donor advised funds?No
Did the organization make any taxable distributions under section 4966?No
Did the organization make a distribution to a donor, donor advisor, or related person?No
The total number of donor advised funds owned at the end of the tax year$0
The aggregate value of assets held in all donor advised funds owned at the end of the tax year$0
The total number of separate funds or accounts owned at the end of the tax year (excluding donor advised funds included above) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts$0
The aggregate value of assets held in all funds or accounts included above at the end of the tax year$0
Reason for Non-Private Foundation Status
The organization is not a private foundation because it isOrganization that normally receives: less than 1/3 of its support from gross investment income and unrelated taxable business income and more than 1/3 of its support from contribution, membership fees
Support Schedule
1999200020012002200320042005
Total$0$0$0$0$0$772,554$794,534
Gifts, grants, and contributions received$0$0$0$0$0$0$0
Membership fees received$0$0$0$0$0$0$0
Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc., purpose$0$0$0$0$0$770,153$791,701
Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30, 1975$0$0$0$0$0$2,401$2,833
Net income from unrelated business activities not included above$0$0$0$0$0$0$0
Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf$0$0$0$0$0$0$0
The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge$0$0$0$0$0$0$0
Other income$0$0$0$0$0$0$0
Lobbying Expenditures by Electing Public Charities (for 2006)
Total exempt purpose expenditures$0
Total lobbying expenditures$0
Total lobbying expenditures to influence public opinion (grassroots lobbying)$0
Total lobbying expenditures to influence a legislative body (direct lobbying)$0
Other exempt purpose expenditures$0
Lobbying nontaxable amount$0
Grassroots nontaxable amount$0
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IdNameAddressStateEstablishedTotal Income
1Peacehealth Southwest Medical Center FoundationPO BOX 1600, Vancouver, WA 98668-1600WA1984-02$23,114,240
2Mary Bridge Childrens FoundationPO BOX 5299, Tacoma, WA 98415-0299WA1991-05$13,022,064
3Health Resources Northwest, Hrn1550 North 115th Street No D-180, Seattle, WA 98133-8401WA1982-03$11,347,730
4Overlake Hospital Foundation1035 116th Ave Ne, Bellevue, WA 98004-4604WA1979-01$11,251,907
5Health Ventures1115 Se 164th Avenue, Vancouver, WA 98683-9324WA$8,667,563
6Mary Bridge Hospital & Orthopedic FoundationPO BOX 21927, Seattle, WA 98111-3927WA1971-08$2,084,392
7Klickitat Valley Health Memorial Foundation310 South Roosevelt, Goldendale, WA 98620WA1991-12$760,299
8St Lukes Memorial Hospital AuxiliaryPO BOX 469, Spokane, WA 99210-0469WA1975-11$75,247
9Caresource Management Group Co230 N Main St, Dayton, OH 45402-1263OH2003-06$387,634,367
10Yakima Valley Memorial Hospital Charitable Foundation2701 Tieton Dr, Yakima, WA 98902-3759WA1978-09$4,387,844
11Southeastern Regional Medical Center FoundationPO BOX 1408, Lumberton, NC 28359-1408NC1999-09$1,084,933
12St Tammany Hospital Guild Inc1202 S Tyler St, Covington, LA 70433-2330LA1999-11$186,485
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14Bellevue Hospital Association1400 West Main Street, Bellevue, OH 44811-9088OH2003-08$0
15Circus To Save Lives Inc1103 Grand Prix Dr, St Charles, MO 63303-6313MO2008-01$0
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Number of organizations performing similar types of work
Alaska1
Alabama5
Arkansas5
Arizona2
California36
Colorado8
Connecticut10
District of Columbia2
Delaware1
Florida18
Georgia5
Hawaii3
Iowa10
Idaho2
Illinois25
Indiana10
Kansas5
Kentucky4
Louisiana9
Massachusetts13
Maryland18
Maine6
Michigan12
Minnesota7
Missouri13
Mississippi3
North Carolina15
North Dakota1
Nebraska5
New Hampshire1
New Jersey14
New Mexico2
Nevada1
New York27
Ohio37
Oklahoma3
Oregon2
Pennsylvania30
Rhode Island9
South Carolina3
South Dakota2
Tennessee5
Texas22
Virginia18
Washington9
Wisconsin6
West Virginia5
Total450

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