Form 990 for tax year 2022
Filed by PEACE HARBOR HOSPITAL FOUNDATION.
Totals
- Total revenue
- $219,947
- Total expenses
- $519,473
- Contributions and grants received
- $161,894
- Grants paid
- $501,183
- Program service revenue
- $0
- Investment income
- $58,053
- Other revenue
- $0
- Total assets, end of year
- $4,722,786
- Total liabilities, end of year
- $93,257
- Net assets or fund balances, end of year
- $4,629,529
- Program services expenses (Part IX)
- $501,183
- Management and general expenses
- $18,290
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $501,183
Program services were 96.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Line items
Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.
Revenue
Part VIII, the statement of revenue.
-
1f · All other contributions, gifts and grants
$161,894
-
1g · Noncash contributions included above
$1,000
-
3 · Investment income
total $55,644 · excluded $55,644
-
7a · Gross sales of assets other than inventory
securities $2,409
-
7b · Less cost or other basis and sales expenses
securities $0
-
7c · Gain or loss
securities $2,409
-
7d · Net gain or loss
total $2,409 · excluded $2,409
Functional expenses
Part IX, the statement of functional expenses.
-
1 · Grants to domestic organizations and governments
total $501,183 · program services $501,183
-
11f · Fees: investment management
total $16,685 · management and general $16,685
-
11g · Fees: other
total $605 · management and general $605
-
24a · Other expenses: IN KIND EXPENSES
total $1,000 · program services $0 · management and general $1,000 · fundraising $0
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $1,297,358 · end of year $50,050
-
2 · Savings and temporary cash investments
beginning of year $558,405 · end of year $1,827,329
-
3 · Pledges and grants receivable
beginning of year $339,078 · end of year $3,236
-
10a · Land, buildings and equipment: cost or other basis
$780,500
-
10c · Land, buildings and equipment, net
beginning of year $780,500 · end of year $780,500
-
11 · Investments: publicly traded securities
beginning of year $1,705,963 · end of year $1,825,227
-
15 · Other assets
beginning of year $233,459 · end of year $236,444
-
25 · Other liabilities
beginning of year $110,882 · end of year $93,257
-
27 · Net assets without donor restrictions
beginning of year $1,564,614 · end of year $1,537,213
-
28 · Net assets with donor restrictions
beginning of year $3,239,267 · end of year $3,092,316
Mission and programs · 2022
Mission
TO IMPROVE THE HEALTH AND LIVES OF COMMUNITY MEMBERS BY PROVIDING CHARITABLE SUPPORT TO PEACEHEALTH PEACE HARBOR MEDICAL CENTER (THE HOSPITAL) SO THAT COMPASSIONATE, AFFORDABLE AND HIGH-QUALITY MEDICAL CARE MAY BE OFFERED TO ALL IN THIS REGION.
Activities or mission (Part I)
IMPROVE THE HEALTH & LIVES OF COMMUNITY MEMBERS BY RAISING FUNDS & PROVIDING CHARITABLE SUPPORT.
-
TRANSFERS TO PEACEHEALTH PEACE HARBOR MEDICAL CENTER TO SUPPORT THEIR PROGRAM SERVICES.
Expenses $501,183 · Grants $501,183
As filed on the 2022 return.
Listed in Part VII
-
Sally WantzSALLY WANTZ
VICE PRESIDENT
- Total calculated
- $0
- Hours/week
- 1
-
Laurel FergusonLAUREL FERGUSON
SECRETARY/TREASURER
- Total calculated
- $0
- Hours/week
- 1
-
Paula BurnettePAULA BURNETTE
PRESIDENT
- Total calculated
- $0
- Hours/week
- 1
-
Jason HawkinsJASON HAWKINS
DIRECTOR, CAO PEACEHARBOR HOSPITAL
- Total calculated
- $379,974
- From this org
- $0
- From related orgs
- $327,667
- Other
- $52,307
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $277,862 related
- Bonus
- $0 + $49,805 related
- Other
- $0
- Deferred
- $0 + $26,417 related
- Nontaxable benefits
- $0 + $25,890 related
- Filer's total
- $0 + $379,974 related
-
Ronald MooreRONALD MOORE
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Norma Kay WoodNORMA KAY WOOD
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Monica KosmanMONICA KOSMAN
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
George HenryGEORGE HENRY
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Beverly ScottBEVERLY SCOTT
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Heather McArthurHEATHER MCARTHUR
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
David Rigsby - Start 12023DAVID RIGSBY - START 12023
EXECUTIVE DIRECTOR
- Total calculated
- $0
- Hours/week
- 40
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
- 1a · First-class or charter travel
- 1a · Travel for companions
- 1a · Tax indemnification and gross-up payments
- 1a · Housing allowance or residence for personal use
- 1b · Written policy on the line-1a expenses
- 2 · Substantiation required before reimbursing expenses
- 4b · Supplemental nonqualified retirement plan
Answered no
- 4a · Severance or change-of-control payment
- 4c · Equity-based compensation arrangement
- 5a · Pay contingent on this organization's revenues
- 5b · Pay contingent on a related organization's revenues
- 6a · Pay contingent on this organization's net earnings
- 6b · Pay contingent on a related organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- 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 ORGANIZATION DOES NOT HAVE ANY PAID EMPLOYEES. EMPLOYEES ARE COMPENSATED BY PEACEHEALTH (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. PEACEHEALTH ESTABLISHES THE INDIVIDUAL RATE OF PAY WITHIN THE PAY RANGE BASED ON RELEVANT EXPERIENCE/SKILLS/COMPETENCE TO DO THE JOB. THE RANGES OF PAY RATES 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 ENTITY 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.
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
-
PEACEHEALTH
$501,183
SUPPORT FOR PEACEHEALTH PEACE HARBOR MEDICAL CENTER.
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
501(C)(3) · HEALTHCARE · WA
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 29 March 2024
- IRS schema version
- 2022v5.0
- Source object
- 202421289349302712
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