Civic Intelligence

Summit Pacific Medical Foundation

990 • Fiscal year 2019 • EIN 91-0593059

Jan 01, 2019 to Dec 31, 2019 • Filed on Oct 30, 2020

Organization ProfileSUMMITPACIFICMEDICALCENTER.ORG/FOUNDAT
600 East Main StreetElma, WA 98541

(360) 346-2250

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

27th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2019 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2019

Liabilities / Revenue

28th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2019 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2019

Net Margin

86th percentile

36%

Higher net margin than 86% of similar nonprofits.

2019 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2019

Top Officer Pay

50th percentile

$0

Higher top officer pay than 50% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

2019 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2019

Asset Growth

78th percentile

21%

Faster asset growth than 78% of similar nonprofits.

2019 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2018 to 2019

Revenue Growth

21st percentile

-13%

Faster revenue growth than 21% of similar nonprofits.

2019 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2018 to 2019

Balance Sheet
Liabilities / Assets27th percentile

Assets

Up

$871,943

Up $152,412 (+21%) from 2018

Net Assets

Up

$871,943

Up $152,412 (+21%) from 2018

Liabilities

Flat

$0

Flat from 2018

Revenue And Expenses
Liabilities / Revenue28th percentileNet Margin86th percentile

Revenue

Down

$427,938

Down $62,852 (-13%) from 2018

Expenses

Up

$275,526

Up $197,721 (+254%) from 2018

Net Income

Down

$152,412

Down $260,573 (-63%) from 2018

Historical Trend

Balance Sheet Trend

Asset Growth78th percentile

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$3.0M$2.0M$1.0M$0Assets 2011: $62,435Liabilities 2011: $02011Assets 2012: $213,785Liabilities 2012: $0Net Assets 2012: $213,7852012Assets 2013: $217,019Liabilities 2013: $02013Assets 2014: $306,393Liabilities 2014: $02014Assets 2015: $329,025Liabilities 2015: $02015Assets 2016: $358,561Liabilities 2016: $02016Assets 2017: $306,546Liabilities 2017: $0Net Assets 2017: $306,5462017Assets 2018: $719,531Liabilities 2018: $0Net Assets 2018: $719,5312018Assets 2019: $871,943Liabilities 2019: $0Net Assets 2019: $871,9432019Assets 2020: $1,089,267Liabilities 2020: $0Net Assets 2020: $1,089,2672020Assets 2021: $1,238,521Liabilities 2021: $0Net Assets 2021: $1,238,5212021Assets 2022: $1,134,519Liabilities 2022: $8,604Net Assets 2022: $1,125,9152022Assets 2023: $1,384,820Liabilities 2023: $0Net Assets 2023: $1,384,8202023Assets 2024: $2,514,764Liabilities 2024: $650Net Assets 2024: $2,514,1142024

Highlighted filing

2019

Assets$871,943
Liabilities$0
Net Assets$871,943
Open 2019 Filing

Operations Trend

Revenue Growth21st percentile

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$3.0M$2.0M$1.0M$0-$1.0MRevenue 2011: $55,787Expenses 2011: $46,608Net Income 2011: $9,1792011Revenue 2012: $262,619Expenses 2012: $111,269Net Income 2012: $151,3502012Revenue 2013: $144,633Expenses 2013: $141,399Net Income 2013: $3,2342013Revenue 2014: $122,039Expenses 2014: $32,660Net Income 2014: $89,3792014Revenue 2015: $64,901Expenses 2015: $42,493Net Income 2015: $22,4082015Revenue 2016: $87,316Expenses 2016: $57,780Net Income 2016: $29,5362016Revenue 2017: $228,195Expenses 2017: $235,187Net Income 2017: -$6,9922017Revenue 2018: $490,790Expenses 2018: $77,805Net Income 2018: $412,9852018Revenue 2019: $427,938Expenses 2019: $275,526Net Income 2019: $152,4122019Revenue 2020: $265,335Expenses 2020: $48,011Net Income 2020: $217,3242020Revenue 2021: $232,938Expenses 2021: $83,684Net Income 2021: $149,2542021Revenue 2022: $480,041Expenses 2022: $592,647Net Income 2022: -$112,6062022Revenue 2023: $405,514Expenses 2023: $146,609Net Income 2023: $258,9052023Revenue 2024: $2,011,817Expenses 2024: $842,580Net Income 2024: $1,169,2372024

Highlighted filing

2019

Revenue$427,938
Expenses$275,526
Net Income$152,412
Open 2019 Filing
Jump To
Filing Snapshot
Filing Period
Jan 1, 2019 to Dec 31, 2019
Signed
Oct 30, 2020
Return Version
2019v5.0
Gross Receipts
$507,228
Mission and Program Overview

Mission

To provide financial support that enhances the quality and availability of healthcare services and programs enjoyed by the residents of grays harbor county public hospital district no. 1, dba summit pacific medical center.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$473,506$625,066▲ $151,560
Savings and Temporary Cash Investments$246,025$246,877▲ $852
Total Assets$719,531$871,943▲ $152,412
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$574,112$727,323▲ $153,211
Net Assets With Donor Restrictions$145,419$144,620▼ $799
Total Net Assets Fund Balance$719,531$871,943▲ $152,412
Total Liabilities and Net Assets / Fund Balance$719,531$871,943▲ $152,412
Compensation and Service Providers
Top Officer Pay50th percentile

Board Members and Trustees

NameTitle
Brian SmithPresident
Amy ThomasonDirector
Brent MeldrumDirector
Dave SiskDirector
James HansenDirector
Josh MartinDirector
Kristi TempletonDirector
Nate RootDirector
Stacie TobeyDirector
Emily DillinghamFoundation D
Patti AmbroseSecretary
Ron HulscherVice Preside
Revenue and Support

Revenue Composition

Contributions and Grants
$456,680
Program Service Revenue
$0
Investment Income
$860
Other Revenue
$-29,602
All Other Contributions
$371,790
Change in Net Assets
$152,412
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Grants and Similar Amounts Paid$228,338
Other Expenses$43,006
Total Fundraising Expense$19,983
Professional Fundraising Fees$4,182
Salaries, Compensation, and Employee Benefits$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Grants to Domestic Orgs$222,338--$222,338
Other Expenses-$22,054$15,801$37,855
Grants to Domestic Individuals$6,000--$6,000
Office Expenses-$5,151-$5,151
Fees for Services Professional Fundraising--$4,182$4,182
Total Functional Expenses$228,338$27,205$19,983$275,526
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Grays Harbor County Public HospitalElma, WA501c3Capital Expenditures$222,338
Fundraising, Events, and Gaming
Fundraising activities
Yes
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$79,290
Fundraising Gross Income$49,688
Professional Fundraising Fees$4,182

Fundraising Events

EventGross ReceiptsGross RevenueDirect ExpensesNet Income
Golf$82,948$31,448$4,976$26,472
Gala$50,630$18,240$3,779$14,461
Total Events$133,578$49,688$77,422$-27,734
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Backup withholding compliance
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
No
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Page 6, Part VI, Line 11B

“A copy of the 990 is provided to the hospital cfo who reviews the form, schedules, and related attachments. Any comments or questions are addressed with the preparer and a final draft is presented to the board of directors who then approve the 990. Once management is satisfied with the 990, the preparer is authorized to e-file the return.”

Form 990, Page 6, Part VI, Line 15A

“The foundation director is on the hospital's payroll and works 40 hours split 20/20 between the foundation and the hospital. Independent analysis of the compensation amount is completed by the hospital human resource director.”

Form 990, Page 6, Part VI, Line 15B

“The foundation director is the only officer or key employee. See 990, part vi, line 15a.”

Form 990, Page 6, Part VI, Line 19

“The foundation makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.”

Filing and Contact Details

Filer

Filer Name
Summit Pacific Medical Foundation
EIN
91-0593059
Phone
3603462250
Address
600 EAST MAIN STREET, ELMA, WA 98541

Signing Officer

Name
James Hansen
Title
Director
Phone
3603462222
Signed
2020-10-30
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Brian Smith
Formed
1950
Legal Domicile
Wa
Voting Board Members
11
Independent Board Members
11
Employees
0
Volunteers
114

Preparer

Firm
Dingus Zarecor & Associates Pllc
Address
12015 E MAIN AVE, SPOKANE VALLEY, WA 99206
Preparer
Thomas Dingus
Phone
5092420874
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IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus2YearsAmt0240729
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus3YearsAmt0137472
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus4YearsAmt0110934
IRS990ScheduleA/TotalCalendarYear170Grp/TotalAmt01439252
IRS990ScheduleA/TotalSupportAmt01441506
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IRS990ScheduleG/FundraisingEventInformationGrp/CharitableContriEvent2Amt032390
IRS990ScheduleG/FundraisingEventInformationGrp/DirectExpenseSummaryEventsAmt077422
IRS990ScheduleG/FundraisingEventInformationGrp/EntertainmentEvent2Amt01000
IRS990ScheduleG/FundraisingEventInformationGrp/EntertainmentTotalEventsAmt01000
IRS990ScheduleG/FundraisingEventInformationGrp/Event1Nm0GOLF
IRS990ScheduleG/FundraisingEventInformationGrp/Event2Nm0GALA
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IRS990ScheduleG/FundraisingEventInformationGrp/FoodAndBeverageEvent2Amt016094
IRS990ScheduleG/FundraisingEventInformationGrp/FoodAndBeverageTotalEventsAmt016494
IRS990ScheduleG/FundraisingEventInformationGrp/GrossReceiptsEvent1Amt082948
IRS990ScheduleG/FundraisingEventInformationGrp/GrossReceiptsEvent2Amt050630
IRS990ScheduleG/FundraisingEventInformationGrp/GrossReceiptsTotalAmt0133578
IRS990ScheduleG/FundraisingEventInformationGrp/GrossRevenueEvent1Amt031448
IRS990ScheduleG/FundraisingEventInformationGrp/GrossRevenueEvent2Amt018240
IRS990ScheduleG/FundraisingEventInformationGrp/GrossRevenueTotalEventsAmt049688
IRS990ScheduleG/FundraisingEventInformationGrp/NetIncomeSummaryAmt0-27734
IRS990ScheduleG/FundraisingEventInformationGrp/NonCashPrizesEvent1Amt010717
IRS990ScheduleG/FundraisingEventInformationGrp/NonCashPrizesEvent2Amt02895
IRS990ScheduleG/FundraisingEventInformationGrp/NonCashPrizesTotalEventsAmt013612
IRS990ScheduleG/FundraisingEventInformationGrp/OthDirectExpnssTotalEventsAmt08755
IRS990ScheduleG/FundraisingEventInformationGrp/OtherDirectExpensesEvent1Amt04976
IRS990ScheduleG/FundraisingEventInformationGrp/OtherDirectExpensesEvent2Amt03779
IRS990ScheduleG/FundraisingEventInformationGrp/RentFacilityCostsEvent1Amt027836
IRS990ScheduleG/FundraisingEventInformationGrp/RentFacilityCostsEvent2Amt09725
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IRS990ScheduleI/RecipientTable/CashGrantAmt0222338
IRS990ScheduleI/RecipientTable/IRCSectionDesc0501C3
IRS990ScheduleI/RecipientTable/PurposeOfGrantTxt0CAPITAL EXPENDITURES
IRS990ScheduleI/RecipientTable/RecipientBusinessName/BusinessNameLine1Txt0GRAYS HARBOR COUNTY PUBLIC HOSPITAL
IRS990ScheduleI/RecipientTable/RecipientEIN0911158307
IRS990ScheduleI/RecipientTable/USAddress/AddressLine1Txt0600 EAST MAIN STREET
IRS990ScheduleI/RecipientTable/USAddress/CityNm0ELMA
IRS990ScheduleI/RecipientTable/USAddress/StateAbbreviationCd0WA
IRS990ScheduleI/RecipientTable/USAddress/ZIPCd098541
IRS990ScheduleI/SupplementalInformationDetail/ExplanationTxt0THE FOUNDATION MONITORS ITS FINANCIAL ASSISTANCE OF THE HOSPITAL BY MAINTAINING CLOSE CONTACT BETWEEN THE GOVERNING BODIES. REQUESTS FOR FINANCIAL ASSISTANCE GENERALLY ARE INITIATED FROM THE HOSPITAL DISTRICT'S CFO AND APPROVED BY THE FOUNDATION BOARD PRIOR TO DISBURSEMENT.
IRS990ScheduleI/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE I, PAGE 1, PART I, LINE 2
IRS990ScheduleI/Total501c3OrgCnt01
IRS990/ScheduleJRequiredInd0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0A COPY OF THE 990 IS PROVIDED TO THE HOSPITAL CFO WHO REVIEWS THE FORM, SCHEDULES, AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PRESENTED TO THE BOARD OF DIRECTORS WHO THEN APPROVE THE 990. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE PREPARER IS AUTHORIZED TO E-FILE THE RETURN.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1THE FOUNDATION DIRECTOR IS ON THE HOSPITAL'S PAYROLL AND WORKS 40 HOURS SPLIT 20/20 BETWEEN THE FOUNDATION AND THE HOSPITAL. INDEPENDENT ANALYSIS OF THE COMPENSATION AMOUNT IS COMPLETED BY THE HOSPITAL HUMAN RESOURCE DIRECTOR.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2THE FOUNDATION DIRECTOR IS THE ONLY OFFICER OR KEY EMPLOYEE. SEE 990, PART VI, LINE 15A.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PAGE 6, PART VI, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PAGE 6, PART VI, LINE 15A
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PAGE 6, PART VI, LINE 15B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PAGE 6, PART VI, LINE 19
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IRS990/SubjectToProxyTaxInd0false
IRS990/SubjToTaxRmnrtnExPrchtPymtInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TerminateOperationsInd0false
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IRS990/TotalContributionsAmt0456680
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IRS990/TotalFunctionalExpensesGrp/FundraisingAmt019983
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt027205
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0228338
IRS990/TotalFunctionalExpensesGrp/TotalAmt0275526
IRS990/TotalGrossUBIAmt00
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IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0871943
IRS990/TotalProgramServiceExpensesAmt0228338
IRS990/TotalRevenueGrp/ExclusionAmt0-28742
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0427938
IRS990/TotalVolunteersCnt0114
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0719531
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt0871943
IRS990/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0600 EAST MAIN STREET
IRS990/USAddress/CityNm0ELMA
IRS990/USAddress/StateAbbreviationCd0WA
IRS990/USAddress/ZIPCd098541
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IRS990/VotingMembersIndependentCnt011
IRS990/WebsiteAddressTxt0SUMMITPACIFICMEDICALCENTER.ORG/FOUNDAT
IRS990/WhistleblowerPolicyInd0false
ReturnHeader/BuildTS02021-01-29 14:40:06Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0JAMES HANSEN
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0DIRECTOR
ReturnHeader/BusinessOfficerGrp/PhoneNum03603462222
ReturnHeader/BusinessOfficerGrp/SignatureDt02020-10-30
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0SUMMIT PACIFIC MEDICAL FOUNDATION
ReturnHeader/Filer/BusinessNameControlTxt0SUMM
ReturnHeader/Filer/EIN0910593059
ReturnHeader/Filer/PhoneNum03603462250
ReturnHeader/Filer/USAddress/AddressLine1Txt0600 EAST MAIN STREET
ReturnHeader/Filer/USAddress/CityNm0ELMA
ReturnHeader/Filer/USAddress/StateAbbreviationCd0WA
ReturnHeader/Filer/USAddress/ZIPCd098541
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ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt0104.209.44.114
ReturnHeader/FilingSecurityInformation/IPDt02020-11-05
ReturnHeader/FilingSecurityInformation/IPTimezoneCd0CS
ReturnHeader/FilingSecurityInformation/IPTm015:52:18
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0200079326
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0DINGUS ZARECOR & ASSOCIATES PLLC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt012015 E MAIN AVE
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0SPOKANE VALLEY
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0WA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd099206
ReturnHeader/PreparerPersonGrp/PhoneNum05092420874
ReturnHeader/PreparerPersonGrp/PreparationDt02020-11-05
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0THOMAS DINGUS

Document Assets

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Filings

Displayed year

2019 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$871,943
Liabilities
$0
Net assets
$871,943
Revenue
$427,938
Expenses
$275,526
Net income
$152,412
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$2.51$0.00$2.51$2.01$0.84$1.17
2023Detailed filing. Detailed filing data is available for this year.$1.38$0.00$1.38$0.41$0.15$0.26
2022Detailed filing. Detailed filing data is available for this year.$1.13$0.01$1.13$0.48$0.59$0.11
2021Detailed filing. Detailed filing data is available for this year.$1.24$0.00$1.24$0.23$0.08$0.15
2020Detailed filing. Detailed filing data is available for this year.$1.09$0.00$1.09$0.27$0.05$0.22
2019Detailed filing. Detailed filing data is available for this year.$0.87$0.00$0.87$0.43$0.28$0.15
2018Detailed filing. Detailed filing data is available for this year.$0.72$0.00$0.72$0.49$0.08$0.41
2017Detailed filing. Detailed filing data is available for this year.$0.31$0.00$0.31$0.23$0.24$0.01
2016Summary only. Only limited summary data is available for this year.$0.36$0.00$0.09$0.06$0.03
2015Summary only. Only limited summary data is available for this year.$0.33$0.00$0.06$0.04$0.02
2014Summary only. Only limited summary data is available for this year.$0.31$0.00$0.12$0.03$0.09
2013Summary only. Only limited summary data is available for this year.$0.22$0.00$0.14$0.14$0.00
2012Summary only. Only limited summary data is available for this year.$0.21$0.00$0.21$0.26$0.11$0.15
2011Summary only. Only limited summary data is available for this year.$0.06$0.00$0.06$0.05$0.01
Peer Organizations

Similar nonprofits based on the same Siviq industry and scale cohort. 2019 filings • 501(c)3 • $500k-$1M nonprofits