2024-05-06T10:52:04-05:00 2023-06-30 390758449 WIPFLI LLP 170 N RADNOR-CHESTER RD SUITE 200 RADNOR PA 19087 990 2022-07-01 931170546 GOOD SHEPHERD COMMUNITY HEALTH FOUNDATION GOOD 5416673419 610 NW 11TH STREET HERMISTON OR 97838 ELIZABETH MARVIN EXECUTIVE DIRECTOR 5416673419 2024-04-22 1 ELIZABETH MARVIN 999009999 0 SOLOMON MARDAKHAEV P01806552 6105653930 2024-04-22 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z ELIZABETH MARVIN 610 NW 11TH STREET HERMISTON OR 97838 762823 0 X WWW.GSHEALTH.ORG/FOUNDATION X 1995 OR TO ENHANCE THE QUALITY OF LIFE AND GENERAL HEALTH OF RESIDENTS LIVING IN THE WEST UMATILLA AND MORROW COUNTY COMMUNITIES IN SUPPORT OF THE MISSION OF GOOD SHEPHERD HEALTH CARE SYSTEM. 16 16 0 30 0 0 337054 456065 0 0 94994 294001 4345 7064 436393 757130 333506 368274 0 0 0 0 0 0 0 294 4728 333800 373002 102593 384128 8531431 9241994 0 0 8531431 9241994 X TO ENHANCE THE QUALITY OF LIFE AND GENERAL HEALTH OF RESIDENTS LIVING IN THE WEST UMATILLA AND MORROW COUNTY COMMUNITIES. RESOURCES ARE PROVIDED TO WORTHY PROJECTS BEST ILLUSTRATING FOUNDATION IDEALS AND FULFILLING THE HEALTH NEEDS OF OUR DESIGNATED REGION. 0 0 368274 368274 0 TOURNAMENTS AND OTHER DESIGNATED PROGRAMS AND EVENTS ARE HELD TO FUND PROJECTS IN KEEPING WITH OUR MISSION. IN DECEMBER 2022, GSCHF PARTNERED WITH HERMISTON KIWANIS CLUB TO SPONSOR THE FESTIVAL OF TREES EVENT, RECEIVING OVER $30,500 IN NET PROCEEDS FOR THE FOUNDATION AT THIS ANNUAL FUNDRAISER. IN JUNE 2023, THE ANNUAL SCRAMBLE FOR SCHOLARSHIPS GOLF TOURNAMENT WAS HELD AND WAS A TREMENDOUS SUCCESS. NET PROCEEDS FROM THE TOURNAMENT WERE OVER $48,000.THE FOLLOWING STATEMENTS INDICATE THE GRANTS AND SCHOLARSHIPS AWARDED DURING THE 2022-2023 FISCAL YEAR. THE ORGANIZATION'S FORM 990, SCHEDULE I WILL ONLY REPORT WHAT WAS ACTUALLY PAID OUT DURING THE FISCAL YEAR. THEREFORE, THE FOLLOWING AMOUNTS MAY NOT RECONCILE WITH FORM 990, SCHEDULE I REPORTING DUE TO THE TIMING OF POST-SECONDARY SCHOOL CURRICULUMS AND GRANT NEED REQUIREMENTS.IN MAY 2023, THE FOUNDATION AWARDED $69,290 IN SCHOLARSHIP FUNDS TO THIRTY-SEVEN MEDICAL STUDENTS. ONE $5,000 SCHOLARSHIP FOR NURSING, TWO $3,000 FOR NURSING, TWO $3,145 SCHOLARSHIPS LYMPHEDEMA AND WOUND CARE SPECIALIST CERTIFICATION, FOUR $2,500 FOR NURSING, ONE $1,500, AND ONE $2,000 FOR RADIOLOGY TECH, AND WERE AWARDED TO MEDICAL PROFESSIONALS TO ENHANCE THEIR SKILLS WHO ARE ALREADY SERVING OUR COMMUNITY. OTHER SCHOLARSHIPS INCLUDE:ONE SCHOLARSHIP FOR $1,000 WAS AWARDED TO A BIOCHEMISTRY MAJOR ATTENDING STANFORD UNIVERSITY. ONE SCHOLARSHIP FOR $500 TO A BIOCHEMISTRY AND BIOPHYSICS STUDENT ATTENDING OREGON STATE UNIVERSITY. TWO $500 SCHOLARSHIPS TO NURSING STUDENTS ATTENDING BLUE MOUNTAIN COMMUNITY COLLEGE. ONE $500 SCHOLARSHIP FOR A MOLECULAR BIOLOGY STUDENT ATTENDING EASTERN OREGON UNIVERSITY. ONE $500 SCHOLARSHIP FOR A DENTAL HYGIENE STUDENT ATTENDING COLUMBIA BASIN COLLEGE. ONE $500 SCHOLARSHIP FOR A NURSING STUDENT ATTENDING GEORGE FOX UNIVERSITY. ONE $1,000 SCHOLARSHIP FOR A NURSING STUDENT TO WENATCHEE VALLEY COLLEGE. TWO $1,000 SCHOLARSHIPS FOR NURSING STUDENTS AT EASTERN OREGON UNIVERSITY. ONE $1,000 FOR NURSING TO COLUMBIA BASIN COLLEGE. $1,000 FOR A SCIENCE MAJOR AT EASTERN OREGON UNIVERSITY. ONE $2,000 SCHOLARSHIP FOR A MASTER OF APPLIED BIO ENGINEERING TO THE UNIVERSITY OF WASHINGTON. TWO $2,000 SCHOLARSHIPS FOR BACHELOR OF NURSING TO OREGON HEALTH SCIENCES UNIVERSITY. $2,000 FOR A BIOLOGY/PRE MEDICINE MAJOR AT OREGON STATE UNIVERSITY. ONE $2,000 SCHOLARSHIP TO A SONOGRAPHY STUDENT AT SPOKANE COMMUNITY COLLEGE. $3,000 SCHOLARSHIP TO A BACHELOR OF SCIENCE IN APPLIED MANAGEMENT WITH A MINOR IN PRE MEDICINE TO GRAND CANYON UNIVERSITY. $3,000 SCHOLARSHIP FOR A MASTER OF OCCUPATIONAL THERAPY TO EASTERN WASHINGTON UNIVERSITY. ONE $1,000 SCHOLARSHIP FOR A DIAGNOSTIC IMAGING STUDENT AT COLUMBIA BASIN COLLEGE. $3,000 SCHOLARSHIP FOR A DOCTOR OF PHARMACY AT OREGON STATE UNIVERSITY COLLEGE OF PHARMACY. $2,000 SCHOLARSHIP FOR A NURSING STUDENT AT COLUMBIA BASIN COLLEGE. $1,000 SCHOLARSHIP FOR A DIAGNOSTIC IMAGING STUDENT AT THE OREGON INSTITUTE OF TECHNOLOGY. $2,000 FOR A BACHELOR OF SCIENCE IN NURSING AT NOTRE DAME, MARYLAND. $2,000 FOR A NURSING STUDENT AT LONE STAR COLLEGE. $2,500 FOR A STUDENT PURSUING A DOCTORATE IN PHYSICAL THERAPY AT WESTERN UNIVERSITY OF HEALTH SCIENCES. FOUNDATION GRANTS ARE AWARDED TWICE A YEAR IN SEPTEMBER AND MARCH. GRANTS TOTALING $241,665.11, WERE AWARDED THIS FISCAL YEAR AS FOLLOWS:$49,959.48 IN GRANTS WERE MADE TO FIVE DESIGNATED CHARITABLE RECIPIENTS INCLUDING: EASTERN OREGON UNIVERSITY, BLUE MOUNTAIN COMMUNITY COLLEGE, VANGE JOHN MEMORIAL HOSPICE, DOMESTIC VIOLENCE WEST END PROJECT, AND HUMANE SOCIETY OF EASTERN OREGON FROM THE INTEREST ON A BEQUEST FROM THE MARY ELLEN PAUL TRUST.OTHER GRANTS MADE BY GOOD SHEPHERD COMMUNITY HEALTH FOUNDATION THIS FISCAL YEAR INCLUDE: $10,000 BOARDMAN PARKS AND REC TO RESURFACE DECK AT PUBLIC POOL. $5,000 COMMUNITY FELLOWSHIP DINNER TO COVER THE COST OF FOOD FOR THANKSGIVING AND CHRISTMAS COMMUNITY MEALS. $10,000 DOMESTIC VIOLENCE SERVICES, INC. TO PURCHASE NEW FLOORING FOR THE BUILDING. $7,100 GSHCS COMMUNITY HEALTH AND OUTREACH TO PROMOTE AND PURCHASE FOOD/MATERIALS FOR FAMILY HEALTH AND FITNESS DAY EVENT. $6,800 GSHCS FACILITIES DEPARTMENT TO PURCHASE HAM RADIO TO ALLOW COMMUNICATION BETWEEN GSMC AND UMATILLA COUNTY EMERGENCY OPERATIONS CENTER.$1,295 GSHCS SOUL CARE TO PURCHASE RESOURCES FOR PASTORS AND TRAINING FOR SOUL CARE MANAGERS. $27,898 GSHCS FOR EMPLOYEE EMERGENCY FUND.$1,300 INLAND NORTHWEST MUSICIANS TO COVER THE COSTS OF PUTTING ON AN ORCHESTRATED CONCERT.$11,965 IRRIGON RURAL FIRE PROTECTION DISTRICT TO PURCHASE AED UNITS. $10,000 KNIGHTS OF COLUMBUS FOR PLUMBING, ELECTRICAL AND COMMERCIAL DISHWASHER.$12,000 MARTHA'S HOUSE TO PURCHASE NEW FLOORING FOR UPSTAIRS OF BUILDING.$4,530 OSU EXTENSION SNAP ED FOR NUTRITIONAL EDUCATION IN ELEMENTARY SCHOOLS.$5,000 SMART READING TO PURCHASE READING BOOKS FOR CHILDREN 6 AND UNDER. $800 STANFIELD COMMUNITY CENTER, TO REPLACE EXISTING LIGHTING IN BUILDING.$10,000 SWEET POTATO'S CLOSET TO PURCHASE ITEMS TO STOCK "STORE" THAT MUST BE BOUGHT BRAND NEW. $5,000 AMERICAN YOUTH SOCCER ORG. HERMISTON TO UPDATE AND REPAIR RESTROOMS AT FUNLAND SOCCER FIELDS. $1,900 BOARDMAN FIRE RESCUE DISTRICT TO PURCHASE AIRWAY TRAINING MANIKIN (1 ADULT) TO PROVIDE NECESSARY HANDS-ON TRAINING.$15,000 GSHCS CHILDRENS CENTER TO BUILD A SHADE STRUCTURE FOR THE CHILDREN'S CENTER PLAYGROUND. $7,350 IRRIGON JR./SR/ HIGHSCHOOL TO TURN OLD GRAVEL TRACK INTO TWO GRASS PRACTICE FIELDS. $2,500 MADE TO THRIVE TO SUPPORT EXTRACURRICULAR PROGRAM EXPENSES INCLUDING FEES, SNACKS, GEAR, EQUIPMENT, AND APPAREL. $25,000 MADE TO THRIVE HEROS PROJECT TO HELP BUILD THE HEROS SPORTSPLEX AT EOTEC$4,995 RIVERSIDE JR./SR. HIGHSCHOOL TRACK & FIELD TO REPLACE OUTDATED AND UNSAFE TRACK EQUIPMENT AT RIVERSIDE HIGH SCHOOL. $1,272.63 UMATILLA HIGHSCHOOL SOFTBALL TO PURCHASE NEW BASES AND NECESSARY HARDWARE TO INSTALL THEM.$5,000 WILLOW CREEK PARK DISTRICT TO REPAIR POOL AND BUILDING. IN DECEMBER 2022, THE FOUNDATION AGAIN SPONSORED THE "CHRISTMAS SPIRIT AWARD." THIS AWARD SOLICITED NOMINATIONS FROM THE COMMUNITY TO IDENTIFY INDIVIDUALS WHO REPRESENTED THE SPIRIT OF CHRISTMAS; A SPIRIT OF GIVING THROUGHOUT THE YEAR. SELECTED AS THE 2022 AWARD RECIPIENTS WERE CARL & EDITH HOLT AND LOY LYONS. 368274 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 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 0 0 0 0 0 0 0 X 16 16 1 1 0 0 0 1 1 1 1 0 0 1 1 1 1 0 0 1 1 0 OR X ELIZABETH MARVIN 5416673419 610 NW 11TH STREET HERMISTON OR 97838 DR BRIAN LARSEN MEDICAL STAFF PRESIDENT 1.00 40.00 X 0 397700 62006 ELIZABETH MARVIN EXECUTIVE DIRECTOR 40.00 X 0 99981 20510 CINDY MIDDLETON PRESIDENT 2.00 X X 0 0 0 LISA MITTELSDORF VICE PRESIDENT 2.00 2.00 X X 0 0 0 DEAN FIALKA TREASURER 1.00 X 0 0 0 TYLER BENDIXSEN DIRECTOR 1.00 X 0 0 0 AMANDA CARNINE DIRECTOR 1.00 X 0 0 0 DAVE EGO DIRECTOR (THRU APRIL 2023) 1.00 X 0 0 0 BILL ELFERING DIRECTOR 1.00 2.00 X 0 0 0 MANUEL GUTIERREZ DIRECTOR 1.00 X 0 0 0 MIKE HENDERSON DIRECTOR 1.00 X X 0 0 0 JON LORENCE DIRECTOR 1.00 2.00 X 0 0 0 MIKE MADSEN DIRECTOR 1.00 X 0 0 0 JULIE PUZEY DIRECTOR 1.00 X 0 0 0 LADONNA QUAEMPTS DIRECTOR 1.00 X 0 0 0 DAVE RADEMACHER DIRECTOR 1.00 X 0 0 0 MAYRA ECHEVERRIA REYES DIRECTOR 1.00 X 0 0 0 MARGARET SAYLOR DIRECTOR 1.00 X 0 0 0 SHERON VARIKATT DIRECTOR (THRU MAY 2023) 1.00 X 0 0 0 TOM WAMSLEY DIRECTOR (THRU NOV 2022) 1.00 2.00 X 0 0 0 0 497681 82516 0 0 1 0 0 72325 176608 207132 456065 57205 57205 236796 0 236796 236796 236796 12757 72325 5693 7064 7064 757130 0 0 301065 298984 298984 69290 69290 4728 4728 373002 368274 4728 0 123174 123542 8408257 9118452 8531431 9241994 0 0 X 6390051 7106813 2141380 2135181 8531431 9241994 8531431 9241994 384128 327479 -1044 0 X 0 1 X 1 0 X 208543 143538 249332 337054 456065 1394532 208543 143538 249332 337054 456065 1394532 75283 1319249 320035 317729 324291 51198 57205 1070458 3220 6253 4345 7064 20882 2485872 0.53070 0.57540 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 746203 746203 746203 746203 746203 746203 746203 746203 746203 746203 0.00000 1.00000 0.00000 0 0 0 PART V, LINE 4: ENDOWMENT FUNDS ARE HELD TO SUPPORT THE EXEMPT PURPOSES OF GOOD SHEPHERD HEALTH CARE SYSTEM. GOLF SCRAMBLE 54582 41825 12757 1800 3893 FESTIVAL OF TREES 30500 30500 85082 72325 12757 1800 3893 5693 7064 1 GOOD SHEPHERD HEALTH CARE SYSTEM (GSHCS) 610 NW 11TH STREET HERMISTON OR 97838 930425580 501(C)(3) 68095 0 GS FACILITIES DEPT - PURCHASE HAM RADIO TO ALLOW COMMUNICATION BETWEEN GSMC AND UMATILLA COUNTY EMERGENCY OPERATIONS CENTER ($6,800) / SOUL CARE - PURCHASE RESOURCES FOR PASTORS AND TRAINING FOR SOUL CARE MANAGER ($1,295) / GS CHILDREN'S CENTER - TO BUILD A SHADE STRUCTURE FOR CHILDREN'S CENTER PLAYGROUND ($15,000) / GS COMMUNITY HEALTH AND OUTREACH - TO PROMOTE AND PURCHASE FOOD / MATERIALS FOR FAMILY HEALTH AND FITNESS DAY EVENT. ($7,100), EMPLOYEE EMERGENCY FUND ($27,898) MADE TO THRIVE PO BOX 684 HERMISTON OR 97838 464617953 501(C)(3) 27500 0 TO HELP BUILD THE HEROS SPORTSPLEX AT EOTEC ($25,000) / TO SUPPORT EXTRACURRICULAR PROGRAM EXPENSES INCLUDING FEES, SNACKS, GEAR, EQUIPMENT, AND APPAREL ($2,500) DOMESTIC VIOLENCE SERVICES INC PO BOX 152 HERMISTON OR 97838 930749483 501(C)(3) 14996 0 NEW FLOORING FOR BUILDING ($10,000) / MARY ELLEN PAUL DISBURSEMENT ($4,995.94) EASTERN OREGON MISSION DBA MARTHA'S HOUSE 305 SE 4TH AVE BEND OR 97701 943055593 501(C)(3) 12000 0 NEW FLOORING FOR UPSTAIRS OF BUILDING IRRIGON RURAL FIRE PROTECTION DISTRICT 705 NE MAIN AVE HERMISTON OR 97838 930756294 GOV 11965 0 PURCHASE AED UNITS SWEET POTATO'S CLOSET 110 TAWNY CT PENDLETON OR 97838 851840310 501(C)(3) 10000 0 PURCHASE ITEMS TO STOCK "STORE" THAT MUST BE BOUGHT BRAND NEW KNIGHTS OF COLUMBUS 565 W HERMISTON AVE HERMISTON OR 97838 237544781 501(C)(3) 10000 0 PLUMBING, ELECTRICAL AND COMMERCIAL DISHWASHER BOARDMAN PARKS AND REC 311 N OLSON ROAD HERMISTON OR 97838 930746082 GOV 10000 0 RESURFACE POOL DECK AT PUBLIC POOL EASTERN OREGON UNIVERSITY FOUNDATION 1 UNIVERSITY BLVD PENDLETON OR 97801 936030669 501(C)(3) 9992 0 MARY ELLEN PAUL DISBURSEMENT BLUE MOUNTAIN COMMUNITY COLLEGE FOUNDATION PO BOX 100 BOARDMAN OR 97818 936033846 GOV 9992 0 MARY ELLEN PAUL DISBURSEMENT IRRIGON JRSR HIGH SCHOOL 315 SE WYOMING HERMISTON OR 97838 936000821 GOV 7350 0 TO TURN OLD GRAVEL TRACK INTO TWO GRASS PRACTICE FIELDS 11 0 SCHOLARSHIPS 37 69290 PART I, LINE 2: REQUESTS FOR FINANCIAL ASSISTANCE GENERALLY ARE INITIATED FROM THE ORGANIZATION OR STUDENT AND APPROVED BY THE FOUNDATION BOARD PRIOR TO DISBURSEMENT. GRANT RECIPIENTS ARE REQUIRED TO SHARE BUDGETS AND REPORT ON HOW GRANT MONIES ARE BEING SPENT ON A MONTHLY BASIS UNTIL FULLY EXPENSED FOR THE PURPOSE FOR WHICH GRANTS WERE MADE. SCHOLARSHIP AWARDS ARE MADE OVER THE COURSE OF A SCHOOL YEAR AND RECIPIENTS ARE REQUIRED TO SUBMIT EVIDENCE OF HAVING RECEIVED PASSING GRADES BEFORE RECEIVING CONTINUED FUNDING. 0 0 0 0 0 0 0 0 0 DR BRIAN LARSEN MEDICAL STAFF PRESIDENT 0 385958 0 11742 0 0 0 41000 0 21006 0 459706 0 0 FORM 990, PART VI, SECTION A, LINE 2 THE EXECUTIVE DIRECTOR IS AN EMPLOYEE OF GOOD SHEPHERD HEALTH CARE SYSTEM (GSHCS), A RELATED ORGANIZATION AND HAS A BUSINESS RELATIONSHIP WITH THE FOLLOWING COMMON BOARD MEMBERS OF GSHCS AND THE FOUNDATION: TOM WAMSLEY, BILL ELFERING AND LISA MITTLESDORF. FORM 990, PART VI, SECTION A, LINE 3 THE FOUNDATION UTILIZES AN EMPLOYEE OF GOOD SHEPHERD HEALTH CARE SYSTEM AS ITS EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS IS APPOINTED BY THE BOARD OF DIRECTORS OF GOOD SHEPHERD HEALTH CARE SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B THE AMENDING OF THE GOVERNING DOCUMENTS IS REQUIRED TO BE APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES OF GOOD SHEPHERD HEALTH CARE SYSTEM. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO THE EXECUTIVE DIRECTOR 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 FORM 990. ONCE MANAGEMENT IS SATISFIED WITH THE FORM 990, THE EXECUTIVE DIRECTOR SIGNS THE FORM 8879-EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES AND THE BOARD OF DIRECTORS ARE REQUIRED TO READ AND SIGN THE CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS. ALL POTENTIAL CONFLICTS ARE DISCLOSED. THE BOARD REVIEWS ALL MEMBERS' STATEMENTS AND IF POTENTIAL ISSUES ARISE, THE MEMBER IN QUESTION IS EXCUSED FROM THE ROOM WHILE THE REST OF THE BOARD DISCUSSES AND VOTES ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE FOUNDATION DOES NOT HAVE ANY COMPENSATED EMPLOYEES, THE COMPENSATION INFORMATION DISCLOSED IN PART VII IS ALL PAID BY GOOD SHEPHERD HEALTH CARE SYSTEM (GSHCS). THE ORGANIZATION RELIES ON GSHCS, A RELATED ORGANIZATION, TO DETERMINE COMPENSATION OF THE EXECUTIVE DIRECTOR. THE BOARD OF TRUSTEES OF GSHCS USES DATA FROM A COMPENSATION SURVEY AND COMPARISON TO OTHER SIMILAR ORGANIZATIONS TO DETERMINE THE COMPENSATION FOR THE EXECUTIVE DIRECTOR. THIS PROCESS IS COMPLETED ANNUALLY ON THE ANNIVERSARY DATE OF THE INDIVIDUAL'S HIRE DATE. THE EXECUTIVE DIRECTOR IS THE ONLY OFFICER OR KEY EMPLOYEE. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. GOOD SHEPHERD HEALTH CARE SYSTEM 610 NW 11TH STREET HERMISTON OR 97838 930425580 HEALTHCARE OR 501(C)(3) LINE 3 N/A 0 GOOD SHEPHERD MEDICAL SERVICE CORP 610 NW 11TH STREET HERMISTON OR 97838 930688940 PHARMACY OR N/A C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0