2025-05-14T09:59:34-05:00 2024-06-30 930623286 ALDRICH CPAS AND ADVISORS LLP 1903 WRIGHT PLACE 180 CARLSBAD CA 92008 990 2023-07-01 930688381 COTTAGE GROVE COMMUNITY HOSPITAL FOUNDATION COTT 5413345810 PO BOX 10905 EUGENE OR 97440 JUDY CUNNINGHAM PRESIDENT 5419531456 2025-05-12 1 1 DEBRA D SMITH CPA P00646873 7604318440 2025-05-09 2023 2025-03-06 01:10:19Z JUDY CUNNINGHAM PO BOX 10905 EUGENE OR 97440 98498 0 X WWW.PEACEHEALTH.ORG/FOUNDATION/COTTAGE-GROVE X 2000 OR IMPROVE THE HEALTH & LIVES OF COMMUNITY MEMBERS BY RAISING FUNDS & PROVIDING CHARITABLE SUPPORT. 9 7 0 10 0 0 65972 85757 0 0 1810 4683 0 0 67782 90440 88764 156838 0 0 0 0 0 0 1122 6373 5573 95137 162411 -27355 -71971 838178 813571 0 0 838178 813571 TO IMPROVE THE HEALTH AND LIVES OF COMMUNITY MEMBERS BY PROVIDING CHARITABLE SUPPORT TO PEACEHEALTH COTTAGE GROVE MEDICAL CENTER (THE HOSPITAL) SO THAT COMPASSIONATE, AFFORDABLE AND HIGH-QUALITY MEDICAL CARE MAY BE OFFERED TO ALL IN THIS REGION. 0 0 156838 156838 TRANSFERS TO PEACEHEALTH COTTAGE GROVE MEDICAL CENTER TO SUPPORT THEIR PROGRAM SERVICES. 156838 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 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 9 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 OR X X SACRED HEART MEDICAL CENTER FOUNDATION 5412227100 123 INTERNATIONAL WAY SPRINGFIELD OR 97477 JUDY CUNNINGHAM PRESIDENT 1.00 X X 0 0 0 FAYE H STEWART VICE PRESIDENT 1.00 X X 0 0 0 GLENDA KOYAMA TREASURER/SECRETARY 1.00 X X 0 0 0 JASON HAWKINS DIRECTOR 1.00 40.00 X 0 286251 59045 ZUZANNA M WIECKOWSKA DIRECTOR 1.00 40.00 X 0 293359 61208 JAMES E GILROY DIRECTOR 1.00 X 0 0 0 ELIZABETH E BADEN DIRECTOR 1.00 X 0 0 0 BRIAN MCCASLINE DIRECTOR 1.00 X 0 0 0 BOBETTE PETERSON DIRECTOR 1.00 X 0 0 0 JENNIFER SVIHUS EXECUTIVE DIRECTOR 40.00 X 0 280494 22965 0 860104 143218 0 0 1 0 0 85757 85757 2969 2969 9772 8058 1714 1714 1714 90440 0 0 4683 156838 156838 3425 3425 505 505 DIRECT EVENT EXPENSE 1122 0 0 1122 BAD DEBT ALLOWANCE 521 0 521 0 162411 156838 4451 1122 107723 30051 493456 517672 0 14213 236999 251635 838178 813571 0 0 X 494424 519668 343754 293903 838178 813571 838178 813571 -71971 47364 0 X 0 1 X 1 0 X 102772 59317 137395 65972 85757 451213 102772 59317 137395 65972 85757 451213 91779 359434 1679 982 2472 2775 2969 10877 4482 4482 10036 556 1149 11741 478313 0.75150 0.74060 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 236999 24408 9772 251635 239823 6478 9302 236999 239030 9638 8845 239823 200699 47169 8838 239030 204425 4999 8725 200699 0.52730 0.47270 1 0 0 BENEFICIAL INTEREST, OREGON COMMUNITY FOUNDATION 251635 F 251635 X 239948 47364 105569 152933 87015 3425 3425 90440 264555 105569 105569 158986 3425 3425 162411 PART V, LINE 4: ENDOWMENT FUNDS ARE HELD BY OREGON COMMUNITY FOUNDATION. INTEREST, DIVIDENDS, REALIZED AND UNREALIZED GAINS AND LOSSES ARE ALLOCATED QUARTERLY TO THE FOUNDATION ENDOWMENT FUNDS IN PROPORTION TO EACH FUND'S SHARE IN THE ASSETS. PART X, LINE 2: FOR THE YEARS ENDED JUNE 30, 2024 AND 2023, 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, 2024 AND 2023. 1 PEACEHEALTH 1115 SE 164TH AVE SUITE 332 VANCOUVER WA 98683 910939479 501(C)(3) 0 156838 SUPPORT FOR PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER. 1 0 PART I, LINE 2: GRANTS REQUESTS FROM DONOR RESTRICTED FUNDS ARE SUBMITTED BY HOSPITAL ADMINISTRATION, INCLUDING AN INDICATION FROM WHICH FOUNDATION FUND MONEY IS BEING REQUESTED, AND ACCOMPANIED BY RECEIPTS, INVOICES AND OTHER VERIFICATION OF THE PROPOSED USE OF FUNDS (REIMBURSEMENT). FOUNDATION STAFF REVIEW THE REQUEST FOR COMPLIANCE WITH DONOR RESTRICTIONS AND COMPLIANCE WITH EXPENDITURE DOCUMENTATION PROCEDURES. IF THIS INFORMATION IS IN ORDER, THEN A TRANSFER IS INITIATED BY THE FOUNDATION TO THE HOSPITAL. THE FOUNDATION BOARD APPROVES THE TRANSFERS AT ITS QUARTERLY BOARD MEETINGS. REQUESTS FOR THE USE OF UNRESTRICTED FUNDS FOLLOWS THE SAME PROCESS, BUT THE FOUNDATION BOARD MOST APPROVE THE REQUESTS BEFORE THE TRANSFERS ARE INITIATED. X X X X 1 1 0 1 0 0 0 0 0 0 0 ZUZANNA M WIECKOWSKA DIRECTOR 0 289699 0 3660 0 0 0 29772 0 31436 0 354567 0 0 JASON HAWKINS DIRECTOR 0 286251 0 0 0 0 0 26739 0 32306 0 345296 0 0 JENNIFER SVIHUS EXECUTIVE DIRECTOR 0 263955 0 10000 0 6539 0 0 0 22965 0 303459 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 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. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY AN INDEPENDENT CPA FIRM AND IS PRESENTED TO THE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REMINDED TO RECUSE THEMSELVES FROM VOTING ON ITEMS THAT INVOLVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 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. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST VIA MAIL OR E-MAIL. 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