2019-11-14T15:17:35-06:00 2018-12-31 930928924 PERKINS & COMPANY PC 1211 SW FIFTH AVE SUITE 1000 PORTLAND OR 972043710 990 2018-01-01 930878074 FAMILYCARE INC FAMI 5034712103 2121 SW BROADWAY SUITE 115 PORTLAND OR 97201 ROBERT K CARUS SECRETARY 5034712103 2019-11-13 1 CYNTHIA P BARTHOLOMEW P01313965 5032210336 2019-11-13 52.183.24.237 2019-11-13 13:05:20 PS P 107EDC9825E31507E2C414B50C50019CDA1077BD D2C01C9AB4B0B15F4225B95C8306F5C5D0622163 2018 2020-04-17 16:48:07Z X ROBERT K CARUS 2121 SW BROADWAY SUITE 115 PORTLAND OR 97201 378633879 0 X WWW.FAMILYCAREINC.ORG X 1984 OR TO PROVIDE COMMUNITY HEALTH CARE. 9 8 326 0 0 20904 60928 118484 512666738 68128160 8360380 3712972 34902 0 521122948 71959616 1114640 20197680 0 0 35111102 8989330 0 0 0 523149001 50791241 559374743 79978251 -38251795 -8018635 176652870 93145656 88546638 17444145 88106232 75701511 TO PROVIDE PROGRAMS OF COOPERATIVE AND COMPREHENSIVE HEALTHCARE TO THE COMMUNITY. 0 0 53605193 20197680 68128160 DURING 2018, FAMILYCARE INC. PROVIDED COMPREHENSIVE AND COOPERATIVE HEALTH CARE TO MEMBERS ACCORDING TO THE TERMS OF A CONTRACT WITH THE OREGON HEALTH PLAN/MEDICAID (THE CONTRACT). THE CONTRACT WITH THE OREGON HEALTH PLAN/MEDICIAD ENDED JANUARY 31, 2018. APPROXIMATELY 106,000 MEMBERS WERE UNDER THE CONTRACT. SINCE THE END OF THE CONTRACT, FAMILYCARE INC. HAS BEEN WINDING DOWN OPERATIONS AS IT SATISFIES REMAINING OBLIGATIONS UNDER THE CONTRACT. FAMILYCARE INC. ANTICIPATES THE ORDERLY WIND DOWN OF OPERATIONS TO CONTINUE THROUGH AT LEAST 2019. 53605193 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 971 0 1 326 1 0 0 0 0 1 1 0 0 0 X 9 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X WILLIAM MURRAY 5037343147 2121 SW BROADWAY SUITE 115 PORTLAND OR 97201 ROBIN RICHARDSON DO CHAIR & BOARD MEMBER 1.00 1.00 X X 8250 0 0 MATT DASKALOS VICE CHAIR & BOARD MEMBER 1.00 0.00 X X 1250 0 0 PATRICIA PARKER SECRETARY (PART YEAR) & BOARD MEMBER 1.00 0.00 X X 750 0 0 JEFFREY PAWLOWSKI TREASURER & BOARD MEMBER 1.00 1.00 X X 6250 0 0 ROBERT CARUS SECRETARY (PART YEAR) & BOARD MEMBER 1.00 0.00 X X 2000 0 0 RICHARD BARSOTTI BOARD MEMBER 1.00 0.00 X 2750 0 0 JOE HROMCO BOARD MEMBER 1.00 0.00 X 1000 0 0 MICHAEL RILEY BOARD MEMBER 1.00 1.00 X 1250 0 0 CARL ERICKSON BOARD MEMBER 1.00 1.00 X 393 0 0 ROYAL E HARRIS BOARD MEMBER 1.00 0.00 X 1000 0 0 JEFFREY HEATHERINGTON PRESIDENT & CEO 25.00 15.00 X 510181 0 32684 WILLIAM MURRAY COO 30.00 10.00 X 372474 0 24806 KEVIN CLANCY VP FINANCE 30.00 10.00 X 217956 0 10942 OSCAR CLARK VP COMMUNITY & HEALTH SERV 30.00 10.00 X 224214 0 13930 CHRIS JACOBSEN VP INFORMATION TECHNOLOGY 30.00 10.00 X 221794 0 15185 CHERI PFANNES VP CORPORATE COMPLIANCE 30.00 10.00 X 192661 0 5746 ANA JIMENEZ DIRECTOR 30.00 10.00 X 305480 0 16949 KARIN VILLIARIMO DIRECTOR 30.00 10.00 X 256546 0 14052 MICHELLE NARDONE ANALYST 30.00 10.00 X 218519 0 8486 SHANNON NOEL PHARMACIST 30.00 10.00 X 198923 0 13509 CHRISTINE PRICE ANALYST 30.00 10.00 X 181240 0 6849 2924881 0 163138 38 0 1 0 PERKINS COIE LLP 1201 THIRD AVENUE SUITE 4900 SEATTLE WA 98101 LEGAL AND PROFESSIONAL 7853584 LEGACY EMANUEL HOSPITAL AND HEALTH CENTE 2801 N GANTENBEIN AVE PORTLAND OR 97227 MEDICAL SERVICES-HOSPITAL 7674648 OREGON HEALTH SCIENCES UNIVERSITY 3181 SW SAM JACKSON PARK RD PORTLAND OR 97239 MEDICAL SERVICES-HOSPITAL 6579335 PROVIDENCE PORTLAND MEDICAL CENTER 4805 NE GLISAN ST PORTLAND OR 97213 MEDICAL SERVICES-HOSPITAL 3463161 PROVIDENCE ST VINCENT MEDICAL CENTER 9205 SW BARNES RD PORTLAND OR 97225 MEDICAL SERVICES-HOSPITAL 3392210 148 118484 118484 MEDICAID CONTRACTS 624100 63066546 63066546 BAD DEBT RECOVERY 424000 5061614 5061614 68128160 2563365 2563365 307756173 67697 305242388 1431875 2513785 -1364178 1149607 1149607 71959616 68128160 0 3712972 20197680 20197680 1867466 505765 1361701 4114360 4114360 283594 219037 64557 1269582 980575 289007 1454328 1123265 331063 9163628 9163628 185188 185188 2579 2579 3442981 3442981 -1055 -1055 248697 248697 710582 710582 42383 42383 6217 6217 454605 454605 476798 476798 OTHER PROFESSIONAL SERV 12248974 12248974 PHYSICIAN SERVICES 10106739 10106739 OTHER ADMINISTRATIVE EX 7760537 7760537 INPATIENT HOSPITAL 5180731 5180731 761657 -1071933 1833590 79978251 53605193 26373058 0 18526539 3214814 26949145 42170629 3581591 0 1558279 19653 0 0 2163399 0 104667100 27212097 0 19206817 20528463 176652870 93145656 88215573 17444145 331065 0 88546638 17444145 X 88106232 75701511 88106232 75701511 176652870 93145656 X -8018635 -7183672 2797586 X X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25000 0 0 0 PART I-A, LINE 1: MONETARY DONATIONS TO SUPPORT CANDIDATES FOR ELECTIVE PUBLIC OFFICE 0 DUE FROM AFFILIATES 53562 OTHER ASSETS, NET 226219 INVESTMENT IN FAMILYCARE HEALTH PLANS 19706816 ACCRUED INTEREST AND DIVIDENDS 541866 20528463 1 GENERAL OPERATING SUPPORT GENERAL OPERATING SUPPORT GENERAL OPERATING SUPPORT GENERAL OPERATING SUPPORT THE LUND REPORT PO BOX 82841 PORTLAND OR 97282 263019179 501(C)(3) 15000 GENERAL SUPPORT AMERICAN OSTEOPATHIC FOUNDATION 142 EAST ONTARIO ST 1450 CHICAGO IL 60611 362170786 501(C)(3) 25000 GENERAL SUPPORT AND EDUCATION WESTERN UNIVERSITY OF HEALTH SCIENCES 200 MULLINS DR LEBANON OR 97355 953127273 501(C)(3) 10000 GENERAL SUPPORT AND EDUCATION WILSON STRATEGIC COMMUNICATIONS 3500 188TH ST SW STE 590 LYNNWOOD WA 98037 201502691 N/A 15000 SPONSORSHIP OF 2018 OREGON STATE OF REFORM HEALTH POLICY CONFERENCE HEATHERINGTON FOUNDATION FOR INNOVATION AND EDUCATION IN HEALTH CARE 2121 SW BROADWAY NO 115 PORTLAND OR 97201 930988354 501(C)(3) 20000000 GENERAL SUPPORT 4 1 PART I, LINE 2: GRANT RECIPIENTS SUBMIT PERIODIC REPORTS AS DEFINED BY THEIR AGREEMENTS. REPORTS INCLUDE INVOICES CONTAINING SERVICES RENDERED AND PERIOD COVERED. X 0 1 X X X X X 1 0 0 0 0 0 0 0 0 JEFFREY HEATHERINGTON PRESIDENT & CEO 504000 0 0 0 6181 0 24750 0 7934 0 542865 0 0 0 WILLIAM MURRAY COO 370494 0 0 0 1980 0 8250 0 16556 0 397280 0 0 0 KEVIN CLANCY VP FINANCE 217498 0 0 0 458 0 4188 0 6754 0 228898 0 0 0 OSCAR CLARK VP COMMUNITY & HEALTH SERV 224029 0 0 0 185 0 6721 0 7209 0 238144 0 0 0 CHRIS JACOBSEN VP INFORMATION TECHNOLOGY 221372 0 0 0 422 0 5204 0 9981 0 236979 0 0 0 CHERI PFANNES VP CORPORATE COMPLIANCE 191535 0 0 0 1126 0 5746 0 0 0 198407 0 0 0 ANA JIMENEZ DIRECTOR 304380 0 0 0 1100 0 7333 0 9616 0 322429 0 0 0 KARIN VILLIARIMO DIRECTOR 256482 0 0 0 64 0 3897 0 10155 0 270598 0 0 0 MICHELLE NARDONE ANALYST 218479 0 0 0 40 0 1732 0 6754 0 227005 0 0 0 SHANNON NOEL PHARMACIST 198813 0 0 0 110 0 3893 0 9616 0 212432 0 0 0 CHRISTINE PRICE ANALYST 181074 0 0 0 166 0 2662 0 4187 0 188089 0 0 0 PART I, LINE 1A FIRST CLASS AIRLINE TRAVEL PAID FOR EXECUTIVES ON LONG DURATION FLIGHTS (I.E. TO EAST COAST) OR FOR OCCASIONAL LAST-MINUTE TRAVEL PLANS WHEN COACH SEATS ARE NOT AVAILABLE. NOT INCLUDED IN TAXABLE COMPENSATION. PART I, LINE 1B THE POLICY IS DETERMINED BY THE CEO AND IS NOT IN WRITING. PART I, LINE 4A SEVERANCE PAYMENTS: CHRIS JACOBSEN - $47,896 KEVIN CLANCY - $77,898 ANA JIMENEZ - $59,932 KARIN VILLIARIMO - $126,588 MICHELLE NARDONE - $160,743 SHANNON NOEL - $66,043 CHRISTINE PRICE - $92,346 WESTERN PSYCHOLOGICAL & COUNSELING SERVICES INC BOARD MEMBER JOSEPH HROMCO IS THE VICE PRESIDENT OF OPERATIONS 572172 EXPENSES PAID TO A PROVIDER CLINIC FOR HEALTHCARE-RELATED SERVICES. 0 FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBER JOE HROMCO CONTROLS AN ENTITY THAT DOES BUSINESS WITH FAMILYCARE, INC. JEFFREY PAWLOWSKI, BOARD MEMBER, AND MICHAEL RILEY, BOARD MEMBER, HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 SEE THE DESCRIPTION PROVIDED FOR PART VI, SECTION A, LINE 7B, BELOW. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS 8 CORPORATE MEMBERS. THE CORPORATE MEMBERS ELECT THE ORGANIZATION'S BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE POWERS RESERVED TO THE MEMBERS ARE THE FOLLOWING: (A) AMENDING THE ARTICLES OF INCORPORATION; (B) AMENDING THE BYLAWS (C) APPOINTING MEMBERS; (D) ELECTING THE BOARD OF DIRECTORS; (E) APPROVING EXPENDITURES OF MORE THAN 5% OF THE RESERVES OF THE ORGANIZATION; AND (F) APPROVING THE SALE, TRANSFER, MERGER, OR DISSOLUTION OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 IS PROVIDED TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING THE OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION METHODOLOGY: CEO: THE LEVEL AND ADEQUACY OF CEO TOTAL COMPENSATION IS DETERMINED AND APPROVED BY THE BOARD OF DIRECTORS. THE CEO PERFORMS UNDER AN EXECUTIVE EMPLOYMENT CONTRACT WHICH IS NEGOTIATED AND UPDATED BY THE BOARD. ONLY INDEPENDENT MEMBERS OF THE BOARD CONDUCT THE REVIEW AND MAKE DECISIONS REGARDING THE CEO'S SALARY. THE BOARD USES AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO REVIEW AND ESTABLISH THE CEO'S TOTAL COMPENSATION. THE TWO MOST RECENT REVIEWS COMPLETED BY THE CONSULTANT WERE IN MAY 2015 AND APRIL 2017. KEY EMPLOYEES: THE LEVEL AND ADEQUACY OF KEY EMPLOYEES TOTAL COMPENSATION IS DETERMINED BY THE CEO, WITH INPUT FROM THE VICE PRESIDENT OF HUMAN RESOURCES. THE CEO AND VICE PRESIDENT OF HUMAN RESOURCES USE AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO REVIEW AND ESTABLISH KEY EMPLOYEES TOTAL COMPENSATION. THE TWO MOST RECENT REVIEWS COMPLETED BY THE CONSULTANT WERE IN MAY 2015 AND APRIL 2017. OTHER EMPLOYEES: THE VICE PRESIDENT OF HUMAN RESOURCES IS ACCOUNTABLE TO USE PUBLISHED, REPUTABLE DATA FOR COMPARISONS OF JOB ACCOUNTABILITIES AND COMPENSATION RANGES, INCLUDING DATA PROVIDED BY INDEPENDENT COMPENSATION CONSULTANTS. BASED ON THE DATA, THE VICE PRESIDENT OF HUMAN RESOURCES ESTABLISHES AND UPDATES THE COMPENSATION RANGES, AND RESPONDS TO ANY INQUIRIES RELATED TO FAIRNESS, EQUITY AND PROCESS. FORM 990, PART VI, SECTION C, LINE 19 FAMILYCARE, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART XI, LINE 9: GAIN FROM SUBSIDIARY 2,797,586. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSEEING THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTING AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. FAMILYCARE HEALTH PLANS INC 2121 SW BROADWAY SUITE 115 PORTLAND OR 97201 911829317 TO PROVIDE COMMUNITY HEALTH CARE OR 501(C)(4) FAMILYCARE INC 1 HEATHERINGTON FOUND FOR INNOVATION AND EDUCATION IN HEALTH CARE 2121 SW BROADWAY SUITE 115 PORTLAND OR 97201 930988354 TO SUPPORT INNOVATION AND FUND HEALTHCARE EDUCATION OR 501(C)(3) PF N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 FAMILYCARE HEALTH PLANS INC N 113006 CASH - U.S. CURRENCY FAMILYCARE HEALTH PLANS INC O 388796 CASH - U.S. CURRENCY HEATHERINGTON FOUNDATION FOR INNOVATION B 20000000 CASH - U.S. CURRENCY PART II FAMILYCARE, INC. IS RELATED TO FAMILYCARE HEALTH PLANS, INC. AND TO HEATHERINGTON FOUNDATION FOR INNOVATION AND EDUCATION IN HEALTH CARE, BOTH TAX-EXEMPT ORGANIZATIONS, BY VIRTUE HAVING BOARD MEMBERS IN COMMON. MORE THAN 50% OF MEMBERS OF THE RELATED ORGANIZATIONS' BOARDS ALSO SERVE ON FAMILYCARE, INC.'S BOARD OF DIRECTORS.