2017-07-26T19:45:22-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2016-01-01 910893287 NEIGHBORCARE HEALTH NEIG 2064616935 1200 12TH AVENUE SOUTH NO 901 SEATTLE WA 98144 MICHAEL ERIKSON CEO 2064616935 2017-07-26 1 KURT BENNION CPA P01469618 4252506100 67.137.57.251 2017-07-26 09:02:09 PD P E8F928E9D0C866B10A8A9E52340F1A707FC238CD 5C00B405BF4A66E7F27E07300AA9AC0D580A9EB8 2016 2021-01-29 14:40:06Z MICHAEL ERIKSON 1200 12TH AVENUE SOUTH NO 901 SEATTLE WA 98144 84581879 0 X WWW.NEIGHBORCARE.ORG X 1969 WA PROVIDE COMPREHENSIVE HEALTH CARE TO FAMILIES AND INDIVIDUALS WHO HAVE DIFFICULTY ACCESSING CARE. 14 14 945 163 0 0 26991252 25206046 40642985 49678477 -182912 144682 1422167 3499936 68873492 78529141 0 0 0 0 40361574 48854532 0 0 86631 20023406 24861835 60384980 73716367 8488512 4812774 73787233 79745839 27882713 28979207 45904520 50766632 X THE ORGANIZATION IS A COMMUNITY-BASED, NON-PROFIT AGENCY THAT OPERATES 31 MEDICAL, DENTAL, AND SCHOOL-BASED HEALTH CENTERS THROUGHOUT SEATTLE AND PROVIDES SERVICES TO OVER 68,398 PEOPLE EACH YEAR. OUR CLINICS ARE LOCATED THROUGHOUT AREAS OF KING COUNTY THAT HAVE THE HIGHEST RATES OF UNINSURED FAMILIES AND THE GREATEST ETHNIC DIVERSITY. INTEGRATED HEALTHCARE SERVICES ARE PROVIDED ON A SLIDING FEE SCALE FOR THE UNINSURED, AND NO ONE IS EVER TURNED AWAY DUE TO INABILITY TO PAY. WE ARE UNIQUELY SKILLED IN PROVIDING CULTURALLY RESPONSIVE SERVICES TO OUR DIVERSE PATIENT POPULATION, WHICH INCLUDES PATIENTS WHO SPEAK MORE THAN 100 DIFFERENT LANGUAGES AND DIALECTS AND REPRESENT MANY CULTURAL GROUPS. WE PROVIDE SERVICES TO RESIDENTS OF URBAN SEATTLE AND SURROUNDING AREAS. OUR TARGET POPULATION CONSISTS OF THE URBAN POOR, UNINSURED, MEDICAID ELIGIBLE, HOMELESS, RECENT IMMIGRANTS, NON-ENGLISH SPEAKING, AS WELL AS THOSE WHO ARE ISOLATED FROM SERVICES DUE TO TRANSPORTATION OR CULTURAL BARRIERS. 0 0 37079421 0 32753337 PRIMARY MEDICAL CARE SERVICES INCLUDE THE DIAGNOSIS AND TREATMENT OF ILLNESS AND INJURY, CHRONIC DISEASE MANAGEMENT, HEALTH EDUCATION AND PREVENTIVE CARE (SUCH AS WELL-CHILD EXAMS, SCREENING SERVICES AND IMMUNIZATIONS), SOCIAL WORK, MENTAL HEALTH AND CHEMICAL DEPENDENCY SERVICES. NEIGHBORCARE HEALTH ALSO PROVIDES NUTRITION EDUCATION, MATERNITY SUPPORT SERVICES (INCLUDING MIDWIFERY SERVICES), WIC (WOMEN, INFANT, AND CHILDREN PROGRAM) SERVICES AND OUTREACH, AND PUBLIC INSURANCE APPLICATION ASSISTANCE. NEIGHBORCARE HEALTH PROVIDES SPECIALIZED PROGRAMS SUCH AS WOMEN'S HEALTH, TB, HIV, AND PROGRAMS FOCUSED ON CARING FOR HOMELESS YOUTH AND FAMILIES. THE MEDICAL PROGRAM ENCOURAGES PATIENT INVOLVEMENT IN IMPROVING AND MAINTAINING GOOD HEALTH. IN 2016, NEIGHBORCARE HEALTH PROVIDED 204,168 VISITS TO 52,488 PATIENTS AND $5,429,754 OF CHARITY CARE. 13197707 0 11793625 GENERAL DENTISTRY SERVICES INCLUDE ORAL HEALTH EXAMS, HYGIENE, AND RESTORATIVE SERVICES TO CONTAIN THE DISEASE PROCESS. PERIODONTAL AND ENDODONTIC CARE IS ALSO PROVIDED. IN 2016, NEIGHBORCARE PROVIDED 76,403 DENTAL VISITS TO 34,671 CHILDREN AND ADULTS. 3463733 0 3018821 SCHOOL-BASED HEALTH SERVICES INCLUDE PRIMARY MEDICAL SERVICES, MENTAL HEALTH, SUBSTANCE ABUSE COUNSELING, TOBACCO PREVENTION AND CESSATION PROGRAMS, AND A VARIETY OF SUPPORT GROUPS FOR YOUTH, ALL WITHIN SEATTLE PUBLIC SCHOOLS. EMPHASIS IS PLACED ON AGE-APPROPRIATE HEALTH EDUCATION AND SKILL-BUILDING TO HELP YOUTH MAKE HEALTHY LIFESTYLE CHOICES SO THAT THEY MAY THRIVE AT SCHOOL AND BUILD STRONG RELATIONSHIPS AT SCHOOL, HOME, AND IN THEIR COMMUNITY. IN 2016, NEIGHBORCARE HEALTH PROVIDED 20,463 VISITS TO 6,932 SCHOOL-BASED PATIENTS. 3259199 0 2840559 SERVICES FOR HOMELESS PATIENTS INCLUDE PROGRAMS OPERATED IN PARTNERSHIP WITH THE CITY OF SEATTLE'S HEALTH CARE FOR THE HOMELESS INITIATIVE. FAMILY TEAM FOCUSES ON CRISIS INTERVENTION THERAPY, MENTAL HEALTH COUNSELING, CHILD GROWTH AND DEVELOPMENT, IMMUNIZATION SCREENING, PARENTING SKILLS, SELF-CARE SKILLS, CHRONIC AND ACUTE DISEASE MANAGEMENT AND REFERRALS FOR LONG-TERM CARE. THE HOMELESS YOUTH CLINIC PROVIDES SERVICES TO HOMELESS AND STREET INVOLVED YOUTH, INCLUDING PRIMARY MEDICAL CARE, DENTAL CARE, SOCIAL SERVICES, MENTAL HEALTH COUNSELING, ACUPUNCTURE, NATUROPATHY, YOGA, AND OUTREACH, AS WELL AS A RANGE OF ALLOPATHIC COMPLEMENTARY AND ALTERNATIVE HEALTH CARE SERVICES. 3259199 0 2840559 57000060 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 92 0 945 1 0 0 0 0 0 1 1 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X X JANINE CHILDS 2065483034 1200 12TH AVENUE SOUTH SUITE 901 SEATTLE WA 98144 TONY BOZZUTI CHAIR 4.50 0.00 X X 0 0 0 RICK RUBIN VICE CHAIR 1.00 0.00 X X 0 0 0 ANDREA DAHL SECRETARY 2.50 0.00 X X 0 0 0 BARBARA SHICKICH TREASURER 2.00 0.00 X X 0 0 0 JENNIFER BELL DIRECTOR 1.00 0.00 X 0 0 0 ANDREW FEMLING DIRECTOR 0.50 0.00 X 0 0 0 HOLLY FERRARO DIRECTOR 0.50 0.00 X 0 0 0 BOB GREENLEE DIRECTOR 1.00 0.00 X 0 0 0 SALIL GUPTE DIRECTOR 2.00 0.00 X 0 0 0 ABDIRASHID ISAAK DIRECTOR 0.50 0.00 X 0 0 0 JOYCE LAMMERT MD DIRECTOR 0.70 0.00 X 0 0 0 ROM LEE DIRECTOR 1.00 0.00 X 0 0 0 TAMIKO MIYANO DIRECTOR 2.00 0.00 X 0 0 0 NANCY NIPPLES DIRECTOR 1.00 0.00 X 0 0 0 EVELYN PICKETTS DIRECTOR 0.30 0.00 X 0 0 0 MARK SECORD MPH EXECUTIVE DIRECTOR/CEO 40.00 0.00 X 45637 0 27322 MICHAEL ERIKSON MSW CHIEF EXECUTIVE OFFICER 50.00 0.00 X 297069 0 31194 JANINE CHILDS MHA CHIEF FINANCIAL OFFICER 49.50 0.50 X 174281 0 24353 KATIE BELL MBA MHA CHIEF OPERATING OFFICER 60.00 0.00 X 242934 0 32391 MARCUS REMPEL MD PHD CHIEF MEDICAL OFFICER 40.00 0.00 X 246665 0 46750 SARAH VANDER BEEK DMD CHIEF DENTAL OFFICER 40.00 0.00 X 183520 0 27735 THOMAS SCOTT MD SITE MEDICAL DIRECTOR 40.00 0.00 X 206110 0 41141 DIANA RYBAKOV DDS DENTIST 40.00 0.00 X 158004 0 36685 MARGARET ADAM MD SITE MEDICAL DIRECTOR 32.00 0.00 X 161603 0 31128 ROGER DOWDY MSW INTERIM CHIEF OPERATING OFFICER 40.00 0.00 X 134619 0 32765 CHRISTOPHER DODD MD SITE MEDICAL DIRECTOR 40.00 0.00 X 134681 0 12705 1985123 0 344169 48 0 1 0 LEASE CRUTCHER LEWIS WA LLC 107 SPRING ST SEATTLE WA 98104 CONSTRUCTION 1133403 UNIVERSAL LANGUAGE SERVICES INC PO BOX 4147 BELLEVUE WA 98009 LANGUAGE INTERPRETATION 307249 JONES BOYS MAINTENANCE CO INC 1813 130TH AVE NE STE 110 BELLEVUE WA 98005 JANITORIAL 295968 INDEMAND INTERPRETING 555 ANDOVER PARK W STE 201 TUKWILA WA 98188 LANGUAGE INTERPRETATION 266514 LE COST DENTAL LABORATORY 4144 CALIFORNIA AVE SW SEATTLE WA 98166 LAB SERVICES 174683 6 31101 48012 1048869 19918273 4159791 1777387 25206046 CAPITATED PLAN 621400 25136530 25136530 MEDICARE/MEDICAID PMT 621400 15098723 15098723 PATIENT FEES 621400 4987537 4987537 OTHER SERVICE REVENUE 621400 4455687 4455687 49678477 176215 176215 727865 0 727865 727865 727865 5630897 324019 5631623 354826 -726 -30807 -31533 -31533 156694 48012 66289 90405 90405 OTHER REVENUE 900099 2681666 2681666 2681666 78529141 50406342 0 2916753 1379851 241067 1138784 39157188 31198508 7901381 57299 1032135 822354 208271 1510 3674168 2857303 811857 5008 3611190 2808327 797941 4922 96342 45840 50502 73013 34740 38273 5779298 2798632 2980666 79566 64302 15264 4497883 3635015 862868 73540 59432 14108 2114532 1663796 450736 48441 18990 29451 240606 94321 146285 216211 213102 3109 2363509 1782295 581214 253246 161189 92057 PHARMACEUTICALS 5003989 5003989 BAD DEBT EXPENSE 1921110 1921110 MEDICAL SUPPLIES 1471243 1174542 278809 17892 LABORATORY FEES 375888 375104 784 253418 26102 227316 73716367 57000060 16629676 86631 775605 3197563 1598315 4167252 2669024 2669747 2948915 4727116 894538 14471 173669 225476 944660 1032077 44244735 15970810 26333022 28273925 5996109 5000268 31453376 30437944 73787233 79745839 5568473 9499542 202550 331749 21981704 19066704 129986 81212 27882713 28979207 X 41530636 45973247 4373884 4793385 45904520 50766632 73787233 79745839 X 4812774 564 48774 X 0 1 X 1 1 1 X 13027656 14098483 18049915 26991252 25206046 97373352 13027656 14098483 18049915 26991252 25206046 97373352 97373352 114609 100658 89642 242960 904080 1451949 1166476 1088724 1020529 1365937 2838360 7480026 106305327 175789748 0.91600 0.93320 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: EHR INCENTIVE PAYMENT OTHER REVENUE SPECIAL FUNDRAISING EVENT REVENUES RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 74168734 74168734 1000000 250000 0 0 1000000 1000000 1000000 3000000 4500000 13000 12000 0 25000 250000 250000 250000 750000 1125000 2592380 2592380 24365198 7520130 16845068 4396874 2792033 1604841 12793953 5658647 7135306 96330 96330 28273925 FACILITY CONTRIBUTION RECEIVABLE 3945242 NEIGHBORCARE HEALTH LENDER RECEIVABLE 12810777 MERIDIAN CENTER FOR HEALTH RECEIVABLE 13681925 30437944 INTEREST RATE SWAP 81212 81212 X 71895183 564 538751 66289 605604 71289579 7239562 7239562 78529141 72400297 538751 66289 605040 71795257 1921110 1921110 73716367 PART X, LINE 2: NEIGHBORCARE HEALTH HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT RELATED TO THE ORGANIZATION'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. MANAGEMENT EVALAUTED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. THE ORGANIZATION'S FEDERAL INCOME TAX RETURNS ARE GENERALLY SUBJECT TO EXAMINATION FOR THREE YEARS AFTER THEY ARE FILED. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 66,289. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT EARNINGS 176,053. AFFORDABLE CARE ACT CAPITAL DEVELOPMENT GRANT REVENUE 2,206,522. CAPITAL CAMPAIGN 2,935,877. BAD DEBT EXPENSE 1,921,110. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 66,289. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,921,110. SPRING EVENT 166691 38012 128679 8350 30333 4200 FEAST AT THE MARKET 38015 10000 28015 200 800 20481 100 1825 0 204706 48012 156694 200 9150 50814 100 6025 66289 90405 X X X X X 1 0 0 0 0 0 0 0 0 MICHAEL ERIKSON MSW CHIEF EXECUTIVE OFFICER 297069 0 0 0 0 0 18000 0 13194 0 328263 0 0 0 JANINE CHILDS MHA CHIEF FINANCIAL OFFICER 174281 0 0 0 0 0 17481 0 6872 0 198634 0 0 0 KATIE BELL MBA MHA CHIEF OPERATING OFFICER 199777 0 0 0 43157 0 25670 0 6721 0 275325 0 0 0 MARCUS REMPEL MD PHD CHIEF MEDICAL OFFICER 246665 0 0 0 0 0 35906 0 10844 0 293415 0 0 0 SARAH VANDER BEEK DMD CHIEF DENTAL OFFICER 183520 0 0 0 0 0 27172 0 563 0 211255 0 0 0 THOMAS SCOTT MD SITE MEDICAL DIRECTOR 206110 0 0 0 0 0 34213 0 6928 0 247251 0 0 0 DIANA RYBAKOV DDS DENTIST 158004 0 0 0 0 0 25638 0 11047 0 194689 0 0 0 MARGARET ADAM MD SITE MEDICAL DIRECTOR 161603 0 0 0 0 0 24256 0 6872 0 192731 0 0 0 ROGER DOWDY MSW INTERIM CHIEF OPERATING OFFICER 134619 0 0 0 0 0 24697 0 8068 0 167384 0 0 0 PART I, LINE 4A KATIE BELL, CHIEF OPERATING OFFICER, RECEIVED A SEVERANCE PAYMENT OF $43,157. X 5 18936 SELLING PRICE X 1 43 DONOR VALUED X 12 1750840 SELLING PRICE X BUS TICKETS 230 7568 DONOR VALUED 0 0 1 1 PART I, LINE 32B: THE ORGANIZATION USES ITS BROKERAGE FIRM, WELLS FARGO SECURITIES LLC, TO ACCEPT AND SELL DONATED SECURITIES. FORM 990, PART VI, SECTION A, LINE 1 THE BOARD HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE FOUR OFFICERS AND THREE ADDITIONAL BOARD MEMBERS. THE EXECUTIVE COMMITTEE HAS THE POWERS CONFERRED BY THE BOARD OF DIRECTORS TO ACT BETWEEN MEETINGS, TO MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS, AND TO CARRY OUT SPECIAL RESPONSIBILITIES ASSIGNED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE FACILITATES AN ANNUAL EVALUATION OF THE CEO, AND ANNUALLY REVIEWS AND SETS THE COMPENSATION OF THE CEO. THE EXECUTIVE COMMITTEE DETERMINES AND RECOMMENDS TO THE BOARD OF DIRECTORS FROM TIME TO TIME THE SLATE OF CANDIDATES FOR NOMINATION TO ELECTION AS OFFICERS OF THE BOARD. ANY INTERIM ACTION TAKEN BY THE EXECUTIVE COMMITTEE MUST BE RATIFIED BY THE BOARD AT ITS NEXT MEETING TO BE VALID AS AN ACT OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE COMMITTEE, WITH AUTHORITY FROM THE BOARD OF DIRECTORS, REVIEWED THE FORM 990 WITH THE CHIEF FINANCIAL OFFICER. A FULL COPY OF THE TAX RETURN WAS MADE AVAILABLE TO THE BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR ANNUALLY SIGNS A DECLARATION IDENTIFYING CONFLICTS BETWEEN PERSONAL INTERESTS AND THE INTERESTS OF THE ORGANIZATION OF WHICH HE/SHE IS AWARE. IF A CONFLICT EXISTS, IT SHALL BE FULLY DISCLOSED TO THE BOARD OF DIRECTORS AND IN CASES WHERE THE CONFLICT MIGHT INFLUENCE A DECISION, THE PERSON WITH THE CONFLICT SHALL NOT PARTICIPATE IN THE DISCUSSION OR VOTE RELATING TO THE MATTER IN WHICH THE CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD USES MARKET DATA AVAILABLE FROM MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA) AND NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) TO DETERMINE THE EXECUTIVE DIRECTOR'S SALARY. THE EXECUTIVE DIRECTOR'S SALARY IS REVIEWED ANNNUALLY WITH THE LAST REVIEW IN 2016. OTHER MANAGEMENT SALARIES ARE REVIEWED BY HUMAN RESOURCES DEPARTMENT AND ARE COMPARED TO MARKET DATA FROM PAYSCALE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF SWAP 48,774. MERIDIAN CENTER FOR HEALTH 1200 12TH AVENUE SOUTH SUITE 901 SEATTLE WA 98144 471766892 SUPPORT NEIGHBORCARE HEALTH WA 501(C)(3) LINE 12C, III-FI N/A 0 NEIGHBORCARE LENDER LLC 1200 12TH AVENUE SOUTH SUITE 901 SEATTLE WA 98144 271529844 FINANCIAL SERVICES WA NEIGHBORCARE HEALTH C 128083 13698897 1.00000 1 0 0 1 1 0 0 0 0 0 0 1 1 0 1 1 0 1 0 0 NEIGHBORCARE LENDER LLC D 12810777 CASH