2015-10-06T14:44:13-05:00 2014-12-31 930928924 PERKINS & COMPANY PC 1211 SW FIFTH AVE SUITE 1000 PORTLAND OR 972043710 990 2014-01-01 930878074 FAMILYCARE INC FAMI 5032223205 825 NE MULTNOMAH SUITE 300 PORTLAND OR 97232 JEFF HEATHERINGTON PRESIDENT 5032223205 2015-09-22 1 ROY ABRAMOWITZ P01329049 5032210336 2014 2016-03-07 17:11:31Z JEFF HEATHERINGTON 825 NE MULTNOMAH SUITE 300 PORTLAND OR 97232 592084125 0 X WWW.FAMILYCAREINC.ORG X 1984 OR TO PROVIDE COMMUNITY HEALTH CARE. 12 6 278 0 0 0 1879799 75000 165510729 408528254 1199396 1879964 0 0 168589924 410483218 214562 15361715 0 0 7010884 11392057 0 0 0 146716481 310450257 153941927 337204029 14647997 73279189 69278325 210164926 30262970 101254186 39015355 108910740 TO PROVIDE PROGRAMS OF COOPERATIVE AND COMPREHENSIVE HEALTHCARE TO THE COMMUNITY. 0 0 317757180 15361715 408528254 PROVIDE COMPREHENSIVE AND COOPERATIVE HEALTH CARE TO MEMBERS ACCORDING TO THE TERMS OF A CONTRACT WITH THE OREGON HEALTH PLAN/MEDICAID. APPROXIMATELY 100,274 SERVED MONTHLY. 317757180 0 1 0 1 0 0 0 0 0 1 1 0 1 1 1 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 1121 0 1 278 1 0 0 0 0 0 0 X 12 6 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X THE ORGANIZATION 5032223205 825 NE MULTNOMAH SUITE 300 PORTLAND OR 97232 JEFF HEATHERINGTON PRESIDENT 40.00 X X 429438 0 14171 JEFFREY PAWLOWSKI TREASURER 1.00 X X 8250 0 0 KAREN CARNAHAN DIRECTOR 1.00 X 11000 0 0 ROBIN RICHARDSON DO CHAIR 1.00 X X 9000 0 0 JANET TESCH VICE CHAIR 1.00 X X 11500 0 0 ROBERT CARUS DIRECTOR 1.00 X 5000 0 0 RICHARD BARSOTTI DIRECTOR 1.00 X 3750 0 0 JOE HROMCO DIRECTOR 1.00 X 4300 0 0 PATRICIA PARKER SECRETARY 1.00 X X 3750 0 0 MIKE RILEY DIRECTOR 1.00 X 3750 0 0 CARL ERICKSON DIRECTOR 1.00 X 2250 0 0 MATT DASKALOS DIRECTOR 1.00 X 2250 0 0 GREG MARTENSON VP OF FINANCE 40.00 X 185318 0 12432 WILLIAM MURRAY CHIEF OPERATING OFFICER 40.00 X 264314 0 17199 RESA BRADEEN MEDICAL DIRECTOR 40.00 X 341881 0 21996 DANIEL ROTH VP OF INTEGRATED SERVICES 40.00 X 188822 0 6100 CHERI PFANNES CHIEF COMPLIANCE OFFICER 40.00 X 148609 0 5311 SHANNON NOEL EMPLOYEE 40.00 X 146604 0 13600 STACY ERIA EMPLOYEE 40.00 X 144934 0 19890 PATRICIA PETERS VP OF HUMAN RESOURCES 40.00 X 186101 0 6594 2100821 0 117293 11 0 1 0 PERFORMANCE HEALTH TECHNOLOGY LTD 3993 FAIRVIEW INDUSTRIAL DR SE SALEM OR 97302 CLAIMS PROCESSING 4077622 LANGLEY INVESTMENT PROPERTIES INC 1211 SW FIFTH AVENUE SUITE 2230 PORTLAND OR 97204 PROPERTY MANAGERS 1955994 METRO PRESORT INC 3506 NW 35TH AVE PORTLAND OR 97210 PRINT/MAIL 927037 CORPORATE ENVIRONMENTS OF OREGON 707 SE BELMONT PORTLAND OR 97214 OFFICE EXPANSION 651385 MCPC INC 15575 SW SEQUOIA PKWY STE 130 PORTLAND OR 97224 TECHNOLOGY PRODUCT & SOLUTIONS 528113 27 75000 75000 408528254 408528254 408528254 1499097 1499097 181981774 181600907 380867 380867 380867 410483218 408528254 0 1879964 X 15361715 15361715 1351549 705498 646051 8388139 6458867 1929272 321096 247244 73852 1331273 1331273 648435 648435 166341 166341 141280 141280 1268 1268 6937947 6937947 19863 19863 1451561 1451561 1136101 1136101 185290 185290 36733 36733 977055 977055 1938941 1938941 INPATIENT HOSPITAL 69085832 69085832 PHYSICIAN SERVICES 65667345 65667345 OTHER PROFESSIONAL SERV 60444138 60444138 MEDICAL AND HOSPITAL EX 45954530 45954530 55657597 53832011 1825586 337204029 317757180 19446849 0 15121065 75133676 824989 216281 5423430 4542339 5979505 2169497 1812253 3810008 23722730 49263532 8921308 40127848 13452550 37071242 69278325 210164926 29229148 100362481 1033822 891705 30262970 101254186 X 37412808 108895745 1602547 14995 39015355 108910740 69278325 210164926 X 73279189 1232508 -4616312 X X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 141280 392390 533670 0 PART III-B PER REV. PROC. 98-19, FAMILYCARE, INC. IS EXEMPTED FROM THE PROXY TAX AND THE NOTIFICATION REQUIREMENT OF IRC SEC. 6033(E)(1) BECAUSE MORE THAN 90% OF THE ORGANIZATION'S ANNUAL DUES (OR SIMILAR AMOUNTS) ARE RECEIVED FROM ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3), STATE GOVERNMENTS, LOCAL GOVERNMENTS, ENTITIES WHOSE INCOME IS EXEMPT FROM TAX UNDER SECTION 115, OR ORGANIZATIONS EXCEPTED UNDER SECTION 4.01 OF REV. PROC. 98-19. 806769 53388 753381 4381215 2105748 2275467 791521 10361 781160 3810008 TSY INFL IX N/B 12815883 F US TREASURY N/B 27311965 F 40127848 OTHER CURRENT ASSETS, NET 3750671 OTHER ASSETS, NET 185525 DUE FROM AFFILIATES 106557 RESTRICTED CASH AND CASH EQUIVALENTS 520531 INVESTMENTS IN FAMILYCARE HEALTH PLANS 20801553 RESTRICTED SHORT-TERM INVESTMENTS 3543646 RESTRICTED LONG-TERM INVESTMENTS 8162759 37071242 CAPITAL LEASE OBLIGATION, LESS CURRENT PORTION 499806 CONTRIBUTIONS TO OTHERS, LESS CURRENT PORTION 391899 891705 X PART X, LINE 2: FINANCIAL STATEMENT FOOTNOTE REGARDING FIN 48: FAMILYCARE AND HEALTH PLANS ARE TAX-EXEMPT ORGANIZATIONS PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4). ONLY THE COMPANY'S UNRELATED BUSINESS INCOME IS SUBJECT TO FEDERAL OR STATE INCOME TAXES. IT IS MANAGEMENT'S BELIEF THAT NONE OF THE COMPANY'S ACTIVITIES HAVE GENERATED MATERIAL UNRELATED BUSINESS INCOME; THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. GENERALLY, THE COMPANY IS SUBJECT TO EXAMINATION BY FEDERAL, STATE AND LOCAL INCOME TAX AUTHORITIES FOR THREE YEARS FROM THE FILING OF A TAX RETURN. WITH FEW EXCEPTIONS, THE COMPANY IS NO LONGER SUBJECT TO SUCH EXAMINATIONS FOR YEARS ENDED BEFORE DECEMBER 31, 2011. 1 OSTEOPATHIC PHYSICIANS & SURGEONS OF OREGON INC 4380 SW MACADAM AVE SUITE 125 PORTLAND OR 97239 936025596 501(C)(6) 100000 OSTEOPATHIC SUPPORT; EDUCATION GRANT CASCADE AIDS PROJECT 208 SW 5TH AVE STE 800 PORTLAND OR 97204 930903383 501(C)(3) 14500 SPONSORSHIP NAMI - OREGON 4701 SE 24TH AVE STE E PORTLAND OR 97202 930875209 501(C)(3) 5601 SPONSORSHIP LUND REPORT PO BOX 82841 PORTLAND OR 97282 263019179 501(C)(3) 10000 DONATION ASIAN HEALTH & SERVICE CENTER 3430 SE POWELL BLVD PORTLAND OR 97202 931192100 501(C)(3) 16800 SPONSORSHIP BASIC RIGHTS OREGON PO BOX 40625 PORTLAND OR 97240 931108531 501(C)(3) 7700 SPONSORSHIP LIFEWORKS NORTHWEST 14600 NW CORNELL RD PORTLAND OR 97229 930502822 501(C)(3) 6500 SPONSORSHIP METROPOLITAN FAMILY SERVICE 1808 SE BELMONT ST PORTLAND OR 97214 930397825 501(C)(3) 17500 DONATION OUTSIDE IN 1132 SW 13TH AVE PORTLAND OR 97205 930567549 501(C)(3) 25619 DONATION PLANNED PARENTHOOD COLUMBIA WILLAMETTE PO BOX 10953 PORTLAND OR 97212 936031270 501(C)(3) 8500 SPONSORSHIP WALLACE MEDICAL CONCERN 124 NE 181ST AVE STE 103 PORTLAND OR 97230 930853709 501(C)(3) 12500 DONATION WEST UNIV HEALTH SCIENCE - COMP NW 200 MULLINS DR LEBANON OR 97355 953127273 501(C)(3) 50000 DONATION OUR HOUSE OF PORTLAND INC 2727 SE ALDER AVE PORTLAND OR 97214 930986632 501(C)(3) 6000 SPONSORSHIP HEATHERINGTON FOUNDATION FOR INNOVATION AND EDUCATION IN HEATH CARE 825 NE MULTNOMAH SUITE 300 PORTLAND OR 97232 930988354 501(C)(3) 15000000 DONATION 12 14 PART I, LINE 2: FAMILYCARE DOES NOT AWARD GRANTS, BUT SPONSORS A LIMITED NUMBER OF CHARITABLE FUNDRAISING EVENTS AND MAKES A LIMITED NUMBER OF CHARITABLE DONATIONS TO QUALIFIED CHARITABLE ORGANIZATIONS. X X 0 0 0 0 0 0 0 0 0 JEFF HEATHERINGTON PRESIDENT 376250 0 39509 0 13679 0 7500 0 6671 0 443609 0 0 0 GREG MARTENSON VP OF FINANCE 107686 0 17400 0 60232 0 3806 0 8626 0 197750 0 0 0 WILLIAM MURRAY CHIEF OPERATING OFFICER 250000 0 6637 0 7677 0 5418 0 11781 0 281513 0 0 0 RESA BRADEEN MEDICAL DIRECTOR 225115 0 111268 0 5498 0 7500 0 14496 0 363877 0 0 0 DANIEL ROTH VP OF INTEGRATED SERVICES 136763 0 36052 0 16007 0 5665 0 435 0 194922 0 0 0 CHERI PFANNES CHIEF COMPLIANCE OFFICER 133082 0 15097 0 430 0 4458 0 853 0 153920 0 0 0 SHANNON NOEL EMPLOYEE 139594 0 4429 0 2581 0 4398 0 9202 0 160204 0 0 0 STACY ERIA EMPLOYEE 138985 0 3974 0 1975 0 4348 0 15542 0 164824 0 0 0 PATRICIA PETERS VP OF HUMAN RESOURCES 166538 0 17107 0 2456 0 5583 0 1011 0 192695 0 0 0 RICHARD BARSOTTI BOARD MEMBER 1807537 EXPENSES PAID TO A PROVIDER CLINIC FOR HEALTHCARE-RELATED SERVICES. DR. RICHARD BARSOTTI IS A PARTNER OF THE CLINIC. 0 KAREN CARNAHAN BOARD MEMBER 160691 EXPENSES PAID TO PROFESSIONAL SERVICES FIRM. MS. KAREN CARNAHAN IS AN OWNER OF THE FIRM. 0 PATRICIA PARKER BOARD MEMBER 3930237 EXPENSES PAID TO A PROVIDER CLINIC FOR HEALTHCARE-RELATED SERVICES. DR. PATRICIA PARKER IS THE MANAGER OF HEALTH & SAFETY FOR THE CLINIC. 0 JOSEPH HROMCO BOARD MEMBER 1809043 EXPENSES PAID TO A PROVIDER CLINIC FOR HEALTHCARE-RELATED SERVICES. DR. JOE HROMCO IS A PARTNER OF THE CLINIC. 0 MICHAEL RILEY BOARD MEMBER 23428 EXPENSES PAID TO PROFESSIONAL SERVICES FIRM. MR. MICHAEL RILEY IS AN OWNER OF THE FIRM. 0 FORM 990, PART VI, SECTION A, LINE 2 JEFFREY PAWLOWSKI, BOARD MEMBER, AND MICHAEL RILEY, BOARD MEMBER, HAVE A BUSINESS RELATIONSHIP. BOARD MEMBERS CARL ERICKSON, RICHARD BARSOTTI, JOE HROMCO, KAREN CARNAHAN, AND PATRICIA PARKER OWN OR CONTROL ENTITIES THAT DO BUSINESS WITH FAMILYCARE, INC. FORM 990, PART VI, SECTION B, LINE 11 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 THE CEO TOTAL COMPENSATION IS A DOMAIN HELD EXCLUSIVELY BY THE BOARD OF DIRECTORS. THE CEO PERFORMS UNDER AN EXECUTIVE EMPLOYMENT CONTRACT WHICH IS NEGOTIATED AND UPDATED BY THE BOARD. COO: THE LEVEL AND ADEQUACY OF THE COO TOTAL COMPENSATION IS DETERMINED BY THE CEO, WITH INPUT AND ANALYSIS SUPPLIED BY THE DIRECTOR OF HUMAN RESOURCES. HIGHLY COMPENSATED EXECUTIVES SUCH AS VICE PRESIDENT OF FINANCE, VICE PRESIDENT COMMUNITY AND BUSINESS DEVELOPMENT, DIRECTOR OF GOVERNMENT PROGRAMS, VICE PRESIDENT OF INTEGRATED SERVICES, DIRECTOR OF INFORMATION SERVICES, AND OTHER EXECUTIVES ALL HAVE COMPENSATION DETERMINED AS DESCRIBED BELOW. GENERAL APPROACH TO COMPENSATION DETERMINATIONS: IN THE FIRST QUARTER OF 2013, ALL COMPENSATION RANGES EXCLUDING THE CEO WERE REVIEWED AND TESTED BY AN EXTERNAL COMPENSATION PROFESSIONAL. HE EXAMINED CURRENT SALARIES, COMPARABILITY, EXEMPTION STATUS, RANGES, AND EQUITY IN ALL JOBS IN FAMILYCARE. HIS FINDINGS WERE POSITIVE, WITH ONLY RECOMMENDATIONS TO CORRECT THE NON-EXEMPT STATUS OF SEVERAL EMPLOYEES. IN DETERMINING WAGE PLACEMENT OR SALARY, THE DIRECTOR OF HR IS ACCOUNTABLE TO USE PUBLISHED, REPUTABLE DATA FOR COMPARISONS OF JOB ACCOUNTABILITIES AND COMPENSATION RANGES. FAMILYCARE ENGAGED AN ORGANIZATION IN THE FIRST QUARTER OF 2013; THIS ORGANIZATION HAS A PUBLISHED INVENTORY OF DETAILED INFORMATION ABOUT NATIONAL JOBS THAT INCLUDE JOB CONTENT, ACCOUNTABILITIES, USUAL REQUIREMENTS, NATIONAL, REGIONAL AND SPECIFIC PORTLAND AREA RANGES. THE DIRECTOR OF HR SETS ALL SALARIES AND RESPONDS TO ANY INQUIRIES RELATED TO FAIRNESS, EQUITY, AND PROCESS. FORM 990, PART VI, SECTION C, LINE 19 FAMILYCARE, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 24E OTHER MEDICAL AND HOSPITAL EXPENSES : PROGRAM SERVICE EXPENSES 34,000,627. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,000,627. EMERGENCY ROOM AND OUT-OF-AREA SERV : PROGRAM SERVICE EXPENSES 19,831,384. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,831,384. EQUIPMENT RENTAL & MAINTENANCE : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,400,845. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,400,845. OTHER EMPLOYEE EXPENSES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 257,534. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 257,534. BOOKS/SUBSCRIPTIONS/DUES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 179,733. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 179,733. OTHER EXPENSES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 157,627. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 157,627. MEALS AND ENTERTAINMENT : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 99,633. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 99,633. OTHER ADMINISTRATIVE EXPENSES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES -269,786. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -269,786. FORM 990, PART XI, LINE 9: INCOME FROM SUBSIDIARY -4,616,312. 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 825 NE MULTNOMAH SUITE 300 PORTLAND OR 97232 911829317 TO PROVIDE COMMUNITY HEALTH CARE OR 501(C)(4) 0 HEATHERINGTON FOUNDATION FOR INNOVATION & EDUCATION IN HEALTHCARE FKA FCMC 825 NE MULTNOMAH SUITE 300 PORTLAND OR 97232 930988354 TO PROVIDE COMMUNITY HEALTH CARE OR 501(C)(3) NON-PRIVATE FDN 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 FAMILYCARE HEALTH PLANS INC R 106557 FMV HEATHERINGTON FOUNDATION FOR INNOVATION AND EDUCATION IN HEALTH CARE B 15000000 FMV FAMILYCARE HEALTH PLANS INC B 15383689 FMV PART II FAMILYCARE, INC. AND FAMILYCARE HEALTH PLANS, INC. ARE RELATED TAX-EXEMPT ORGANIZATIONS BY VIRTUE OF HAVING THE SAME BOARD OF DIRECTORS. HEATHERINGTON FOUNDATION FOR INNOVATION AND EDUCATION IN HEALTH CARE IS A RELATED TAX-EXEMPT ORGANIZATION BY VIRTUE OF ITS BOARD MEMBERS SERVING ON THE BOARD OF FAMILYCARE, INC. AND FAMILYCARE HEALTH PLANS, INC. PART V THE ORGANIZATIONS OTHER TRANSFER OF CASH TO FAMILYCARE HEALTH PLANS, INC. WAS FOR OPERATIONAL EXPENSES.