2015-05-15T19:48:19-05:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2014-01-01 910893287 NEIGHBORCARE HEALTH NEIG 2064616935 1200 12TH AVENUE SOUTH NO 901 SEATTLE WA 98144 MARK SECORD EXECUTIVE DIRECTOR/CEO 2064616935 2015-05-15 1 KYLA DELGADO P01874220 4252506100 2014 2016-02-25 16:41:14Z MARK SECORD 1200 12TH AVENUE SOUTH NO 901 SEATTLE WA 98144 61726354 0 X WWW.NEIGHBORCARE.ORG X 1969 WA PROVIDE COMPREHENSIVE HEALTH CARE TO FAMILIES AND INDIVIDUALS WHO HAVE DIFFICULTY ACCESSING CARE. 13 13 735 174 0 0 14098483 18049915 27799833 34053625 96887 670245 1005860 953643 43001063 53727428 0 0 0 0 30445660 34391086 0 11500 56217 14034136 15067935 44479796 49470521 -1478733 4256907 57742301 62920005 25850405 26201515 31891896 36718490 X THE ORGANIZATION IS A COMMUNITY-BASED, NON-PROFIT AGENCY THAT OPERATES 27 MEDICAL, DENTAL, AND SCHOOL-BASED HEALTH CENTERS THROUGHOUT SEATTLE AND PROVIDES SERVICES TO OVER 55,118 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 27542064 0 24799745 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 2014, NEIGHBORCARE HEALTH PROVIDED 166,228 VISITS TO 41,417 PATIENTS. NEIGHBORCARE HEALTH PROVIDED $3,432,183 OF CHARITY CARE IN 2014. 8205306 0 8219310 GENERAL DENTISTRY SERVICES INCLUDE ORAL HEALTH EXAMS, HYGIENE, AND RESTORATIVE SERVICES TO CONTAIN THE DISEASE PROCESS. PERIODONTAL AND ENDODONTIC CARE IS ALSO PROVIDED. IN 2014, NEIGHBORCARE PROVIDED 58,182 DENTAL VISITS TO 22,167 CHILDREN AND ADULTS. 2896540 0 749581 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 2014, NEIGHBORCARE HEALTH PROVIDED 17,235 VISITS TO 6,511 SCHOOL-BASED PATIENTS. 1659309 0 284989 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. 1659309 0 284989 40303219 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 88 0 735 1 0 0 0 0 0 1 1 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X X JANINE CHILDS 2065483034 1200 12TH AVENUE SOUTH SUITE 901 SEATTLE WA 98144 JOYCE LAMMERT CHAIR (THROUGH MARCH 2014) 2.50 X X 0 0 0 TONY BOZZUTI TREASURER & CHAIR 2.50 X X 0 0 0 RICK RUBIN VICE CHAIR 1.00 X X 0 0 0 ANDREA DAHL SECRETARY 1.00 X X 0 0 0 BARBARA SHICKICH TREASURER 2.00 X X 0 0 0 FARIBA ALAMADARI DIRECTOR 0.50 X 0 0 0 DICK BARBIERI DIRECTOR 1.00 X 0 0 0 ALLISON BROWN DIRECTOR 0.50 X 0 0 0 NANCY DOUTY DIRECTOR 0.50 X 0 0 0 HOLLY FERRARO DIRECTOR 0.50 X 0 0 0 ROBERT GREENLEE DIRECTOR 1.00 X 0 0 0 SALIL GUPTE DIRECTOR 1.00 X 0 0 0 ROM LEE DIRECTOR 0.50 X 0 0 0 TAMIKO MIYANO DIRECTOR 1.00 X 0 0 0 GEORGE PARKER DIRECTOR 1.00 X 0 0 0 EVELYN PICKETTS DIRECTOR 0.50 X 0 0 0 JENNIFER RYAN DIRECTOR 0.50 X 0 0 0 MARK SECORD EXECUTIVE DIRECTOR/CEO 50.00 X 192529 0 12291 KATIE BELL CHIEF OPERATING OFFICER 50.00 X 168943 0 11306 JANINE CHILDS CHIEF FINANCIAL OFFICER 50.00 X 147085 0 10615 MARCUS REMPEL CHIEF MEDICAL OFFICER 50.00 X 213011 0 12577 SARAH VANDER BEEK CHIEF DENTAL OFFICER 50.00 X 161732 0 5377 THOMAS SCOTT SITE MEDICAL DIRECTOR 40.00 X 188722 0 11895 CHRISTOPHER DODD SITE MEDICAL DIRECTOR 40.00 X 164986 0 9095 ALLISON FITZGERALD PHYSICIAN 40.00 X 179301 0 11495 DIANA RYBAKOV DENTIST 50.00 X 172523 0 12235 JOHN OLSON PHYSICIAN 40.00 X 157292 0 5243 1746124 0 102129 31 0 1 0 NBBJ LP PO BOX 742088 LOS ANGELES CA 900742088 ARCHITECTURE 940275 HOWARD S WRIGHT CONSTRUCTORS LP 501 EASTLAKE AVE E 100-A SEATTLE WA 98109 CONSTRUCTION 730766 LEASE CRUTCHER LEWIS WA LLC 107 SPRING STREET SEATTLE WA 981041052 CONSTRUCTION 669074 JONES BOYS MAINTENANCE CO 1813 130TH AVE NE SUITE 110 BELLEVUE WA 98005 JANITORIAL 444034 UNIVERSAL LANGUAGE SERVICES INC PO BOX 4147 BELLEVUE WA 98009 LANGUAGE INTERPRETATION 377178 11 51191 13509461 4489263 1129512 18049915 CAPITATED PLAN 621400 15014748 15014748 MEDICARE/MEDICAID PMT 621400 12394801 12394801 PATIENT FEES 621400 3831364 3831364 OTHER SERVICE REVENUE 621400 2812712 2812712 34053625 89442 89442 200 0 200 200 200 7646950 865693 7659782 272058 -12832 593635 580803 580803 122883 51191 67086 55797 55797 OTHER REVENUE 900099 897646 897646 897646 53727428 34053625 0 1623888 868884 177635 691249 27732844 23883874 3823799 25171 490618 409150 80911 557 2813855 2271492 539306 3057 2484885 1990685 491525 2675 215073 107434 106705 934 84196 42058 41772 366 11500 11500 3440765 1724485 1712785 3495 72306 57929 14015 362 89983 72092 17441 450 68392 54794 13256 342 1314901 1161745 153156 32639 13211 19416 12 203484 82362 121050 72 176046 174983 1063 1759545 1364020 395525 184707 131021 53686 MEDICAL SUPPLIES 3260366 2619426 633716 7224 PHARMACEUTICALS 2259450 2259450 BAD DEBT EXPENSE 1448302 1448302 LABORATORY FEES 233533 233533 224247 23538 200709 49470521 40303219 9111085 56217 1817108 2311216 1354556 4445130 1224349 2487976 3128995 3113593 1220814 1220935 148617 161022 822332 885885 40251306 12407454 24608892 27843852 9907288 6941744 13509350 13508652 57742301 62920005 5502128 6414286 531254 193514 19591704 19416704 225319 177011 25850405 26201515 X 31108364 35746940 783532 971550 31891896 36718490 57742301 62920005 X 4256907 46914 474465 48308 X 0 1 X 1 1 1 X 16152894 14862504 13027656 14098483 18049915 76191452 16152894 14862504 13027656 14098483 18049915 76191452 76191452 263749 119128 114609 100658 89642 687786 55306 1358772 1166476 915145 897646 4393345 81272583 134694273 0.93750 0.94140 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: EHR INCENTIVE PAYMENT SETTLEMENT PAYMENT HRSA PAYMENT OTHER REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 13000 13000 49401304 49414304 1000000 250000 0 0 1000000 1000000 1500000 13000 13000 250000 250000 375000 2592380 2592380 22803760 6166065 16637695 4531702 2348146 2183556 6862750 3893243 2969507 3460714 3460714 27843852 FACILITY CONTRIBUTION RECEIVABLE 697875 NEIGHBORCARE HEALTH LENDER RECEIVABLE 12810777 13508652 INTEREST RATE SWAP 177011 177011 X 50485896 474465 67086 541551 49944345 3783083 3783083 53727428 48089305 67086 67086 48022219 1448302 1448302 49470521 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. THE ORGANIZATION'S FEDERAL INCOME TAX RETURNS FOR 2011, 2012 AND 2013 ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 67,086. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT EARNINGS 89,442. LOSS ON SALE OF INVESTMENTS -12,832. DEVELOPMENT GRANT REVENUE 1,452,901. CAPITAL CAMPAIGN 805,270. BAD DEBT EXPENSE 1,448,302. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 67,086. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,448,302. SPRING EVENT 122344 31011 91333 7500 7600 31384 250 1001 FEAST AT THE MARKET 51730 20180 31550 18551 300 500 0 174074 51191 122883 7500 7600 49935 550 1501 67086 55797 X 0 0 0 0 0 0 0 0 0 MARK SECORD EXECUTIVE DIRECTOR/CEO 192529 0 0 0 0 0 6098 0 6193 0 204820 0 0 0 KATIE BELL CHIEF OPERATING OFFICER 168943 0 0 0 0 0 5113 0 6193 0 180249 0 0 0 JANINE CHILDS CHIEF FINANCIAL OFFICER 147085 0 0 0 0 0 4422 0 6193 0 157700 0 0 0 MARCUS REMPEL CHIEF MEDICAL OFFICER 213011 0 0 0 0 0 6384 0 6193 0 225588 0 0 0 SARAH VANDER BEEK CHIEF DENTAL OFFICER 161732 0 0 0 0 0 4848 0 529 0 167109 0 0 0 THOMAS SCOTT SITE MEDICAL DIRECTOR 188722 0 0 0 0 0 5702 0 6193 0 200617 0 0 0 CHRISTOPHER DODD SITE MEDICAL DIRECTOR 164986 0 0 0 0 0 2902 0 6193 0 174081 0 0 0 ALLISON FITZGERALD PHYSICIAN 179301 0 0 0 0 0 5302 0 6193 0 190796 0 0 0 DIANA RYBAKOV DENTIST 172523 0 0 0 0 0 5492 0 6743 0 184758 0 0 0 JOHN OLSON PHYSICIAN 157292 0 0 0 0 0 4714 0 529 0 162535 0 0 0 X 3144 DONOR VALUED X 8 25120 SELLING PRICE X 12 548 DONOR VALUED X 12 1099485 SELLING PRICE X MINOR EQUIPMENT 2 1215 DONOR VALUED 0 0 0 0 FORM 990, PART I, LINE 19 THE ORGANIZATION'S REVENUES LESS EXPENSES REPORTED IN FORM 990, PART I, LINE 19 INCLUDE EXCESS OPERATING SUPPORT AND REVENUES OF ($12,040) IN 2013 AND $2,524,699 IN 2014. THE REMAINING AMOUNTS REPRESENT DEVELOPMENT GRANTS AND CAPITAL CAMPAIGN CONTRIBUTIONS FOR THE ORGANIZATION'S 45TH STREET CLINIC AND MERIDIAN CENTER FOR HEALTH. 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 11 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 JUNE/JULY 2014. OTHER MANAGEMENT SALARIES ARE REVIEWED BY HUMAN RESOURCES DEPARTMENT AND ARE COMPARED TO MARKET DATA FROM MILLIMAN, ETC. 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 48,308. MERIDIAN CENTER FOR HEALTH 1200 12TH AVENUE SOUTH SUITE 901 SEATTLE WA 98144 471766892 SUPPORT NEIGHBORCARE HEALTH WA 501(C)(3) LINE 11C, III-FI NEIGHBORCARE HEALTH 0 NEIGHBORCARE LENDER LLC 1200 12TH AVENUE SOUTH SUITE 901 SEATTLE WA 98144 271529844 FINANCIAL SERVICES WA NEIGHBORCARE HEALTH C 128108 13442706 1.00000 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 NEIGHBORCARE LENDER LLC D 12810777 CASH