GREATER OREGON BEHAVIORAL HEALTH INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- GREATER OREGON BEHAVIORAL HEALTH INC (EIN 93-1144014)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-15
- IRS object ID
- 201402279349304230
- Schema version
- 2012v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-15T15:28:35-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JONES & ROTH PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 SW COLUMBIA SUITE 201 | AddressLine1 |
| City | BEND | City |
| State | OR | State |
| ZIP Code | 97702 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 931144014 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER OREGON BEHAVIORAL HEALTH I | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GREA | NameControl |
| Phone | 5412982101 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 EAST SECOND ST | AddressLine1 |
| City | THE DALLES | City |
| State | OR | State |
| ZIP Code | 97058 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KEVIN CAMPBELL | Name |
| Title | CEO | Title |
| Phone | 5412982101 | Phone |
| Date Signed | 2014-08-08 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRIAN G NEWTON | Name |
| Phone | 5413823590 | Phone |
| Date Prepared | 2014-08-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KEVIN CAMPBELL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 EAST SECOND ST | AddressLine1 |
| City | THE DALLES | City |
| State | OR | State |
| ZIP Code | 97058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 32567646 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.GOBHI.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | MENTAL HEALTH ADMINISTRATIVE SERVICES FOR OREGON HEALTH PLAN MEMBERS IN SIXTEEN OREGON COUNTIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 19 | NbrIndependentVotingMembers |
| Total Nbr Employees | 30 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 430470 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 159019 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 30629551 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 32152317 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 8619 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2505 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 78866 | OtherRevenuePriorYear |
| Other Revenue Current Year | 253805 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 31147506 | TotalRevenuePriorYear |
| Total Revenue Current Year | 32567646 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2161543 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2734305 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 29312341 | OtherExpensePriorYear |
| Other Expenses Current Year | 30701009 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 31473884 | TotalExpensesPriorYear |
| Total Expenses Current Year | 33435314 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -326378 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -867668 | RevenuesLessExpensesCY |
| Total Assets BOY | 5529831 | TotalAssetsBOY |
| Total Assets EOY | 5524415 | TotalAssetsEOY |
| Total Liabilities BOY | 1221953 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2084205 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4307878 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3440210 | NetAssetsOrFundBalancesEOY |
| Mission Description | MENTAL HEALTH ADMINISTRATIVE SERVICES FOR OREGON HEALTH PLAN MEMBERS IN SIXTEEN OREGON COUNTIES. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 29864827 | Expense |
| Revenue | 32406122 | Revenue |
| Description | THE ORGANIZATION HAS AT-RISK MANAGE CARE CONTRACTS TO PROVIDE BEHAVIORAL HEALTHCARE SERVICES TO THE MEDICAID ELIGIBLE POPULATION OF SIXTEEN COUNTIES IN RURAL OREGON. | Description |
| Total Program Service Expense | 29864827 | TotalProgramServiceExpense |
| Described In501 C3 | false | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 84 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 30 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 19 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TONJA HODGKINSON | BusinessNameLine1 |
| Business Name Line2 | GREATER OREGON BEHAVIORAL HEALTH | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5412982101 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 EAST SECOND STREET | AddressLine1 |
| City | THE DALLES | City |
| State | OR | State |
| ZIP Code | 97058 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| DWIGHT DILL | ||||||
| CHAIR | 2.00 | X | X | 0 | 0 | 0 |
| ROLAND MIGCHIELSEN | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| CHRIS SIEGNER | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| JANET HOLLAND | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| BARBARA SEATTER | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| FRANK HANNA-WILLIAMS | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| KIMBERLY LINDSAY | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| SHARI SELANDER | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| JANET HAMADA | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| JUDY CORDENIZ | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| STEPHEN KLIEWER | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| EARL FISHER | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| STEVE MCCLURE | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| NORMA WAHL | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| SALLY HANNU | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| SUMUER WATKINS | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| BENJAMIN PAZ | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| BILL ELFERING | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| CHRIS COOLEY | ||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |
| KEVIN CAMPBELL | ||||||
| CEO | 40.00 | X | 193580 | 0 | 21325 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 193580 | TotalReportableCompFromOrg |
| Total Other Compensation | 21325 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| HM TIMMONS | |||||
| 1110 MANZANITA ST NE | KEIZER | OR | 97303 | CONSULTING | 147450 |
| SCHWABE WILLIAMSON & WYATT | |||||
| 1211 SW 5TH AVE | PORTLAND | OR | 97204 | LEGAL | 119296 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Government Grants | 159019 | GovernmentGrants |
| Total Contributions | 159019 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MENTAL HEALTH SERVICES | Description |
| Total Revenue Column | 32152317 | TotalRevenueColumn |
| Related Or Exempt Function Income | 32152317 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 32152317 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2505 | TotalRevenueColumn |
| Exclusion | $2,505 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER INCOME | Description |
| Total Revenue Column | 253805 | TotalRevenueColumn |
| Related Or Exempt Function Income | 253805 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 253805 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 32567646 | TotalRevenueColumn |
| Related Or Exempt Function Income | 32406122 | RelatedOrExemptFunctionIncome |
| Exclusion | $2,505 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 239542 | Total |
| Management And General | 239542 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1778082 | Total |
| Management And General | 1778082 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 84810 | Total |
| Management And General | 84810 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 457652 | Total |
| Management And General | 457652 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 174219 | Total |
| Management And General | 174219 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 99655 | Total |
| Management And General | 99655 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25100 | Total |
| Program Services | 25100 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 831745 | Total |
| Program Services | 651966 | ProgramServices |
| Management And General | 179779 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55262 | Total |
| Management And General | 55262 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20202 | Total |
| Management And General | 20202 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 243480 | Total |
| Management And General | 243480 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 170708 | Total |
| Program Services | 170708 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57000 | Total |
| Management And General | 57000 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74540 | Total |
| Management And General | 74540 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| MENTAL HEALTH CAPITATION | 20742494 | 20742494 |
| INPATIENT RISK POOL | 5816539 | 5816539 |
| ADULT MENTAL HEALTH | 1186231 | 1186231 |
| BEHAVIORAL REHABILITATION | 801140 | 801140 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 576913 | Total |
| Program Services | 470649 | ProgramServices |
| Management And General | 106264 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33435314 | Total |
| Program Services | 29864827 | ProgramServices |
| Management And General | 3570487 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 441157 | BOY |
| EOY | 414619 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 345350 | BOY |
| EOY | 498729 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 919883 | BOY |
| EOY | 329433 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 744611 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19616 | BOY |
| EOY | 102041 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1495009 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 214005 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1303825 | BOY |
| EOY | 1281004 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2500000 | BOY |
| EOY | 2153978 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5529831 | BOY |
| EOY | 5524415 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 985535 | BOY |
| EOY | 1549033 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 236418 | BOY |
| EOY | 535172 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1221953 | BOY |
| EOY | 2084205 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4307878 | BOY |
| EOY | 3440210 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4307878 | BOY |
| EOY | 3440210 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5529831 | BOY |
| EOY | 5524415 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -867668 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 203101 | OtherCostOrOtherBasis |
| Book Value | 203101 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 598915 | OtherCostOrOtherBasis |
| Depreciation | 50097 | Depreciation |
| Book Value | 548818 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 493242 | OtherCostOrOtherBasis |
| Depreciation | 47922 | Depreciation |
| Book Value | 445320 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 199751 | OtherCostOrOtherBasis |
| Depreciation | 115986 | Depreciation |
| Book Value | 83765 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1281004 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INVESTMENT IN EOCCO | 1724042 |
| INPATIENT RISK POOL | 429936 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2153978 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| MEMBER BENEFITS, INPATIENT RISK POOL | $345,913 |
| PAYROLL RELATED LIABILITIES | $182,523 |
| PROVIDER TAX PAYABLE | $6,736 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 535172 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 32567646 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 32567646 | RevenueSubtotal |
| Total Revenue Per Form990 | 32567646 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 33435314 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 33435314 | ExpensesSubtotal |
| Total Expenses Per Form990 | 33435314 | TotalExpensesPerForm990 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Survey | X | CompensationSurvey |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KEVIN CAMPBELL | NamePerson |
| Title | CEO | Title |
| Base Compensation Filing Org | 193580 | BaseCompensationFilingOrg |
| Deferred Comp Filing Org | 12583 | DeferredCompFilingOrg |
| Nontaxable Benefits Filing Org | 8742 | NontaxableBenefitsFilingOrg |
| Total Compensation Filing Org | 214905 | TotalCompensationFilingOrg |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FRINGE OR EXPENSE EXPLANATION | Identifier |
| Return Reference | SCHEDULE J, PAGE 1, PART I, LINE 1A | ReturnReference |
| Explanation | THE ORGANIZATION PAYS FOR HEALTH OR SOCIAL DUES OR INITITION FEES FOR ALL EMPLOYEES. THE ORGANZIATION ALSO PROVIDES GROSS-UP PAYMENTS ON DISABILITY FOR ALL EMPLOYEES. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE EXECUTIVE DIRECTOR REVIEWS AND APPROVES THE FORM 990 RETURN. THE FORM 990 RETURN IS MADE AVAILABLE TO THE GOVERNING BOARD WHEN REQUESTED. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE POTENTIAL FOR CONFLICTS OF INTEREST AT BOTH THE BOARD AND STAFF LEVEL IS ONE OF THE COMPLIANCE RISK AREAS MONITORED BY THE CORPORATE INTEGRITY OFFICER WHO ATTENDS BOARD AND EXECUTIVE COMMITTEE MEETINGS AND STAFF MEETINGS. CONFLICT OF INTEREST QUESTIONNAIRES ARE COMPLETED AND SIGNED BY ALL BOARD MEMBERS AS WELL AS KEY STAFF MEMBERS WHO HAVE THE AUTHORITY TO MAKE COMMITMENTS ON BEHALF OF THE ORGANIZATION. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE CEO HAS A 360 POINT REVIEW PROCESS FACILITATED BY THE EXECUTIVE COMMITTEE. EXECUTIVE COMMITTEE DETEREMINES THE PARTICIPATNS IN THE COMPENSATION COMMITTEE. A COMPENSATION STUDY IS PRESENTED TO THEM, IT IS REVIEWED AND COMPENSATION COMMITTEE APPROVES THE COMPENSATION PACKAGE. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE ORGANIZATIONS ADMINISTRATIVE OFFICES. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EOCCO | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 SW SECOND AVE 24TH FLOOR | AddressLine1 |
| City | PORTLAND | City |
| State | OR | State |
| ZIP Code | 97204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800835179 | EIN |
| Primary Activity | HEALTHCARE | PrimaryActivity |
| Legal Domicile State | OR | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Predominant Income Type | RELATED | PredominantIncomeType |
| Share Of Total Income | -15958 | ShareOfTotalIncome |
| Share Of EOY Assets | 6158651 | ShareOfEOYAssets |
| Disproportionate Allocations | false | DisproportionateAllocations |
| General Or Managing Partner | true | GeneralOrManagingPartner |
| Percentage Ownership | 0.29000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | true | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| EASTERN OREGON COORDINATED CARE ORG | ||
| D | 760000 | REDEMPTION NR |
| EASTERN OREGON COORDINATED CARE ORG | ||
| S | 15389 | LOAN PAYMENTS RECEIVED |
| EASTERN OREGON COORDINATED CARE ORG | ||
| S | 9170338 | CAPITATION PASS THROUGH |
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