2014-11-17T19:50:00-06:00 2013-12-31 930743240 HOFFMAN STEWART & SCHMIDT PC 4900 MEADOWS ROAD STE 200 LAKE OSWEGO OR 970353295 990 2013-01-01 910896241 COWLITZ FAMILY HEALTH CENTER COWL 3606363892 1057 12TH AVENUE LONGVIEW WA 986322509 DIAN COOPER EXECUTIVE DIRECTOR 3606363892 2014-11-06 1 ROBERT M PRILL P00236613 5032205900 2013 2015-11-30 17:44:51Z DIAN COOPER 1057 12TH AVENUE LONGVIEW WA 986322509 11532747 0 X WWW.COWLITZFAMILYHEALTH.ORG X 1972 WA TO PROMOTE, ENCOURAGE AND PROVIDE HEALTH SERVICES IN ORDER TO IMPROVE THE QUALITY OF LIFE THROUGH SOUND NUTRITION, EDUCATION, PREVENTIVE HEALTH CARE, AND THE EMPOWERMENT OF CHOICE. 12 12 183 5 0 0 2967414 3426912 8206778 8103383 4814 2452 2533 0 11181539 11532747 0 0 0 0 7376367 8054730 0 0 0 3871871 4343598 11248238 12398328 -66699 -865581 8245392 8412570 1659547 2692306 6585845 5720264 X TO PROMOTE, ENCOURAGE AND PROVIDE HEALTH SERVICES IN ORDER TO IMPROVE THE QUALITY OF LIFE THROUGH SOUND NUTRITION, EDUCATION, PREVENTIVE HEALTH CARE, AND THE EMPOWERMENT OF CHOICE. 0 0 5401386 4864185 TO PROVIDE MEDICAL SERVICES TO LOW INCOME INDIVIDUALS. THE TOTAL MEDICAL ENCOUNTERS DURING THE YEAR WERE 37,821. 2385269 1829701 TO PROVIDE DENTAL SERVICES TO LOW INCOME INDIVIDUALS. THE TOTAL DENTAL ENCOUNTERS DURING THE YEAR WERE 21,564. 648042 TO PROVIDE SUPPLEMENTAL NUTRITION SERVICES FOR PREGNANT AND BREASTFEEDING WOMEN AND THEIR CHILDREN TO AGE 5. DURING 2013, THE CENTER SERVED 6,167 WOMEN, INFANTS AND CHILDREN. 571953 1409497 TO PROVIDE MEDICAL RELATED SERVICES TO LOW INCOME INDIVIDUALS. ENABLING SERVICE ENCOUNTERS AND MENTAL HEALTH ENCOUNTERS TOTALED 6,884 AND 3,801 RESPECTIVELY. 571953 1409497 9006650 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 25 0 1 183 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X DIAN COOPER 3066363892 1057 12TH AVENUE LONGVIEW WA 98632 RICK HUCKABY PRESIDENT 2.00 X X 0 0 0 MELISSA TAYLOR TREASURER 2.00 X X 0 0 0 WANDA MCBEE SECRETARY 2.00 X X 0 0 0 CARLEEN WOLGAMOTT DIRECTOR 2.00 X 0 0 0 CYNTHIA WASHINGTON-MATTSON VICE PRESIDENT 2.00 X 0 0 0 ALISABETH BUCK DIRECTOR 2.00 X 0 0 0 CARLOS CARREON DIRECTOR 2.00 X 0 0 0 JOE TITUS DIRECTOR 2.00 X 0 0 0 JEANE CONRAD DIRECTOR 2.00 X 0 0 0 NANCY BELL DIRECTOR 2.00 X 0 0 0 JULIE MERCHANT DIRECTOR 2.00 X 0 0 0 CHARLOTTE CAUDLE DIRECTOR 2.00 X 0 0 0 DIAN COOPER EXECUTIVE DIRECTOR 40.00 X 120301 0 7168 PAM SPEARS FINANCE DIRECTOR 40.00 X 57768 0 0 GERARDO MELGAR MEDICAL DIRECTOR 40.00 X 176922 0 7168 ROBERT PETERSON PHYSICIAN 40.00 X 134543 0 6571 ROXANE OSHIRO DENTIST DIRECTOR 40.00 X 146193 0 7168 PARTHA GONAVARAM PHYSICIAN 40.00 X 142060 0 7168 GAIL CONWAY PHYSICIAN 40.00 X 120541 0 7168 TATIANNA TROTT DENTIST 40.00 X 120000 0 7168 1018328 0 49579 7 0 1 0 OCHIN INC 1881 SW NAITO PARKWAY PORTLAND OR 972015195 EMR AND PRACTICE MANAGEMENT FEES 496843 POLAR SYSTEMS 21890 WILLAMETTE DRIVE WEST LINN OR 97068 COMPUTER CONSULTING 410441 BOB LARGE CONSTRUCTION LLC 2240 34TH AVENUE LONGVIEW WA 98632 CONSTRUCTION SERVICES 129112 3 3426912 3426912 PATIENT SERVICE REVENUE 624100 5352405 5352405 PREMIUM REVENUE 624100 2276871 2276871 PHARMACY FEES 624100 471974 471974 OTHER 624100 2133 2133 8103383 2452 2452 11532747 8103383 0 2452 X 369327 184090 185237 6306078 5541978 764100 793945 686787 107158 585380 502581 82799 59674 59674 31000 31000 1335270 400378 934892 17748 9236 8512 425151 192153 232998 629577 157566 472011 78403 64932 13471 54145 44842 9303 58193 58193 434265 193474 240791 48861 48861 MEDICAL SUPPLIES 634320 634320 BAD DEBT 311563 311563 TAXES AND LICENSES 79037 51472 27565 DUES & SUBSCRIPTIONS 57351 16583 40768 89040 14695 74345 12398328 9006650 3391678 0 1425681 1519360 3201070 3434042 434853 486971 643158 547022 59309 64838 129180 105765 5618412 3363840 2352141 2254572 8245392 8412570 899053 1273522 760494 1418784 1659547 2692306 X 6585845 5720264 6585845 5720264 8245392 8412570 -865581 0 X X 0 1 X 1 1 1 X 2835315 2803464 2240136 2967414 3426912 14273241 2835315 2803464 2240136 2967414 3426912 14273241 14273241 33882 23882 14106 4814 2452 79136 8318 4679 2575 2533 18105 14370482 40911418 0.99320 0.98810 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 83030 83030 719994 166162 553832 2308959 1404275 904684 2506429 1793403 713026 2254572 X 11221184 0 11221184 311563 311563 11532747 12086765 0 12086765 311563 311563 12398328 PART X, LINE 2: MANAGEMENT OF COWLITZ FAMILY HEALTH CENTER DOES NOT BELIEVE THE CENTER HAS ANY UNCERTAIN TAX POSITIONS. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 311,563. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 311,563. X X 0 0 0 0 0 0 0 0 0 GERARDO MELGAR MEDICAL DIRECTOR 173232 0 0 0 3690 0 0 0 7168 0 184090 0 0 0 ROXANE OSHIRO DENTIST DIRECTOR 146193 0 0 0 0 0 0 0 7168 0 153361 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION SENDS AN EMAIL WITH THE FORM 990 TO ALL BOARD MEMBERS AND SOLICITS COMMENTS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION INQUIRES ABOUT CONFLICTS OF INTEREST AT INITIAL INTERVIEWS WITH CANDIDATES FOR EMPLOYMENT AND BOARD MEMBERS ARE REQUIRED TO SIGN A STATEMENT OF DECLARATION OF ANY CONFLICTS OF INTEREST. BOARD MEMBERS ARE REQUIRED TO FILL OUT AN ANNUAL CONFLICT OF INTEREST FORM. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE REVIEWS AND APPROVES THE CEO'S PAY BASED ON PERFORMANCE AND COMPARABLE MARKET SALARIES. COMPENSATION FOR KEY EMPLOYEES ARE REVIEWED AND APPROVED BY THE CEO BASED ON PERFORMANCE AND COMPARABLE MARKET SALARIES. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 400,378. MANAGEMENT AND GENERAL EXPENSES 934,892. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,335,270. FORM 990, PART IX, LINE 24E RECRUITMENT & RETENTION: PROGRAM SERVICE EXPENSES 12,067. MANAGEMENT AND GENERAL EXPENSES 43,274. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 55,341. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 2,628. MANAGEMENT AND GENERAL EXPENSES 31,071. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,699. FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGE IN THE PROCESS FROM THE PRIOR YEAR REGARDING THE OVERSIGHT OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANTS' THAT AUDIT THE FINANCIAL STATEMENTS OF THE ORGANIZATION.