FAMILYCARE INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- FAMILYCARE INC (EIN 93-0878074)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-08-14
- IRS object ID
- 201312269349304151
- Schema version
- 2012v2.1
- 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 | 2013-08-14T16:59:52-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930928924 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PERKINS & COMPANY PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 SW FIFTH AVE SUITE 1000 | AddressLine1 |
| City | PORTLAND | City |
| State | OR | State |
| ZIP Code | 972043710 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930878074 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILYCARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FAMI | NameControl |
| Phone | 5032223205 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 NE MULTNOMAH SUITE 300 | AddressLine1 |
| City | PORTLAND | City |
| State | OR | State |
| ZIP Code | 97232 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEFF HEATHERINGTON | Name |
| Title | PRESIDENT | Title |
| Phone | 5032223205 | Phone |
| Date Signed | 2013-08-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROY ABRAMOWITZ | Name |
| PTIN | P01329049 | PTIN |
| Phone | 5032210336 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JEFF HEATHERINGTON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 NE MULTNOMAH SUITE 300 | AddressLine1 |
| City | PORTLAND | City |
| State | OR | State |
| ZIP Code | 97232 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 141807725 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.FAMILYCAREINC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1984 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE COMMUNITY HEALTH CARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 167 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 145060257 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 138374851 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 245004 | InvestmentIncomePriorYear |
| Investment Income Current Year | 357683 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 145305261 | TotalRevenuePriorYear |
| Total Revenue Current Year | 138732534 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 341207 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 2109924 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8167768 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7554574 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 127778763 | OtherExpensePriorYear |
| Other Expenses Current Year | 120711790 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 136287738 | TotalExpensesPriorYear |
| Total Expenses Current Year | 130376288 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 9017523 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8356246 | RevenuesLessExpensesCY |
| Total Assets BOY | 42848263 | TotalAssetsBOY |
| Total Assets EOY | 51943890 | TotalAssetsEOY |
| Total Liabilities BOY | 26176775 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 27000566 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 16671488 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 24943324 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE PROGRAMS OF COOPERATIVE AND COMPREHENSIVE HEALTHCARE TO THE COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 120593590 | Expense |
| Grants | 2109924 | Grants |
| Revenue | 138374851 | Revenue |
| Description | PROVIDE COMPREHENSIVE AND COOPERATIVE HEALTH CARE TO MEMBERS ACCORDING TO THE TERMS OF A CONTRACT WITH THE OREGON HEALTH PLAN/MEDICAID. APPROXIMATELY 52,653 SERVED MONTHLY. | Description |
| Total Program Service Expense | 120593590 | TotalProgramServiceExpense |
| Described In501 C3 | 0 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 1 | PoliticalActivities |
| Subject To Proxy Tax | 1 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 1046 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 167 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFF HEATHERINGTON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5032223205 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 NE MULTNOMAH SUITE 300 | AddressLine1 |
| City | PORTLAND | City |
| State | OR | State |
| ZIP Code | 97232 | 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 | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| JEFFREY PAWLOWSKI | ||||||||
| TREASURER | 1.00 | X | X | 15100 | 0 | 0 | ||
| KAREN CARNAHAN | ||||||||
| CHAIR | 1.00 | X | X | 20549 | 0 | 0 | ||
| ROBIN RICHARDSON DO | ||||||||
| SECRETARY | 1.00 | X | X | 5300 | 0 | 0 | ||
| JANET TESCH | ||||||||
| VICE CHAIR | 1.00 | X | X | 8320 | 0 | 0 | ||
| ROBERT CARUS | ||||||||
| DIRECTOR | 1.00 | X | 6400 | 0 | 0 | |||
| ROSS RONISH | ||||||||
| DIRECTOR | 1.00 | X | 3937 | 0 | 0 | |||
| RICHARD BARSOTTI | ||||||||
| DIRECTOR | 1.00 | X | 2200 | 0 | 0 | |||
| JOE HROMCO | ||||||||
| DIRECTOR | 1.00 | X | 3900 | 0 | 0 | |||
| RICHARD OLSON | ||||||||
| DIRECTOR | 1.00 | X | 2500 | 0 | 0 | |||
| PATRICIA PARKER | ||||||||
| DIRECTOR | 1.00 | X | 2400 | 0 | 0 | |||
| MIKE RILEY | ||||||||
| DIRECTOR | 1.00 | X | 3227 | 0 | 0 | |||
| JEFF HEATHERINGTON | ||||||||
| PRESIDENT | 40.00 | X | 416848 | 0 | 14143 | |||
| GREG MARTENSON | ||||||||
| DIRECTOR OF FINANCE | 40.00 | X | 164900 | 0 | 20763 | |||
| JESSE GAMEZ | ||||||||
| DIRECTOR OF OPERATIONS | 40.00 | 233790 | 0 | 7563 | X | |||
| DOUGLAS LUTHER | ||||||||
| MEDICAL DIRECTOR | 40.00 | 267283 | 0 | 8167 | X | |||
| DAYNA STERINGER | ||||||||
| DIRECTOR OF GOVERNMENT AFFAIRS | 40.00 | 152932 | 0 | 15933 | X | |||
| BILL BUTCHER | ||||||||
| HEALTH & NETWORK SERVICES DIRECTOR | 40.00 | 146676 | 0 | 3727 | X | |||
| DANIEL ROTH | ||||||||
| ASST MEDICAL DIRECTOR | 40.00 | 265914 | 0 | 23397 | X | |||
| BILL HURST | ||||||||
| IT MANAGER | 40.00 | 128791 | 0 | 2781 | X | |||
| AMY BRUCE | ||||||||
| CLAIMS MANAGER | 40.00 | 109451 | 0 | 20717 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1960418 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 117191 | TotalOtherCompensation |
| Number Individuals GT100 K | 12 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| PHYSICIANS INSURANCE A MUTAL CO | |||||
| 1301 SECOND AVENUE SUITE 2700 | SEATTLE | WA | 98101 | INSURANCE SERVICES | 2425839 |
| HEALTH NET OF OREGON | |||||
| 11918 SE DIVISION 144 | PORTLAND | OR | 97266 | INSURANCE SERVICES | 1295173 |
| VISION SERVICE PLAN | |||||
| 9600 SW NUMBUS AVE SUITE 200 | BEAVERTON | OR | 97008 | INSURANCE SERVICES | 628832 |
| MCKESSON HEALTH SOLUTIONS LLC | |||||
| 22423 NETWORK PLACE | CHICAGO | IL | 606731224 | CONSULTING | 460744 |
| PERFORMANCE HEALTH TECHNOLOGY LTD | |||||
| 3993 FAIRVIEW INDUSTRIAL DR SE | SALEM | OR | 97302 | CLAIMS PROCESSING | 344393 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 19 | NumberOfContractorsGT100K |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 138374851 | TotalRevenueColumn |
| Related Or Exempt Function Income | 138374851 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 138374851 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 339124 | TotalRevenueColumn |
| Exclusion | $339,124 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3093750 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3075191 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 18559 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 18559 | TotalRevenueColumn |
| Exclusion | $18,559 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 138732534 | TotalRevenueColumn |
| Related Or Exempt Function Income | 138374851 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $357,683 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2109924 | Total |
| Program Services | 2109924 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1207288 | Total |
| Program Services | 597699 | ProgramServices |
| Management And General | 609589 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5236917 | Total |
| Program Services | 4608487 | ProgramServices |
| Management And General | 628430 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 228370 | Total |
| Program Services | 200966 | ProgramServices |
| Management And General | 27404 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 881999 | Total |
| Management And General | 881999 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 273034 | Total |
| Management And General | 273034 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89409 | Total |
| Management And General | 89409 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32050 | Total |
| Management And General | 32050 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14283 | Total |
| Management And General | 14283 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 406000 | Total |
| Management And General | 406000 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 997406 | Total |
| Management And General | 997406 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 135896 | Total |
| Management And General | 135896 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11148 | Total |
| Management And General | 11148 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28459 | Total |
| Management And General | 28459 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1039159 | Total |
| Management And General | 1039159 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1433373 | Total |
| Management And General | 1433373 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| INPATIENT HOSPITAL | 31554605 | 31554605 | |
| PHYSICIAN SERVICES | 28740700 | 28740700 | |
| OTHER PROFESSIONAL SERV | 26504824 | 24839815 | 1665009 |
| OTHER MEDICAL AND HOSPI | 16691004 | 16691004 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12760440 | Total |
| Program Services | 11250390 | ProgramServices |
| Management And General | 1510050 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130376288 | Total |
| Program Services | 120593590 | ProgramServices |
| Management And General | 9782698 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18218115 | BOY |
| EOY | 11375340 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1251074 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3006286 | BOY |
| EOY | 4597946 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 5095002 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3291905 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3034135 | BOY |
| EOY | 1803097 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3333565 | BOY |
| EOY | 21418421 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14005088 | BOY |
| EOY | 12749086 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42848263 | BOY |
| EOY | 51943890 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25712291 | BOY |
| EOY | 26647319 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 464484 | BOY |
| EOY | 353247 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26176775 | BOY |
| EOY | 27000566 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16671488 | BOY |
| EOY | 24943324 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16671488 | BOY |
| EOY | 24943324 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42848263 | BOY |
| EOY | 51943890 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 8356246 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 168842 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -253252 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Political Expenditures | 5050 | PoliticalExpenditures |
| Substantially All Dues Nondeduct | 1 | SubstantiallyAllDuesNondeduct |
| Only In House Lobbying | 0 | OnlyInHouseLobbying |
| Agree To Carryover Prior Year | 1 | AgreeToCarryoverPriorYear |
| Non Ded Lobby Political Current | 32000 | NonDedLobbyPoliticalCurrent |
| Non Ded Lobby Political Carryover | 263992 | NonDedLobbyPoliticalCarryover |
| Non Ded Lobby Political Total | 295992 | NonDedLobbyPoliticalTotal |
| Amount To Be Carried Over | 0 | AmountToBeCarriedOver |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART IV, SUPPLEMENTAL INFORMATION: | Identifier |
| Explanation | PART I-A, LINE 1 $50 WAS CONTRIBUTED TO THE JUDGE KEMP CAMPAIGN $5,000 WAS CONTRIBUTED TO THE KITZHABER FOR GOVERNOR CAMPAIGN 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. | Explanation |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 68312 | OtherCostOrOtherBasis |
| Depreciation | 24707 | Depreciation |
| Book Value | 43605 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4391145 | OtherCostOrOtherBasis |
| Depreciation | 3083536 | Depreciation |
| Book Value | 1307609 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 635545 | OtherCostOrOtherBasis |
| Depreciation | 183662 | Depreciation |
| Book Value | 451883 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1803097 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (7 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER CURRENT ASSETS, NET | 1399466 |
| OTHER ASSETS, NET | 167643 |
| DUE FROM AFFILIATES | 353235 |
| RESTRICTED CASH AND CASH EQUIVALENTS | 388070 |
| INVESTMENTS IN FAMILYCARE HEALTH PLANS | 4486685 |
| RESTRICTED SHORT-TERM INVESTMENTS | 3383232 |
| RESTRICTED LONG-TERM INVESTMENTS | 2570755 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 12749086 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CAPITAL LEASE OBLIGATION, LESS CURRENT PORTION | Description |
| Amount | $353,247 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 353247 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 167616470 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 168842 | NetUnrealizedGainsInvestments |
| Other Revenues | 28715094 | OtherRevenues |
| Revenue Not Rptd F990 | 28883936 | RevenueNotRptdF990 |
| Revenue Subtotal | 138732534 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 138732534 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 159344634 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 28968346 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 28968346 | ExpensesNotRptdF990 |
| Expenses Subtotal | 130376288 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 130376288 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | OTHER ENTITY REVENUE 28,715,094. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | OTHER ENTITY EXPENSE 28,968,346. |
| SCHEDULE D, PART X, LINE 1 FINANCIAL STATEMENT FOOTNOTE REGARDING ASC 740: 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, 2009. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| OSTEOPATHIC PHYSICIANS & SURGEONS OF OREGON INC | |||||||
| 4380 SW MACADAM AVE SUITE 125 | PORTLAND | OR | 97239 | 936025596 | 501(C)(6) | 115000 | OSTEOPATHIC SUPPORT; EDUCATION GRANT. |
| BASIC RIGHTS EDUCATION FUND | |||||||
| PO BOX 40625 | PORTLAND | OR | 97240 | 931266613 | 501(C)(3) | 7500 | SPONSORSHIP - EQUALITY LUNCH & JUST CIRCLE |
| CASCADE AIDS PROJECT | |||||||
| 208 SW 5TH AVE STE 800 | PORTLAND | OR | 97204 | 930903383 | 501(C)(3) | 10010 | SPONSORSHIP - AIDS WALK |
| WESTERN UNIVERSITY OF HEALTH SCIENCES | |||||||
| 200 MULLINS DR | LEBANON | OR | 97355 | 953127273 | 501(C)(3) | 1882993 | SPONSORSHIP & DONATION - NEW SCHOOL |
| GLADSTONE EDUCATION FOUNDATION - JOHN WETTEN ELEMENTARY SCHOOL | |||||||
| 250 E EXETER ST | GLADSTONE | OR | 97027 | 931284265 | 501(C)(3) | 8000 | SPONSORSHIP & DONATION |
| NAMI - OREGON | |||||||
| 4701 SE 24TH AVE STE E | PORTLAND | OR | 97202 | 930875209 | 501(C)(3) | 5371 | SPONSORSHIP - WALK KICKOFF LUNCH & FUNDRAISING MATCH |
| LUND REPORT | |||||||
| PO BOX 82841 | PORTLAND | OR | 97282 | 263019179 | 501(C)(3) | 7500 | DONATION |
| OREGON PUBLIC HEALTH INSTITUTE | |||||||
| 315 SW FIFTH AVE SUITE 202 | PORTLAND | OR | 97204 | 931259522 | 501(C)(3) | 15000 | SPONSORSHIP |
| DE PAUL TREATMENT CENTERS INC | |||||||
| PO BOX 3007 | PORTLAND | OR | 97208 | 930706892 | 501(C)(3) | 10000 | DONATION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 8 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: FAMILYCARE DOES NOT AWARD GRANTS, BUT SPONSORS A LIMITED NUMBER OF CHARITABLE FUNDRAISING EVENTS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFF HEATHERINGTON | ||||||||||||||
| PRESIDENT | 350000 | 0 | 43802 | 0 | 23046 | 0 | 7500 | 0 | 6643 | 0 | 430991 | 0 | 0 | 0 |
| GREG MARTENSON | ||||||||||||||
| DIRECTOR OF FINANCE | 160000 | 0 | 1015 | 0 | 3885 | 0 | 3002 | 0 | 17761 | 0 | 185663 | 0 | 0 | 0 |
| JESSE GAMEZ | ||||||||||||||
| DIRECTOR OF OPERATIONS | 229231 | 0 | 1077 | 0 | 3482 | 0 | 6896 | 0 | 667 | 0 | 241353 | 0 | 0 | 0 |
| DOUGLAS LUTHER | ||||||||||||||
| MEDICAL DIRECTOR | 248586 | 0 | 2675 | 0 | 16022 | 0 | 7500 | 0 | 667 | 0 | 275450 | 0 | 0 | 0 |
| DAYNA STERINGER | ||||||||||||||
| DIRECTOR OF GOVERNMENT AFFAIRS | 121357 | 0 | 26127 | 0 | 5448 | 0 | 4438 | 0 | 11495 | 0 | 168865 | 0 | 0 | 0 |
| BILL BUTCHER | ||||||||||||||
| HEALTH & NETWORK SERVICES DIRECTOR | 139048 | 0 | 1271 | 0 | 6357 | 0 | 3273 | 0 | 454 | 0 | 150403 | 0 | 0 | 0 |
| DANIEL ROTH | ||||||||||||||
| ASST MEDICAL DIRECTOR | 244354 | 0 | 1207 | 0 | 20353 | 0 | 5598 | 0 | 17799 | 0 | 289311 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| ROBIN RICHARDSON DO | |||
| SECRETARY AND BOARD MEMBER | 57311 | EXPENSES PAID TO A PROVIDER CLINIC FOR HEALTHCARE-RELATED SERVICES. DR. ROBIN RICHARDSON IS THE PRESIDENT OF THE CLINIC. | 0 |
| KAREN CARNAHAN | |||
| CHAIR AND BOARD MEMBER | 191882 | EXPENSES PAID TO PROFESSIONAL SERVICES FIRM. MS. KAREN CARNAHAN IS AN OWNER OF THE FIRM. | 0 |
| ROSS RONISH | |||
| BOARD MEMBER | 2478016 | EXPENSES PAID TO A PROVIDER CLINIC FOR HEALTHCARE-RELATED SERVICES. MR. ROSS RONISH IS THE CHIEF MEDICAL OFFICER OF THE CLINIC. | 0 |
| RICHARD BARSOTTI | |||
| BOARD MEMBER | 1312961 | EXPENSES PAID TO A PROVIDER CLINIC FOR HEALTHCARE-RELATED SERVICES. MR. RICHARD BARSOTTI IS A PARTNER OF THE CLINIC. | 0 |
| JOSEPH HROMCO | |||
| BOARD MEMBER | 1116961 | EXPENSES PAID TO A PROVIDER CLINIC FOR HEALTHCARE-RELATED SERVICES. DR. JOE HROMCO IS A PARTNER OF THE CLINIC. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | JEFFREY PAWLOWSKI, BOARD MEMBER, AND MICHAEL RILEY, BOARD MEMBER, HAVE A BUSINESS RELATIONSHIP. | |
| 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 XI, LINE 9: | INCOME FROM SUBSIDIARY -253,252. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| 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. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Controlled OrgControlledOrg | Public Charity StatusPublicCharityStatus |
|---|---|---|---|---|---|---|---|---|---|
| FAMILYCARE HEALTH PLANS INC | |||||||||
| 825 NE MULTNOMAH SUITE 300 | PORTLAND | OR | 97232 | 911829317 | TO PROVIDE COMMUNITY HEALTH CARE | OR | 501(C)(4) | 0 | |
| FAMILYCARE MEDICAL CLINICS INC | |||||||||
| 825 NE MULTNOMAH SUITE 300 | PORTLAND | OR | 97232 | 930988354 | TO PROVIDE COMMUNITY HEALTH CARE | OR | 501(C)(3) | 0 | NON-PRIVATE FDN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILYCARE HEALTH PLANS INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionType |
| Amount Involved | 353235 | AmountInvolved |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART II | ReturnReference |
| Explanation | FAMILYCARE, INC., FAMILYCARE HEALTH PLANS, INC. AND FAMILYCARE MEDICAL CLINICS, INC. ARE RELATED TAX-EXEMPT ORGANIZATIONS BY VIRTUE OF INTERLOCKING BOARD MEMBERS. | Explanation |
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