NEIGHBORHOOD HEALTH CENTER: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- NEIGHBORHOOD HEALTH CENTER (EIN 27-3524752)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201333189349305363
- 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 | 2013-11-14T14:50:51-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910189318 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SW BROADWAY 1200 | AddressLine1 |
| City | PORTLAND | City |
| State | OR | State |
| ZIP Code | 97205 | 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 | 273524752 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEIGHBORHOOD HEALTH CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NEIG | NameControl |
| Phone | 5039413033 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3720 SW 141ST AVENUE SUITE 100 | AddressLine1 |
| City | BEAVERTON | City |
| State | OR | State |
| ZIP Code | 97005 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BLAIN WEST | Name |
| Title | CFO | Title |
| Phone | 5039413033 | Phone |
| Date Signed | 2013-11-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WENDY CAMPOS | Name |
| PTIN | P00448102 | PTIN |
| Phone | 5032421447 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BLAIN WEST | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3720 SW 141ST AVENUE SUITE 100 | AddressLine1 |
| City | BEAVERTON | City |
| State | OR | State |
| ZIP Code | 97005 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 7643408 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | HTTP://WWW.HEALTHCENTEROR.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2010 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | NEIGHBORHOOD HEALTH CENTER WAS CREATED TO MEET THE HEALTH CARE NEEDS OF UNDERSERVED, AT RISK MEMBERS OF OUR COMMUNITIES, INCLUDING MEDICAID AND MEDICARE PATIENTS AS WELL AS THE UNINSURED. NEIGHBORHOOD HEALTH CENTER STRIVES TO COLLABORATE WITH COMMUNITY PARTNERS, COUNTY, LOCAL AND STATE OFFICIALS, AS WELL AS OTHER HEALTH CARE PROFESSIONALS AND WILL CONTINUE TO DEVELOP PARTNERSHIPS TO OFFER HIGH QUALITY HEALTH CARE TO THE COMMUNITIES IN WHICH WE SERVE. NEIGHBORHOOD HEALTH CENTER OFFERS HEALTH CARE SERVICES USING A TEAM BASED CARE MODEL, WITH CREATING A "HEALTH HOME" FOR ITS PATIENTS AT THE CORE OF ITS VALUES. CURRENT LOCATIONS ARE BEAVERTON, CANBY, MILWAUKIE, GLADSTONE AND OREGON CITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 62 | TotalNbrEmployees |
| Total Nbr Volunteers | 8 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 4918720 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3627931 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 541556 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3931824 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 85 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4642 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 11564 | OtherRevenuePriorYear |
| Other Revenue Current Year | 79011 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5471925 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7643408 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1273027 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5269488 | 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 | 322795 | OtherExpensePriorYear |
| Other Expenses Current Year | 2690293 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1595822 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7959781 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3876103 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -316373 | RevenuesLessExpensesCY |
| Total Assets BOY | 4339423 | TotalAssetsBOY |
| Total Assets EOY | 4301880 | TotalAssetsEOY |
| Total Liabilities BOY | 386492 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 665322 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3952931 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3636558 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF NEIGHBORHOOD HEALTH CENTER IS TO INCREASE ACCESS TO HEALTH CARE SERVICES IN THE COMMUNITIES IN WHICH WE SERVE, BY PROVIDERS WHO ARE PASSIONATE ABOUT QUALITY HEALTH CARE FOR EACH INDIVIDUAL AND FAMILY MEMBER. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 5683405 | Expense |
| Revenue | 2869570 | Revenue |
| Description | PATIENT SERVICES - MEDICAL: TO OPERATE COMMUNITY MEDICAL HEALTH CENTERS TO INCREASE ACCESS TO COMPREHENSIVE AND PREVENTIVE MEDICAL SERVICES AND TO IMPROVE HEALTH CARE STATUS OF THE VULNERABLE AND UNDERSERVED POPULATIONS OF THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 701455 | Expense |
| Revenue | 360298 | Revenue |
| Description | PATIENT SERVICES - DENTAL: TO OPERATE COMMUNITY DENTAL CENTERS TO INCREASE ACCESS TO COMPREHENSIVE AND PREVENTIVE DENTAL SERVICES AND TO IMPROVE HEALTH CARE STATUS OF THE VULNERABLE AND UNDERSERVED POPULATIONS OF THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 71284 | Expense |
| Revenue | 780967 | Revenue |
| Description | GRANT DENTAL SERVICES: THIS PROGRAM PROVIDES DENTAL SERVICES ACCORDING TO THE GUIDELINES OF THE GRANT AGREEMENTS. ONE GRANT PROGRAM IS KAISER PERMANENTE ORAL HEALTH SPECIAL INITIATIVE GRANT AND THE OTHER IS EMERGENCY DENTAL CARE COORDINATION PILOT OF CLACKAMAS COUNTY. THE PURPOSE OF THIS GRANT IS TO OFFER SUPPORT FOR THE ORAL HEALTH INITIATIVE OF CLACKAMAS COUNTY. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 910 | Expense |
| Description | HOME VISIT - CARE WORKERS VISIT THE PATIENTS ON SITES OR BY PHONE. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 910 | TotalOfOtherProgramServiceExp |
| Total Program Service Expense | 6457054 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | 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 | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 0 | 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 | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | 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 | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 31 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 62 | 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 |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BLAIN WEST | NamePerson |
| Telephone Number | 5039413028 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3720 SW 141ST AVENUE SUITE 100 | AddressLine1 |
| City | BEAVERTON | City |
| State | OR | State |
| ZIP Code | 97005 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| ROBIN MACK | |||||||
| BOARD CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| DONALDA DODSON | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| TERESA LEARN | |||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| ANITA SMITH | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| NICKIE CARTER | |||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | |
| FABIOLA CRETAROLO | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| RACHEL VELLONE | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JOHN RIHERD | |||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| JAMES SCHROEDER | |||||||
| FORMER CEO | 32.00 | X | 64504 | 0 | 11702 | ||
| BLAIN WEST | |||||||
| CFO | 40.00 | X | 74900 | 0 | 6883 | ||
| JERI WEEKS | |||||||
| CEO | 40.00 | X | 37948 | 0 | 5620 | ||
| JILL ARENA | |||||||
| INTERIM CEO | 40.00 | X | 0 | 0 | 0 | ||
| MICHAEL PLUNKETT | |||||||
| DENTAL DIRECTOR | 40.00 | 183944 | 0 | 38247 | X | ||
| MARY MILLER | |||||||
| PHYSICIAN | 40.00 | 181747 | 0 | 26038 | X | ||
| JOHN NAJERA | |||||||
| PHYSICIAN | 40.00 | 176951 | 0 | 24863 | X | ||
| ANGELA UBA | |||||||
| PHYSICIAN | 40.00 | 172640 | 0 | 46050 | X | ||
| SAFINA KOREISHI | |||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.00 | 153039 | 0 | 16745 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1045673 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 176148 | TotalOtherCompensation |
| Number Individuals GT100 K | 11 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CAREOREGON INC | |||||
| 315 SW 5TH AVE STE 900 | PORTLAND | OR | 97204 | MANAGEMENT SERVICES | 213434 |
| OREGON COMMUNITY HEALTH INFO NET | |||||
| 1881 SW NAITO PARKWAY | PORTLAND | OR | 97201 | PROFESSIONAL SERVICES | 131005 |
| THERAPEUTIC ASSOCIATES | |||||
| 7100 FORT DENT WAY STE 220 | SEATTLE | WA | 98188 | PROFESSIONAL SERVICES | 112061 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| All Other Contributions | 3627931 | AllOtherContributions |
| Total Contributions | 3627931 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICES | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 3931824 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3931824 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3931824 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4642 | TotalRevenueColumn |
| Exclusion | $4,642 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SUPPORT SERVICES | Description |
| Business Code | 561000 | BusinessCode |
| Total Revenue Column | 79011 | TotalRevenueColumn |
| Related Or Exempt Function Income | 79011 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 79011 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7643408 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4010835 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $4,642 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 201557 | Total |
| Program Services | 60467 | ProgramServices |
| Management And General | 141090 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3937735 | Total |
| Program Services | 3285828 | ProgramServices |
| Management And General | 651907 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 293068 | Total |
| Program Services | 274003 | ProgramServices |
| Management And General | 19065 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 506792 | Total |
| Program Services | 494328 | ProgramServices |
| Management And General | 12464 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 330336 | Total |
| Program Services | 276341 | ProgramServices |
| Management And General | 53995 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4991 | Total |
| Management And General | 4991 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44373 | Total |
| Program Services | 6879 | ProgramServices |
| Management And General | 37494 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1007841 | Total |
| Program Services | 777248 | ProgramServices |
| Management And General | 230593 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2942 | Total |
| Program Services | 1696 | ProgramServices |
| Management And General | 1246 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 351969 | Total |
| Program Services | 264072 | ProgramServices |
| Management And General | 87897 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141365 | Total |
| Program Services | 33653 | ProgramServices |
| Management And General | 107712 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 324832 | Total |
| Program Services | 292447 | ProgramServices |
| Management And General | 32385 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33317 | Total |
| Program Services | 16321 | ProgramServices |
| Management And General | 16996 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46033 | Total |
| Program Services | 17833 | ProgramServices |
| Management And General | 28200 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2205 | Total |
| Program Services | 2205 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 211131 | Total |
| Program Services | 139325 | ProgramServices |
| Management And General | 71806 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42923 | Total |
| Program Services | 42923 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 238661 | 238661 | |
| MEDICAL SUPPLIES | 218064 | 218064 | |
| DUES & SUBSCRIPTIONS | 18611 | 13725 | 4886 |
| INTERPRETATION | 1035 | 1035 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7959781 | Total |
| Program Services | 6457054 | ProgramServices |
| Management And General | 1502727 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3162029 | BOY |
| EOY | 1421720 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 423440 | BOY |
| EOY | 2069098 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18000 | BOY |
| EOY | 18000 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 118573 | BOY |
| EOY | 144244 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 903094 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 254276 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 617381 | BOY |
| EOY | 648818 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4339423 | BOY |
| EOY | 4301880 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 325352 | BOY |
| EOY | 590709 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39925 | BOY |
| EOY | 47719 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21215 | BOY |
| EOY | 26894 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 386492 | BOY |
| EOY | 665322 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3942931 | BOY |
| EOY | 3626558 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10000 | BOY |
| EOY | 10000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3952931 | BOY |
| EOY | 3636558 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4339423 | BOY |
| EOY | 4301880 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -316373 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | 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 Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 67372 | OtherCostOrOtherBasis |
| Depreciation | 13926 | Depreciation |
| Book Value | 53446 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 835722 | OtherCostOrOtherBasis |
| Depreciation | 240350 | Depreciation |
| Book Value | 595372 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 648818 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CAPITAL LEASES | Description |
| Amount | $26,894 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 26894 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 7404747 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 7404747 | RevenueSubtotal |
| Other Revenues Not Included | 238661 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 238661 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 7643408 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7721120 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 7721120 | ExpensesSubtotal |
| Other Expenses Not Included | 238661 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 238661 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 7959781 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 238,661. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 238,661. |
| PART X, LINE 2: THE ORGANIZATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A QUALIFIED TAX-EXEMPT ENTITY UNDER THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3). NO PROVISION FOR INCOME TAXES IS MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS, AS THE ORGANIZATION HAS NO ACTIVITIES SUBJECT TO UNRELATED BUSINESS INCOME TAX. THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN ADMINISTRATIVE EXPENSE. THE ORGANIZATION HAD NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2012 AND 2011. NO INTEREST AND PENALTIES WERE ACCRUED FOR THE YEAR. THE ORGANIZATION FILES AN EXEMPT ORGANIZATION RETURN IN THE U.S. FEDERAL JURISDICTION AND WITH THE OREGON CHARITIES DIVISION AND IS SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR ITS 2012 AND 2011 YEARS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Survey | X | CompensationSurvey |
| 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL PLUNKETT | ||||||||||||||
| DENTAL DIRECTOR | 144944 | 0 | 35000 | 0 | 4000 | 0 | 14457 | 0 | 23790 | 0 | 222191 | 0 | 0 | 0 |
| MARY MILLER | ||||||||||||||
| PHYSICIAN | 164747 | 0 | 0 | 0 | 17000 | 0 | 16426 | 0 | 9612 | 0 | 207785 | 0 | 0 | 0 |
| JOHN NAJERA | ||||||||||||||
| PHYSICIAN | 173398 | 0 | 0 | 0 | 3553 | 0 | 15988 | 0 | 8875 | 0 | 201814 | 0 | 0 | 0 |
| ANGELA UBA | ||||||||||||||
| PHYSICIAN | 153409 | 0 | 0 | 0 | 19231 | 0 | 16555 | 0 | 29495 | 0 | 218690 | 0 | 0 | 0 |
| SAFINA KOREISHI | ||||||||||||||
| ASSOCIATE MEDICAL DIRECTOR | 136039 | 0 | 0 | 0 | 17000 | 0 | 13602 | 0 | 3143 | 0 | 169784 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 1A | ReturnReference |
| Explanation | ALL EMPLOYEES INCLUDING THOSE LISTED ON FORM 990 PART VII RECEIVE FITNESS CLUB MEMBERSHIP REIMBURSEMENT. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JILL ARENA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | JILL ARENA IS AN OFFICER OF THE ORGANIZATION. | Relationship |
| Amount Of Transaction | 106813 | AmountOfTransaction |
| Description Of Transaction | JILL ARENA PROVIDED INTERIM CEO SERVICES TO THE ORGANIZATION DURING THE YEAR THROUGH A THIRD PARTY MANAGEMENT CONSULTING FIRM IN WHICH JILL IS A PARTNER. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NEW PROGRAM SERVICES | FORM 990, PART III, LINE 2 | THE ORGANIZATION RECEIVED A DENTAL GRANT TO FUND CARE FOR THE UNINSURED PATIENTS AND ALSO PARTICIPATED IN A KAISER PERMANENTE ORAL HEALTH SPECIAL INITIATIVE PROGRAM TO FURTHER SERVICE THE COMMUNITY. |
| FORM 990, PART VI, SECTION B, LINE 11 | MEMBERS OF STAFF GATHER THE INFORMATION FOR THE FORM 990, REVIEW THIS INFORMATION WITH THE CFO, AND THEN FORWARD TO MOSS ADAMS, AN INDEPENDENT CPA FIRM, WHO PREPARES THE FORM 990. ONCE THE RETURN IS COMPLETED IT IS REVIEWED BY MEMBERS OF STAFF, THE CFO AND ALL MEMBERS OF THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST AFFIDAVIT. | |
| FORM 990, PART VI, SECTION B, LINE 15 | HUMAN RESOURCES CONTRACTED MANAGEMENT SERVICES CONDUCTS MARKET SALARY SURVEYS AND MEMBERS OF THE BOARD APPROVE THE CEO, CFO AND CMO COMPENSATION RANGE. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XII, LINE 2C: | THE FINANCE COMMITTEE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED DURING THE TAX YEAR. |
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