2011-08-15T10:41:27-05:00 2010-12-31 HOFFMAN STEWART & SCHMIDT PC 4900 MEADOWS ROAD STE 200 LAKE OSWEGO OR 970353295 990 2010-01-01 910896241 COWLITZ FAMILY HEALTH CENTER COWL 3606363892 1057 12TH AVENUE LONGVIEW WA 986322509 DIAN COOPER 3606363892 2011-08-16 1 ROBERT M PRILL 5032205900 2010 2016-02-24 21:20:13Z DIAN COOPER 1057 12TH AVENUE LONGVIEW WA 986322509 11044398 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. 11 11 167 0 0 0 2835315 2803464 7535565 8212373 33922 23882 8318 4679 10413120 11044398 0 0 0 0 6632242 7432284 0 0 0 3209831 3483747 9842073 10916031 571047 128367 7471176 7499495 1727642 1627594 5743534 5871901 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 5098452 4942134 TO PROVIDE MEDICAL SERVICES TO LOW INCOME INDIVIDUALS. THE TOTAL MEDICAL ENCOUNTERS DURING THE YEAR WERE 42,147. 689948 TO PROVIDE SUPPLEMENTAL NUTRITION SERVICES FOR PREGNANT AND BREASTFEEDING WOMEN AND THEIR CHILDREN TO AGE 5. DURING 2010, THE CENTER SERVED 6,799 WOMEN, INFANTS AND CHILDREN. 2255066 2448218 TO PROVIDE DENTAL SERVICES TO LOW INCOME INDIVIDUALS. THE TOTAL DENTAL ENCOUNTERS DURING THE YEAR WERE 23,295. 510056 826700 TO PROVIDE MEDICAL RELATED SERVICES TO LOW INCOME INDIVIDUALS. ENABLING SERVICE ENCOUNTERS AND MENTAL HEALTH ENCOUNTERS TOTALED 6,799 AND 1,610 RESPECTIVELY. 510056 826700 8553522 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 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 0 1 19 0 167 1 0 0 0 0 0 0 0 0 0 0 X 11 11 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 2.00 X X 0 0 0 CARLOS CARREON 2.00 X X 0 0 0 MELISSA TAYLOR 2.00 X X 0 0 0 WANDA MCBEE 2.00 X X 0 0 0 CARLEEN WOLGAMOTT 2.00 X 0 0 0 CYNTHIA WASHINGTON-MATTSON 2.00 X 0 0 0 JOSIAH JOHNSON 2.00 X 0 0 0 GEORGE ROBERTSON 2.00 X 0 0 0 JOE TITUS 2.00 X 0 0 0 JUDY BRIGHT 2.00 X 0 0 0 THOMAS DOUMIT 2.00 X 0 0 0 DIAN COOPER 40.00 X 101019 0 6871 ANDREA TRENNER 40.00 X 30451 0 2290 NORMAN KRAFT 40.00 X 48844 0 6512 GERARDO MELGAR 40.00 X 170546 0 6871 ROBERT PETERSON 40.00 X 156319 0 8071 TRESHA DRONEN 40.00 X 141588 0 6004 PARTHA GONAVARAM 40.00 X 134580 0 7398 ROXANE OSHIRO 40.00 X 143515 0 6871 WEN LUM 40.00 X 127492 0 5691 1054354 0 56579 13 0 1 0 OCHIN INC 707 SW WASHINGTON STREET 1200 PORTLAND OR 972053529 EMR AND PRACTICE MANAGEMENT FEES 272280 POLAR SYSTEMS 21890 WILLAMETTE DRIVE WEST LINN OR 97068 COMPUTER CONSULTING 247726 2 2798417 5047 2803464 PATIENT SERVICE REVENU 624100 5974736 5974736 PREMIUM REVENUE 624100 2237637 2237637 8212373 23882 23882 OTHER REVENUE 624100 4679 4679 4679 11044398 8217052 0 23882 417114 205931 211183 5726344 4989677 736667 761692 649294 112398 527134 464828 62306 47062 47062 35826 35826 1208474 597309 611165 18355 17272 1083 199868 133295 66573 541637 507256 34381 96683 73709 22974 34406 34406 440979 266042 174937 39768 39768 MEDICAL SUPPLIES 364915 364915 BAD DEBT 146669 146669 TAXES AND LICENSES 68634 62968 5666 TELEPHONE 62254 48603 13651 RECRUITMENT & RETENTION 54729 3955 50774 123488 21799 101689 10916031 8553522 2362509 0 485646 876866 2583277 2543406 139696 88590 939072 979256 44510 45029 158906 160158 5148298 2342108 3120069 2806190 7471176 7499495 936144 845990 791498 781604 1727642 1627594 X 5743534 5871901 5743534 5871901 7471176 7499495 128367 0 X X 0 1 1 X 1 1 X 1562433 1832679 2411332 2835315 2803464 11445223 1562433 1832679 2411332 2835315 2803464 11445223 11445223 29828 102661 65048 33922 23882 255341 8318 4679 12997 11713561 0.97710 0.97860 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 83030 83030 699680 107802 591878 1830228 1067166 763062 2535360 1167140 1368220 2806190 11044398 10916031 128367 0 128367 11044398 0 11044398 0 11044398 10916031 0 10916031 0 10916031 X X 0 0 0 0 0 0 0 0 0 GERARDO MELGAR 158996 0 0 0 11550 0 0 0 6871 0 177417 0 0 0 ROBERT PETERSON 156319 0 0 0 0 0 0 0 8071 0 164390 0 0 0 ROXANE OSHIRO 143515 0 0 0 0 0 0 0 6871 0 150386 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 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.