2020-01-25T10:27:26-06:00 2019-06-30 930764156 NEUNER DAVIDSON & CO PO BOX 1786 ROSEBURG OR 97470 990 2018-07-01 930611783 ADAPT ADAP 5416722691 621 W MADRONE ROSEBURG OR 97470 GREGORY S BRIGHAM CHIEF EXECUTIVE OFFICER 5416722691 2020-01-10 1 P01061476 5416724886 108.174.188.26 2020-01-10 13:47:58 PS P B8729F160EF3633D2316ACA5A43C63ED9AACAB6A 1B7BB3CC995054AA314A2D1E7AFFA7DD8970E865 2018 2020-09-23 17:36:50Z GREGORY S BRIGHAM 621 W MADRONE ROSEBURG OR 97470 32619417 0 X WWW.ADAPTOREGON.ORG X NON-PROFIT - PUBLIC BENEFIT 1971 OR PROVIDE PRIMARY CARE, BEHAVIORAL HEALTH CARE AND PREVENTIONS SERVICES. 11 11 445 0 0 786 8395289 10070822 19605114 22306362 21124 -23084 296159 239196 28317686 32593296 0 0 0 0 22992266 24284389 0 0 0 5304111 5460114 28296377 29744503 21309 2848793 16559284 20312423 3828494 4732843 12730790 15579580 PROVIDE OUR COMMUNITIES OPEN ACCESS TO WORLD CLASS PRIMARY CARE, ADDICTIONS TREATMENT, AND BEHAVIOR HEALTH CARE TO PROMOTE HEALTH AND RESTORE LIVES, WITHOUT REGARD FOR THE ABILITY TO PAY. 0 0 12508329 12939976 OUTPATIENT SERVICES: EVALUATION, TREATMENT, OPIOID TREATMENT PROGRAM, TRANSITIONAL HOUSING, EDUCATION, REFERRAL AND EMERGENCY SERVICES TO INDIVIDUALS AND FAMILIES WITH DRUG, ALCOHOL AND RELATED PROBLEMS.RESIDENTIAL TREATMENT (ADULT AND YOUTH): OPERATION OF A 24 BED ADULT ALCOHOL AND DRUG TREATMENT FACILITY SERVING THIRTEEN COUNTIES, A 12 BED YOUTH ALCOHOL AND DRUG TREATMENT FACILITY SERVING SIX COUNTIES IN SOUTHWEST OREGON, AND AN 11 BED SUB-ACUTE MEDICALLY MONITORED DETOXIFICATION PROGRAM. 8147093 10843928 MENTAL HEALTH PROGRAMS & SERVICES: COMPREHENSIVE MENTAL HEALTH SERVICES INCLUDING ADULT, YOUTH AND FAMILY TREATMENT, CRISIS INTERVENTION AND EVALUATION, MOBILE MENTAL HEALTH CRISIS SERVICES, SCREENING, PSYCHOTHERAPY, THERAPEUTIC FOSTER CARE, THERAPEUTIC LEARNING CLASSROOMS AND SCHOOL-BASED PROGRAMS. SERVICES ALSO INCLUDE EARLY ASSESSMENT AND SUPPORT ALLIANCE (EASA), INDIVIDUAL PLACEMENT SUPPORT (IPS), SUPPORTED EMPLOYMENT AND ASSERTIVE COMMUNITY TREATMENT (ACT) PROGRAMS. 5408632 7957048 SOUTH RIVER COMMUNITY HEALTH CENTER (SRCHC): A PATIENT CENTERED PRIMARY CARE HOME. SRCHC PROVIDES COMMUNITY ACCESS HEALTH SERVICES PARTICULARLY TO INDIVIDUALS WITH LOWER INCOMES AND HOMELESSNESS. SRCHC OFFERS PATIENTS ACCESS TO INTEGRATED PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES INCLUDING MEDICATION ASSISTED TREATMENT FOR OPIOID USE DISORDER 218776 218776 26282830 1 0 0 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 1 50 0 445 1 1 1 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 1 1 1 0 0 OR X ADAPT 5416722691 621 MADRONE ST ROSEBURG OR 97470 TODD MUNSEY CHAIRMAN 2.00 X X 0 0 0 LEE PATERSON VICE CHAIR 2.00 X X 0 0 0 GARY WAYMAN TREASURER 2.00 X X 0 0 0 NEAL BROWN DIRECTOR 2.00 X 0 0 0 GRACE POWERS DIRECTOR 2.00 X 0 0 0 DALLAS AMER DIRECTOR 2.00 X 0 0 0 VERONICA GILLESPIE DIRECTOR 2.00 X 0 0 0 KELSEY WOOD DIRECTOR 2.00 X 0 0 0 GREGORY S BRIGHAM PHD CEO 40.00 X 337831 0 42764 JOHN COLLINS MEDICAL DIRECTOR 40.00 X 260000 0 35305 GEORGE MIDDLEKAUFF LMP 40.00 X 242372 0 14731 TONI DAMEWOOD NURSE PRACTITIONER 40.00 X 185737 0 11674 TERRI SQUIRES NURSE PRACTITIONER 40.00 X 196329 0 19436 GLEN MONTEIRO CMO 40.00 X 240527 0 25694 1462796 0 149604 18 0 1 0 HEALTHCO INFORMATION SYSTEMS 7657 SW MOHAWK ST TUALITIN OR 97062 EHR SYSTEM 188195 STERLING REFERENCE LABORATORIES PO BOX 17103 DENVER CO 802170103 UA TESTING LAB 165447 QUALIFACTS PO BOX 4577 CAROL STREAM IL 601974577 EMR SUBSCRIPTION 147536 ZERBACH CONSTRUCTION INC 1224 NE WALNUT PMB 291 ROSEBURG OR 97471 BUILDING CONSTRUCTION 143427 PHYSICIAN EHEALTH SERVICES UMPQUA HEALTH 3031 NE STEPHENS ST ROSEBURG OR 97470 EMR SERVICES 107512 5 902 9803039 266881 10070822 CLIENT FEES 624100 11529726 11529726 MEDICARE / MEDICAID 624100 7958397 7958397 MISCELLANEOUS PROGRAM 624100 2781577 2781577 FOOD STAMPS 624100 36662 36662 22306362 314 314 2723 26121 -23398 -23398 -23398 MISCELLANEOUS 624100 239196 239196 239196 32593296 22522474 0 0 1462796 1124965 337831 17757346 16025645 1731701 806685 704420 102265 2573235 2282612 290623 1684327 1512660 171667 12830 7610 5220 41794 2194 39600 90860 56049 34811 66197 51167 15030 177095 71053 106042 302519 101043 201476 827055 645800 181255 193023 168177 24846 41465 41465 405856 405856 192877 159406 33471 PROGRAM SUPPLIES 831707 826307 5400 SRCHC ADAPT & COMPASS B 467299 467299 SUB CONTRACTS 343813 343813 COMMUNICATIONS 302097 258819 43278 1163627 1026470 137157 29744503 26282830 3461673 0 3825 5175 3704440 3894324 795275 2733925 3186246 3289077 579719 570664 13397669 3626411 8241779 9771258 48000 48000 16559284 20312423 2267768 2281577 168289 294957 1392437 2156309 3828494 4732843 X 12730790 15579580 12730790 15579580 16559284 20312423 X 2848793 -3 X 1 X 1 X 1 1 1 X 4578811 4351701 5923550 8395289 10070821 33320172 6725 6725 6725 6725 8266 35166 4585536 4358426 5930275 8402014 10079087 33355338 33355338 61214 65734 189390 187395 142739 646472 34001810 0.98100 0.98570 X 2391478 2391478 8768871 1993801 6775070 2237320 1632610 604710 9771258 32619422 26121 5 26126 32593296 0 32593296 29770631 26121 7 26128 29744503 0 29744503 PART XI, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 5. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 7. X 0 0 0 0 0 0 0 0 0 GREGORY S BRIGHAM PHD CEO 337831 0 0 0 0 0 21404 0 21360 0 380595 0 0 0 JOHN COLLINS MEDICAL DIRECTOR 260000 0 0 0 0 0 13000 0 22305 0 295305 0 0 0 GEORGE MIDDLEKAUFF LMP 242372 0 0 0 0 0 14718 0 13 0 257103 0 0 0 TONI DAMEWOOD NURSE PRACTITIONER 185556 0 181 0 0 0 11645 0 29 0 197411 0 0 0 TERRI SQUIRES NURSE PRACTITIONER 181329 0 15000 0 0 0 10548 0 8888 0 215765 0 0 0 GLEN MONTEIRO CMO 239444 0 1083 0 0 0 12583 0 13111 0 266221 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE GOVERNING BODY DOES NOT REVIEW THE TAX RETURN. THEY REVIEW THE FINAL AUDITED FINANCIALS. FORM 990 IS PROVIDED TO THE STAFF ACCOUNTANT WHO REVIEWS FOR CORRECTNESS. ONCE APPROVED BY THE STAFF ACCOUNTANT THE CEO REVIEWS, SIGNS AND SUBMITS THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ADAPT DOES NOT REQUIRE AN ANNUAL DISCLOSURE, BUT ADDRESSES EACH CONFLICT AS IT ARISES. FORM 990, PART VI, SECTION B, LINE 15A CHIEF HUMAN RESOURCE OFFICER PROVIDES THE BOARD OF DIRECTORS WITH A COMPARISON OF VARIOUS COMPARABLES THROUGHOUT THE STATE OF OREGON. THE BOARD DOES A PERFORMANCE REVIEW AND EVALUATION OF CEO'S ACCOMPLISHMENTS AND ESTABLISHES NEW WAGE BASE. FORM 990, PART VI, SECTION C, LINE 19 ADAPT MAKES ITS ORGANIZATIONAL DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS AVAILABLE UPON WRITTEN REQUEST. FORM 990, PART XI, LINE 9: ROUNDING -3.