2019-09-23T15:56:50-05:00 2018-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2018-01-01 912168190 UNITY CARE NORTHWEST UNIT 3606766177 1616 CORNWALL AVENUE NO 205 BELLINGHAM WA 98225 DESMOND SKUBI EXECUTIVE DIRECTOR 3606766177 2019-08-15 1 KURT BENNION P01469618 4252506100 2019-08-15 67.137.57.251 2019-08-15 22:09:43 PD P 87BD3611550E1D67138C53841B1C9A886D50C97E BF9991DD2DB12812CD4D00877CE6B9F0AB9EA94D 2018 2019-02-21 02:37:17Z X DESMOND SKUBI 1616 CORNWALL AVENUE NO 205 BELLINGHAM WA 98225 35087053 0 X HTTPS://UNITYCARENW.ORG X 2001 WA ASSURING HIGH QUALITY AFFORDABLE HEALTH CARE TO ALL, REGARDLESS OF ABILITY TO PAY. 11 11 294 15 30226108 0 2998490 4622608 32119318 30226108 37190 172874 89602 48613 35244600 35070203 0 653096 0 0 18417330 19736781 0 0 104961 11990306 10513602 30407636 30903479 4836964 4166724 28234393 29316820 8976012 5899338 19258381 23417482 X WE THE STAFF, VOLUNTEERS AND COMMUNITY PARTNERS OF UNITY CARE NORTHWEST ARE COMMITTED TO ASSURING HIGH QUALITY, AFFORDABLE HEALTH CARE FOR EVERYONE. OUR VALUES INCLUDE A PROFESSIONAL, CARING ENVIRONMENT FOR PATIENTS AND STAFF, THE ABILITY TO PROVIDE CARE REGARDLESS OF ABILITY TO PAY, WELLNESS AND PREVENTION, AND COMMUNITY PARTNERSHIPS. 0 0 25559025 653096 30226108 UNITY CARE NORTHWEST PROVIDES HIGH QUALITY, PATIENT-CENTERED SERVICES TO THE PEOPLE OF WHATCOM COUNTY REGARDLESS OF ABILITY TO PAY. INTEGRATED CARE TEAMS PROVIDE COMPREHENSIVE COORDINATION OF PRIMARY MEDICAL HEALTH CARE NEEDS, AS WELL AS DENTAL, PHARMACY AND BEHAVIORAL HEALTH SERVICES. DURING 2018, UNITY CARE NORTHWEST PROVIDED SERVICES TO 21,478 UNDUPLICATED PATIENTS AND A TOTAL OF 92,681 VISITS AT FOUR CLINIC SITES. OVER 45% OF PATIENTS SERVED LIVE AT OR BELOW 100% OF THE FEDERAL POVERTY LINE AND 73% ARE AT OR UNDER 200% OF THIS SCALE. 25559025 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 39 0 294 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X DIAHANN BARRERA 3606766177 1616 CORNWALL AVENUE NO 205 BELLINGHAM WA 98225 DANIEL WHITTLE PRESIDENT & PAST PRESIDENT 2.00 0.10 X X 0 0 0 MELVIN DE JONG VICE PRESIDENT & PRESIDENT 2.00 0.10 X X 0 0 0 LARRY THOMPSON SECRETARY & VICE PRESIDENT 2.00 0.00 X X 0 0 0 REBECCA SCHAYES ARNP DIRECTOR & SECRETARY 2.00 0.00 X X 0 0 0 CURTIS BUSH TREASURER & DIRECTOR (THROUGH NOVEMBER 2018) 1.00 0.00 X X 0 0 0 JENNIFER MOLDVER DIRECTOR & TREASURER 2.00 0.10 X X 0 0 0 JAMES BROWN DIRECTOR 1.00 0.00 X 0 0 0 TERRY BROWN DIRECTOR (THROUGH FEBRUARY 2018) 1.00 0.00 X 0 0 0 MELANIE COOL DIRECTOR (THROUGH SEPTEMBER 2018) 1.00 0.00 X 0 0 0 BRUCE KADAR DIRECTOR (THROUGH APRIL 2018) 1.00 0.00 X 0 0 0 ELIZABETH RAMOS DIRECTOR 1.00 0.00 X 0 0 0 KELLIE SLATER DIRECTOR 1.00 0.00 X 0 0 0 REBECCA SPITHILL DIRECTOR 1.00 0.00 X 0 0 0 CHARLES WALTER DIRECTOR 1.00 0.00 X 0 0 0 ELAINE WOODS DIRECTOR 1.00 0.00 X 0 0 0 DESMOND SKUBI EXECUTIVE DIRECTOR 46.00 4.00 X 242189 0 12291 SHANON HARDIE CHIEF OPERATIONS OFFICER 50.00 0.00 X 148337 0 13924 JAN KLINEBURGER FINANCE DIRECTOR (THROUGH JULY 2018) 50.00 0.00 X 95527 0 7799 DIAHANN BARRERA CHIEF FINANCIAL OFFICER 50.00 0.00 X 57251 0 2763 BARBARA CLURE MD MEDICAL DIRECTOR 50.00 0.00 X 253469 0 18764 CARRIE SHANE DDS DENTAL DIRECTOR / DENTIST 50.00 0.00 X 175425 0 15643 JOHN TILLEY JR MD MEDICAL DOCTOR 45.00 0.00 X 238087 0 810 CASEY LIEN MD MEDICAL DOCTOR 45.00 0.00 X 201912 0 15109 DONALD BRUNK MD MEDICAL DOCTOR 45.00 0.00 X 228201 0 17533 COLIN GOGGIN MD PSYCHIATRIST 45.00 0.00 X 193320 0 14369 AARON MOORE MD PSYCHIATRIST 45.00 0.00 X 221113 0 9656 2054831 0 128661 38 0 1 0 COMPHEALTH PO BOX 972670 DALLAS TX 753972670 CONTRACT MEDICAL PROVIDERS 474202 ALDRICH & ASSOCIATES INC 810 240TH STREET SE BOTHELL WA 98021 GENERAL CONTRACTOR 465847 THE FINAL TOUCH CLEANING SERVICE INC PO BOX 5927 BELLINGHAM WA 98227 OFFICE CLEANING 154798 EVERGREEN WELLNESS ADVOCATES 115 UNITY STREET 302 BELLINGHAM WA 98225 CASE MANAGEMENT SERVICES 116324 4 66768 3099195 1456645 208953 4622608 PATIENT SERVICE REVENUE 624100 30124108 30124108 MEANINGFUL USE 624100 102000 102000 30226108 172874 172874 8362 66768 16850 -8488 -8488 OTHER REVENUE 900099 57101 57101 57101 35070203 0 30226108 221487 653096 653096 1043382 463301 580081 15447575 13158968 2212126 76481 429479 362137 65277 2065 1522146 1267213 247987 6946 1294199 1068237 219833 6129 6425 6425 72765 72765 1536099 1346861 185260 3978 102655 52967 49673 15 692336 212701 474170 5465 892574 447651 444112 811 20487 16891 3596 61215 9465 51693 57 96574 96574 643409 534101 109308 129475 104580 24895 MEDICAL SUPPLIES 5438705 5437772 933 TAXES & FEES 343280 11370 329532 2378 TRAINING 163412 78681 84395 336 BAD DEBT 162701 162701 151490 73758 77432 300 30903479 25559025 5239493 104961 16463791 13367950 101489 326112 1300161 2047292 4535400 100637 97911 459765 616425 12306215 3980485 9808550 8325730 28234393 29316820 6313859 3405070 2662153 2494268 8976012 5899338 X 19057894 23260324 200487 157158 19258381 23417482 28234393 29316820 4166724 -7623 0 X 0 1 X 1 1 1 X 0 1 0 0 0 0 1 5252 0 0 5252 0 PART II-B, LINE 1: UNITY CARE NORTHWEST LEADERS AND EMPLOYEES PARTICIPATED IN THE STATE'S LEGISLATIVE DAYS, DISCUSSING CURRENT AND PROPOSED LEGISLATION AS IT IMPACTS THE FQHC COMMUNITY. UNITY CARE NORTHWEST LEADERS ALSO MET WITH VARIOUS FEDERAL LEGISLATORS, DISCUSSED CURRENT AND PROPOSED LEGISLATION IMPACTING THE FQHC COMMUNITY, AND REPRESENTED THE INTERESTS OF FQHC'S. 1300000 1300000 6640496 2410497 4229999 2393272 868757 1524515 1931768 701231 1230537 40679 40679 8325730 X 34385662 -7623 16850 9227 34376435 693768 693768 35070203 30269233 16850 16850 30252383 651096 651096 30903479 PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS RECOGNIZED THE CENTER AS EXEMPT FROM FEDERAL INCOME TAXES UNDER PROVISION SECTION 501(A) OF THE INTERNAL REVENUE CODE AS A CENTER DESCRIBED IN SECTION 501(C)(3) AND NOT AS A PRIVATE FOUNDATION. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE CENTER EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2018 AND 2017, THE CENTER HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. ALL TAX-EXEMPT ENTITIES ARE SUBJECT TO REVIEW AND AUDIT BY FEDERAL, STATE, AND OTHER APPLICABLE STATE STATUTES. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 16,850. PART XI, LINE 4B - OTHER ADJUSTMENTS: CAPITAL CONTRIBUTIONS 693,768. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 16,850. PART XII, LINE 4B - OTHER ADJUSTMENTS: TRANSFER TO AFFILIATE 651,096. ANNUAL EVENT 75130 66768 8362 1195 11105 4550 75130 66768 8362 1195 11105 4550 16850 -8488 1 NORTH WHATCOM CLINIC 1616 CORNWALL AVENUE SUITE 205 BELLINGHAM WA 98225 830597273 501(C)(2) 651096 GENERAL OPERATING SUPPORT 0 1 PART I, LINE 2: TRANSFERS TO THE RELATED ORGANIZATION ARE MONITORED THROUGH COMMON BOARD OVERSIGHT AND EXECUTIVE OVERSIGHT BETWEEN THE ORGANIZATIONS. X X X X X X 0 0 0 0 0 0 0 0 0 DESMOND SKUBI EXECUTIVE DIRECTOR 242189 0 0 0 0 0 4675 0 7616 0 254480 0 0 0 SHANON HARDIE CHIEF OPERATIONS OFFICER 140783 0 7554 0 0 0 6288 0 7636 0 162261 0 0 0 BARBARA CLURE MD MEDICAL DIRECTOR 242296 0 11173 0 0 0 11128 0 7636 0 272233 0 0 0 CARRIE SHANE DDS DENTAL DIRECTOR / DENTIST 167037 0 8388 0 0 0 7947 0 7696 0 191068 0 0 0 JOHN TILLEY JR MD MEDICAL DOCTOR 230231 0 7856 0 0 0 0 0 810 0 238897 0 0 0 CASEY LIEN MD MEDICAL DOCTOR 197994 0 3918 0 0 0 7473 0 7636 0 217021 0 0 0 DONALD BRUNK MD MEDICAL DOCTOR 218125 0 10076 0 0 0 9897 0 7636 0 245734 0 0 0 COLIN GOGGIN MD PSYCHIATRIST 185164 0 8156 0 0 0 8244 0 6125 0 207689 0 0 0 AARON MOORE MD PSYCHIATRIST 216936 0 4177 0 0 0 8846 0 810 0 230769 0 0 0 A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 2018-06-22 2614983 REFINANCE SERIES 2009 BONDS 0 0 0 A 64144 2614983 2614983 2010 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 X 501 FAIR MARKET VALUE X 1005 FAIR MARKET VALUE X 1 150 FAIR MARKET VALUE X 2801 170786 INVOICE PRICE X EQUIPMENT 1 36396 FAIR MARKET VALUE X GIFT CERTIFICATES 3 115 FACE VALUE 0 0 1 0 PART I, COLUMN (B): THE NUMBER REPORTED IN LINE 20 IS THE NUMBER OF DONATED ITEMS RECEIVED. ALL OTHER AMOUNTS ARE THE NUMBER OF DONATIONS RECEIVED. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CFO, THE EXECUTIVE DIRECTOR, AND THE FINANCE COMMITTEE, THEN PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY FOR APPROVAL PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL OFFICERS, DIRECTORS, MEMBERS OF BOARD COMMITTEES, AND KEY EMPLOYEES. UPON JOINING THE ORGANIZATION, AND THEN ANNUALLY THEREAFTER, ALL COVERED INDIVIDUALS SIGN A DETAILED CONFLICT OF INTEREST STATEMENT THAT CLEARLY DEFINES EACH INDIVIDUAL'S RESPONSIBILITY TO DISCLOSE ANY POSSIBLE RELATIONSHIPS OR ARRANGEMENTS THAT COULD RESULT IN A CONFLICT OF INTEREST, AS WELL AS THE PROCEDURE FOR DEALING WITH THESE CONFLICTS IF THEY SHOULD ARISE. IF AN INDIVIDUAL HAS A POTENTIAL CONFLICT OF INTEREST, THEY DISCLOSE THE FACTS TO THE BOARD OR COMMITTEE CHAIR, AS APPROPRIATE. THE BOARD OR COMMITTEE DETERMINES WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT EXISTS, THE CONFLICTED INDIVIDUAL MUST LEAVE THE ROOM FOR ALL DISCUSSIONS AND VOTES ON THE MATTER. CONFLICT OF INTEREST DISCUSSIONS AND RESULTS ARE NOTED IN MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD HAS A POLICY REGARDING EXECUTIVE DIRECTOR AND KEY EMPLOYEE SALARY AND BENEFITS TO ENSURE THAT COMPENSATION FOR KEY EMPLOYEES IS REVIEWED AND APPROVED BY INDEPENDENT PERSONS, COMPARED AGAINST APPROPRIATE BENCHMARKS AND DOCUMENTED ADEQUATELY. TO ENSURE THAT THERE IS NO CONFLICT OF INTEREST IN THE DECISION MAKING PROCESS, THE EXECUTIVE COMMITTEE HAS ACCESS TO AN INDEPENDENT CONSULTANT TO ASSIST WITH EVALUATING SALARY AND BENEFIT STRUCTURES FOR KEY EMPLOYEES. THE PROCESS LAST INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION IN 2017. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE UPON REQUEST AND ONLINE AT WWW.GUIDESTAR.ORG, A WEBSITE THAT THE PUBLIC CAN ACCESS TO OBTAIN INFORMATION ABOUT NON-PROFITS. THE FORM 1023 IS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. NORTH WHATCOM CLINIC 1616 CORNWALL AVENUE SUITE 205 BELLINGHAM WA 98225 830597273 CONSTRUCT AND HOLD REAL ESTATE WA 501(C)(2) UNITY CARE NORTHWEST 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 NORTH WHATCOM CLINIC B 651096 CASH