2016-11-14T17:21:55-06:00 2015-12-31 930743240 HOFFMAN STEWART & SCHMIDT PC 4900 MEADOWS ROAD STE 200 LAKE OSWEGO OR 970353295 990 2015-01-01 910896241 COWLITZ FAMILY HEALTH CENTER COWL 3606363892 1057 12TH AVENUE LONGVIEW WA 986322509 DIAN COOPER EXECUTIVE DIRECTOR 3606363892 2016-11-09 1 ROBERT M PRILL P00236613 5032205900 2015 2017-02-10 21:41:12Z DIAN COOPER 1057 12TH AVENUE LONGVIEW WA 986322509 19602085 0 X WWW.COWLITZFAMILYHEALTH.ORG X 1972 WA EVERYONE DESERVES HIGH QUALITY COMPASSIONATE CARE. WE DO THIS BY PROVIDING COMPREHENSIVE HEALTH SERVICES AND EDUCATION, REGARDLESS OF CIRCUMSTANCES OR INCOME. TOGETHER WE IMPROVE QUALITY OF LIFE AND TRANSFORM OUR COMMUNITIES. 14 14 282 19 0 0 3408144 4299952 12970303 15298632 2158 3501 0 0 16380605 19602085 0 0 0 0 8799591 11139983 0 0 0 4867084 6463613 13666675 17603596 2713930 1998489 12277446 16109540 3843252 4135674 8434194 11973866 X EVERYONE DESERVES HIGH QUALITY COMPASSIONATE CARE. WE DO THIS BY PROVIDING COMPREHENSIVE HEALTH SERVICES AND EDUCATION, REGARDLESS OF CIRCUMSTANCES OR INCOME. TOGETHER WE IMPROVE QUALITY OF LIFE AND TRANSFORM OUR COMMUNITIES. 0 0 6945138 9965691 TO PROVIDE MEDICAL SERVICES TO LOW INCOME INDIVIDUALS. THE TOTAL MEDICAL ENCOUNTERS DURING THE YEAR WERE 51,793. 2689357 3226957 TO PROVIDE DENTAL SERVICES TO LOW INCOME INDIVIDUALS. THE TOTAL DENTAL ENCOUNTERS DURING THE YEAR WERE 23,341. 639567 TO PROVIDE SUPPLEMENTAL NUTRITION SERVICES FOR PREGNANT AND BREASTFEEDING WOMEN AND THEIR CHILDREN TO AGE 5. DURING 2015, THE CENTER SERVED 5,752 WOMEN, INFANTS AND CHILDREN. 2303844 2105984 TO PROVIDE MEDICAL RELATED SERVICES TO LOW INCOME INDIVIDUALS. ENABLING SERVICE ENCOUNTERS AND MENTAL HEALTH ENCOUNTERS TOTALED 7,690 AND 6,041 RESPECTIVELY. 2303844 2105984 12577906 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 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 64 0 1 282 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 1 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 PRESIDENT 2.00 X X 0 0 0 MELISSA TAYLOR TREASURER 2.00 X X 0 0 0 WANDA MCBEE SECRETARY 2.00 X X 0 0 0 CARLEEN WOLGAMOTT DIRECTOR 2.00 X 0 0 0 CYNTHIA WASHINGTON-MATTSON VICE PRESIDENT 2.00 X X 0 0 0 ALISABETH BUCK DIRECTOR 2.00 X 0 0 0 CARLOS CARREON DIRECTOR 2.00 X 0 0 0 JEANE CONRAD DIRECTOR 2.00 X 0 0 0 NANCY BELL DIRECTOR 2.00 X 0 0 0 SANDRA BENBROOK RIEDER DIRECTOR 2.00 X 0 0 0 WAYNE CAIN DIRECTOR 2.00 X 0 0 0 JAMES A SCOTT DIRECTOR 2.00 X 0 0 0 PAMELA SCHULZ DIRECTOR 2.00 X 0 0 0 JOHN PAUL PRADO DIRECTOR 2.00 X 0 0 0 DIAN COOPER EXECUTIVE DIRECTOR 40.00 X 185512 0 7754 PAM SPEARS FINANCE DIRECTOR 40.00 X 103756 0 7304 GERARDO MELGAR MEDICAL DIRECTOR 40.00 X 250727 0 7304 GAIL CONWAY PHYSICIAN 40.00 X 159343 0 7304 ANTHONY REYES PHYSICIAN 40.00 X 156779 0 7607 ERIC GURRAD DENTIST 40.00 X 134313 0 7593 TRESHA CARROLL PHYSICIAN 40.00 X 159465 0 7754 JUSTIN TAN DENTIST 40.00 X 141371 0 7304 1291266 0 59924 8 0 1 0 OCHIN INC 1881 SW NAITO PARKWAY PORTLAND OR 972015195 EMR AND PRACTICE MANAGEMENT FEES 634695 POLAR SYSTEMS 21890 WILLAMETTE DRIVE WEST LINN OR 97068 COMPUTER CONSULTING 446090 ALLIED HEALTH SEARCH 71 E WADSWORTH PARK DRIVE DRAPER UT 84020 HEALTH SERVICES 394233 STAFF CARE 5001 STATESMAN DRIVE IRVING TX 75063 LOCUM TENENS 388281 CARDINAL HEALTH 7000 CARDINAL PL DUBLIN OH 43017 HEALTH SERVICES 293049 12 4299952 4299952 PATIENT SERVICE REVENUE 624100 8087217 8087217 PREMIUM REVENUE 624100 6381433 6381433 PHARMACY FEES 624100 765441 765441 PROGRAM SERVICE REVENUE 624100 53374 53374 OTHER 624100 11167 11167 15298632 3501 3501 19602085 15298632 0 3501 X 562357 258031 304326 8633088 7171485 1461603 1165679 953975 211704 778859 630198 148661 262857 262857 43018 43018 2612235 1406976 1205259 11591 8785 2806 415394 284766 130628 1020315 337522 682793 88320 65898 22422 43324 32325 10999 92647 4830 87817 403089 156946 246143 72485 20146 52339 MEDICAL SUPPLIES 855482 855482 BAD DEBT 303948 303948 TAXES AND LICENSES 70833 59217 11616 RECRUITMENT & RETENTION 60698 5111 55587 107377 22265 85112 17603596 12577906 5025690 0 1760871 2588350 6840513 5776464 354837 518956 762301 1509377 77700 113289 611405 322446 9460842 4180184 1869819 5280658 12277446 16109540 1436177 1426566 2407075 2709108 3843252 4135674 X 8434194 11937940 35926 8434194 11973866 12277446 16109540 X 1998489 1541183 X X 0 1 X 1 1 1 X 2240136 2967414 3426912 3408144 4299952 16342558 2240136 2967414 3426912 3408144 4299952 16342558 16342558 14106 4814 2452 2158 3501 27031 2575 2533 5677 11167 21952 16391541 53432415 0.99700 0.99580 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 219950 219950 2724625 241367 2483258 2315275 1672317 642958 2793826 2260137 533689 1407166 6363 1400803 5280658 X 20839320 1541183 1541183 19298137 303948 303948 19602085 17299648 0 17299648 303948 303948 17603596 PART X, LINE 2: MANAGEMENT OF COWLITZ FAMILY HEALTH CENTER DOES NOT BELIEVE THE CENTER HAS ANY UNCERTAIN TAX POSITIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: INHERENT CONTRIBUTION FROM ACQUISITION 1,541,183. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 303,948. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 303,948. X X 0 0 0 0 0 0 0 0 0 DIAN COOPER EXECUTIVE DIRECTOR 185512 0 0 0 0 0 0 0 7754 0 193266 0 0 0 GERARDO MELGAR MEDICAL DIRECTOR 248597 0 0 0 2130 0 0 0 7304 0 258031 0 0 0 GAIL CONWAY PHYSICIAN 152993 0 6350 0 0 0 0 0 7304 0 166647 0 0 0 ANTHONY REYES PHYSICIAN 156779 0 0 0 0 0 0 0 7607 0 164386 0 0 0 TRESHA CARROLL PHYSICIAN 145440 0 14025 0 0 0 0 0 7754 0 167219 0 0 0 FORM 990, PART VI, SECTION A, LINE 4 THE CENTER REVISED THEIR ARTICLES OF INCORPORATION AND BY-LAWS IN OCTOBER 2015 WITH AN UPDATED MISSION, REVISED POLICIES FOR THE BOARD OF DIRECTORS, AND OTHER UPDATES DUE TO ORGANIZATIONAL CHANGES. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE AND THE FULL BOARD OF DIRECTORS MUST APPROVE THE FILING OF THE FORM 990. 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 IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,406,976. MANAGEMENT AND GENERAL EXPENSES 1,205,259. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,612,235. FORM 990, PART XI, LINE 9: INHERENT CONTRIBUTION FROM ACQUISITION 1,541,183. 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.