SERENITY LANE: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- SERENITY LANE (EIN 93-0606316)
- Tax period
- 2013-04-01 to 2014-03-31
- Filed
- 2015-01-26
- IRS object ID
- 201520269349300902
- Schema version
- 2013v4.0
- 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) |
|---|---|---|
| Return | 2015-01-26T15:57:44-06:00 | ReturnTs |
| Tax Period End | 2014-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 975 OAK STREET SUITE 500 | AddressLine1 |
| City | EUGENE | City |
| State | OR | State |
| ZIP Code | 97401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930606316 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SERENITY LANE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SERE | BusinessNameControlTxt |
| Phone | 5414842156 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2133 CENTENNIAL PLAZA | AddressLine1 |
| City | EUGENE | City |
| State | OR | State |
| ZIP Code | 97401 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MIKE DYER | PersonNm |
| Person Title | PRESIDENT AND CEO | PersonTitleTxt |
| Phone | 5414842156 | PhoneNum |
| Signature | 2015-01-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WENDY CAMPOS | PreparerPersonNm |
| PTIN | P00448102 | PTIN |
| Phone | 5416861040 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MIKE DYER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2133 CENTENNIAL PLAZA | AddressLine1 |
| City | EUGENE | City |
| State | OR | State |
| ZIP Code | 97401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,065,819 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SERENITYLANE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | TREATMENT OF THE DISEASE OF CHEMICAL DEPENDENCY | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 185 | TotalEmployeeCnt |
| Total Volunteers | 8 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,534 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,975 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,757,441 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,057,459 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,448 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,385 | CYInvestmentIncomeAmt |
| PY Other Revenue | $122,786 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $12,889,209 | PYTotalRevenueAmt |
| CY Total Revenue | $13,065,819 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,866,902 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,266,577 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $336,665 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,977,612 | PYOtherExpensesAmt |
| CY Other Expenses | $4,877,524 | CYOtherExpensesAmt |
| PY Total Expenses | $12,844,514 | PYTotalExpensesAmt |
| CY Total Expenses | $13,144,101 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $44,695 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$78,282 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,502,173 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,800,783 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,494,678 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,871,570 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,007,495 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $929,213 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDING A HEALING ENVIRONMENT IN WHICH CHEMICALLY DEPENDENT INDIVIDUALS AND THEIR FAMILIES DISCOVER AN ENHANCED QUALITY OF LIFE THROUGH LONG-TERM RECOVERY FROM ADDICTIONS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,580,652 | ExpenseAmt |
| Revenue | $13,057,459 | RevenueAmt |
| Desc | TREATMENT OF CHEMICAL DEPENDENCY THROUGH INPATIENT AND RESIDENTIAL SERVICES. | Desc |
| Total Program Service Expenses | $12,580,652 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 43 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 185 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DUSTIN STAPLETON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5412848617 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2133 CENTENNIAL PLAZA | AddressLine1 |
| City | EUGENE | City |
| State | OR | State |
| ZIP Code | 97401 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JOHN DUNPHY | |||||||||
| CHAIRMAN | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN LIPKIN | |||||||||
| VICE CHAIRMAN | 0.50 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MIKE KEHOE | |||||||||
| TREASURER | 0.50 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KATE KLOOS | |||||||||
| SECRETARY | 0.50 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LARRY OLSEN | |||||||||
| MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| REV JOHN KERNS | |||||||||
| MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| TIM DANFORTH | |||||||||
| MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| CINDY WEINHOLD | |||||||||
| MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| MIKE DYER | |||||||||
| PRESIDENT & CEO | 1.00 | 40.00 | Yes (X) | $0 | $137,742 | $24,224 | |||
| KAREN WILLOCK | |||||||||
| VP OF CLINICAL SERVICES | 1.00 | 40.00 | Yes (X) | $0 | $93,046 | $4,652 | |||
| PETER ASMUTH | |||||||||
| FORMER PRESIDENT & CEO | 0.50 | 40.00 | Yes (X) | $0 | $176,792 | $48,010 | |||
| RONALD SCHWERZLER | |||||||||
| MEDICAL DIRECTOR | 40.00 | 0.00 | $189,733 | $0 | $26,213 | Yes (X) | |||
| MICHAEL SCHWARTZ | |||||||||
| DOCTOR | 40.00 | 0.00 | $174,691 | $0 | $25,461 | Yes (X) | |||
| JOSH BOLTON | |||||||||
| CHIEF INFORMATION OFFICER | 40.00 | 0.00 | $103,288 | $0 | $5,164 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $467,712 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $407,580 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $133,724 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $5,975 | AllOtherContributionsAmt |
| Total Contributions | $5,975 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAL TREATMENT FOR | 621400 | $12,928,828 | $12,928,828 |
| FINANCE CHARGE | 621400 | $128,631 | $128,631 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,057,459 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,385 | TotalRevenueColumnAmt |
| Exclusion | $2,385 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,065,819 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,057,459 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,385 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $427,603 | TotalAmt |
| Program Services | $342,082 | ProgramServicesAmt |
| Management And General | $85,521 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,471,105 | TotalAmt |
| Program Services | $5,171,917 | ProgramServicesAmt |
| Management And General | $109,369 | ManagementAndGeneralAmt |
| Fundraising | $189,819 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,334 | TotalAmt |
| Program Services | $233,594 | ProgramServicesAmt |
| Fundraising | $7,740 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,586,148 | TotalAmt |
| Program Services | $1,541,710 | ProgramServicesAmt |
| Fundraising | $44,438 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $540,387 | TotalAmt |
| Program Services | $505,530 | ProgramServicesAmt |
| Management And General | $11,893 | ManagementAndGeneralAmt |
| Fundraising | $22,964 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,300,000 | TotalAmt |
| Program Services | $1,300,000 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,001 | TotalAmt |
| Management And General | $20,001 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,665 | TotalAmt |
| Program Services | $130,868 | ProgramServicesAmt |
| Fundraising | $28,797 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $502,267 | TotalAmt |
| Program Services | $491,798 | ProgramServicesAmt |
| Fundraising | $10,469 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $543,329 | TotalAmt |
| Program Services | $526,353 | ProgramServicesAmt |
| Fundraising | $16,976 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,234,480 | TotalAmt |
| Program Services | $1,234,480 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,255 | TotalAmt |
| Program Services | $68,562 | ProgramServicesAmt |
| Fundraising | $6,693 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,711 | TotalAmt |
| Program Services | $29,427 | ProgramServicesAmt |
| Fundraising | $1,284 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| DIETARY SUPPLIES | $412,832 | $412,832 | |
| LAB FEES | $179,339 | $179,339 | |
| TAXES AND LICENSES | $141,149 | $135,246 | $5,903 |
| HOUSEKEEPING AND LINEN | $111,157 | $111,157 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,339 | TotalAmt |
| Program Services | $165,757 | ProgramServicesAmt |
| Fundraising | $1,582 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,144,101 | TotalAmt |
| Program Services | $12,580,652 | ProgramServicesAmt |
| Management And General | $226,784 | ManagementAndGeneralAmt |
| Fundraising | $336,665 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,655 | BOYAmt |
| EOY | $2,655 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,116,837 | BOYAmt |
| EOY | $2,742,403 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,242,025 | BOYAmt |
| EOY | $1,884,076 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,656 | BOYAmt |
| EOY | $171,649 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,502,173 | BOYAmt |
| EOY | $4,800,783 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,494,678 | BOYAmt |
| EOY | $3,871,570 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,494,678 | BOYAmt |
| EOY | $3,871,570 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,007,495 | BOYAmt |
| EOY | $929,213 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,007,495 | BOYAmt |
| EOY | $929,213 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,502,173 | BOYAmt |
| EOY | $4,800,783 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$78,282 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | SERENITY LANE HEALTH SERVICES, SERENITY LANE, AND SERENITY LANE HEALTH SERVICES FOUNDATION ARE NOT-FOR-PROFIT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND HAVE BEEN CLASSIFIED AS ENTITIES THAT ARE NOT PRIVATE FOUNDATIONS WITHIN THE MEANING OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES IN THE CONSOLIDATED FINANCIAL STATEMENTS PURSUANT TO ASC 740, INCOME TAXES. THE ORGANIZATION GENERALLY EVALUATES ANY UNCERTAIN TAX POSITIONS CONSISTENT WITH THE ACCOUNTING AND DISCLOSURE REQUIREMENTS OF ASC 450, CONTINGENCIES. THE ORGANIZATION DID NOT HAVE ANY UNCERTAIN TAX POSITIONS IN CONNECTION WITH THESE CONSOLIDATED STATEMENTS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | 0 | FPGReferenceFreeCareInd |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 347 | PersonsServedCnt |
| Total Community Benefit Expns | $427,716 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $427,716 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03260 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 347 | PersonsServedCnt |
| Total Community Benefit Expns | $427,716 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $427,716 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03260 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 138 | ActivitiesOrProgramsCnt |
| Persons Served | 6107 | PersonsServedCnt |
| Total Community Benefit Expns | $231,104 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $231,104 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01760 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $73,103 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $73,103 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00560 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 139 | ActivitiesOrProgramsCnt |
| Persons Served | 6107 | PersonsServedCnt |
| Total Community Benefit Expns | $304,207 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $304,207 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02320 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 139 | ActivitiesOrProgramsCnt |
| Persons Served | 6454 | PersonsServedCnt |
| Total Community Benefit Expns | $731,923 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $731,923 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05580 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $39,026 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SERENITY LANE | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 616 E 16TH AVENUE | AddressLine1 |
| City | EUGENE | City |
| State | OR | State |
| ZIP Code | 97401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SERENITY LANE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | 0 | FPGUsedDeterEligFreeCareInd |
| FPG Used Determ Elig Dscnt Care | 0 | FPGUsedDetermEligDscntCareInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Lawsuit | Yes (X) | PermitLawsuitInd |
| Permit Lien On Residence | Yes (X) | PermitLienOnResidenceInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Lawsuit | Yes (X) | LawsuitInd |
| Liens On Residences | Yes (X) | LiensOnResidencesInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| No Emergency Care | Yes (X) | NoEmergencyCareInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SERENITY LANE | PART V, SECTION B, LINE 3: THE HOSPITAL CONSULTED WITH RESPECTED COMMUNITY MEMBERS AND INCLUDED THEIR COMMENTARY IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL CONSULTED WITH WENDY H PARK, PMHCNS-PP, PH.D, CLINICAL SUPERVISOR OF MENTAL HEALTH SERVICES FOR THE UNIVERSITY OF OREGON HEALTH CENTER AND CANDACE LANGHOUSE, PEACEHEALTH HUMAN RESOURCES AT SACRED HEART MEDICAL CENTER. |
| SERENITY LANE | PART V, SECTION B, LINE 10: PATIENT'S PROVIDE DOCUMENTATION TO SUPPORT INCOME AND EXPENSES. THIS INFORMATION IS USED TO DETERMINE THE LEVEL OF FINANCIAL ASSISTANCE. |
| SERENITY LANE | PART V, SECTION B, LINE 20D: CHARGES TO FAP ELIGIBLE PATIENTS ARE DETERMINED BASED ON FINANCIAL NEED ON A CASE BY CASE BASIS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| SERENITY LANE | ||||
| 1050 PRICE ROAD SE | ALBANY | OR | 97322 | OUTPATIENT REHABILITATION CLINIC |
| SERENITY LANE | ||||
| 601 NW HARMON BLVD | BEND | OR | 97701 | OUTPATIENT REHABILITATION CLINIC |
| SERENITY LANE | ||||
| 10920 SW BARBUR BLVD | PORTLAND | OR | 97219 | OUTPATIENT REHABILITATION CLINIC |
| SERENITY LANE | ||||
| 12662 SE STARK STREET | PORTLAND | OR | 97233 | OUTPATIENT REHABILITATION CLINIC |
| SERENITY LANE | ||||
| 1800 NW 167TH PL | BEAVERTON | OR | 97006 | OUTPATIENT REHABILITATION CLINIC |
| SERENITY LANE | ||||
| 2575 NW KLINE STREET | ROSEBURG | OR | 97471 | OUTPATIENT REHABILITATION CLINIC |
| SERENITY LANE | ||||
| 1885 FISHER ROAD NE | SALEM | OR | 97305 | OUTPATIENT REHABILITATION CLINIC |
| SERENITY LANE - NEW HOPE | ||||
| 2133 CENTENNIAL PLAZA | EUGENE | OR | 97401 | OUTPATIENT REHABILITATION CLINIC |
| SERENITY LANE | ||||
| 4305 NE THURSTON WAY | VANCOUVER | WA | 98662 | OUTPATIENT REHABILITATION CLINIC |
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | PATIENTS WHO REQUEST FINANCIAL ASSISTANCE ARE ASKED TO COMPLETE A FINANCIAL STATEMENT DESCRIBING THEIR SOURCES OF INCOME AND ALL EXPENSES. EACH DETAIL OF EACH APPLICATION IS REVIEWED AND A DECISION IS MADE WHETHER TO PROVIDE A CHARITY CARE DISCOUNT WITHIN THE FINANCIAL CAPABILITIES OF ORGANIZATION. |
| PART I, LN 7 COL(F): | X |
| PART III, LINE 4: | THE ORGANIZATION UTILIZES THE ALLOWANCE METHOD TO ACCOUNT FOR BAD DEBTS BASED UPON EVALUATION OF ACCOUNTS RECEIVABLE, ANALYSIS OF HISTORICAL DATA AND EXISTING ECONOMIC CONDITIONS. THE ORGANIZATION PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND FOR ADMINISTRATIVE ADJUSTMENTS THAT IS BASED UPON REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. DISCOUNTS AND PAYMENTS ARE APPLIED TO PATIENT ACCOUNTS PRIOR TO RECORDING ANY BAD DEBT EXPENSE. |
| PART VI, LINE 2: | IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT SERENITY LANE DOES THE FOLLOWING TO ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITY:1. THE BOARD IS MADE UP OF HIGHLY RESPECTED MEMBERS OF THE COMMUNITY REPRESENTING DIFFERENT ASPECTS, SUCH AS DOCTORS, HUMAN RESOURCE DIRECTORS, PRIESTS, ETC...2. SERENITY LANE STAYS IN CONTACT WITH NUMEROUS REPRESENTATIVES OF THE COMMUNITY, SUCH AS POLICE OFFICERS AND ELECTED REPRESENTATIVES. THE ORGANIZATION ALSO MAINTAINS CONTACT WITH OTHER PROFESSIONALS SERVICING THE ALCOHOL AND DRUG ABUSE ARENA INCLUDING AN ANNUAL AWARDS BANQUET SPONSORED AND ORGANIZED BY SERENITY LANE THAT RECOGNIZES OTHERS IN THE COMMUNITY THAT HAVE A SIGNIFICANT IMPACT IN THIS ARENA.3. SERENITY LANE HAS AN INTERNAL QUALITY ASSURANCE LICENSED STAFF TO PERFORM ROUTINE INSPECTIONS OF OTHER SIMILAR FACILITIES TO ENSURE THE ORGANIZATION IS UP TO DATE WITH THE LATEST PROCESSES AND TECHNOLOGY.4. SERENITY LANE PERFORMS ANNUAL PATIENT SURVEYS5. SERENITY LANE ACCUMULATES PATIENT DATA BY GEOGRAPHICAL LOCATION WHICH HELPS ALIGN SERVICES WITH THE CURRENT NEED. |
| PART VI, LINE 3: | PATIENTS WITHOUT ADEQUATE RESOURCES ARE DIRECTED TO THE BUSINESS OFFICE TO APPLY FOR FINANCIAL ASSISTANCE. |
| PART VI, LINE 4: | NEARLY ALL COMMUNITIES IN THE STATE OF OREGON AND VANCOUVER, WA. CONSTITUENTS SERVED ARE THE WORKING MEN AND WOMEN AND THEIR FAMILIES. |
| PART VI, LINE 5: | PROVIDING COMMUNITY EDUCATION AND RESOURCES REGARDING THE DISEASE OF CHEMICAL DEPENDENCY. THIS IS DONE THROUGH PARTICIPATION IN CONFERENCES, EDUCATING EMPLOYERS, NEWS ARTICLES AND OTHER COMMUNITY OUTREACH PRACTICES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MIKE DYER | ||||||||||||||
| PRESIDENT & CEO | $0 | $137,742 | $0 | $0 | $0 | $0 | $0 | $6,887 | $0 | $17,337 | $0 | $161,966 | $0 | $0 |
| PETER ASMUTH | ||||||||||||||
| FORMER PRESIDENT & CEO | $0 | $176,792 | $0 | $0 | $0 | $0 | $0 | $28,840 | $0 | $19,170 | $0 | $224,802 | $0 | $0 |
| RONALD SCHWERZLER | ||||||||||||||
| MEDICAL DIRECTOR | $189,733 | $0 | $0 | $0 | $0 | $0 | $9,487 | $0 | $16,726 | $0 | $215,946 | $0 | $0 | $0 |
| MICHAEL SCHWARTZ | ||||||||||||||
| DOCTOR | $174,691 | $0 | $0 | $0 | $0 | $0 | $8,735 | $0 | $16,726 | $0 | $200,152 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | COUNTRY CLUB DUES ARE PAID ON BEHALF OF MIKE DYER, PRESIDENT & CEO. THE COUNTRY CLUB IS USED FOR BUSINESS MEETINGS AND FOR DEVELOPMENT AND FUNDRAISING PURPOSES. |
| PART I, LINE 7 | CEO & PRESIDENT RECEIVED A $15,000 BONUS AS APPROVED BY THE BOARD OF DIRECTORS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 IS REVEIWED BY THE CFO, CEO AND THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THROUGH A CONFLICT OF INTEREST STATEMENT FILLED OUT AND SIGNED ANNUALLY |
| FORM 990, PART VI, SECTION B, LINE 15 | CEO COMPENSATION IS SET BY THE BOARD OF DIRECTORS USING DATA FROM COMPARABLE ORGANIZATIONS. VICE PRESIDENT'S COMPENSATION IS SET BY THE CEO USING THE SAME METHOD. |
| FORM 990, PART VI, SECTION C, LINE 19 | UPON REQUEST |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SERENITY LANE HEALTH SERVICES | ||||||||||
| 2133 CENTENNIAL PLAZA | EUGENE | OR | 97401 | 943113708 | ADMINISTRATIVE SERVICE AND SUPPORT FOR SERENITY LANE | OR | 501(C)(3) | 509(A)(3) TYPE I | SERENITY LANE | 0 |
| SERENITY LANE HEALTH SERVICES FOUNDATION | ||||||||||
| 2133 CENTENNIAL PLAZA | EUGENE | OR | 97401 | 461684147 | FINANCIAL SUPPORT FOR SERENITY LANE | OR | 501(C)(3) | 509(A)(3) TYPE I | SERENITY LANE | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SERENITY LANE HEALTH SERVICES | ||
| K | $917,714 | CASH |
| SERENITY LANE HEALTH SERVICES | ||
| M | $1,300,000 | CASH |