2013-04-29T16:00:07-05:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2012-01-01 910893287 NEIGHBORCARE HEALTH NEIG 2064616935 905 SPRUCE STREET SUITE 300 SEATTLE WA 98104 MARK SECORD 2064616935 2013-04-29 1 PAUL MBAILEY P00292653 4252506100 2013-04-25 2012 2016-02-25 16:41:14Z MARK SECORD 905 SPRUCE STREET SUITE 300 SEATTLE WA 98104 62120097 0 X WWW.NEIGHBORCARE.ORG X 1969 WA THE MISSION OF NEIGHBORCARE HEALTH IS TO PROVIDE COMPREHENSIVE HEALTH CARE TO FAMILIES AND INDIVIDUALS WHO HAVE DIFFICULTY ACCESSING CARE, RESPOND WITH SENSITIVITY TO THE NEEDS OF OUR CULTURALLY DIVERSE PATIENTS, AND ADVOCATE AND WORK WITH OTHERS TO IMPROVE THE OVERALL HEALTH STATUS OF THE COMMUNITIES WE SERVE. 16 16 570 143 0 0 14862504 13027656 24105520 23465477 124659 -395436 1371693 1221192 40464376 37318889 0 0 0 0 25896632 26902388 0 0 166331 12162964 12954778 38059596 39857166 2404780 -2538277 59699791 58930907 26611840 27107770 33087951 31823137 X THE ORGANIZATION IS A COMMUNITY-BASED, NON-PROFIT AGENCY THAT OPERATES 23 MEDICAL, DENTAL, AND SCHOOL-BASED HEALTH CENTERS THROUGHOUT SEATTLE AND PROVIDES SERVICES TO OVER 49,565 PEOPLE EACH YEAR. OUR CLINICS ARE LOCATED THROUGHOUT AREAS OF KING COUNTY THAT HAVE THE HIGHEST RATES OF UNINSURED FAMILIES AND THE GREATEST ETHNIC DIVERSITY. INTEGRATED HEALTHCARE SERVICES ARE PROVIDED ON A SLIDING FEE SCALE FOR THE UNINSURED, AND NO ONE IS EVER TURNED AWAY DUE TO INABILITY TO PAY. WE ARE UNIQUELY SKILLED IN PROVIDING CULTURALLY RESPONSIVE SERVICES TO OUR DIVERSE PATIENT POPULATION, WHICH INCLUDES PATIENTS WHO SPEAK MORE THAN 100 DIFFERENT LANGUAGES AND DIALECTS AND REPRESENT MANY CULTURAL GROUPS. WE PROVIDE SERVICES TO RESIDENTS OF URBAN SEATTLE AND SURROUNDING AREAS. OUR TARGET POPULATION CONSISTS OF THE URBAN POOR, UNINSURED, MEDICAID ELIGIBLE, HOMELESS, RECENT IMMIGRANTS, NON-ENGLISH SPEAKING, AS WELL AS THOSE WHO ARE ISOLATED FROM SERVICES DUE TO TRANSPORTATION OR CULTURAL BARRIERS. 0 0 20973566 16842857 PRIMARY MEDICAL CARE SERVICES INCLUDE THE DIAGNOSIS AND TREATMENT OF ILLNESS AND INJURY, CHRONIC DISEASE MANAGEMENT, HEALTH EDUCATION AND PREVENTIVE CARE (SUCH AS WELL-CHILD EXAMS, SCREENING SERVICES AND IMMUNIZATIONS), SOCIAL WORK, MENTAL HEALTH AND CHEMICAL DEPENDENCY SERVICES. NEIGHBORCARE HEALTH ALSO PROVIDES NUTRITION EDUCATION, MATERNITY SUPPORT SERVICES (INCLUDING MIDWIFERY SERVICES), WIC (WOMEN, INFANT, AND CHILDREN PROGRAM) SERVICES AND OUTREACH, AND PUBLIC INSURANCE APPLICATION ASSISTANCE. NEIGHBORCARE HEALTH PROVIDES SPECIALIZED PROGRAMS SUCH AS WOMEN'S HEALTH, TB, HIV, AND PROGRAMS FOCUSED ON CARING FOR HOMELESS YOUTH AND FAMILIES. THE MEDICAL PROGRAM ENCOURAGES PATIENT INVOLVEMENT IN IMPROVING AND MAINTAINING GOOD HEALTH. IN 2012, NEIGHBORCARE HEALTH PROVIDED 148,718 VISITS TO 36,974 PATIENTS. NEIGHBORCARE HEALTH PROVIDED $7,606,748 OF CHARITY CARE IN 2012. 8087095 6176086 GENERAL DENTISTRY SERVICES INCLUDE ORAL HEALTH EXAMS, HYGIENE, AND RESTORATIVE SERVICES TO CONTAIN THE DISEASE PROCESS. PERIODONTAL AND ENDODONTIC CARE IS ALSO PROVIDED. IN 2012, NEIGHBORCARE PROVIDED 47,677 DENTAL VISITS TO 18,786 CHILDREN AND ADULTS. 1798482 446534 SCHOOL-BASED HEALTH SERVICES INCLUDE PRIMARY MEDICAL SERVICES, MENTAL HEALTH, SUBSTANCE ABUSE COUNSELING, TOBACCO PREVENTION AND CESSATION PROGRAMS, AND A VARIETY OF SUPPORT GROUPS FOR YOUTH, ALL WITHIN SEATTLE PUBLIC SCHOOLS. EMPHASIS IS PLACED ON AGE-APPROPRIATE HEALTH EDUCATION AND SKILL-BUILDING TO HELP YOUTH MAKE HEALTHY LIFESTYLE CHOICES SO THAT THEY MAY THRIVE AT SCHOOL AND BUILD STRONG RELATIONSHIPS AT SCHOOL, HOME, AND IN THEIR COMMUNITY. IN 2012, NEIGHBORCARE HEALTH PROVIDED 13,864 VISITS TO 4,681 SCHOOL-BASED PATIENTS. 1451172 SERVICES FOR HOMELESS PATIENTS INCLUDE PROGRAMS OPERATED IN PARTNERSHIP WITH THE CITY OF SEATTLE'S HEALTH CARE FOR THE HOMELESS INITIATIVE. FAMILY TEAM FOCUSES ON CRISIS INTERVENTION THERAPY, MENTAL HEALTH COUNSELING, CHILD GROWTH AND DEVELOPMENT, IMMUNIZATION SCREENING, PARENTING SKILLS, SELF-CARE SKILLS, CHRONIC AND ACUTE DISEASE MANAGEMENT AND REFERRALS FOR LONG-TERM CARE. THE HOMELSS YOUTH CLINIC PROVIDES SERVICES TO HOMELESS AND STREET INVOLVED YOUTH, INCLUDING PRIMARY MEDICAL CARE, DENTAL CARE, SOCIAL SERVICES, MENTAL HEALTH COUNSELING, ACUPUNCTURE, NATUROPATHY, YOGA, AND OUTREACH, AS WELL AS A RANGE OF ALLOPATHIC COMPLEMENTARY AND ALTERNATIVE HEALTH CARE SERVICES. 1451172 32310315 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 71 0 1 570 1 0 0 0 0 0 1 1 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X X JANINE CHILDS 2065483034 905 SPRUCE STREET STE 300 SEATTLE WA 98104 JOYCE LAMMERT 3.00 X X 0 0 0 RICK RUBIN 1.50 X X 0 0 0 ANDREA DAHL 1.50 X X 0 0 0 TONY BOZZUTI 3.00 X X 0 0 0 FARIBA ALAMADARI 1.00 X 0 0 0 DICK BARBIERI 2.00 X 0 0 0 ALLY BROWN 1.00 X 0 0 0 ROBERT GREENLEE 1.00 X 0 0 0 ROM LEE 1.50 X 0 0 0 TAMIKO MIYANO 2.50 X 0 0 0 NANCY DOUTY 1.00 X 0 0 0 GEORGE PARKER 1.50 X 0 0 0 EVELYN PICKETTS 1.00 X 0 0 0 HOLLY FERRARO 1.00 X 0 0 0 JENNIFER RYAN 1.00 X 0 0 0 BARBARA SHICKICH 1.50 X 0 0 0 OCTAVIA EDWARDS 0.30 X 0 0 0 TIM RANDALL 0.30 X 0 0 0 MARK SECORD 50.00 X 170050 0 11589 KATIE BELL 50.00 X 141022 0 10237 JANINE CHILDS 45.00 X 129306 0 9837 MARCUS REMPEL 50.00 X 203686 0 12284 MARTIN LIEBERMAN 40.00 X 182222 0 11466 THOMAS SCOTT 40.00 X 173768 0 11307 ALLISON FITZGERALD 40.00 X 176959 0 11285 DIANA RYBAKOV 50.00 X 162633 0 11536 BEVERLY SIMPSON 40.00 X 155746 0 10638 JOHN OLSON 40.00 X 142631 0 4859 1638023 0 105038 31 0 1 0 JONES BOYS MAINTENANCE CO 1813 130TH AVE NE STE 110 BELLEVUE WA 98005 JANITORIAL 361840 UNIVERSAL LANGUAGE SERVICES INC PO BOX 4147 BELLEVUE WA 98009 INTERPRETER SERVICES 293816 REYNALDO RENDEROS CONSTRUCTION LLC 16760 SE 63RD PL BELLEVUE WA 98106 CONSTRUCTION 287962 OLYMPIC SECURITY SERVICES INC 631 STRANDER BLVD STE A TUKWILA WA 98188 SECURITY SERVICES 125901 THE GUIDANCE CORPORATION PO BOX 823473 PHILADELPHIA PA 19182 TEMP STAFFING 119499 5 74093 9615982 3337581 832549 13027656 MEDICARE/MEDICAID PMT 621400 8898828 8898828 CAPITATED PLAN 621400 6882763 6882763 PATIENT FEES 621400 5792222 5792222 OTHER SERVICE REVENUE 621400 1891664 1891664 23465477 114609 114609 24113508 83020 24129214 577359 -15706 -494339 -510045 -510045 149351 74093 94635 54716 54716 EHR AND SETTLEMENT PAYMENTS 900099 1166476 1166476 1166476 37318889 23465477 0 825756 881699 409658 472041 21324505 18292067 2990561 41877 434602 365178 68819 605 2651261 2185476 462256 3529 1610321 1319725 288477 2119 133775 56491 76975 309 115953 48965 66720 268 2512035 1060792 1445434 5809 16738 8695 8043 1839424 1606756 232662 6 116098 60312 55786 1003476 920359 83117 41477 12030 28968 479 130837 52064 77491 1282 218729 180798 37931 1618664 1209379 409285 141746 98443 43303 BAD DEBT EXPENSE 2153271 2153271 PHARMACEUTICALS 1589326 1589326 DUES AND TAXES 207912 16776 191136 LABORATORY FEES 162752 162752 952565 501002 341515 110048 39857166 32310315 7380520 166331 1039748 1439539 3374992 2492581 1516750 1883907 3598795 2262599 2170535 2170752 171220 239487 927261 917579 33922572 9954256 25351428 23968316 8037793 10045490 13511269 13510657 59699791 58930907 5182536 5950226 202488 136520 20866704 20685736 360112 335288 26611840 27107770 X 32326421 31061607 761530 761530 33087951 31823137 59699791 58930907 -2538277 18796 1229844 24823 X 0 1 X 1 1 1 X 14265187 15745847 16152894 14862504 13027656 74054088 14265187 15745847 16152894 14862504 13027656 74054088 74054088 552266 410434 263749 119128 114609 1460186 35732 3119 8904 12921 -510045 -449369 37202 98420 55306 1358772 1094409 2644109 77709014 0.95300 0.95360 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: EHR INCENTIVE PROGRAM SETTLEMENT REIMBURSEMENT 501C AGENCY TRUST MISCELLANEOUS INSURANCE REIMBURSEMENT REBATES AND INCENTIVES HRSA PAYMENT RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1000000 1000000 2000000 3000000 11000 4000 15000 250000 250000 500000 750000 2592380 2592380 21843561 5036101 16807460 3840323 1703337 2136986 5599544 3214818 2384726 46764 46764 23968316 FACILITY CONTRIBUTION RECEIVABLE 699880 NEIGHBORCARE HEALTH LENDER RECEIVABLE 12810777 13510657 INTEREST RATE SWAP 335288 335288 X 36439082 18796 1229844 -2128447 -879807 37318889 0 37318889 37703896 0 37703896 2153270 2153270 39857166 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE CONSOLIDATED FINANCIAL STATEMENTS. MANAGEMENT EVALUATED NEIGHBORCARE HEALTHS TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE CONSOLIDATED FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2009. PART XI, LINE 2D - OTHER ADJUSTMENTS: INTEREST RATE SWAP AGREEMENT 24,823. BAD DEBT EXPENSE -2,153,270. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 2,153,270. PUMPKIN PUSH 85900 42593 43307 5570 5250 20006 SPRING EVENT 89396 17500 71896 4800 32016 350 1 48148 14000 34148 4000 20240 2403 223444 74093 149351 14370 57506 22759 94635 54716 X 0 0 0 0 0 0 0 0 0 MARK SECORD 170050 0 0 0 0 0 5412 0 6177 0 181639 0 0 0 KATIE BELL 141022 0 0 0 0 0 4265 0 5972 0 151259 0 0 0 MARCUS REMPEL 203686 0 0 0 0 0 6106 0 6178 0 215970 0 0 0 MARTIN LIEBERMAN 182222 0 0 0 0 0 5494 0 5972 0 193688 0 0 0 THOMAS SCOTT 173768 0 0 0 0 0 5335 0 5972 0 185075 0 0 0 ALLISON FITZGERALD 176959 0 0 0 0 0 5312 0 5973 0 188244 0 0 0 DIANA RYBAKOV 162633 0 0 0 0 0 5153 0 6383 0 174169 0 0 0 BEVERLY SIMPSON 155746 0 0 0 0 0 4666 0 5972 0 166384 0 0 0 X 4 9303 SELLING PRICE X 12 823246 SELLING PRICE 0 0 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): VARIOUS METHODS ARE USED TO MEASURE THE NUMBER OF CONTRIBUTIONS OR ITEMS RECEIVED FOR PUBLICLY TRADED SECURITIES, THE NUMBER OF CONTRIBUTIONS RECEIVED IS COUNTED. THE ORGANIZATION RECEIVES VACCINES AND PHARMACEUTICALS THROUGHOUT THE MONTH FOR ITS VARIOUS CLINICS. IT IS DIFFICULT TO TRACK THE NUMBER OF ITEMS RECEIVED EACH MONTH; HOWEVER, WE ESTIMATED THAT WE RECEIVE AT LEAST ONE CONTRIBUTION PER MONTH THROUGHOUT THE YEAR. FOR OUR VACCINES AND PHARMACEUTICALS WE HAVE BEEN KEEPING TRACK OF TE VALUE OF NON-CASH CONTRIBUTIONS WE RECEIVE. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE, WITH AUTHORITY FROM THE BOARD OF DIRECTORS, REVIEWS THE FORM 990 WITH THE CHIEF FINANCIAL OFFICER. A FULL COPY OF THE TAX RETURN IS MADE AVAILABLE TO THE BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR ANNUALLY SIGNS A DECLARATION IDENTIFYING CONFLICTS BETWEEN PERSONAL INTERESTS AND THE INTERESTS OF THE ORGANIZATION OF WHICH HE/SHE IS AWARE. IF A CONFLICT EXISTS, IT SHALL BE FULLY DISCLOSED TO THE BOARD OF DIRECTORS AND IN CASES WHERE THE CONFLICT MIGHT INFLUENCE A DECISION, THE PERSON WITH THE CONFLICT SHALL NOT PARTICIPATE IN THE DISCUSSION OR VOTE RELATING TO THE MATTER IN WHICH THE CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD USES MARKET DATA AVAILABLE FROM MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA) AND NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) TO DETERMINE THE EXECUTIVE DIRECTOR'S SALARY. THE EXECUTIVE DIRECTOR'S SALARY IS REVIEWED ANNNUALLY WITH THE LAST REVIEW IN JUNE/JULY 2012, OTHER MANAGEMENT SALARIES ARE REVIEWED BY HUMAN RESOURCES DEPARTMENT AND ARE COMPARED TO MARKET DATA FROM MILLIMAN, ETC. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC. FORM 990, PART I, LINE 6 OUR VOLUNTEERS PROVIDE MEDICAL, DENTAL, NATUROPATHIC CARE, AS WELL AS CLERICAL ASSISTANCE IN THE CLINICS, INTERPRETER SERVICES, AND ASSISTANCE WITH FUNDRAISING EVENTS. IN ADDITION, THERE ARE 16 VOLUNTEER BOARD OF DIRECTORS. FORM 990, PART I, LINE 19 PART I, LINE 19 INCLUDES EXCESS OPERATING SUPPORT AND REVENUES OF $938,833 IN 2011 AND A DEFICIT IN OPERATING SUPPORT OF $(2,330,250) IN 2012. THE REMAINING AMOUNTS REPRESENT CAPITAL CAMPAIGN INCOME FOR THE ORGANIZATION'S RAINIER BEACH MEDICAL AND DENTAL CLINIC IN 2011. NEIGHBORCARE LENDER LLC 905 SPRUCE STREET SUITE 300 SEATTLE WA 98104 271529844 FINANCIAL SERVICES WA C 126689 13187790 1.00000 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 NEIGHBORCARE LENDER LLC D 12810777 CASH NEIGHBORCARE LENDER LLC Q 126689 CASH