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FAMILYCARE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
FAMILYCARE INC (EIN 93-0878074)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-23
IRS object ID
201202369349300525
Schema version
2011v1.2
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

FieldValueIRS element (for citing)
Timestamp2012-08-23T19:43:41-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN930928924EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PERKINS & COMPANY PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11211 SW FIFTH AVE SUITE 1000AddressLine1
CityPORTLANDCity
StateORState
ZIP Code972043710ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930878074EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FAMILYCARE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFAMINameControl
Phone5032223205Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1825 NE MULTNOMAH SUITE 300AddressLine1
CityPORTLANDCity
StateORState
ZIP Code97232ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJESSE GAMEZName
TitleDIRECTOR OF OPERATIONSTitle
Phone5032223205Phone
Date Signed2012-08-17DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameROY ABRAMOWITZName
PTINP01329049PTIN
Phone5032210336Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJESSE GAMEZNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1825 NE MULTNOMAH SUITE 300AddressLine1
CityPORTLANDCity
StateORState
ZIP Code97232ZIPCode
FieldValueIRS element (for citing)
Gross Receipts149198184GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.FAMILYCAREINC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1984YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE COMMUNITY HEALTH CARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees179TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year107150185ProgramServiceRevenuePriorYear
Program Service Revenue CY145060257ProgramServiceRevenueCY
Investment Income Prior Year191253InvestmentIncomePriorYear
Investment Income Current Year245004InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year107341438TotalRevenuePriorYear
Total Revenue Current Year145305261TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year149279GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY341207GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year5943072SalariesEtcPriorYear
Salaries Etc Current Year8167768SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year99310978OtherExpensePriorYear
Other Expenses Current Year127778763OtherExpensesCurrentYear
Total Expenses Prior Year105403329TotalExpensesPriorYear
Total Expenses Current Year136287738TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1938109RevenuesLessExpensesPriorYear
Revenues Less Expenses CY9017523RevenuesLessExpensesCY
Total Assets BOY32675412TotalAssetsBOY
Total Assets EOY42848263TotalAssetsEOY
Total Liabilities BOY24950182TotalLiabilitiesBOY
Total Liabilities EOY26176775TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7725230NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY16671488NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE PROGRAMS OF COOPERATIVE AND COMPREHENSIVE HEALTHCARE TO THE COMMUNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense127695681Expense
Grants341207Grants
Revenue145060257Revenue
DescriptionPROVIDE COMPREHENSIVE AND COOPERATIVE HEALTH CARE TO MEMBERS ACCORDING TO THE TERMS OF A CONTRACT WITH THE OREGON HEALTH PLAN/MEDICAID. APPROXIMATELY 50,584 SERVED MONTHLY.Description
Total Program Service Expense127695681TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities1PoliticalActivities
Subject To Proxy Tax1SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961009NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees179NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JEFF HEATHERINGTONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5032223205TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1825 NE MULTNOMAH SUITE 300AddressLine1
CityPORTLANDCity
StateORState
ZIP Code97232ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
JEFFREY PAWLOWSKI
TREASURER1.00XX800000
KAREN CARNAHAN
CHAIR1.00XX1200000
ROBIN RICHARDSON DO
SECRETARY1.00XX385000
JANET TESCH
VICE CHAIR1.00XX335000
ROBERT CARUS
DIRECTOR1.00X400000
ROSS RONISH
DIRECTOR1.00X356200
JILL RISSI
DIRECTOR1.00X300000
JEFF HEATHERINGTON
PRESIDENT40.00X380323029951
GREG MARTENSON
DIRECTOR OF FINANCE40.00X1550400
KATHERINE ELLIS
DIRECTOR OF FINANCE40.00X135810011871
DOUGLAS LUTHER
MEDICAL DIRECTOR40.0026124907571X
JESSE GAMEZ
DIRECTOR OF OPERATIONS40.0015703708605X
RONALD PRESTON
DIRECTOR OF OPERATIONS40.00158750010555X
AMY SZCZUKOWSHI
PHARMACY MANAGER40.00127750017952X
NANCY BOYD
CONTROLLER40.0011504604000X
DERRICK DALE
CLAIMS MANAGER40.00107318014221X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1496549TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation104726TotalOtherCompensation
Number Individuals GT100 K9NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
PHYSICIANS INSURANCE A MUTAL CO
1301 SECOND AVENUE SUITE 2700SEATTLEWA98101INSURANCE SERVICES4067156
HEALTH NET OF OREGON
11918 SE DIVISION 144PORTLANDOR97266INSURANCE SERVICES1119803
AXIAN INC
9600 SW NUMBUS AVE SUITE 200BEAVERTONOR97008IT SERVICES & REPORTING930077
VISION SERVICE PLAN
121 SW MORRISON ST SUITE 1050PORTLANDOR97204INSURANCE SERVICES625336
STOEL RIVES LLP
900 SW FIFTH AVE SUITE 2600PORTLANDOR97204LEGAL SERVICES610477
FieldValueIRS element (for citing)
Number Of Contractors GT100 K21NumberOfContractorsGT100K

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column145060257TotalRevenueColumn
Related Or Exempt Function Income145060257RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue145060257TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column159383TotalRevenueColumn
Exclusion$159,383ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3978544Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3892923Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities85621Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column85621TotalRevenueColumn
Exclusion$85,621ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column145305261TotalRevenueColumn
Related Or Exempt Function Income145060257RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$245,004ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total341207Total
Program Services341207ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total880040Total
Program Services514753ProgramServices
Management And General365287ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6570152Total
Program Services5321823ProgramServices
Management And General1248329ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total136253Total
Program Services110365ProgramServices
Management And General25888ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total557Total
Management And General557ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total580766Total
Management And General580766ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total352537Total
Management And General352537ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total109987Total
Management And General109987ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total94761Total
Management And General94761ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total25465Total
Management And General25465ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total471491Total
Management And General471491ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total613232Total
Management And General613232ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total72567Total
Management And General72567ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total10600Total
Management And General10600ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total26356Total
Management And General26356ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total948392Total
Management And General948392ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total865885Total
Management And General865885ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
INPATIENT HOSPITAL4334385243343852
OTHER PROFESSIONAL SERV28907708271987471708961
PHYSICIAN SERVICES2835627528356275
EMERGENCY ROOM AND OUT-1244008512440085

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total11139570Total
Program Services10068574ProgramServices
Management And General1070996ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total136287738Total
Program Services127695681ProgramServices
Management And General8592057ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY10966698BOY
EOY18218115EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY920925BOY
EOY1251074EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4001864BOY
EOY3006286EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5430993LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2396858LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3053527BOY
EOY3034135EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY3845571BOY
EOY3333565EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9886827BOY
EOY14005088EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY32675412BOY
EOY42848263EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY24742858BOY
EOY25712291EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY207324BOY
EOY464484EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY24950182BOY
EOY26176775EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7725230BOY
EOY16671488EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7725230BOY
EOY16671488EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32675412BOY
EOY42848263EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses9017523ReconcilationRevenueExpenses
Reconcilation Other Changes-71265ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Political Expenditures10000PoliticalExpenditures
Substantially All Dues Nondeduct1SubstantiallyAllDuesNondeduct
Only In House Lobbying0OnlyInHouseLobbying
Agree To Carryover Prior Year1AgreeToCarryoverPriorYear
Non Ded Lobby Political Current84761NonDedLobbyPoliticalCurrent
Non Ded Lobby Political Carryover179231NonDedLobbyPoliticalCarryover
Non Ded Lobby Political Total263992NonDedLobbyPoliticalTotal
Amount To Be Carried Over0AmountToBeCarriedOver

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPART IV, SUPPLEMENTAL INFORMATION:Identifier
ExplanationPART I-A, LINE 1 $10,000 WAS CONTRIBUTED TO THE EILEEN FOR MAYOR CAMPAIGN. PART III-B PER REV. PROC. 98-19, FAMILYCARE, INC. IS EXEMPTED FROM THE PROXY TAX AND THE NOTIFICATION REQUIREMENT OF IRC SEC. 6033(E)(1) BECAUSE MORE THAN 90% OF THE ORGANIZATION'S ANNUAL DUES (OR SIMILAR AMOUNTS) ARE RECEIVED FROM ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3), STATE GOVERNMENTS, LOCAL GOVERNMENTS, ENTITIES WHOSE INCOME IS EXEMPT FROM TAX UNDER SECTION 115, OR ORGANIZATIONS EXCEPTED UNDER SECTION 4.01 OF REV. PROC. 98-19.Explanation

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis68312OtherCostOrOtherBasis
Depreciation17753Depreciation
Book Value50559BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4725336OtherCostOrOtherBasis
Depreciation2324574Depreciation
Book Value2400762BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis637345OtherCostOrOtherBasis
Depreciation54531Depreciation
Book Value582814BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3034135TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
OTHER CURRENT ASSETS, NET2802720
OTHER ASSETS, NET167654
RESTRICTED CASH AND CASH EQUIVALENTS334656
INVESTMENTS IN FAMILYCARE HEALTH PLANS4739938
RESTRICTED SHORT-TERM INVESTMENTS634087
RESTRICTED LONG-TERM INVESTMENTS5326033
FieldValueIRS element (for citing)
Total Book Value Other Assets14005088TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCAPITAL LEASE OBLIGATION, LESS CURRENT PORTIONDescription
Amount$464,484Amount
FieldValueIRS element (for citing)
Total Of Amounts464484TotalOfAmounts
Total Revenue145305261TotalRevenue
Total Expenses136287738TotalExpenses
Excess Or Deficit For Year9017523ExcessOrDeficitForYear
Net Unrealized GL On Investments-107835NetUnrealizedGLOnInvestments
Other$36,570OtherAmount
Total Adjustments-71265TotalAdjustments
Excess Or Deficit Per FS8946258ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt176999120TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-107835NetUnrealizedGainsInvestments
Other Revenues31801694OtherRevenues
Revenue Not Rptd F99031693859RevenueNotRptdF990
Revenue Subtotal145305261RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990145305261TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt168052862TotExpensesEtcAuditedFinclStmt
Other Expenses Included31765124OtherExpensesIncluded
Expenses Not Rptd F99031765124ExpensesNotRptdF990
Expenses Subtotal136287738ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990136287738TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierExplanationExplanation
PART XI, LINE 8 - OTHER ADJUSTMENTS:INCOME FROM SUBSIDIARY 36,570.
PART XII, LINE 2D - OTHER ADJUSTMENTS:OTHER ENTITY REVENUE 31,801,694.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:OTHER ENTITY EXPENSE 31,765,124.
SCHEDULE D, PART X, LINE 1 FINANCIAL STATEMENT FOOTNOTE REGARDING ASC 740: FAMILYCARE, AND HEALTH PLANS ARE TAX-EXEMPT ORGANIZATIONS PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4). ONLY THE COMPANY'S UNRELATED BUSINESS INCOME IS SUBJECT TO FEDERAL OR STATE INCOME TAXES. IT IS MANAGEMENT'S BELIEF THAT NONE OF THE COMPANY'S ACTIVITIES HAVE GENERATED MATERIAL UNRELATED BUSINESS INCOME; THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. GENERALLY, THE COMPANY IS SUBJECT TO EXAMINATION BY FEDERAL, STATE AND LOCAL INCOME TAX AUTHORITIES FOR THREE YEARS FROM THE FILING OF A TAX RETURN. WITH FEW EXCEPTIONS, THE COMPANY IS NO LONGER SUBJECT TO SUCH EXAMINATIONS FOR YEARS ENDED BEFORE DECEMBER 31, 2008.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
CHILDREN'S RELIEF NURSERY
8425 N LOMBARDPORTLANDOR97203931260988501(C)(3)10000SPONSORSHIP - IRON CHEF
NW OSTEOPATHIC MEDICAL FOUNDATION
1410 SW MORRISON ST SUITE 700PORTLANDOR97205930882138501(C)(3)18000EDUCATION; SPONSORSHIP
OSTEOPATHIC PHYSICIANS & SURGEONS OF OREGON INC
4380 SW MACADAM AVE SUITE 125PORTLANDOR97239936025596501(C)(6)100000OSTEOPATHIC SUPPORT; EDUCATION GRANT.
BASIC RIGHTS EDUCATION FUND
PO BOX 40625PORTLANDOR97240931266613501(C)(3)17500DONATION & SPONSORSHIP
CASCADE AIDS PROJECT
208 SW 5TH AVE STE 800PORTLANDOR97204930903383501(C)(3)15000SPONSORSHIP
WESTERN UNIVERSITY OF HEALTH SCIENCES
200 MULLINS DRLEBANONOR97355953127273501(C)(3)20000DONATION - NEW SCHOOL
HILLSBORO SCHOOL DISTRICT - EASTWOOD ELEMENTARY SCHOOL
2100 NE LINCOLN STHILLSBOROOR97124936001037501(C)(3)20000SPONSORSHIP - HSHO 2011 AWARD
GLADSTONE EDUCATION FOUNDATION - JOHN WETTEN ELEMENTARY SCHOOL
250 E EXETER STGLADSTONEOR97027931284265501(C)(3)20000SPONSORSHIP - HSHO 2011 AWARD
NAMI
4701 SE 24TH AVE STE EPORTLANDOR97202930875209501(C)(3)9045SPONSORSHIP
NORTHWEST MOTHERS MILK BANK
3439 NE SANDY BLVD 130PORTLANDOR97232263458029501(C)(3)10000DONATION
OREGON SCHOOL-BASED HEALTH CARE NETWORK
PO BOX 12191PORTLANDOR97212364588657501(C)(3)21000SPONSORSHIP
REYNOLDS SCHOOL DISTRICT #7
1204 NE 201ST AVEFAIRVIEWOR97024931220481501(C)(3)20000SPONSORSHIP - HSHO 2011 AWARD
GRESHAM-BARLOW EDUCATION FOUNDATION
1331 NW EASTMAN PKYGRESHAMOR97030931148994501(C)(3)20000SPONSORSHIP - HSHO 2011 AWARD
FieldValueIRS element (for citing)
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: FAMILYCARE DOES NOT AWARD GRANTS, BUT SPONSORS A LIMITED NUMBER OF CHARITABLE FUNDRAISING EVENTS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JEFF HEATHERINGTON
350000011227019096023708062430410274000
DOUGLAS LUTHER
242204072830117620703605350268820000
JESSE GAMEZ
152596010010344002650059550165642000
RONALD PRESTON
15384606010430301244093110169305000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
ROBIN RICHARDSON DO
SECRETARY AND BOARD MEMBER11475EXPENSES PAID FOR HEALTHCARE-RELATED SERVICES0
KAREN CARNAHAN
CHAIR AND BOARD MEMBER135038EXPENSES PAID TO PROFESSIONAL SERVICES FIRM0
ROSS RONISH
BOARD MEMBER2082432EXPENSES PAID TO A PROVIDER CLINIC FOR HEALTHCARE-RELATED SERVICES0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11A COPY OF FORM 990 IS PROVIDED TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING THE OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS.
FORM 990, PART VI, SECTION C, LINE 19FAMILYCARE, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -107,835. INCOME FROM SUBSIDIARY 36,570. TOTAL TO FORM 990, PART XI, LINE 5: -71,265.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:THE PROCESS FOR OVERSEEING THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTING AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionControlled OrgControlledOrgPublic Charity StatusPublicCharityStatus
FAMILYCARE HEALTH PLANS INC
825 NE MULTNOMAH SUITE 300PORTLANDOR97232911829317TO PROVIDE COMMUNITY HEALTH CAREOR501(C)(4)0
FAMILYCARE MEDICAL CLINICS INC
825 NE MULTNOMAH SUITE 300PORTLANDOR97232930988354TO PROVIDE COMMUNITY HEALTH CAREOR501(C)(3)0NON-PRIVATE FDN
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1FAMILYCARE HEALTH PLANS INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeRTransactionType
Amount Involved397751AmountInvolved

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
Return ReferencePART IIReturnReference
ExplanationFAMILYCARE, INC., FAMILYCARE HEALTH PLANS, INC. AND FAMILYCARE MEDICAL CLINICS, INC. ARE RELATED TAX-EXEMPT ORGANIZATIONS BY VIRTUE OF COMMON BOARD MEMBERS.Explanation