2012-10-10T12:24:37-05:00 2011-12-31 930743240 HOFFMAN STEWART & SCHMIDT PC 4900 MEADOWS ROAD STE 200 LAKE OSWEGO OR 970353295 990 2011-01-01 910896241 COWLITZ FAMILY HEALTH CENTER COWL 3606363892 1057 12TH AVENUE LONGVIEW WA 986322509 DIAN COOPER 3606363892 2012-10-09 1 ROBERT M PRILL P00236613 5032205900 2011 2016-02-24 21:20:13Z DIAN COOPER 1057 12TH AVENUE LONGVIEW WA 986322509 11110136 0 X WWW.COWLITZFAMILYHEALTH.ORG X 1972 WA TO PROMOTE, ENCOURAGE AND PROVIDE HEALTH SERVICES IN ORDER TO IMPROVE THE QUALITY OF LIFE THROUGH SOUND NUTRITION, EDUCATION, PREVENTIVE HEALTH CARE, AND THE EMPOWERMENT OF CHOICE. 12 12 151 40 0 0 2803464 2240136 8212373 8853319 23882 14106 4679 2575 11044398 11110136 0 0 0 0 7432284 6979917 0 0 0 3483747 3349576 10916031 10329493 128367 780643 7499495 8327725 1627594 1675181 5871901 6652544 X TO PROMOTE, ENCOURAGE AND PROVIDE HEALTH SERVICES IN ORDER TO IMPROVE THE QUALITY OF LIFE THROUGH SOUND NUTRITION, EDUCATION, PREVENTIVE HEALTH CARE, AND THE EMPOWERMENT OF CHOICE. 0 0 4639300 5742529 TO PROVIDE MEDICAL SERVICES TO LOW INCOME INDIVIDUALS. THE TOTAL MEDICAL ENCOUNTERS DURING THE YEAR WERE 42,252. 635798 TO PROVIDE SUPPLEMENTAL NUTRITION SERVICES FOR PREGNANT AND BREASTFEEDING WOMEN AND THEIR CHILDREN TO AGE 5. DURING 2010, THE CENTER SERVED 6,626 WOMEN, INFANTS AND CHILDREN. 2235093 2249964 TO PROVIDE DENTAL SERVICES TO LOW INCOME INDIVIDUALS. THE TOTAL DENTAL ENCOUNTERS DURING THE YEAR WERE 22,700. 378637 877507 TO PROVIDE MEDICAL RELATED SERVICES TO LOW INCOME INDIVIDUALS. ENABLING SERVICE ENCOUNTERS AND MENTAL HEALTH ENCOUNTERS TOTALED 4,846 AND 2,766 RESPECTIVELY. 378637 877507 7888828 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 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 0 1 17 0 151 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 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 2.00 X X 0 0 0 MELISSA TAYLOR 2.00 X X 0 0 0 WANDA MCBEE 2.00 X X 0 0 0 CARLEEN WOLGAMOTT 2.00 X 0 0 0 CYNTHIA WASHINGTON-MATTSON 2.00 X 0 0 0 JOSIAH JOHNSON 2.00 X 0 0 0 GEORGE ROBERTSON 2.00 X 0 0 0 JUDY BRIGHT 2.00 X 0 0 0 THOMAS DOUMIT 2.00 X 0 0 0 ALISABETH BUCK 2.00 X 0 0 0 ANN SHODDY 2.00 X 0 0 0 DONNA SETTERS 2.00 X 0 0 0 DIAN COOPER 40.00 X 103546 0 6802 ANDREA TRENNER 40.00 X 66725 0 6802 GERARDO MELGAR 40.00 X 174902 0 6802 ROBERT PETERSON 40.00 X 155682 0 6802 ROXANE OSHIRO 40.00 X 146414 0 6802 TRESHA DRONEN 40.00 X 143824 0 6802 PARTHA GONAVARAM 40.00 X 142448 0 6802 TATIANNA TROTT 40.00 X 122496 0 6802 1056037 0 54416 12 0 1 0 OCHIN INC 707 SW WASHINGTON STREET 1200 PORTLAND OR 972053529 EMR AND PRACTICE MANAGEMENT FEES 468396 POLAR SYSTEMS 21890 WILLAMETTE DRIVE WEST LINN OR 97068 COMPUTER CONSULTING 277847 COWLITZ COUNTY GUIDANCE ASSOCIATION 921 14TH AVENUE LONGVIEW WA 98632 MENTAL HEALTH SERVICES 120690 3 2235602 4534 2240136 PATIENT SERVICE REVENU 624100 6504513 6504513 PREMIUM REVENUE 624100 2348806 2348806 8853319 14106 14106 OTHER REVENUE 624100 2575 2575 2575 11110136 8870000 0 0 395607 196919 198688 5470354 4750240 720114 638069 550857 87212 475887 413242 62645 67101 67101 28544 28544 1064393 498844 565549 17004 13995 3009 169755 89472 80283 518156 356817 161339 38138 24889 13249 72363 47224 25139 34385 34385 431074 183811 247263 33182 33182 MEDICAL SUPPLIES 425769 425769 BAD DEBT 198989 198989 TAXES AND LICENSES 68554 62944 5610 TELEPHONE 63396 46841 16555 118773 27975 90798 10329493 7888828 2440665 0 876866 1615159 2543406 3186714 88590 104997 979256 829243 45029 55288 160158 132752 4924163 2520591 2806190 2403572 7499495 8327725 845990 903903 781604 771278 1627594 1675181 X 5871901 6652544 5871901 6652544 7499495 8327725 780643 0 X X 0 1 1 X 1 1 X 1832679 2411332 2835315 2803464 2240136 12122926 1832679 2411332 2835315 2803464 2240136 12122926 12122926 102661 65048 33922 23882 14106 239619 8318 4679 2575 15572 12378117 0.97940 0.97710 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 83030 83030 719994 127198 592796 1837143 1176370 660773 2283996 1217023 1066973 2403572 11110136 10329493 780643 780643 11110136 0 11110136 0 11110136 10329493 0 10329493 0 10329493 X X 0 0 0 0 0 0 0 0 0 GERARDO MELGAR 154558 0 0 0 20344 0 0 0 6802 0 181704 0 0 0 ROBERT PETERSON 155682 0 0 0 0 0 0 0 6802 0 162484 0 0 0 ROXANE OSHIRO 146414 0 0 0 0 0 0 0 6802 0 153216 0 0 0 TRESHA DRONEN 143824 0 0 0 0 0 0 0 6802 0 150626 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION SENDS AN EMAIL WITH THE FORM 990 TO ALL BOARD MEMBERS AND SOLICITS COMMENTS PRIOR TO FILING. 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 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.