ACUMENTRA HEALTH INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- ACUMENTRA HEALTH INC (EIN 93-0857205)
- Tax period
- 2009-08-01 to 2010-07-31
- Filed
- 2011-06-14
- IRS object ID
- 201101659349300510
- Schema version
- 2009v1.7
- 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) |
|---|---|---|
| Timestamp | 2011-06-14T10:02:19-05:00 | Timestamp |
| Tax Period End Date | 2010-07-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hoffman Stewart & Schmidt PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4900 Meadows Road Ste 200 | AddressLine1 |
| City | Lake Oswego | City |
| State | OR | State |
| ZIP Code | 970353295 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-08-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930857205 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Acumentra Health Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ACUM | NameControl |
| Phone | 5032790100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2020 SW 4th Ave Suite 520 | AddressLine1 |
| City | Portland | City |
| State | OR | State |
| ZIP Code | 972014960 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jon Mitchell | Name |
| Title | President & CEO | Title |
| Phone | 5032790100 | Phone |
| Date Signed | 2011-06-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Robert M Prill | Name |
| Phone | 5032205900 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Jon Mitchell | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2020 SW 4th Ave Suite 520 | AddressLine1 |
| City | Portland | City |
| State | OR | State |
| ZIP Code | 972014960 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5808787 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.acumentra.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1984 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | IMPROVE HEALTH CARE QUALITY AND COST EFFECTIVENESS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 67 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 6682569 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5671002 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 43083 | InvestmentIncomePriorYear |
| Investment Income Current Year | 71427 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 6725652 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5742429 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4817988 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4403323 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1769673 | OtherExpensePriorYear |
| Other Expenses Current Year | 1404576 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6587661 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5807899 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 137991 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -65470 | RevenuesLessExpensesCY |
| Total Assets BOY | 4115203 | TotalAssetsBOY |
| Total Assets EOY | 4040302 | TotalAssetsEOY |
| Total Liabilities BOY | 897156 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 567018 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3218047 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3473284 | NetAssetsOrFundBalancesEOY |
| Mission Description | To improve patient safety, health, and health care through community partnerships and the practical application of science, resulting in quality health solutions. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4442343 | Expense |
| Revenue | 5671002 | Revenue |
| Description | REVIEW OF THE QUALITY, QUANTITY AND COST OF MEDICAL CARE PROVIDED AND THE UTILIZATION OF THE MEDICAL AND HOSPITAL FACILITIES THROUGH EDUCATION, MEASUREMENT, AND COLLABORATION WITH THE HEALTH CARE COMMUNITY AND THE PUBLIC. | Description |
| Total Program Service Expense | 4442343 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 25 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 67 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Timothy A Dragila | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5032790100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2020 SW 4th Ave Suite 520 | AddressLine1 |
| City | Portland | City |
| State | OR | State |
| ZIP Code | 97201 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Andris Antoniskis MD | |||||||
| Secretary/Treasurer | 1.00 | X | X | 0 | 0 | 0 | |
| Thomas Aschenbrener | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| SHELLEY BARNES NHA | |||||||
| Chair | 1.00 | X | X | 0 | 0 | 0 | |
| Barbara Christensen | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| JOY CONKLIN | |||||||
| Vice Chair | 1.00 | X | X | 0 | 0 | 0 | |
| BRIAN GARD | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Robert A Gluckman MD | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| HUGH SOWERS | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| ROBERT SWANGARD MD | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Bob Williams | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Jon K Mitchell FACHE | |||||||
| President & CEO | 55.00 | X | 188231 | 0 | 36551 | ||
| Ruth Medak MD | |||||||
| Assoc. Med. Dir. | 38.00 | 140201 | 0 | 24100 | X | ||
| Michael Cooper | |||||||
| Dir. St/Private Svc. | 47.00 | 122229 | 0 | 23259 | X | ||
| Stacy Moritz | |||||||
| Dir. Medicare Qual. Svc. | 48.00 | 109637 | 0 | 22217 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 560298 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 106127 | TotalOtherCompensation |
| Number Individuals GT100 K | 4 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| HealthServices Advisory Group | |||||
| 1600 E Northern Ave Suite 100 | Phoenix | AZ | 850502822 | Consulting | 198469 |
| University of Washington | |||||
| 3917 University Way NE | Seattle | WA | 981051122 | Consulting | 192199 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Gov't Contracts | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 5671002 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5671002 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5671002 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 51785 | TotalRevenueColumn |
| Exclusion | $51,785 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 86000 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 66358 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 19642 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19642 | TotalRevenueColumn |
| Exclusion | $19,642 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5742429 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5671002 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $71,427 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 220325 | Total |
| Program Services | 94740 | ProgramServices |
| Management And General | 125585 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2603087 | Total |
| Program Services | 1963172 | ProgramServices |
| Management And General | 639915 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 511568 | Total |
| Program Services | 385574 | ProgramServices |
| Management And General | 125994 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 789484 | Total |
| Program Services | 587636 | ProgramServices |
| Management And General | 201848 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 278859 | Total |
| Program Services | 206356 | ProgramServices |
| Management And General | 72503 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16848 | Total |
| Program Services | 12388 | ProgramServices |
| Management And General | 4460 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34521 | Total |
| Program Services | 25383 | ProgramServices |
| Management And General | 9138 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 472115 | Total |
| Program Services | 464382 | ProgramServices |
| Management And General | 7733 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 238782 | Total |
| Program Services | 192263 | ProgramServices |
| Management And General | 46519 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 362915 | Total |
| Program Services | 266852 | ProgramServices |
| Management And General | 96063 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 100572 | Total |
| Program Services | 99913 | ProgramServices |
| Management And General | 659 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16802 | Total |
| Program Services | 12355 | ProgramServices |
| Management And General | 4447 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16325 | Total |
| Program Services | 12004 | ProgramServices |
| Management And General | 4321 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44227 | Total |
| Program Services | 32520 | ProgramServices |
| Management And General | 11707 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Miscellaneous | 55217 | 48892 | 6325 |
| Maintenance | 25219 | 18544 | 6675 |
| STORAGE | 14747 | 14747 | |
| TRAINING | 6286 | 4622 | 1664 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5807899 | Total |
| Program Services | 4442343 | ProgramServices |
| Management And General | 1365556 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1058356 | BOY |
| EOY | 1154019 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1072769 | BOY |
| EOY | 776510 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67151 | BOY |
| EOY | 78660 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 723719 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 712130 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24857 | BOY |
| EOY | 11589 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 303788 | BOY |
| EOY | 321085 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1287807 | BOY |
| EOY | 1395644 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 300475 | BOY |
| EOY | 302795 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4115203 | BOY |
| EOY | 4040302 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 520156 | BOY |
| EOY | 411136 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 45882 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 377000 | BOY |
| EOY | 110000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 897156 | BOY |
| EOY | 567018 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3218047 | BOY |
| EOY | 3473284 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3218047 | BOY |
| EOY | 3473284 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4115203 | BOY |
| EOY | 4040302 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6326796 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6292972 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5653066 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6682569 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5671002 | CurrentTaxYear |
| Total | 30626405 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6326796 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6292972 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5653066 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6682569 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5671002 | CurrentTaxYear |
| Total | 30626405 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 30626405 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 104249 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 142932 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 114003 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 55819 | CurrentTaxYearMinus1Year |
| Current Tax Year | 51795 | CurrentTaxYear |
| Total | 468798 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 104249 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 142932 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 114003 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 55819 | CurrentTaxYearMinus1Year |
| Current Tax Year | 51795 | CurrentTaxYear |
| Total | 468798 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6431045 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6435904 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5767069 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6738388 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5722797 | CurrentTaxYear |
| Total | 31095203 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.98490 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.98570 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.01510 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.01430 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 311426 | OtherCostOrOtherBasis |
| Depreciation | 308866 | Depreciation |
| Book Value | 2560 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 412293 | OtherCostOrOtherBasis |
| Depreciation | 403264 | Depreciation |
| Book Value | 9029 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 11589 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Investment in HealthMetrix | 40000 | C |
| Money Market Funds | 40617 | F |
| Corporate and government bonds | 1315027 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 1395644 | TotalOfBookValueSecurities |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Due from HealthMetrix, Inc. | Description |
| Book Value | 302795 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 302795 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Provision for losses on uncompleted contracts | Description |
| Amount | $110,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 110000 | TotalOfAmounts |
| Total Revenue | 5742429 | TotalRevenue |
| Total Expenses | 5807899 | TotalExpenses |
| Excess Or Deficit For Year | -65470 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 53707 | NetUnrealizedGLOnInvestments |
| Other | $267,000 | OtherAmount |
| Total Adjustments | 320707 | TotalAdjustments |
| Excess Or Deficit Per FS | 255237 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 6063187 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 53707 | NetUnrealizedGainsInvestments |
| Other Revenues | 267051 | OtherRevenues |
| Revenue Not Rptd F990 | 320758 | RevenueNotRptdF990 |
| Revenue Subtotal | 5742429 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 5742429 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 5811287 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 3388 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 3388 | ExpensesNotRptdF990 |
| Expenses Subtotal | 5807899 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 5807899 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part XI, Line 8 - Other Adjustments: | Provision for income on uncompleted contracts: 267000. |
| Part XII, Line 2d - Other Adjustments: | Interest income earned by HealthMetrix: 51. Provision for loss on uncompleted contracts: 267000. |
| Part XIII, Line 2d - Other Adjustments: | Expenses allocated to HealthMetrix, Inc.: 3388. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jon K Mitchell FACHE | |||||||||||||
| 188231 | 0 | 0 | 0 | 0 | 0 | 25721 | 0 | 10830 | 0 | 224782 | 0 | 0 | 0 |
| Ruth Medak MD | |||||||||||||
| 140201 | 0 | 0 | 0 | 0 | 0 | 19158 | 0 | 4942 | 0 | 164301 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Brian Gard | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Chair of Board of Trustees | Relationship |
| Amount Of Transaction | 34387 | AmountOfTransaction |
| Description Of Transaction | Mr. Gard is the Chair of the Board of Trustees of the organization, and is president of Gard Communications, an advertising and public relations firm that has provided services to the organization. Mr. Gard has abstained from voting on all matters related to the hiring of Gard Communications. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 6 | Acumentra Health, Inc. serves as the Quality Improvement Organization in the state of Oregon and membership is open to all doctors of medicine and doctors of osteopathy who hold an unresricted license to practice medicine or osteopathy in the state of Oregon, and who maintain all or a portion of their practice in Oregon. |
| Form 990, Part VI, Section A, line 7a | Enrolled members in Acumentra Health, Inc. (as decribed in above in question 6) are permitted to elect members of the Board of Trustees of the organization. |
| Form 990, Part VI, Section A, line 7b | Each member of the organization is entitled to one vote on all propositions submitted to the membership by the board of trustees or as required by law, including certain amendments to the organization's articles of incorporation, plans of merger, sales of assets, other than in the ordinary course of activities, and dissolution. |
| Form 990, Part VI, Section B, line 11 | The Organization's President and CEO and Director of Finance performed a detailed review of Form 990 prior to filing. In addition, the form was provided electronically to members of the board of directors for their review. |
| Form 990, Part VI, Section B, line 12c | A conflict of interest questionnaire and statement is completed/signed annually by all board members and employees. |
| Form 990, Part VI, Section B, line 15 | The compensation of the President/CEO of the organization is determined annually by the organization's board of directors. Salary is determined by reference to published compensation surveys and consideration of the regional employement market. Compensation of other key employees of the organization is determined on an annual basis in a similar fashion by the President/CEO, and is approved by the board of directors as part of the annual budget approval process. |
| Form 990, Part VI, Section C, line 19 | Governing documents of the organization, as well as Form 990 and Form 1023 are made available from the organization upon request. |
| Form 990, Part XI, 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. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HealthMetrix Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2020 SW 4th Avenue Suite 520 | AddressLine1 |
| City | Portland | City |
| State | OR | State |
| ZIP Code | 97201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 931310737 | EIN |
| Primary Activities | Review of quality, quantity and cost of medical care | PrimaryActivities |
| Legal Domicile State | OR | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 9 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | healthmetrix Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | D | TransactionType |