2011-06-14T10:02:19-05:00 2010-07-31 Hoffman Stewart & Schmidt PC 4900 Meadows Road Ste 200 Lake Oswego OR 970353295 990 2009-08-01 930857205 Acumentra Health Inc ACUM 5032790100 2020 SW 4th Ave Suite 520 Portland OR 972014960 Jon Mitchell 5032790100 2011-06-13 1 Robert M Prill 5032205900 2009 2016-02-24 21:20:13Z Jon Mitchell 2020 SW 4th Ave Suite 520 Portland OR 972014960 5808787 0 X www.acumentra.org X 1984 OR IMPROVE HEALTH CARE QUALITY AND COST EFFECTIVENESS. 10 10 67 0 0 0 0 6682569 5671002 43083 71427 0 6725652 5742429 0 0 4817988 4403323 0 0 1769673 1404576 6587661 5807899 137991 -65470 4115203 4040302 897156 567018 3218047 3473284 To improve patient safety, health, and health care through community partnerships and the practical application of science, resulting in quality health solutions. 0 0 4442343 5671002 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. 4442343 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 0 0 1 25 0 67 1 0 0 0 0 0 0 0 0 0 10 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X Timothy A Dragila 5032790100 2020 SW 4th Ave Suite 520 Portland OR 97201 Andris Antoniskis MD 1.00 X X 0 0 0 Thomas Aschenbrener 1.00 X 0 0 0 SHELLEY BARNES NHA 1.00 X X 0 0 0 Barbara Christensen 1.00 X 0 0 0 JOY CONKLIN 1.00 X X 0 0 0 BRIAN GARD 1.00 X 0 0 0 Robert A Gluckman MD 1.00 X 0 0 0 HUGH SOWERS 1.00 X 0 0 0 ROBERT SWANGARD MD 1.00 X 0 0 0 Bob Williams 1.00 X 0 0 0 Jon K Mitchell FACHE 55.00 X 188231 0 36551 Ruth Medak MD 38.00 X 140201 0 24100 Michael Cooper 47.00 X 122229 0 23259 Stacy Moritz 48.00 X 109637 0 22217 560298 0 106127 4 0 1 0 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 2 Gov't Contracts 900099 5671002 5671002 5671002 51785 51785 86000 66358 19642 19642 19642 5742429 5671002 0 71427 220325 94740 125585 2603087 1963172 639915 511568 385574 125994 789484 587636 201848 278859 206356 72503 16848 12388 4460 34521 25383 9138 472115 464382 7733 238782 192263 46519 362915 266852 96063 100572 99913 659 16802 12355 4447 16325 12004 4321 44227 32520 11707 Miscellaneous 55217 48892 6325 Maintenance 25219 18544 6675 STORAGE 14747 14747 TRAINING 6286 4622 1664 5807899 4442343 1365556 0 1058356 1154019 1072769 776510 67151 78660 723719 712130 24857 11589 303788 321085 1287807 1395644 300475 302795 4115203 4040302 520156 411136 45882 377000 110000 897156 567018 X 3218047 3473284 3218047 3473284 4115203 4040302 X 0 1 1 X 1 1 X 6326796 6292972 5653066 6682569 5671002 30626405 6326796 6292972 5653066 6682569 5671002 30626405 0 0 0 30626405 104249 142932 114003 55819 51795 468798 104249 142932 114003 55819 51795 468798 6431045 6435904 5767069 6738388 5722797 31095203 0.98490 0.98570 0.01510 0.01430 X 311426 308866 2560 412293 403264 9029 11589 Investment in HealthMetrix 40000 C Money Market Funds 40617 F Corporate and government bonds 1315027 F 1395644 Due from HealthMetrix, Inc. 302795 302795 Provision for losses on uncompleted contracts 110000 110000 5742429 5807899 -65470 53707 267000 320707 255237 6063187 53707 267051 320758 5742429 0 5742429 5811287 3388 3388 5807899 0 5807899 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. X X X 0 0 0 0 0 0 0 0 0 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 Brian Gard Chair of Board of Trustees 34387 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. 0 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. HealthMetrix Inc 2020 SW 4th Avenue Suite 520 Portland OR 97201 931310737 Review of quality, quantity and cost of medical care OR 501(c)(3) 9 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 healthmetrix Inc D