2024-12-03T12:50:40-06:00 2024-06-30 930743240 HOFFMAN STEWART & SCHMIDT PC 3 CENTERPOINTE DRIVE SUITE 300 LAKE OSWEGO OR 970358663 990 2023-07-01 930706892 FORA HEALTH INC FORA 5035351151 PO BOX 16040 PORTLAND OR 972920040 DEVARSHI BAJPAI CEO 5035351151 2024-11-26 1 0 ROBERT M PRILL P00236613 5032205900 2023 2024-10-15 13:58:12Z DEVARSHI BAJPAI PO BOX 16040 PORTLAND OR 972920040 15901525 0 X WWW.FORAHEALTH.ORG X 1977 OR PROVIDE TREATMENT, CARE, AND ADVOCACY FOR ALL WHO ARE AFFECTED BY SUBSTANCE USE DISORDER. 10 10 218 10 0 0 1978519 830810 12545303 14823322 216258 216326 -97619 -69770 14642461 15800688 0 0 0 0 10221717 11446327 0 0 488614 4061029 5021569 14282746 16467896 359715 -667208 25090170 25080015 3893339 5202765 21196831 19877250 FORA HEALTH PROVIDES TREATMENT, CARE, AND ADVOCACY FOR ALL WHO ARE AFFECTED BY SUBSTANCE USE DISORDER. 0 0 12276689 14854389 THE ADULT AND FAMILY SERVICES PROGRAM PROVIDES UP TO 95 BEDS FOR INTENSIVE RESIDENTIAL TREATMENT AND MEDICAL DETOXIFICATION FOR MEN AND WOMEN AT ITS SOUTHEAST PORTLAND LOCATION. THE ORGANIZATION ALSO PROVIDES AN INTENSIVE OUTPATIENT STABILIZATION PROGRAM AND OUTPATIENT SERVICES FOR THOSE WHO HAVE COMPLETED OR DO NOT REQUIRE RESIDENTIAL TREATMENT AT ITS OFFICES IN WASHINGTON COUNTY OR SOUTHEAST PORTLAND LOCATIONS. THE ORGANIZATION PROVIDES PUBLIC INFORMATION REGARDING DRUG AND ALCOHOL ISSUES FACING THE PORTLAND METROPOLITANAREA. WORK ALSO IS DONE TO EDUCATE THE PUBLIC ABOUT ADDICTION AND TO CHANGE THE STIGMA ATTACHED TO ALCOHOLISM AND OTHER ADDICTION DISEASES. 12276689 1 1 0 1 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 0 0 0 0 0 1 0 0 0 1 14 0 1 218 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X COURTNEY WOOD 5035351151 10230 SE CHERRY BLOSSOM DRIVE PORLTAND OR 97216 JAMES POLO CHAIR 1.00 X X 0 0 0 ANDY DARKINS VICE-CHAIR 1.00 X X 0 0 0 JASON NASH TREASURER 1.00 X X 0 0 0 MELISSA TOPP SECRETARY 1.00 X X 0 0 0 JAY MINOR IMMEDIATE PAST CHAIR 1.00 X X 0 0 0 AMIT SHAH MEMBER AT LARGE 1.00 X X 0 0 0 KELSIE CRIPPEN DIRECTOR 1.00 X 0 0 0 RACHEL PRUSAK DIRECTOR 1.00 X 0 0 0 DR TERRY JOHNSSON DIRECTOR 1.00 X 0 0 0 KEVIN VALK DIRECTOR 1.00 X 0 0 0 MAREE WACKER FORMER CEO 40.00 X 356509 0 26005 PAMELA BELLI FORMER CFO 30.00 X 294022 0 17547 NERISSA HELLER CCO 40.00 X 187653 0 16900 DEVARSHI BAJPAI CEO 40.00 X 16860 0 0 COURTNEY WOOD CFO 40.00 X 0 0 0 JESSICA GREGG FORMER CHIEF MEDICAL OFFICER 40.00 X 309849 0 18191 EOWYN RIEKE MEDICAL DIRECTOR 40.00 X 241018 0 31628 JENNIFER HARTLEY INTERIM CHIEF MEDICAL OFFICER 40.00 X 225384 0 8273 CHARLOTTE VANCLEVE NURSE 40.00 X 183667 0 19255 JANA VARNER SENIOR DIRECTOR OF OPERATIONS 40.00 X 149035 0 19920 CHARLES WILLIAMSON NURSE 40.00 X 174100 0 15854 2138097 0 173573 21 0 1 0 0 209855 276920 344035 830810 CLIENT FEES 621400 14691035 14691035 CCO INCENTIVE REVENUE 624200 132287 132287 14823322 216326 216326 0 209855 100837 -100837 -100837 MISCELLANEOUS 900099 31067 31067 31067 15800688 14854389 0 115489 X 1136889 658109 372991 105789 8459319 6473466 1789094 196759 192298 147119 40734 4445 880496 660572 193902 26022 777325 578441 174621 24263 1820669 1166989 615834 37846 82270 40747 7155 34368 713915 538899 162743 12273 52565 45873 5725 967 1946 1946 390204 292320 87590 10294 310476 262393 37023 11060 FOOD SERVICES 479467 478915 502 50 REPAIRS & MAINTENANCE 375941 307491 66416 2034 CLIENT ASSISTANCE AND P 375721 360042 15170 509 MISCELLANEOUS 125855 83349 37606 4900 292540 181964 93541 17035 16467896 12276689 3702593 488614 2542438 3884248 358034 83457 985552 845787 56946 99489 5721247 3316494 2657529 2404753 410549 112546 18079122 17649735 25090170 25080015 1484997 1539042 0 1211037 2177000 2177000 150000 100000 81342 175686 3893339 5202765 X 21196831 19877250 21196831 19877250 25090170 25080015 X -667208 12400 -664773 X X 0 1 X 1 0 X 3548861 4058047 4277479 1978519 830810 14693716 3548861 4058047 4277479 1978519 830810 14693716 849002 13844714 69703 216307 216279 216258 216326 934873 41500 46303 15420 103223 32274 40866 55527 41745 31067 201479 15933291 57679555 0.86890 0.87560 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 18700 18700 16449196 16467896 973395 243349 0 0 739110 801294 864137 973395 3377936 5066904 16000 19806 9700 18700 64206 184778 200324 216034 243349 844485 1266728 16000 19806 9700 18700 64206 37300 37300 2978539 2421177 557362 1649312 824442 824870 1056096 70875 985221 2404753 NOTE RECEIVABLE 15650200 INVESTMENT IN DE PAUL QALICB, INC. 1824296 OPERATING LEASE RIGHT-OF-USE ASSETS 175239 17649735 FINANCE LEASE LIABILITY 447 OPERATING LEASE LIABILITIES 175239 175686 X PART X, LINE 2: MANAGEMENT DOES NOT BELIEVE FORA HEALTH, INC. HAS ANY UNCERTAIN TAX POSITIONS. FORA HEALTH, INC. FILES INFORMATIONAL RETURNS WHICH ARE GENERALLY SUBJECT TO EXAMINATION BY INCOME TAX AUTHORITIES FOR THREE YEARS FROM THE FILING OF A RETURN. THERE ARE CURRENTLY NO EXAMINATIONS IN PROGRESS FOR ANY PERIODS. ANNUAL FREEDOM AWARD FUNDRAISER 209855 209855 100837 209855 209855 100837 100837 -100837 X X X X X 0 0 0 0 0 0 0 0 0 MAREE WACKER FORMER CEO 356509 0 0 0 0 0 17331 0 8674 0 382514 0 0 0 JESSICA GREGG FORMER CHIEF MEDICAL OFFICER 309849 0 0 0 0 0 17241 0 950 0 328040 0 0 0 PAMELA BELLI FORMER CFO 294022 0 0 0 0 0 16835 0 712 0 311569 0 0 0 EOWYN RIEKE MEDICAL DIRECTOR 241018 0 0 0 0 0 13617 0 18011 0 272646 0 0 0 JENNIFER HARTLEY INTERIM CHIEF MEDICAL OFFICER 225384 0 0 0 0 0 0 0 8273 0 233657 0 0 0 NERISSA HELLER CCO 187653 0 0 0 0 0 8883 0 8017 0 204553 0 0 0 CHARLOTTE VANCLEVE NURSE 183667 0 0 0 0 0 11020 0 8235 0 202922 0 0 0 CHARLES WILLIAMSON NURSE 174100 0 0 0 0 0 7660 0 8194 0 189954 0 0 0 JANA VARNER SENIOR DIRECTOR OF OPERATIONS 149035 0 0 0 0 0 8942 0 10978 0 168955 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEWS THE FORM 990 PRIOR TO FILING, PROVIDING AN OPPORTUNITY FOR QUESTIONS AND FEEDBACK. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE ASKED TO REVIEW AND SIGN CONFLICT OF INTEREST AND CODE OF CONDUCT AND ETHICS DOCUMENTS AT THE COMMENCEMENT OF THEIR SERVICE AS A DIRECTOR, AND ANNUALLY THEREAFTER. FORM 990, PART VI, SECTION B, LINE 15 CEO COMPENSATION IS SET BASED ON DATA COLLECTED ANNUALLY BY HUMAN RESOURCES STAFF AND INCLUDES THE USE OF THE MBL GROUP'S ANNUAL NONPROFIT SALARY SURVEY, AND INTERVIEWS WITH OTHER HUMAN RESOURCE DEPARTMENTS OF OTHER NONPROFITS. ADDITIONALLY, THE BOARD EVALUATES AND COMPARES OTHER NON-PROFIT AND COMPARABLE ORGANIZATION CEO COMPENSATION PACKAGES TO REVIEW AND APPROVE THE CEO COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER: PROGRAM SERVICE EXPENSES 1,166,989. MANAGEMENT AND GENERAL EXPENSES 615,834. FUNDRAISING EXPENSES 37,846. TOTAL EXPENSES 1,820,669. FORM 990, PART XI, LINE 9: DECREASE IN INVESTMENT IN QALIC B -664,773. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE ANNUAL AUDIT OF THE FINANCIAL STATEMENTS. THERE HAS BEEN NO CHANGE IN THE OVERSIGHT OR SELECTION PROCESS SINCE THE PRIOR YEAR. DE PAUL QALICB INC 1312 SW WASHINGTON ST PORTLAND OR 97205 844475246 SUPPORTING ORGANIZATION OR 501(C)(3) LINE 12B, II N/A 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0