2024-11-08T13:16:07-06:00 2023-12-31 910189318 MOSS ADAMS LLP 6565 AMERICAS PARKWAY NE STE 600 ALBUQUERQUE NM 87110 990 2023-01-01 201358178 TRICORE LABORATORY SERVICES CORP TRIC 5059388888 1001 WOODWARD PLACE NE ALBUQUERQUE NM 87102 ROBIN DIVINE CEO 5059388888 2024-10-28 1 1 PAMELA ALEXANDERSON P01218925 5058787200 2024-10-28 2023 2024-10-15 13:58:12Z ROBIN DIVINE 1001 WOODWARD PLACE NE ALBUQUERQUE NM 87102 122945986 0 X WWW.TRICORE.ORG X 2004 NM THE ORGANIZATION WAS ORGANIZED AND IS OPERATED AS A COOPERATIVE HOSPITAL SERVICE ORGANIZATION. 8 8 0 8 0 0 0 0 131180332 122945986 -10560 -7865 0 0 131169772 122938121 0 0 0 0 53624986 57273404 0 0 0 77544786 65664717 131169772 122938121 0 0 26648666 24397024 13211751 10960109 13436915 13436915 THE ORGANIZATION PERFORMS LABORATORY SERVICES EXCLUSIVELY FOR ITS MEMBERS, EACH OF WHOM IS A HOSPITAL DESCRIBED IN SECTION 501(E)(1)(B) OF THE INTERNAL REVENUE CODE, AND FOR NO ONE ELSE. 0 0 105857721 122945986 THE ORGANIZATION PERFORMS LABORATORY SERVICES EXCLUSIVELY FOR ITS MEMBERS, EACH OF WHOM IS A HOSPITAL DESCRIBED IN SECTION 501(E)(1)(B) OF THE INTERNAL REVENUE CODE, AND FOR NO ONE ELSE. 105857721 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 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 1 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NM X X ELLA WATT 5059388926 1001 WOODWARD PL NE ALBUQUERQUE NM 87102 JILL KLAR BOARD CHAIR 1.00 2.00 X 0 0 0 BONNIE WHITE BOARD VICE CHAIR 1.00 2.00 X 0 0 0 CHRIS SPENCER FINANCE COMMITTEE CHAIR 1.00 2.00 X 0 0 0 NANCY JOSTE MD BOARD MEMBER 1.00 2.00 X 0 0 0 DALE MAXWELL BOARD MEMBER (THRU 8/1/23) 1.00 2.00 X 0 0 0 ALEXEI BAKHIREV MD BOARD MEMBER 1.00 2.00 X 0 0 0 DR MICHAEL RICHARDS BOARD MEMBER 1.00 2.00 X 0 0 0 JASON MITCHELL MD BOARD MEMBER 1.00 2.00 X 0 0 0 LAUREN MADIGAN BOARD MEMBER 1.00 2.00 X 0 0 0 ROBIN DIVINE CHIEF EXECUTIVE OFFICER 22.00 18.00 X 0 497939 35385 NICHOLAS DAYAN CHIEF PEOPLE OFFICER 22.00 18.00 X 0 389317 15943 ERIC CARBONNEAU CHIEF OPERATING OFFICER 22.00 18.00 X 0 295237 31111 ELLA WATT CHIEF FINANCIAL OFFICER 22.00 18.00 X 0 322438 16856 DAVID GRENACHE CHIEF SCIENTIFIC OFFICER 22.00 18.00 X 0 328482 30288 ARAND PIERCE CHIEF MEDICAL OFFICER (THRU 6/2/23) 22.00 18.00 X 0 205902 13431 KATHRYN FORT OPERATIONS CONTROLLER 19.00 21.00 X 0 224721 17767 KARISSA MCCALL CULBREATH CHIEF MEDICAL DIRECTOR 15.00 25.00 X 0 213478 10626 HONGYAN XIE SCIENTIFIC DIRECTOR CYTOGENICS 25.00 15.00 X 0 221464 20997 AARON FRANKEL DIRECTOR, INFORMATION SECURITY 19.00 21.00 X 0 187930 23661 MICHELLE NEEL SENIOR DIRECTOR, COMPLIANCE 19.00 21.00 X 0 188458 26435 0 3075366 242500 0 0 1 0 TRIAGE LLC 12020 PACIFIC STREET OMAHA NE 68154 STAFFING AGENCY 3443499 PATHOLOGY ASSOCIATES OF ALBUQUERQUE 1100 CENTRAL AVE SE ALBUQUERQUE NM 87106 PATHOLOGY CONSULTANTS 1294620 UNM MEDICAL GROUP INC PO BOX 27200 ALBUQUERQUE NM 87125 PATHOLOGY CONSULTANTS 937197 QUALIVIS LLC 5930 CORNERSTONE CT W SUITE 300 SAN DIEGO CA 92121 STAFFING AGENCY 196993 4 SALES, NET OF DISCOUNTS 621500 122945986 122945986 122945986 7865 -7865 -7865 -7865 122938121 122945986 0 -7865 X 1277746 1277746 42210829 36804701 5406128 1675943 1506839 169104 8199650 6915105 1284545 3909236 3373785 535451 176400 25570 150830 234818 234818 16519905 15372662 1147243 17107 16241 866 1537683 1279610 258073 4644425 960122 3684303 1882762 1017455 865307 165997 117952 48045 221396 221396 3870072 3018790 851282 378003 378003 SUPPLIES 33328314 33328314 EQUIPMENT EXPENSES 2331147 1939842 391305 FEES 229067 170810 58257 127621 9923 117698 122938121 105857721 17080400 0 2782891 2133650 18723598 15627351 3711271 3096247 20154504 19167127 26648666 24397024 4174086 3198557 9037665 7761552 13211751 10960109 X 13436915 13436915 13436915 13436915 26648666 24397024 0 0 X X 0 1 X 1 0 X 18960 18960 0 2603805 2271647 332158 14956209 12306115 2650094 1144624 1030629 113995 3096247 DUE FROM MEMBERS 10101863 ROU ASSETS 7672484 OTHER RECEIVABLES 77490 DUE FROM TRICORE LABORATORIES AND TRICORE, INC. 1315290 19167127 LEASE LIABILITIES 7761552 7761552 X 122938121 0 122938121 0 122938121 122938121 0 122938121 0 122938121 PART X, LINE 2: THE CORPORATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE CODE. ACCORDINGLY, NO PROVISION FOR FEDERAL OR STATE INCOME TAXES ARE INCLUDING THE ACCOMPANYING FINANCIAL STATEMENTS. X X X X 1 0 0 0 0 1 1 0 0 ROBIN DIVINE CHIEF EXECUTIVE OFFICER 0 406034 0 91125 0 780 0 16500 0 18885 0 533324 0 0 NICHOLAS DAYAN CHIEF PEOPLE OFFICER 0 305359 0 37804 0 46154 0 10448 0 5495 0 405260 0 0 DAVID GRENACHE CHIEF SCIENTIFIC OFFICER 0 306733 0 20969 0 780 0 16298 0 13990 0 358770 0 0 ELLA WATT CHIEF FINANCIAL OFFICER 0 301033 0 20625 0 780 0 10262 0 6594 0 339294 0 0 ERIC CARBONNEAU CHIEF OPERATING OFFICER 0 275551 0 18906 0 780 0 14695 0 16416 0 326348 0 0 KATHRYN FORT OPERATIONS CONTROLLER 0 213150 0 11571 0 0 0 11173 0 6594 0 242488 0 0 HONGYAN XIE SCIENTIFIC DIRECTOR CYTOGENICS 0 210894 0 0 0 10570 0 9103 0 11894 0 242461 0 0 KARISSA MCCALL CULBREATH CHIEF MEDICAL DIRECTOR 0 203514 0 9184 0 780 0 10626 0 0 0 224104 0 0 ARAND PIERCE CHIEF MEDICAL OFFICER (THRU 6/2/23) 0 189573 0 16004 0 325 0 5223 0 8208 0 219333 0 0 MICHELLE NEEL SENIOR DIRECTOR, COMPLIANCE 0 181517 0 6161 0 780 0 9366 0 17069 0 214893 0 0 AARON FRANKEL DIRECTOR, INFORMATION SECURITY 0 181654 0 6026 0 250 0 9161 0 14500 0 211591 0 0 PART I, LINE 3 ALTHOUGH THE FILING ORGANIZATION DOES NOT ISSUE FORMS W-2, IT DOES REPORT THE REIMBURSED SALARIES AND RELATED PAYROLL EXPENSES ON FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES. AS SUCH, THE ORGANIZATION IS ANSWERING SCHEDULE J AS THOUGH THE COMPENSATION IS COMING FROM THE ORGANIZATION. PART I, LINE 4A NICHOLAS DAYAN RECEIVED SEVERANCE PAY OF $46,154 IN 2023. PART I, LINE 6 BONUS COMPENSATION IS PAID BASED ON A COMPARISON OF ACTUAL NET INCOME TO BUDGETED NET INCOME FOR EACH QUARTER. FORM 990, PART V, LINE 2B: OFFICERS AND EMPLOYEES RECEIVE COMPENSATION FROM A RELATED ORGANIZATION. THE FILING ORGANIZATION THEN REIMBURSES THE RELATED ORGANIZATION FOR ITS PORTION OF THE SALARIES AND PAYROLL EXPENSES. ACCORDINGLY, ALTHOUGH THE FILING ORGANIZATION DOES NOT ISSUE FORMS W-2, IT DOES REPORT THE REIMBURSED SALARIES AND RELATED PAYROLL EXPENSES ON FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES. FORM 990, PART VI, SECTION A, LINE 2 ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER THROUGH THEIR INVOLVEMENT WITH TRICORE REFERENCE LABORATORIES AND TRICORE INC., WHICH ARE BOTH RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 3 TRICORE REFERENCE LABORATORIES (TRL) ACTS AS AGENT FOR TRICORE LABORATORY SERVICES CORPORATION (TLSC). UNDER WRITTEN AGREEMENT, TRL MAY PROVIDE MANAGEMENT, ADMINISTRATIVE RESOURCES AND SHARED EMPLOYEES TO TLSC, WHICH MAY ACCEPT SUCH SERVICES. ACCORDINGLY, THE ORGANIZATION, AS PRINCIPAL, PAYS TRL, AS AGENT, SPECIFIC AND ALLOCATED EXPENSES. ALL OF THE OFFICERS LISTED ON THE 990, PART VII, SECTION A, WERE COMPENSATED BY TRL IN THE AMOUNTS SHOWN ON THAT SCHEDULE. FORM 990, PART VI, SECTION A, LINE 6 AS AN IRC SECTION 501(E) ORGANIZATION, TLSC IS ORGANIZED AND OPERATED SOLELY TO PERFORM, ON A CENTRALIZED BASIS, FOR ITS MEMBERS AND ONLY FOR ITS MEMBERS, LABORATORY SERVICES AND NOT OTHERS, EXCEPT THOSE SERVICES REFERRED TO IN TREAS. REG. 1.501(E)-1(B)(4) THAT ARE INCIDENTAL TO THE CONDUCT OF THE CORPORATION'S TAX-EXEMPT FUNCTION AND PURPOSE. ACCORDINGLY, THE UNIVERSITY OF NEW MEXICO HOSPITAL (UNMH), A HOSPITAL OWNED AND OPERATED BY THE UNIVERSITY OF NEW MEXICO, AND PRESBYTERIAN, A TAX-EXEMPT ORGANIZATION UNDER IRC SECTION 501(C)(3), ARE EQUAL VOTING MEMBERS AND PATRON HOSPITALS OF TLSC. FORM 990, PART VI, SECTION A, LINE 7A AS THE ORIGINAL AND ONLY VOTING MEMBERS OF TLSC, PRESBYTERIAN AND UNMH EFFECTIVELY CONTROL TLSC THROUGH THEIR RESPECTIVE RIGHTS TO APPOINT AN EQUAL NUMBER OF DIRECTORS TO THE CORPORATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE OFFICERS ARE SUBJECT TO AN AUTHORITY MATRIX (WRITTEN POLICY), WHICH IS REVIEWED ANNUALLY AND UPDATED IF NECESSARY. CERTAIN ACTIONS OF THE OFFICERS ARE SUBJECT TO BOARD APPROVAL AND ARE PRESENTED AT EACH BOARD MEETING. THE BOARD IS COMPOSED OF 4 INDIVIDUALS FROM EACH OF THE ORIGINAL MEMBERS (UNMH AND PRESBYTERIAN HEALTH SERVICES), SO THEY REPRESENT THE MEMBER HOSPITALS DIRECTLY IN THEIR ACTIONS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 AND SUPPORTING SCHEDULES ARE DELIVERED TO THE FINANCE COMMITTEE, AS APPOINTED BY THE BOARD OF DIRECTORS, IMMEDIATELY PRECEDING FILING, FOR REVIEW AND DISCUSSION. THE FINANCE COMMITTEE THEN FORWARDS A COPY OF THE FORM 990 TO BOARD MEMBERS FOR REVIEW AND DISCUSSION. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST (COI) STATEMENT IS DISTRIBUTED ANNUALLY TO THE OFFICERS, BOARD MEMBERS, AND BOARD SUB-COMMITTEE MEMBERS. THE CEO'S ADMINISTRATIVE ASSISTANT ENSURES THAT THE OFFICERS, BOARD MEMBERS, AND SUB-COMMITTEE MEMBERS RETURN THEIR SIGNED COI TIMELY FOR REVIEW BY THE CHIEF PEOPLE OFFICER (CPO). IF THERE IS A COI STATED, THE CPO ADVISES THE BOARD OF DIRECTORS. THE BOARD THEN DETERMINES ON A CASE-BY-CASE BASIS IF THE MEMBER IS DISALLOWED FROM VOTING ON THE MATTER INVOLVED. COPIES OF THE SIGNED COI'S ARE MAINTAINED IN THE BOARD FILES. FORM 990, PART VI, SECTION B, LINE 15 CEO COMPENSATION DETERMINATIONS AND REVIEWS ARE INDEPENDENTLY PERFORMED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS, THE BOARD OF DIRECTORS, AND THE CHIEF PEOPLE OFFICER. DELIBERATIONS AND DECISIONS ARE BASED UPON THE ADVICE OF AN INDEPENDENT CONSULTANT(S) AS WELL AS EXTERNAL COMPENSATION SURVEYS. THE ORGANIZATION MAINTAINS CONTEMPORANEOUS DOCUMENTATION OF ALL DELIBERATIONS AND DECISIONS. ALL OTHER OFFICER, KEY EMPLOYEE AND MANAGEMENT COMPENSATION DETERMINATIONS ARE PERFORMED IN HOUSE. APPROVAL IS REQUIRED BY THE CEO AND/OR EXECUTIVE MANAGEMENT TEAM AND HUMAN CAPITAL MANAGEMENT (HCM). THE COMPENSATION DETERMINATIONS ARE ANALYZED AGAINST SALARY SOURCES. THESE SALARY SOURCES MAY INCLUDE, BUT ARE NOT LIMITED TO, COMPARABLE DATA FROM OTHER HEALTH-CARE ORGANIZATIONS, DEPARTMENT OF LABOR STUDIES AND SPECIALIZED COMPENSATION SURVEYS. THE PAY PHILOSOPHY OF THE ORGANIZATION IS TO HAVE COMPENSATION THAT IS MARKET-DRIVEN. THE ORGANIZATION MAINTAINS CONTEMPORANEOUS DOCUMENTATION OF ALL COMPENSATION DECISIONS. THIS OCCURS AS PART OF THE REGULAR RECRUITING AND HIRING PROCESSES. THE OVERALL COMPENSATION STRUCTURE WAS LAST REVIEWED IN 2023 AND WILL BE REVIEWED ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE ON THE NEW MEXICO ATTORNEY GENERAL'S WEBSITE. THE CONFLICT OF INTEREST POLICY IS NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G SHARED PERSONNEL - PRESBYTERIAN: PROGRAM SERVICE EXPENSES 3,479,560. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,479,560. SHARED PERSONNEL - UNIVERSITY OF NM HOSPITAL: PROGRAM SERVICE EXPENSES 4,218,214. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,218,214. PATHOLOGY GROUP PROFESSIONAL AND CONSULTING: PROGRAM SERVICE EXPENSES 2,461,855. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,461,855. SHARED PERSONNEL - OTHER: PROGRAM SERVICE EXPENSES 83,074. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 83,074. OTHER CONTRACT LABOR AND PATIENT CARE: PROGRAM SERVICE EXPENSES 5,117,971. MANAGEMENT AND GENERAL EXPENSES 850,185. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,968,156. CONSULTANT FEES: PROGRAM SERVICE EXPENSES 11,988. MANAGEMENT AND GENERAL EXPENSES 297,058. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 309,046. FORM 990, PART XII, LINE 2C: NO CHANGE HAS BEEN MADE TO THE OVERSIGHT OR SELECTION PROCESSES. TRICORE INC 1001 WOODWARD PLACE NE ALBUQUERQUE NM 87102 843909066 MEDICAL REFERENCE & CLINICAL LABORATORIES NM 501(C)(3) LINE 10 0 TRICORE REFERENCE LABORATORIES 1001 WOODWARD PLACE NE ALBUQUERQUE NM 87102 850444170 LABORATORY TESTING NM N/A C 0 0 0 0 1 1 0 0 0 0 0 1 0 0 1 1 1 1 0 0