2022-11-14T19:06:40-06:00 2021-12-31 562382653 NORTHWEST CPA GROUP PLLC 1333 COLUMBIA PARK TRAIL STE 210 RICHLAND WA 99352 990 2021-01-01 910913590 TRI-CITIES CHAPLAINCY TRI- 5097837416 1480 FOWLER STREET RICHLAND WA 99352 LAURIE JACKSON CEO 5097837416 2022-11-14 1 LAURIE JACKSON 999009999 ALISON C GEBERS P00423745 5097351300 2022-11-14 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z CHAPLAINCY HEALTH CARE LAURIE JACKSON 1480 FOWLER STREET RICHLAND WA 99352 22388953 0 X WWW.CHAPLAINCYHEALTHCARE.ORG X 1974 WA WE GUIDE, COMFORT, AND CARE FOR PEOPLE EXPERIENCING SERIOUS ILLNESS, END OF LIFE, AND GRIEF. 11 11 190 74 0 0 2561895 4377393 12044671 10731707 212210 755298 -635628 -795752 14183148 15068646 0 0 0 0 10493140 9486642 0 0 556197 3506749 3837379 13999889 13324021 183259 1744625 12602957 11848152 3047766 902238 9555191 10945914 X CHAPLAINCY HEALTH CARE EXISTS TO SERVE OTHERS WITH EXEMPLARY SPIRITUAL, EMOTIONAL, AND PHYSICAL CARE. 0 0 10206585 10261994 HOSPICE CARE - THE HOSPICE TEAM PROVIDES COMPASSIONATE CARE TO INDIVIDUALS WITH A LIFE-LIMITING ILLNESS THAT FOCUSES ON ADDING COMFORT AND QUALITY TO EACH DAY. THE HOSPICE TEAM IS AN INTERDISCIPLINARY TEAM CONSISTING OF A PHYSICIAN, NURSES, SOCIAL WORKERS, CHAPLAINS, NURSING ASSISTANTS, GRIEF CARE SPECIALISTS AND VOLUNTEERS WHO CARE FOR THE FAMILY AS WELL AS THE PATIENT. PATIENTS RECEIVE EXPERT MEDICAL CARE, AS WELL AS EMOTIONAL AND SPIRITUAL SUPPORT WHEREVER THEY CALL HOME. OUR 10-BED HOSPICE HOUSE IS AVAILABLE FOR GENERAL IN-PATIENT CARE WHEN PAIN AND SYMPTOMS CANNOT BE MANAGED IN THE HOME SETTING. 439639 368140 CHAPLAIN SERVICES - PROFESSIONAL CHAPLAINS CONNECT BODY, MIND AND SPIRIT, ESPECIALLY WHEN UNDER STRESS. OUR TEAM OF PROFESSIONAL CHAPLAINS PROVIDE SPIRITUAL CARE SERVICES TO HOSPITALS, CORRECTIONAL INSTITUTIONS, HOSPICE, AND THE COMMUNITY AT LARGE. CHAPLAINS OFFER EMOTIONAL AND SPIRITUAL SUPPORT THOUGH DISTRESSING TIMES TO GUIDE PEOPLE TOWARD PEACE, UNDERSTANDING, RECOVERY, AND DIGNIFIED DYING. OUR CHAPLAINS REPRESENT A WIDE RANGE OF DENOMINATIONS AND CARE FOR THOSE IN CRISIS REGARDLESS OF THEIR RELIGIOUS AFFILIATION (OR LACK THEREOF). THEY PRIORITIZE AND PROMOTE THE SPRITUAL AND EXISTENTIAL RESOURCES OF THE INDIVIDUAL. 96392 79695 BEHAVIORAL HEALTH - ASSISTS INDIVIDUALS AND FAMILIES TO WORK THROUGH LIFE'S CHALLENGES BY PROVIDING HELP MANAGING CHANGE AND NAVIGATING UNCERTAINTY. LICENSED THERAPISTS OFFER EVIDENCE-BASED TREATMENTS AND EMPHASIZE IMPROVING THE TWO THINGS THAT MATTER MOST - QUALITY OF LIFE AND RELATIONSHIPS. COUNSELING IS FOR INDIVIDUALS, COUPLES, CHILDREN AND FAMILIES AND IS CULTURALLY SENSITIVE AND BI-LINGUAL. 600967 21878 CORK'S PLACE - PROVIDES A SAFE AND NURTURING PLACE WHERE HURTING CHILDREN, TEENS AND FAMILIES CAN SHARE EXPERIENCES AND SUPPORT ONE ANOTHER THROUGH THE DIFFICULT PROCESS OF EMOTIONAL HEALING. IT IS STAFFED BY PROFESSIONAL GRIEF COUNSELORS AND TRAINED VOLUNTEERS AND IS THE ONLY FACILITY IN OUR AREA THAT IS SPECIFICALLY DESIGNED FOR CHILDREN AND TEENAGERS WHO ARE GRIEVING THE DEATH OF A LOVED ONE. OTHER PROGRAMS INCLUDE BEREAVEMENT GROUPS AND COMMUNITY OUTREACH. 600967 21878 11343583 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 39 0 1 190 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X LAURIE JACKSON 5097837416 1480 FOWLER STREET RICHLAND WA 99352 JOHN SERLE CHAIR 6.00 X X 0 0 0 NAVDEEP GIL BOARD MEMBER 2.00 X 0 0 0 SYNDEE SAUCEDA-CAVAZOS BOARD MEMBER 2.00 X 0 0 0 GEORGE CICOTTE BOARD MEMBER 2.00 X 0 0 0 RON KATHREN BOARD MEMBER 2.00 X 0 0 0 SHELLEY MATTA BOARD MEMBER 2.00 X 0 0 0 ROGER GILCHRIST VICE CHAIR /CEO (INTERIM) 40.00 X X 18813 0 0 QUINN SMITH BOARD MEMBER 2.00 X 0 0 0 FARION WILLIAMS BOARD MEMBER 2.00 X 0 0 0 BRUCE COVERT BOARD MEMBER 2.00 X 0 0 0 BARBARA MEAD BOARD MEMBER 2.00 X 0 0 0 JAMES MAIN CHIEF FINANCIAL OFFICER/TR 40.00 X 161064 0 21929 ZOE DIAZ SECRETARY 40.00 X 54246 0 10719 GARY CASTILLO EXECUTIVE DIRECTOR (FORMER) 40.00 X 148002 0 6203 THOMAS CORLEY CHIEF EXECUTIVE OFFICER (INTERIM) 40.00 X 64500 0 0 ROBERT ROSSELLI CHIEF EXECUTIVE OFFICER (INTERIM) 40.00 X 18569 0 0 WAYNE KOHAN MEDICAL DIRECTOR (FORMER) 40.00 X 224339 0 26973 JILL ADCOCK DIRECTOR OF HOSPICE (FORMER) 40.00 X 129057 0 19163 SHANNON NOVAKOVICH DIRECTOR OF HUMAN RESOURCE 40.00 X 139995 0 13381 YVONNE MICHEL RN 40.00 X 122553 0 12924 ROBIN KUEMPER RN 40.00 X 124694 0 19201 1205832 0 130493 12 0 1 0 MACDONALD-MILLER FACILITY SOLUTIONS LLC DEPT C700 PO BOX 509017 SAN DIEGO CA 921509017 HVAC CONTRACTOR 426625 ALSC ARCHITECTS PS 203 N WASHINGTON ST SUITE 400 SPOKANE WA 992010224 ARCHITECTURAL FEES 194982 MEDEFIS INC PO BOX 5065 NEW YORK NY 10087 CONTRACTED RN STAFFING 187432 WELLSKY FINANCIAL SERVICES LLC PO BOX 207613 DALLAS TX 753207613 MEDICAL BILLING SERVICES 145533 VISION MUNICIPAL SOLUTIONS INC PO BOX 2849 SPOKANE WA 99228 IT AND HELP DESK SUPPORT 129492 6 8029 186245 1982528 2200591 608877 4377393 HOSPICE CARE 621610 10261994 10261994 CHAPLAIN SERVICES 812900 368140 368140 BEHAVIOR HEALTH 621300 79695 79695 OTHER PROGRAMS 812900 21878 21878 10731707 37282 37282 6632408 5914392 718016 718016 718016 0 186245 20049 -20049 -20049 610163 1385866 -775703 -775703 15068646 10731707 0 -40454 309066 309066 7473128 6654060 497657 321411 282645 246163 25744 10738 700640 583595 75549 41496 721163 628024 66115 27024 20791 13201 6450 1140 37057 37057 28460 28460 872312 675363 159184 37765 229525 131050 91739 6736 195848 171236 9651 14961 206344 169047 29975 7322 266818 228934 22900 14984 172630 169640 1579 1411 31731 21773 5507 4451 210087 179710 20416 9961 103120 78550 20593 3977 SUPPLIES 1190626 1184823 3619 2184 BAD DEBTS 174822 156938 2884 15000 MISCELLANEOUS 65078 27757 7493 29828 DUES AND LICENSES 32130 23719 2603 5808 13324021 11343583 1424241 556197 872869 723426 1818983 1637662 36528 13750 1736835 1029847 143830 155921 159156 92830 7425667 3146747 4429201 4278920 2952553 2714362 453002 1201434 12602957 11848152 1022848 902238 219533 0 1805385 0 3047766 902238 X 7541568 9086824 2013623 1859090 9555191 10945914 12602957 11848152 1744625 -353901 0 X 0 1 X 1 0 X 772338 1077823 1581877 2561895 4377393 10371326 772338 1077823 1581877 2561895 4377393 10371326 10371326 91495 81991 81908 64923 37282 357599 10728925 56993381 0.96670 0.94710 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2244633 339594 269005 890865 19566 1942801 2460207 108434 195708 500414 19302 2244633 2587379 213301 315978 629000 27451 2460207 2548015 509062 -142171 299000 28527 2587379 2024970 310766 256700 18000 26421 2548015 0.21620 0.53840 0.24540 0 0 1047831 1047831 5047823 2248100 2799723 25524 12450 13074 1304489 886197 418292 4278920 CONSTRUCTION IN PROGRESS 1201434 1201434 X 16092200 -353901 -353901 16446101 28460 -1405915 -1377455 15068646 14701477 0 14701477 28460 -1405915 -1377455 13324022 PART X, LINE 2: UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, THE CHAPLAINCY IS EXEMPT FROM FEDERAL INCOME TAXES, EXCEPT FOR NET INCOME FROM UNRELATED BUSINESS ACTIVITIES. FOR THE YEAR ENDED DECEMBER 31, 2021, THE CHAPLAINCY HAD NO UNRELATED BUSINESS ACTIVITIES SUBJECT TO FEDERAL INCOME TAX. MANAGEMENT HAS EVALUATED THE CHAPLAINCY'S TAX POSITIONS AND CONCLUDED THAT THE CHAPLAINCY HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES -20,049. COST OF GOODS SOLD -1,385,866. PART XII, LINE 4B - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES -20,049. COST OF GOODS SOLD -1,385,866. LIGHTING THE PATH BREAKFAST 127922 127922 11588 HEART OF HEALING 58323 58323 8461 186245 186245 20049 20049 -20049 X X X 0 0 0 0 0 0 0 0 0 WAYNE KOHAN MEDICAL DIRECTOR (FORMER) 224339 0 0 0 0 0 8919 0 18054 0 251312 0 0 0 JAMES MAIN CHIEF FINANCIAL OFFICER/TR 161064 0 0 0 0 0 6618 0 15311 0 182993 0 0 0 GARY CASTILLO EXECUTIVE DIRECTOR (FORMER) 148002 0 0 0 0 0 2906 0 3297 0 154205 0 0 0 SHANNON NOVAKOVICH DIRECTOR OF HUMAN RESOURCE 139995 0 0 0 0 0 5610 0 7771 0 153376 0 0 0 PART I, LINE 3 COMPENSATION OF THE EXECUTIVE DIRECTOR IS DETERMINED USING COMPARABLE INFORMATION FROM SIMILAR POSITIONS WITHIN THE COMMUNITY. THE BOARD OF DIRECTORS APPROVES THE COMPENSATION, WHICH IS DOCUMENTED THROUGH WRITTEN EMPLOYMENT CONTRACT. X 608877 RESALE VALUE 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE TRI-CITIES CHAPLAINCY HAS ONE CLASS OF MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A THE TRI-CITIES CHAPLAINCY HAS ONE CLASS OF MEMBERSHIP. THE MEMBERS ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE TRI-CITIES CHAPLAINCY HAS ONE CLASS OF MEMBERSHIP. THE MEMBERS ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY SENIOR MANAGEMENT BEFORE FILING WITH THE INTERNAL REVENUE SERVICE. THE FORM 990 IS ALSO PROVIDED TO THE BOARD OF DIRECTORS' FINANCE COMMITTEE AND THE BOARD OF DIRECTORS FOR INFORMATIONAL REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE TRI-CITIES CHAPLAINCY PROVIDES EDUCATION AND WRITTEN COMPLIANCE PROCEDURES TO DIRECTORS AND STAFF. A SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENT IS OBTAINED ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 ALL LISTED ELEMENTS UNDER LINE 15 ARE PERFORMED ON AN ANNUAL BASIS TO DETERMINE COMPENSATION FOR THE EXECUTIVE DIRECTOR. BOARD OF DIRECTORS APPROVAL IS REQUIRED PRIOR TO ANY CHANGE IN COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. THERE ARE NO OTHER GOVERNING DOCUMENTS AVAILABLE FOR DISTRIBUTION TO THE GENERAL PUBLIC. IRS FORMS 990 AND 1023 ARE AVAILABLE UPON REQUEST.