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TRICORE LABORATORY SERVICES CORPORATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
TRICORE LABORATORY SERVICES CORPORATION (EIN 20-1358178)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-08-01
IRS object ID
201302139349300810
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2013-08-01T14:08:34-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN910189318EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line16100 UPTOWN BLVD NE STE 400AddressLine1
CityALBUQUERQUECity
StateNMState
ZIP Code87110ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN201358178EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1TRICORE LABORATORY SERVICES CORPBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlTRICNameControl
Phone5059388888Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 WOODWARD PLACE NEAddressLine1
CityALBUQUERQUECity
StateNMState
ZIP Code87102ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL J CROSSEY MDName
TitleINTERIM CEOTitle
Phone5059388888Phone
Date Signed2013-07-31DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameANTHONY W ROYLEName
PTINP00627895PTIN
Phone5058787200Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMICHAEL J CROSSEY MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11001 WOODWARD PLACE NEAddressLine1
CityALBUQUERQUECity
StateNMState
ZIP Code87102ZIPCode
FieldValueIRS element (for citing)
Gross Receipts74386402GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.TRICORE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2004YearFormation
State Legal DomicileNMStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION WAS ORGANIZED AND IS OPERATED AS A COOPERATIVE HOSPITAL SERVICE ORGANIZATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers8TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year7542ContributionsGrantsPriorYear
Contributions Grants Current Year10225ContributionsGrantsCurrentYear
Program Service Revenue Prior Year71927365ProgramServiceRevenuePriorYear
Program Service Revenue CY74376177ProgramServiceRevenueCY
Investment Income Prior Year-80842InvestmentIncomePriorYear
Investment Income Current Year-92158InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year71854065TotalRevenuePriorYear
Total Revenue Current Year74294244TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year36869322SalariesEtcPriorYear
Salaries Etc Current Year38663404SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year33447539OtherExpensePriorYear
Other Expenses Current Year35630840OtherExpensesCurrentYear
Total Expenses Prior Year70316861TotalExpensesPriorYear
Total Expenses Current Year74294244TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1537204RevenuesLessExpensesPriorYear
Revenues Less Expenses CY0RevenuesLessExpensesCY
Total Assets BOY15023000TotalAssetsBOY
Total Assets EOY15047175TotalAssetsEOY
Total Liabilities BOY1277604TotalLiabilitiesBOY
Total Liabilities EOY1301779TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY13745396NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY13745396NetAssetsOrFundBalancesEOY
Mission DescriptionTHE 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense61359268Expense
Revenue74376177Revenue
DescriptionTHE 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.Description
Total Program Service Expense61359268TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNMStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RENEE ENNISBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5059388914TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11001 WOODWARD PL NEAddressLine1
CityALBUQUERQUECity
StateNMState
ZIP Code87102ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
ROBERT GARCIA
DIRECTOR1.001.00X000
PAUL BRIGGS
BOARD CHAIR/STRATEGIC COMMITTEE CHAIR1.001.00X000
ROBIN DIVINE
BOARD VICE CHAIR1.001.00X000
ERIN DOLES
QUALITY COMMITTEE CHAIR1.001.00X000
ANDREW HORVATH MD
COMPLIANCE & INTERNAL AUDIT CHAIR1.001.00X000
RICHARD LARSON MD PHD
DIRECTOR1.001.00X000
STEVE MCKERNAN
FINANCE COMMITTEE CHAIR1.001.00X000
THOMAS WILLIAMS MD
DIRECTOR1.001.00X000
CATHY-ANNE PETTI
CHIEF MEDICAL OFFICER19.0021.0003957783167X
JESSIE L SALK
CEO19.0021.00037603216199X
DOROTHY R ENNIS
CFO19.0021.00026301619102X
DAVID H JENKINS
CIO19.0021.0001273704872X
CHERRI L COLLINS
SR DIRECTOR OF HUMAN RESOURCES19.0021.00016183714938X
NORMAN A STITELER
SR. DIR LEGAL, COMP, RISK19.0021.0001558318352X
MARIT J PETERS
SR DIRECTOR OF ENTERPRISE STRATEGY19.0021.0001394106896X
ERIC K CARBONNEAU
DIRECTOR OF TECHNICAL OPERATIONS19.0021.00012996114568X
MARCIA WOOLLEY
DIRECTOR OF HOSPITAL SYSTEMS (UH/PH)19.0021.0001274539576X
MICHAEL H KNELLINGER
FORMER CIO0.000.0001683261567X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2045014TotalReportableCompFrmRltdOrgs
Total Other Compensation99237TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
UNM MEDICAL GROUP INC
PO BOX 27200ALBUQUERQUENM87125PATHOLOGY CONSULT1520949
PATHOLOGY ASSOCIATES OF ALBUQUERQUE
1100 CENTRAL AVE SEALBUQUERQUENM87106PATHOLOGY CONSULT1246290
MEDTREK
2709 VASSAR PLACE NE SUTE CALBUQUERQUENM87107FREIGHT SERVICE218787
AUREUS RADIOLOGY LLC
13609 CALIFORNIA ST STE 200OMAHANE68154CONTRACT LABOR157806
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Related Organizations10225RelatedOrganizations
Noncash Contributions10225NoncashContributions
Total Contributions10225TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionSALES, NET OF DISCOUNTDescription
Business Code621500BusinessCode
Total Revenue Column74376177TotalRevenueColumn
Related Or Exempt Function Income74376177RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue74376177TotalProgramServiceRevenue

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other92158Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-92158Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-92158TotalRevenueColumn
Exclusion-$92,158ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column74294244TotalRevenueColumn
Related Or Exempt Function Income74376177RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$92,158ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total578657Total
Management And General578657ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total28856763Total
Program Services23318207ProgramServices
Management And General5538556ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total854951Total
Program Services674357ProgramServices
Management And General180594ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5496214Total
Program Services4280269ProgramServices
Management And General1215945ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2876819Total
Program Services2307519ProgramServices
Management And General569300ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total74182Total
Program Services1663ProgramServices
Management And General72519ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total191296Total
Management And General191296ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total8874709Total
Program Services7979832ProgramServices
Management And General894877ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1234Total
Program Services870ProgramServices
Management And General364ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1086777Total
Program Services429464ProgramServices
Management And General657313ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1799952Total
Program Services1455308ProgramServices
Management And General344644ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1013788Total
Program Services333117ProgramServices
Management And General680671ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total257623Total
Program Services76197ProgramServices
Management And General181426ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total451802Total
Management And General451802ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2920514Total
Program Services1927293ProgramServices
Management And General993221ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total141568Total
Management And General141568ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES1629619716296197
EQUIPMENT EXPENSES2097443204234555098
FEES24164721848523162
MISCELLANEOUS OPERATING13487610643124233

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total47232Total
Program Services7502ProgramServices
Management And General39730ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total74294244Total
Program Services61359268ProgramServices
Management And General12934976ManagementAndGeneral
Fundraising0Fundraising

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY9003739BOY
EOY4546939EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1050558BOY
EOY1305398EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis13687408LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8947313LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4968703BOY
EOY4740095EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY4454743EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY15023000BOY
EOY15047175EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1160606BOY
EOY1301779EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY116998BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1277604BOY
EOY1301779EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY13745396BOY
EOY13745396EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13745396BOY
EOY13745396EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY15023000BOY
EOY15047175EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses0ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis18960OtherCostOrOtherBasis
Depreciation5899Depreciation
Book Value13061BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1395809OtherCostOrOtherBasis
Depreciation296048Depreciation
Book Value1099761BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis11259601OtherCostOrOtherBasis
Depreciation8241316Depreciation
Book Value3018285BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1013038OtherCostOrOtherBasis
Depreciation404050Depreciation
Book Value608988BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4740095TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionDUE FROM MEMBERSDescription
Book Value4454743BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets4454743TotalBookValueOtherAssets
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt74294244TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal74294244RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99074294244TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt74294244TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal74294244ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99074294244TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationTHE CORPORATION IS A TAX-EXEMPT, COOPERATIVE HOSPITAL SERVICE ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. ACCORDINGLY, NO PROVISION FOR FEDERAL OR STATE INCOME TAX HAS BEEN MADE. AS OF DECEMBER 31, 2012, THE INTERNAL REVENUE SERVICE HAS NOT PROPOSED ANY ADJUSTMENTS THAT WOULD RESULT IN A MATERIAL CHANGE TO THE CORPORATION'S FINANCIAL POSITION. THE CORPORATION IS NO LONGER SUBJECT TO U.S. FEDERAL OR STATE INCOME TAX EXAMINATION BY TAX AUTHORITIES FOR THE YEARS 2008 AND PRIOR. THE CORPORATION WOULD RECOGNIZE ACCRUED INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. THERE WAS NO SUCH INTEREST OR PENALTIES RECORDED FOR THE YEARS ENDED DECEMBER 31, 2012 AND 2011.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org1CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs1CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CATHY-ANNE PETTI
CHIEF MEDICAL OFFICER0348528047250000003167039894500
JESSIE L SALK
CEO0301032075000000957706622039223100
DOROTHY R ENNIS
CFO02285890344270001048908613028211800
CHERRI L COLLINS
SR DIRECTOR OF HUMAN RESOURCES0129784032053000632508613017677500
NORMAN A STITELER
SR. DIR LEGAL, COMP, RISK015583100000008352016418300
MICHAEL H KNELLINGER
FORMER CIO01683260000012990268016989300

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 4ASEVERANCE PAYMENTS WERE MADE TO THE FOLLOWING PERSONS: CATHY-ANNE PETTI: $232,718; MICHAEL KNELLINGER: $169,893
PART I, LINE 5A PORTION OF THE BONUS PAID TO OFFICERS AND HIGHEST COMPENSATED EMPLOYEES IS BASED UPON ACHIEVEMENT OF REVENUE GOALS.
PART I, LINE 6A PORTION OF THE BONUS PAID TO OFFICERS AND HIGHEST COMPENSATED EMPLOYEES IS CONTINGENT ON NET EARNINGS GOALS OF THE RELATED ORGANIZATION.

Schedule L IRS990ScheduleL

Loan Table LoanTable

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1TRICORE REFERENCE LABORATORIESBusinessNameLine1
FieldValueIRS element (for citing)
Relationship With OrganizationTRICORE REFERENCE LABORATORIES IS OWNED BY THE SAME PATRON HOSPITALS.RelationshipWithOrganization
Purpose Of LoanOPERATIONSPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$9,003,739OriginalPrincipalAmount
Balance Due4546939BalanceDue
Default0Default
Approved By Board1ApprovedByBoard
Written Agreement1WrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due4546939TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1PATHOLOGY ASSOCIATES OF ALBUQUERQUEBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipANDREW HORVATH, DIRECTOR, IS A BOARD MEMBER OF BOTH ORGANIZATIONSRelationship
Amount Of Transaction1246290AmountOfTransaction
Description Of TransactionINDEPENDENT CONTRACTOR ARRANGEMENTDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART V, LINE 2AOFFICERS 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.
ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER THROUGH THEIR INVOLVEMENT WITH TRICORE REFERENCE LABORATORIES, A RELATED ORGANIZATION.FORM 990, PART VI, SECTION A, LINE 2
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, WHO MAY ACCEPT SUCH SERVICES. ACCORDINGLY, THE ORGANIZATION, AS PRINCIPAL, PAYS TRL, AS AGENT, SPECIFIC AND ALLOCATED EXPENSES.FORM 990, PART VI, SECTION A, LINE 3
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 NO OTHERS, EXCEPT THOSE SERVICES REFERRED TO IN TREAS. REG. 1.501(E)-1(B)(4) THAT ARE INCIDENTAL TO THE CONDUCT OF THE CORPORATIONS 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 6
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 CORPORATIONS BOARD OF DIRECTORS.FORM 990, PART VI, SECTION A, LINE 7A
THE OFFICERS ARE SUBJECT TO AN AUTHORITY MATRIX (WRITTEN POLICY) WHICH IS UPDATED ANNUALLY. 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 MEMBER (UNMH AND PRESBYTERIAN HEALTH SERVICES), SO THEY REPRESENT THE MEMBER HOSPITALS DIRECTLY IN THEIR ACTIONS.FORM 990, PART VI, SECTION A, LINE 7B
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 11
THE CONFLICT OF INTEREST (COI) STATEMENT IS DISTRIBUTED AT THE ANNUAL MEETING OF THE BOARD TO THE OFFICERS, BOARD MEMBERS, AND SUB-COMMITTEE BOARD MEMBERS. THE CEO'S ADMINISTRATIVE ASSISTANT FOLLOWS UP WITH ALL THE OFFICERS, BOARD MEMBERS, AND SUB-COMMITTEE BOARD MEMBERS TO MAKE SURE THAT THE COI IS RECEIVED BACK WITHIN 4 WEEKS. A SIGNED COPY OF ALL COI'S ARE SENT TO THE BOARD MEMBERS AND OFFICERS FOR REFERENCE. IF THERE IS A COI STATED, THE BOARD MAKES THE DECISION ON A CASE-BY-CASE BASIS IF THE MEMBER IS DISALLOWED FROM VOTING ON THE MATTER INVOLVED.FORM 990, PART VI, SECTION B, LINE 12C
CEO COMPENSATION DETERMINATIONS AND REVIEWS ARE INDEPENDENTLY PERFORMED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. APPROVAL IS REQUIRED BY THE COMPENSATION COMMITTEE AND BOARD OF DIRECTORS. DELIBERATIONS AND DECISIONS ARE BASED ON THE ADVICE OF AN INDEPENDENT CONSULTANT AS WELL AS 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 RESOURCES. THE COMPENSATION DETERMINATIONS ARE ANALYZED AGAINST SALARY SOURCES. THESE SALARY SOURCES MAY INCLUDE, BUT ARE NOT LIMITED TO COMPARABILITY DATA FROM OTHER HEALTHCARE ORGANIZATIONS, DEPARTMENT OF LABOR STUDIES AND SPECIALIZED COMPENSATION SURVEYS. THE PHILOSOPHY OF THE ORGANIZATION IS TO HAVE COMPENSATION WHICH IS MARKET DRIVEN. THE ORGANIZATION MAINTAINS CONTEMPORANEOUS DOCUMENTATION OF ALL COMPENSATION DECISIONS. THIS OCCURS AS PART OF THE REGULAR RECRUITING AND HIRING PROCESS. THIS PROCESS WAS LAST UNDERTAKEN FOR ALL CURRENT EMPLOYEES IN DECEMBER 2010 AND IS SCHEDULED TO TAKE PLACE AGAIN IN 2013.FORM 990, PART VI, SECTION B, LINE 15
THE FORM 990 AND FORM 1023 ARE AVAILABLE TO THE PUBLIC UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 18
NO DOCUMENTS AVAILABLE TO PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
OTHER FEESSHARED PERSONNEL - PRESBYTERIAN: PROGRAM SERVICE EXPENSES 1,503,008. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,503,008. SHARED PERSONNEL - UNIVERSITY OF NM HOSPITAL: PROGRAM SERVICE EXPENSES 2,324,739. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,324,739. PATHOLOGY GROUP PROFESSIONAL AND CONSULTING : PROGRAM SERVICE EXPENSES 3,636,294. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,636,294. CONSULTING: PROGRAM SERVICE EXPENSES 65,687. MANAGEMENT AND GENERAL EXPENSES 258,077. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 323,764. OTHER CONTRACT LABOR: PROGRAM SERVICE EXPENSES 450,104. MANAGEMENT AND GENERAL EXPENSES 636,800. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,086,904.FORM 990, PART IX, LINE 11G

Schedule R IRS990ScheduleR

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1TRICORE REFERENCE LABORATORIESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11001 WOODWARD PLACE NEAddressLine1
CityALBUQUERQUECity
StateNMState
ZIP Code87102ZIPCode
FieldValueIRS element (for citing)
EIN850444170EIN
Primary ActivityLABORATORY TESTINGPrimaryActivity
Legal Domicile StateNMLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg