TRI CITIES COMMUNITY HEALTH: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- TRI CITIES COMMUNITY HEALTH (EIN 91-1138675)
- Tax period
- 2009-06-01 to 2010-05-31
- Filed
- 2011-01-14
- IRS object ID
- 201130149349301118
- Schema version
- 2009v1.7
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-01-14T15:50:49-06:00 | Timestamp |
| Tax Period End Date | 2010-05-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DINGUS ZARECOR & ASSOCIATES | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12015 E MAIN STE A | AddressLine1 |
| City | SPOKANE VALLEY | City |
| State | WA | State |
| ZIP Code | 99206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-06-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911138675 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LA CLINICA-SOUTH COLUMBIA RURAL | BusinessNameLine1 |
| Business Name Line2 | HEALTH CLINIC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LACL | NameControl |
| Phone | 5055472204 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 WEST COURT ST PO BOX 1452 | AddressLine1 |
| City | PASCO | City |
| State | WA | State |
| ZIP Code | 99301 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CARL I WALTERS II | Name |
| Title | CHIEF EXECUTIVE OFFICER | Title |
| Phone | 5055472204 | Phone |
| Date Signed | 2011-01-12 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TOM DINGUS | Name |
| Phone | 5092420874 | Phone |
| Date Prepared | 2011-01-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTER LA CLINICA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CARL I WALTERS II | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 WEST COURT ST | AddressLine1 |
| City | PASCO | City |
| State | WA | State |
| ZIP Code | 99301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 19344879 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.TCC-HEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1981 | YearFormation |
| State Legal Domicile | WA | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HIGH QUALITY, EFFECTIVE, AND AFFORDABLE HEALTH CARE AND OTHER ASSOCIATED SERVICES IN A COMPASSIONATE AND CULTURALLY SENSITIVE MANNER TO ALL PEOPLE WITHOUT PREJUDICE TO RACE, COLOR, CREED, GENDER OR ECONOMIC STATUS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 240 | TotalNbrEmployees |
| Total Nbr Volunteers | 25 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 4088481 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 7854066 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 13947870 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 10759171 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 66565 | InvestmentIncomePriorYear |
| Investment Income Current Year | 468446 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 37293 | OtherRevenuePriorYear |
| Other Revenue Current Year | 140723 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 18140209 | TotalRevenuePriorYear |
| Total Revenue Current Year | 19222406 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13223045 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12033420 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3995121 | OtherExpensePriorYear |
| Other Expenses Current Year | 4497653 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 17218166 | TotalExpensesPriorYear |
| Total Expenses Current Year | 16531073 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 922043 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2691333 | RevenuesLessExpensesCY |
| Total Assets BOY | 8734693 | TotalAssetsBOY |
| Total Assets EOY | 11999543 | TotalAssetsEOY |
| Total Liabilities BOY | 3160942 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4069525 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 5573751 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7930018 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE HIGH QUALITY, EFFECTIVE, AND AFFORDABLE HEALTH CARE AND OTHER ASSOCIATED SERVICES IN A COMPASSIONATE AND CULTURALLY SENSITIVE MANNER TO ALL PEOPLE WITHOUT PREJUDICE TO RACE, COLOR, CREED, GENDER OR ECONOMIC STATUS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 9228360 | Expense |
| Revenue | 9884927 | Revenue |
| Description | THE CLINIC PROVIDES MEDICAL, DENTAL, AND URGENT CARE TO MIGRANT AND LOW INCOME PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 1,216,699 FOR CHARITY CARE, 457,107 FOR MEDICARE, 1,528,296 FOR MEDICAID, AND 3,232,650 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR. THE CLINIC PROVIDED 49,805 MEDICAL, 13,469 DENTAL, AND 14,023 URGENT CARE ENCOUNTERS FOR THE YEAR. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2306065 | Expense |
| Revenue | 127662 | Revenue |
| Description | THE CLINIC PROVIDES MENTAL AND SUBSTANCE ABUSE COUNSELING, THERAPY AND PSYCHIATRIC SERVICES TO MIGRANT AND LOW INCOME PERSONS THROUGOUT THE BENTON AND FRANKLIN COUNTIES. THE PROGRAM SERVES APPROXIMATE 215 CHILDREN, 235 ADOLESCENTS, AND 1,103 ADULTS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1178877 | Expense |
| Revenue | 746582 | Revenue |
| Description | THE CLINIC PROVIDES NUTRITIONAL AND EARLY DEVELOPMENT SERVICES TO OVER 4,000 MIGRANT AND LOW INCOME INDIVIDUALS. OUR SOCIAL SERVICES DEPARTMENT ASSISTS FAMILIES THROUGH COMMUNITY EDUCATION, WIC NUTRITIONAL PROGRAMS AND MANAGED CARE. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | THE CLINIC PARTICIPATED IN A PROGRAM TO PROVIDE FINANCING FOR LAND ACQUISITION AND MORTGAGE SUBSIDIES FOR VERY LOW-INCOME FAMILIES IN BENTON, FRANKLIN, AND WALLA WALLA COUNTIES OF WASHINGTON STATE. THE CLINIC HAS CHOSEN NOT TO CONTINUE THE HOUSING PROGRAM. NO NEW SUBSIDIES OR LOT PURCHASES ARE BEING MADE. ACTIVITY IS LIMITED TO THE SALE OF EXISTING LOTS AND REPAYMENT OF SUBSIDIES, WHICH WILL BE USED TO REPAY THE ACCRUED HOUSING COSTS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 12713302 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 39 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 240 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | true | Form1098CFiled |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | CARL I WALTERS II | NamePerson |
| Telephone Number | 5095472204 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1452 | AddressLine1 |
| City | PASCO | City |
| State | WA | State |
| ZIP Code | 99301 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| LINDA GUSTAFSON | |||||||
| PRESIDENT | 1.00 | X | 0 | 0 | 0 | ||
| RAMPUR VISWANATH | |||||||
| VICE PRESIDE | 1.00 | X | 0 | 0 | 0 | ||
| AVIGAIL SANCHEZ | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | ||
| BEVERLY HERRIN | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | ||
| JOSE A ROJAS | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| RON WEED | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DOROTEO CHAVEZ | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JOHN INTRAVARTOLO | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| LILLIAN PARRA | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| RUDY MENDOZA | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| SERGIO FLORES | |||||||
| CMO | 40.00 | 270489 | 0 | 16492 | X | ||
| CARL I WALTERS II | |||||||
| CEO | 40.00 | 189531 | 0 | 13171 | X | ||
| DIANN KUMMER | |||||||
| COO | 40.00 | 116715 | 0 | 399 | X | ||
| ROBERT WILKINSON | |||||||
| INTERIM CFO | 40.00 | 48038 | 0 | 8236 | X | ||
| AMY LEMMONS | |||||||
| INTERIM CFO | 40.00 | 34383 | 0 | 5990 | X | ||
| MICHEL DEWITT | |||||||
| CFO | 40.00 | 0 | 0 | 0 | X | ||
| LEONEL ZOLESSI | |||||||
| PHYSICIAN | 40.00 | 290493 | 0 | 12080 | X | ||
| ZIBA IRAEE | |||||||
| PHYSICIAN | 40.00 | 222335 | 0 | 16317 | X | ||
| RICHARD WILLIAMS | |||||||
| PHYSICIAN | 40.00 | 191600 | 0 | 6833 | X | ||
| LAURIE ZIMMERMAN | |||||||
| PHYSICIAN | 40.00 | 188131 | 0 | 17322 | X | ||
| JAVIER HUERTA | |||||||
| PHYSICIAN AS | 40.00 | 148560 | 0 | 17322 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1700275 | TotalReportableCompFromOrg |
| Total Other Compensation | 114162 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MEIER ENTERPRISES INC | |||||
| 8697 W GAGE BLVD | KENNEWICK | WA | 99336 | ARCHITECT | 273104 |
| COMMUNITY LINK CONSULTING INC | |||||
| 25011 E TRENT AVE C | NEWMAN LAKE | WA | 99025 | FINANCIAL | 257777 |
| PERKINS COIE | |||||
| 1201 3RD AVE SUITE 4800 | SEATTLE | WA | 98101 | LEGAL COUNSEL | 116249 |
| STAFF CARE INC | |||||
| 4021 SOUTH 700 EAST STE 220 | SALT LAKE CITY | UT | 84107 | PHYSICIAN SRVS | 112868 |
| SILVER BOW ROOFING INC | |||||
| 3718 W 15TH AVE | KENNEWICK | WA | 99338 | CONSTRUCTION | 101814 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Government Grants | 4111341 | GovernmentGrants |
| All Other Contributions | 3742725 | AllOtherContributions |
| Noncash Contributions | 387464 | NoncashContributions |
| Total Contributions | 7854066 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENUE, NET | 624100 | 7031129 | 7031129 |
| CAPITATION REVENUE | 624100 | 3728042 | 3728042 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 10759171 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 38255 | TotalRevenueColumn |
| Exclusion | $38,255 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 474918 | Securities |
| Other | 77746 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 122473 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 474918 | Securities |
| Other | -44727 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 430191 | TotalRevenueColumn |
| Exclusion | $430,191 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| OTHER | 900099 | 87962 | $87,962 |
| MEDICAL RECORDS | 900099 | 52761 | $52,761 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 140723 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19222406 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10759171 | RelatedOrExemptFunctionIncome |
| Exclusion | $609,169 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 712775 | Total |
| Program Services | 63984 | ProgramServices |
| Management And General | 648791 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8884519 | Total |
| Program Services | 7804851 | ProgramServices |
| Management And General | 1079668 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91487 | Total |
| Program Services | 64448 | ProgramServices |
| Management And General | 27039 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1344411 | Total |
| Program Services | 1080479 | ProgramServices |
| Management And General | 263932 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1000228 | Total |
| Program Services | 791838 | ProgramServices |
| Management And General | 208390 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 453064 | Total |
| Program Services | 3408 | ProgramServices |
| Management And General | 449656 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89656 | Total |
| Management And General | 89656 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 887275 | Total |
| Program Services | 700159 | ProgramServices |
| Management And General | 187116 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 116398 | Total |
| Program Services | 17787 | ProgramServices |
| Management And General | 98611 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1354832 | Total |
| Program Services | 1141164 | ProgramServices |
| Management And General | 213668 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85472 | Total |
| Program Services | 28696 | ProgramServices |
| Management And General | 56776 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 494106 | Total |
| Program Services | 317593 | ProgramServices |
| Management And General | 176513 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78714 | Total |
| Program Services | 32618 | ProgramServices |
| Management And General | 46096 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34058 | Total |
| Program Services | 26662 | ProgramServices |
| Management And General | 7396 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8948 | Total |
| Management And General | 8948 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 234963 | Total |
| Program Services | 123733 | ProgramServices |
| Management And General | 111230 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72509 | Total |
| Program Services | 45134 | ProgramServices |
| Management And General | 27375 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| OTHER EXPENSE | 287668 | 224848 | 62820 |
| BAD DEBT | 179510 | 179510 | |
| DUES AND SUBSCRIPTIONS | 65798 | 13370 | 52428 |
| LICENSES AND TAXES | 54682 | 53020 | 1662 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16531073 | Total |
| Program Services | 12713302 | ProgramServices |
| Management And General | 3817771 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32660 | BOY |
| EOY | 12929 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2500632 | BOY |
| EOY | 4327140 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 385057 | BOY |
| EOY | 1153610 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 913326 | BOY |
| EOY | 1114235 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1478715 | BOY |
| EOY | 1406728 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9900 | BOY |
| EOY | 8172 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42942 | BOY |
| EOY | 23414 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 6866445 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4241790 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1998803 | BOY |
| EOY | 2624655 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 596423 | BOY |
| EOY | 659993 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 776235 | BOY |
| EOY | 668667 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8734693 | BOY |
| EOY | 11999543 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1901697 | BOY |
| EOY | 1366774 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1259245 | BOY |
| EOY | 437729 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 2265022 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3160942 | BOY |
| EOY | 4069525 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5573751 | BOY |
| EOY | 7930018 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5573751 | BOY |
| EOY | 7930018 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8734693 | BOY |
| EOY | 11999543 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 173983 | OtherCostOrOtherBasis |
| Book Value | 173983 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3200718 | OtherCostOrOtherBasis |
| Depreciation | 1891453 | Depreciation |
| Book Value | 1309265 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2769836 | OtherCostOrOtherBasis |
| Depreciation | 2350337 | Depreciation |
| Book Value | 419499 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 721908 | OtherCostOrOtherBasis |
| Book Value | 721908 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2624655 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| SELF-FUNDED INSURANCE ASSET | 336492 |
| HOUSING PREDEVELOPMENT COSTS | 312175 |
| BHP SPONSORSHIP PROGRAM | 20000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 668667 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED HOUSING COSTS | $1,106,000 |
| ESTIMATED POOL SETTLEMENT | $948,022 |
| ESTIMATED MEDICAID ENHANCEMENT | $211,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2265022 | TotalOfAmounts |
| Total Revenue | 19222406 | TotalRevenue |
| Total Expenses | 16531073 | TotalExpenses |
| Excess Or Deficit For Year | 2691333 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 42175 | NetUnrealizedGLOnInvestments |
| Other | -$377,241 | OtherAmount |
| Total Adjustments | -335066 | TotalAdjustments |
| Excess Or Deficit Per FS | 2356267 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 19264581 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 42175 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 42175 | RevenueNotRptdF990 |
| Revenue Subtotal | 19222406 | RevenueSubtotal |
| Total Revenue Per Form990 | 19222406 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 16908314 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 377241 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 377241 | ExpensesNotRptdF990 |
| Expenses Subtotal | 16531073 | ExpensesSubtotal |
| Total Expenses Per Form990 | 16531073 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RECONCILIATION OF CHANGES - OTHER | SCHEDULE D, PAGE 4, PART XI, LINE 8 | RISK POOL LOSS -377,241 |
| EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER | SCHEDULE D, PAGE 4, PART XIII, LINE 2D | RISK POOL LOSS 377,241 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|
| SERGIO FLORES | ||
| 270489 | 16492 | 286981 |
| CARL I WALTERS II | ||
| 189531 | 13171 | 202702 |
| LEONEL ZOLESSI | ||
| 290493 | 12080 | 302573 |
| ZIBA IRAEE | ||
| 222335 | 16317 | 238652 |
| RICHARD WILLIAMS | ||
| 191600 | 6833 | 198433 |
| LAURIE ZIMMERMAN | ||
| 188131 | 17322 | 205453 |
| JAVIER HUERTA | ||
| 148560 | 17322 | 165882 |
Schedule M IRS990ScheduleM
Cars And Other Vehicles CarsAndOtherVehicles
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 16335 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenues |
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 315287 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenues |
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | OFFICE FURNITUR | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 55842 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | TO PROVIDE HIGH QUALITY, EFFECTIVE, AND AFFORDABLE HEALTH CARE AND OTHER ASSOCIATED SERVICES IN A COMPASSIONATE AND CULTURALLY SENSITIVE MANNER TO ALL PEOPLE WITHOUT PREJUDICE TO RACE, COLOR, CREED, GENDER OR ECONOMIC STATUS. |
| EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS | FORM 990, PAGE 1, PART I, LINE 6 | VOLUNTEERS FOR THE CLINIC PROVIDE SUPPORT IN ADMINISTRATION, FACILITY, AND SUPPORT SERVICE DEPARTMENTS. |
| ALL OTHER ACHIEVEMENTS DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4D | THE CLINIC PARTICIPATED IN A PROGRAM TO PROVIDE FINANCING FOR LAND ACQUISITION AND MORTGAGE SUBSIDIES FOR VERY LOW-INCOME FAMILIES IN BENTON, FRANKLIN, AND WALLA WALLA COUNTIES OF WASHINGTON STATE. THE CLINIC HAS CHOSEN NOT TO CONTINUE THE HOUSING PROGRAM. NO NEW SUBSIDIES OR LOT PURCHASES ARE BEING MADE. ACTIVITY IS LIMITED TO THE SALE OF EXISTING LOTS AND REPAYMENT OF SUBSIDIES, WHICH WILL BE USED TO REPAY THE ACCRUED HOUSING COSTS. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11 | A COPY OF THE 990 IS PROVIDED TO THE CEO AND CFO WHO REVIEWS THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PRESENTED TO THE CEO, WHO THEN APPROVES THE 990. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS THE FORM 8879-EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN. THE BOARD OF DIRECTORS ARE NOTIFIED WHEN THE RETURN HAS BEEN FILED AND THE BOARD OF DIRECTORS REVIEW THE FILED RETURN AT THE NEXT SCHEDULED BOARD FINANCE COMMITTEE MEETING. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | ALL BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST AT THE TIME OF APPOINTMENT TO THE BOARD. DISCLOSURES ARE REVIEWED BY THE FULL BOARD. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER IS EXCUSED FROM ALL DISCUSSIONS AND ANY VOTING THAT RELATES TO THE MATTER IN QUESTION. IT IS UNDERSTOOD THAT ALL BOARD MEMBERS HAVE AN OBLIGATION TO REPORT ANY MATTERS OR ISSUES THAT MAY BE APPLICABLE TO REPORT PURSUANT TO THE CONFLICT OF INTEREST POLICY. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE HUMAN RESOURCES DEPARTMENT REGULARLY CONDUCTS SALARY REVIEWS AND SURVEYS FOR ALL POSITIONS, INCLUDING KEY EMPLOYEES, AND ADVISES THE BOARD OF DIRECTORS THEIR FINDINGS UPON REQUEST. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | THE COMPENSATION PROCESS FOR OTHER OFFICERS IS THE SAME AS THE COMPENSATION PROCESS DESCRIBED ABOVE. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE CLINIC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| ADDITIONAL INFORMATION | SCHEDULE O | EFFECTIVE JULY 2010, THE CLINIC CHANGED ITS NAME TO TRI-CITIES COMMUNITY HEALTH. FORM 990, PART X, LINE 10 - DESCRIPTION OF DEPRECIATION EXPENSE COMPUTATION IT IS THE CLINIC'S POLICY TO CAPITALIZE PROPERTY, BUILDINGS AND EQUIPMENT WITH A BASIS GREATER THAN 5,000 AND AN ESTIMATED USEFUL LIFE OF ONE OR MORE YEARS, LESSER AMOUNTS ARE EXPENSED. PROPERTY, BUILDINGS, AND EQUIPMENT ARE STATED AT COST. DONATED PROPERTY, BUILDINGS, AND EQUIPMENT ARE STATED AT THEIR FAIR VALUE AT THE DATE OF DONATION. DEPRECIATION IS CALCULATED USING THE STRAIGHT-LINE METHOD OVER THE ASSETS' USEFUL LIVES RANGING FROM 3 TO 40 YEARS. LEASEHOLD IMPROVEMENTS ARE AMORTIZED OVER THE SHORTER OF THE LIFE OF THE ASSET OR THE LEASE TERM. FORM 990, PART VII SECTION A, MANAGEMENT - OFFICERS LISTING DURING THE FISCAL YEAR, THE CLINIC HAD TURNOVER IN THE CHIEF FINANCIAL OFFICER (CFO) POSITION. THREE SEPERATE INDIVIDUALS PERFORMED CFO DUTIES OVER THE COURSE OF THE FISCAL YEAR. |