2011-01-14T15:50:49-06:00 2010-05-31 DINGUS ZARECOR & ASSOCIATES 12015 E MAIN STE A SPOKANE VALLEY WA 99206 990 2009-06-01 911138675 LA CLINICA-SOUTH COLUMBIA RURAL HEALTH CLINIC LACL 5055472204 515 WEST COURT ST PO BOX 1452 PASCO WA 99301 CARL I WALTERS II 5055472204 2011-01-12 true TOM DINGUS 5092420874 2011-01-14 2009 2016-02-24 21:20:13Z COMMUNITY HEALTH CENTER LA CLINICA CARL I WALTERS II 515 WEST COURT ST PASCO WA 99301 19344879 false X WWW.TCC-HEALTH.ORG X 1981 WA 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. 10 10 240 25 0 4088481 7854066 13947870 10759171 66565 468446 37293 140723 18140209 19222406 0 0 13223045 12033420 0 0 3995121 4497653 17218166 16531073 922043 2691333 8734693 11999543 3160942 4069525 5573751 7930018 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. false false 9228360 9884927 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. 2306065 127662 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. 1178877 746582 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. 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. 12713302 true true false false false false false false false true true false false false false false false false false false false false false true false false false false false false false false true false false false false false false false false true 39 0 true 240 true false false false false false false false false false false true 10 10 false false false false false false false true true false false false true true true true false true true false X CARL I WALTERS II 5095472204 PO BOX 1452 PASCO WA 99301 LINDA GUSTAFSON 1.00 X 0 0 0 RAMPUR VISWANATH 1.00 X 0 0 0 AVIGAIL SANCHEZ 1.00 X 0 0 0 BEVERLY HERRIN 1.00 X 0 0 0 JOSE A ROJAS 1.00 X 0 0 0 RON WEED 1.00 X 0 0 0 DOROTEO CHAVEZ 1.00 X 0 0 0 JOHN INTRAVARTOLO 1.00 X 0 0 0 LILLIAN PARRA 1.00 X 0 0 0 RUDY MENDOZA 1.00 X 0 0 0 SERGIO FLORES 40.00 X 270489 0 16492 CARL I WALTERS II 40.00 X 189531 0 13171 DIANN KUMMER 40.00 X 116715 0 399 ROBERT WILKINSON 40.00 X 48038 0 8236 AMY LEMMONS 40.00 X 34383 0 5990 MICHEL DEWITT 40.00 X 0 0 0 LEONEL ZOLESSI 40.00 X 290493 0 12080 ZIBA IRAEE 40.00 X 222335 0 16317 RICHARD WILLIAMS 40.00 X 191600 0 6833 LAURIE ZIMMERMAN 40.00 X 188131 0 17322 JAVIER HUERTA 40.00 X 148560 0 17322 1700275 114162 10 false true false 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 5 4111341 3742725 387464 7854066 PATIENT SERVICE REVENUE, NET 624100 7031129 7031129 CAPITATION REVENUE 624100 3728042 3728042 10759171 38255 38255 474918 77746 122473 474918 -44727 430191 430191 OTHER 900099 87962 87962 MEDICAL RECORDS 900099 52761 52761 140723 19222406 10759171 609169 712775 63984 648791 8884519 7804851 1079668 91487 64448 27039 1344411 1080479 263932 1000228 791838 208390 453064 3408 449656 89656 89656 887275 700159 187116 116398 17787 98611 1354832 1141164 213668 85472 28696 56776 494106 317593 176513 78714 32618 46096 34058 26662 7396 8948 8948 234963 123733 111230 72509 45134 27375 OTHER EXPENSE 287668 224848 62820 BAD DEBT 179510 179510 DUES AND SUBSCRIPTIONS 65798 13370 52428 LICENSES AND TAXES 54682 53020 1662 16531073 12713302 3817771 0 32660 12929 2500632 4327140 385057 1153610 913326 1114235 1478715 1406728 9900 8172 42942 23414 6866445 4241790 1998803 2624655 596423 659993 776235 668667 8734693 11999543 1901697 1366774 1259245 437729 2265022 3160942 4069525 X 5573751 7930018 5573751 7930018 8734693 11999543 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false 173983 173983 3200718 1891453 1309265 2769836 2350337 419499 721908 721908 2624655 SELF-FUNDED INSURANCE ASSET 336492 HOUSING PREDEVELOPMENT COSTS 312175 BHP SPONSORSHIP PROGRAM 20000 668667 ACCRUED HOUSING COSTS 1106000 ESTIMATED POOL SETTLEMENT 948022 ESTIMATED MEDICAID ENHANCEMENT 211000 2265022 19222406 16531073 2691333 42175 -377241 -335066 2356267 19264581 42175 42175 19222406 19222406 16908314 377241 377241 16531073 16531073 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 X X X false false false false false false false false false 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 X 1 16335 FAIR MARKET VALUE X 1 315287 COST X OFFICE FURNITUR 1 55842 FAIR MARKET VALUE false false false 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.