2011-08-30T11:51:58-05:00 2010-12-31 MOSS ADAMS LLP 6100 UPTOWN BLVD NE STE 400 ALBUQUERQUE NM 87110 990 2010-01-01 201358178 TRICORE LABORATORY SERVICES CORP TRIC 5059388888 1001 WOODWARD PLACE NE ALBUQUERQUE NM 87102 JESSIE SALK 5059388888 2011-08-24 1 ANTHONY W ROYLE 5058787200 2010 2016-02-24 21:20:13Z JESSIE SALK 1001 WOODWARD PLACE NE ALBUQUERQUE NM 87102 72844935 0 X WWW.TRICORE.ORG X 2004 NM THE ORGANIZATION WAS ORGANIZED AND IS OPERATED AS A COOPERATIVE HOSPITAL SERVICE ORGANIZATION. 8 7 0 8 0 0 0 0 69367123 72836803 0 -2250 0 0 69367123 72834553 0 0 0 0 35974059 37329203 0 0 0 31518372 33173228 67492431 70502431 1874692 2332122 11614504 13532305 1738434 1324113 9876070 12208192 THE ORGANIZATION PERFORMS LABORATORY SERVICES EXCLUSIVELY FOR ITS MEMBERS, EACH OF WHOM IS A HOSPITAL DESCRIBED IN SECTION 501(E)(1)(B) OF THE INTERNAL REVENUE CODE, AND FOR NO ONE ELSE. 0 0 57522346 72836803 THE ORGANIZATION PERFORMS LABORATORY SERVICES EXCLUSIVELY FOR ITS MEMBERS, EACH OF WHOM IS A HOSPITAL DESCRIBED IN SECTION 501(E)(1)(B) OF THE INTERNAL REVENUE CODE, AND FOR NO ONE ELSE. 57522346 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NM X RENEE ENNIS 5059388888 1001 WOODWARD PL NE ALBUQUERQUE NM 87102 ROBERT GARCIA 1.00 X 0 0 0 ROBIN DIVINE 1.00 X 0 0 0 PAUL BRIGGS 1.00 X 0 0 0 ANDREW HORVATH MD 1.00 X 0 0 0 RICHARD LARSON MD PHD 1.00 X 0 0 0 THOMAS WILLIAMS MD 1.00 X 0 0 0 STEVE MCKERNAN 1.00 X 0 0 0 ERIN DOLES 1.00 X 0 0 0 DOROTHY RENEE ENNIS MBA 40.00 X 0 226210 17670 MICHAEL H KNELLINGER 40.00 X 0 200000 3734 JESSIE LOUISE SALK 40.00 X 0 332284 22412 MARCIA WOOLLEY 40.00 X 0 120587 9790 DENISE R BALLOU 40.00 X 0 120788 5771 CHERRI LEANN COLLINS 40.00 X 0 146406 15934 BRADLEY BRIMHALL MD MPH 40.00 X 0 251593 5790 0 1397868 81101 0 1 1 0 UNIVERSITY OF NEW MEXICO MEDICAL GROUP PO BOX 27200 ALBUQUERQUE NM 87125 PATHOLOGY CONSULT 1418912 PATHOLOGY ASSOCIATES OF ALBUQUERQUE 1100 CENTRAL AVE SE ALBUQUERQUE NM 87106 PATHOLOGY CONSULT 1253700 AUREUS RADIOLOGY LLC 13609 CALIFORNIA ST STE 200 OMAHA NE 68154 CONTRACT LABOR 196497 3 SALES, NET OF DISCOUNT 621500 72836803 72836803 72836803 8132 10382 -2250 -2250 -2250 72834553 72836803 0 -2250 836620 130320 706300 27611657 22400292 5211365 867333 687778 179555 5348663 4160937 1187726 2664930 2124273 540657 96765 51 96714 123210 123210 8940305 7705842 1234463 5722 5722 995132 297897 697235 1822317 1451040 371277 1088886 365291 723595 247739 95219 152520 493342 493342 2375625 1565710 809915 122130 122130 SUPPLIES 15035100 15035100 EQUIPMENT EXPENSES 1433345 1346760 86585 FEES 215900 152532 63368 177710 3304 174406 70502431 57522346 12980085 0 147457 933167 954579 11068738 6001216 5492523 5067522 5188814 7362747 11614504 13532305 1577470 1252565 160964 71548 1738434 1324113 X 9876070 12208192 9876070 12208192 11614504 13532305 2332122 0 X 0 1 1 X 0 X 18960 3371 15589 801113 135814 665299 9439218 5630703 3808515 809447 231328 578119 5067522 DUE FROM TRICORE REFERENCE LABORATORIES 7362747 7362747 CAPITAL LEASE OBLIGATIONS 71548 71548 72834553 70502431 2332122 0 2332122 72834553 0 72834553 0 72834553 70502431 0 70502431 0 70502431 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE 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. THE CORPORATION QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, THEREFORE, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN PROVIDED. AS OF DECEMBER 31, 2010, 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 ENDED DECEMBER 31, 2006 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, 2010 AND 2009. X X X X X X 1 0 0 1 1 0 1 0 0 DOROTHY RENEE ENNIS MBA 0 199585 0 26625 0 0 0 9979 0 7691 0 243880 0 0 MICHAEL H KNELLINGER 0 200000 0 0 0 0 0 0 0 3734 0 203734 0 0 JESSIE LOUISE SALK 0 286634 0 45650 0 0 0 14582 0 7830 0 354696 0 0 CHERRI LEANN COLLINS 0 146406 0 0 0 0 0 7320 0 8614 0 162340 0 0 BRADLEY BRIMHALL MD MPH 0 71593 0 0 0 180000 0 3580 0 2210 0 257383 0 0 PART I, LINE 4A FORMER CMO, BRADLEY BRIMHALL, RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $180,000. PART I, LINE 5 A PORTION OF THE BONUS PAID TO OFFICERS AND HIGHEST COMPENSATED EMPLOYEES IS BASED UPON ACHIEVEMENT OF REVENUE GOALS. PART I, LINE 6 A PORTION OF THE BONUS PAID TO OFFICERS AND HIGHEST COMPENSATED EMPLOYEES OF THE RELATED ORGANIZATION IS CONTINGENT ON NET EARNINGS GOALS OF THE RELATED ORGANIZATION. PATHOLOGY ASSOCIATES OF ALBUQUERQUE ANDREW HORVATH, DIRECTOR, IS A BOARD MEMBER OF BOTH ORGANIZATIONS 1253700 INDEPENDENT CONTRACTOR ARRANGEMENT 0 FORM 990, PART VI, SECTION A, LINE 2 ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER THROUGH THEIR INVOLVEMENT WITH TRICORE REFERENCE LABORATORIES. FORM 990, PART VI, SECTION A, LINE 3 TRICORE REFERENCE LABORATORY (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 6 AS AN IRC SECTION 501(E) ORGANIZATION TLSC IS ORGANIZED AND OPERATED SOLELY TO PERFORM, ON A CENTRALIZED BASIS, FOR ITS MEMBERS AND ONLY FOR ITS MEMBERS, LABORATORY SERVICES AND 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 7A AS THE ORIGINAL AND ONLY VOTING MEMBERS OF TLSC, PRESBYTERIAN AND UNMH EFFECTIVELY CONTROL TLSC THROUGH THEIR RESPECTIVE RIGHTS TO APPOINT AN EQUAL NUMBER OF DIRECTORS TO THE CORPORATIONS BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B 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 B, LINE 11 FORM 990 AND SUPPORTING SCHEDULES ARE DELIVERED TO THE FINANCE COMMITTEE, AS APPOINTED BY THE BOARD OF DIRECTORS, IMMEDIATELY PRECEDING FILING, FOR REVIEW AND DISCUSSION. THE FINANCE COMMITTEE THEN FORWARDS A COPY OF THE FORM 990 TO BOARD MEMBERS FOR REVIEW AND DISCUSSION. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST (COI) STATEMENT IS DISTRIBUTED AT THE ANNUAL MEETING OF THE BOARD EACH JULY 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 15 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 PROCESS WAS LAST UNDERTAKEN IN 2009. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS AVAILABLE TO PUBLIC. TRICORE REFERENCE LABORATORIES 1001 WOODWARD PLACE NE ALBUQUERQUE NM 87102 850444170 LABORATORY TESTING NM N/A C 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0