TRI CITIES COMMUNITY HEALTH: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- TRI CITIES COMMUNITY HEALTH (EIN 91-1138675)
- Tax period
- 2020-06-01 to 2021-05-31
- Filed
- 2022-04-13
- IRS object ID
- 202201039349301750
- Schema version
- 2020v4.2
- 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) |
|---|---|---|
| Return | 2022-04-13T17:32:51-05:00 | ReturnTs |
| Tax Period End | 2021-05-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10700 NORTHUP WAY SUITE 200 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911138675 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-CITIES COMMUNITY HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TRI- | BusinessNameControlTxt |
| Phone | 5095472204 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1452 | AddressLine1Txt |
| City | PASCO | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JIM MERRILL | PersonNm |
| Person Title | CFO & INTERIM CEO | PersonTitleTxt |
| Phone | 5095472204 | PhoneNum |
| Signature | 2022-04-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JIM | PersonFirstNm |
| Person Last | MERRILL | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KURT BENNION | PreparerPersonNm |
| PTIN | P01469618 | PTIN |
| Phone | 4252506100 | PhoneNum |
| Preparation | 2022-04-13 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JIM MERRILL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1452 | AddressLine1Txt |
| City | PASCO | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $48,814,041 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MYTCCH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | DELIVER THE HIGHEST QUALITY HEALTH CARE TO EVERY PERSON, EVERY TIME. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 455 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $8,181,194 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,472,204 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $33,455,452 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $35,358,951 | CYProgramServiceRevenueAmt |
| PY Investment Income | $27,065 | PYInvestmentIncomeAmt |
| CY Investment Income | $46,108 | CYInvestmentIncomeAmt |
| PY Other Revenue | $977,710 | PYOtherRevenueAmt |
| CY Other Revenue | $3,936,778 | CYOtherRevenueAmt |
| PY Total Revenue | $42,641,421 | PYTotalRevenueAmt |
| CY Total Revenue | $48,814,041 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $8,540 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,750 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $25,874,033 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,888,397 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,441,422 | PYOtherExpensesAmt |
| CY Other Expenses | $13,855,284 | CYOtherExpensesAmt |
| PY Total Expenses | $39,323,995 | PYTotalExpensesAmt |
| CY Total Expenses | $42,747,431 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,317,426 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,066,610 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $35,477,192 | TotalAssetsBOYAmt |
| Total Assets EOY | $36,919,370 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,754,565 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,012,623 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,722,627 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $30,906,747 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE ARE DEDICATED TO THE COMMUNITIES WE SERVE, BRINGING TOGETHER A UNIFIED TEAM THAT DELIVERS THE HIGHEST QUALITY HEALTH CARE TO EVERY PERSON, EVERY TIME. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $28,774,120 | ExpenseAmt |
| Grant | $3,750 | GrantAmt |
| Revenue | $30,254,110 | RevenueAmt |
| Desc | THE CLINIC PROVIDES MEDICAL, DENTAL, VISION AND URGENT CARE TO MIGRANT AND LOW-INCOME PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO SELF-PAY PATIENTS WAS $3,887,263 FOR THE FISCAL YEAR ENDED 5/31/2021. THE CLINIC PROVIDED 104,506 MEDICAL, DENTAL AND VISION ENCOUNTERS DURING THE FISCAL YEAR. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,524,368 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,705,644 | RevenueAmt |
| Desc | THE CLINIC PROVIDES MENTAL HEALTH AND SUBSTANCE ABUSE COUNSELING, THERAPY AND PSYCHIATRIC SERVICES TO MIGRANT AND LOW INCOME PERSONS THROUGHOUT BENTON AND FRANKLIN COUNTIES. THE CLINIC PROVIDED 19,269 MENTAL HEALTH AND SUBSTANCE ABUSE ENCOUNTERS DURING THE FISCAL YEAR. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,330,751 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,399,197 | RevenueAmt |
| Desc | THE CLINIC OFFERS MATERNITY SUPPORT SERVICES (MSS), INFANT CASE MANAGEMENT (ICM), SOCIAL SERVICES (OUTREACH) AND WIC NUTRITION EDUCATION APPOINTMENTS, AND CLASSES TO HIGH RISK MOMS DURING AND POST-DELIVERY. A LARGE PERCENTAGE OF THOSE TCCH SERVES ARE MIGRANT AND SEASONAL FARM WORKERS. TCCH PROVIDED 4,092 ENCOUNTERS DURING THE FISCAL YEAR. THESE PROGRAMS IMPROVE ACCESS TO CARE AND PROMOTE PROACTIVE HEALTH CARE MESSAGES TO IMPROVE HEALTHY DELIVERIES AND LIVING. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $33,629,239 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 455 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JIM MERRILL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5095432772 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1452 | AddressLine1Txt |
| City | PASCO | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99301 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| RICHARD WILLIAMS | |||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $538,323 | $0 | $8,357 | |||
| HALA MADI | |||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $388,962 | $0 | $138 | |||
| SRINIVAS MASCAL | |||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $371,954 | $0 | $8,556 | |||
| KENDAL SNIDER | |||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $265,908 | $0 | $7,851 | |||
| LAURIE ZIMMERMAN | |||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $262,797 | $0 | $8,052 | |||
| JIM DAVIS | |||||||||
| CEO | 40.00 | 0.25 | $219,621 | $0 | $9,146 | Yes (X) | |||
| AMANDA LANG | |||||||||
| MEDICAL DIRECTOR | 40.00 | 0.00 | $198,120 | $0 | $6,191 | Yes (X) | |||
| BRIAN SCHUR | |||||||||
| DENTAL DIRECTOR | 40.00 | 0.00 | $191,107 | $0 | $6,302 | Yes (X) | |||
| JIM MERRILL | |||||||||
| CFO | 40.00 | 0.00 | $190,894 | $0 | $6,018 | Yes (X) | |||
| RICHARD LEIGH | |||||||||
| PHARMACY DIRECTOR | 40.00 | 0.00 | $154,498 | $0 | $6,738 | Yes (X) | |||
| RICK BALLARD DIRECTOR | |||||||||
| OF FACILITIES & SUPPORT SERVICES | 40.00 | 0.00 | $119,810 | $0 | $6,660 | Yes (X) | |||
| ANA RUIZ RAMIREZ | |||||||||
| CHAIR | 1.00 | 0.25 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| RUDY MENDOZA | |||||||||
| VICE CHAIR | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| KRISTINE TAGGARES | |||||||||
| SECRETARY | 1.00 | 0.25 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| MICHAEL TUOHY | |||||||||
| TREASURER | 1.00 | 0.25 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| DR SHARON AHART | |||||||||
| BOARD MEMBER | 1.00 | 0.25 | $0 | $0 | $0 | Yes (X) | |||
| DEE DICKERSON | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| FILIPE GARCIA | |||||||||
| BOARD MEMBER & SARGEANT-AT-ARMS | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| PHIL HILL | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| DR GUY JONES | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| LARRY KURZ | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| CYNTHIA PEREZ | |||||||||
| BOARD MEMBER | 1.00 | 0.25 | $0 | $0 | $0 | Yes (X) | |||
| NIKKI TORRES | |||||||||
| SERGEANT-AT-ARMS (THROUGH JULY 2020) | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,901,994 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $74,009 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 56 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDICUS HEALTHCARE SOLUTIONS | |||||
| 22 ROULSTON ROAD | WINDHAM | NH | 03087 | LOCUM TENENS | $910,357 |
| EXPRESS SERVICES | |||||
| PO BOX 844277 | LOS ANGELES | CA | 900844277 | TEMP SERVICES | $179,440 |
| BARRETT BUSINESS SERVICES INC | |||||
| 9825 SANDIFUR PARKWAY SUITE E | PASCO | WA | 99301 | TEMP SERVICES | $132,455 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $9,470,510 | GovernmentGrantsAmt |
| All Other Contributions | $1,694 | AllOtherContributionsAmt |
| Noncash Contributions | $352,197 | NoncashContributionsAmt |
| Total Contributions | $9,472,204 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE, NET | 624100 | $31,271,290 | $31,271,290 |
| CAPITATION REVENUE | 624100 | $3,754,062 | $3,754,062 |
| EHR INCENTIVE | 624100 | $333,599 | $333,599 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $35,358,951 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,108 | TotalRevenueColumnAmt |
| Exclusion | $46,108 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| OTHER REVENUE | 900099 | $3,805,813 | $3,805,813 |
| RISK POOL REVENUE | 900099 | $130,965 | $130,965 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,936,778 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $48,814,041 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,358,951 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,982,886 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,750 | TotalAmt |
| Program Services | $3,750 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,244,827 | TotalAmt |
| Program Services | $274,190 | ProgramServicesAmt |
| Management And General | $970,637 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,398,219 | TotalAmt |
| Program Services | $18,754,513 | ProgramServicesAmt |
| Management And General | $3,643,706 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $286,442 | TotalAmt |
| Program Services | $275,515 | ProgramServicesAmt |
| Management And General | $10,927 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,354,873 | TotalAmt |
| Program Services | $2,655,964 | ProgramServicesAmt |
| Management And General | $698,909 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,604,036 | TotalAmt |
| Program Services | $1,263,072 | ProgramServicesAmt |
| Management And General | $340,964 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,360 | TotalAmt |
| Management And General | $140,360 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,679 | TotalAmt |
| Management And General | $66,679 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,141,601 | TotalAmt |
| Program Services | $3,029,803 | ProgramServicesAmt |
| Management And General | $1,111,798 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,171 | TotalAmt |
| Program Services | $229,777 | ProgramServicesAmt |
| Management And General | $115,394 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $436,206 | TotalAmt |
| Program Services | $251,021 | ProgramServicesAmt |
| Management And General | $185,185 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,961 | TotalAmt |
| Program Services | $78,241 | ProgramServicesAmt |
| Management And General | $57,720 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $822,978 | TotalAmt |
| Program Services | $634,503 | ProgramServicesAmt |
| Management And General | $188,475 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,507 | TotalAmt |
| Program Services | $46,651 | ProgramServicesAmt |
| Management And General | $39,856 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,240 | TotalAmt |
| Program Services | $42,193 | ProgramServicesAmt |
| Management And General | $36,047 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,708 | TotalAmt |
| Program Services | $35,342 | ProgramServicesAmt |
| Management And General | $69,366 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,438,280 | TotalAmt |
| Program Services | $813,626 | ProgramServicesAmt |
| Management And General | $624,654 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,945 | TotalAmt |
| Program Services | $867 | ProgramServicesAmt |
| Management And General | $105,078 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $4,631,179 | $4,622,721 | $8,458 |
| EQUIPMENT LEASE, REPAIR | $404,132 | $144,825 | $259,307 |
| MISCELLANEOUS | $352,628 | $116,537 | $236,091 |
| BAD DEBT | $199,039 | $199,039 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $365,670 | TotalAmt |
| Program Services | $157,089 | ProgramServicesAmt |
| Management And General | $208,581 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,747,431 | TotalAmt |
| Program Services | $33,629,239 | ProgramServicesAmt |
| Management And General | $9,118,192 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,546,356 | BOYAmt |
| EOY | $10,438,251 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $608,733 | BOYAmt |
| EOY | $486,968 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,501,927 | BOYAmt |
| EOY | $6,795,241 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $574,832 | BOYAmt |
| EOY | $588,680 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $445,146 | BOYAmt |
| EOY | $258,426 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $538,585 | BOYAmt |
| EOY | $155,278 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $28,876,713 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $13,423,148 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,791,697 | BOYAmt |
| EOY | $15,453,565 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,133,968 | BOYAmt |
| EOY | $1,296,665 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,335,948 | BOYAmt |
| EOY | $1,446,296 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,477,192 | BOYAmt |
| EOY | $36,919,370 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,668,585 | BOYAmt |
| EOY | $2,887,317 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $509,929 | BOYAmt |
| EOY | $69,602 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,497,488 | BOYAmt |
| EOY | $1,497,923 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,858,994 | BOYAmt |
| EOY | $1,557,781 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,609,142 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $610,427 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,754,565 | BOYAmt |
| EOY | $6,012,623 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,722,627 | BOYAmt |
| EOY | $30,906,747 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,722,627 | BOYAmt |
| EOY | $30,906,747 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,477,192 | BOYAmt |
| EOY | $36,919,370 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,066,610 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $117,510 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $11,835 | BeginningBalanceAmt |
| Additions During Year | $327,081 | AdditionsDuringYearAmt |
| Distributions During Year | $325,283 | DistributionsDuringYearAmt |
| Ending Balance | $13,633 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $576,977 | OtherCostOrOtherBasisAmt |
| Book Value | $576,977 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,647,216 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,037,009 | DepreciationAmt |
| Book Value | $12,610,207 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $229,725 | OtherCostOrOtherBasisAmt |
| Depreciation | $100,946 | DepreciationAmt |
| Book Value | $128,779 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,634,002 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,285,193 | DepreciationAmt |
| Book Value | $1,348,809 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $788,793 | OtherCostOrOtherBasisAmt |
| Book Value | $788,793 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,453,565 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $48,568,894 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $117,510 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $117,510 | RevenueNotReportedAmt |
| Revenue Subtotal | $48,451,384 | RevenueSubtotalAmt |
| Other Revenues Not Included | $362,657 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $362,657 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $48,814,041 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $42,548,392 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $42,548,392 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $199,039 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $199,039 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $42,747,431 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1B: | CHECK BOOKS ARE HELD FOR A NUMBER OF PATIENTS. THE BANK ACCOUNT IS UNDER THE PATIENT'S NAME. TCCH MAKES SURE BILLS ARE PAID BUT THE MONEY IS NOT PROVIDED TO TCCH DIRECTLY. |
| PART IV, LINE 2B: | STATE DEPARTMENT OF COMMERCE: THESE FUNDS ARE AVAILABLE TO SUPPORT HOUSING PROJECTS FOR INDIVIDUALS FOR 50 YEARS. HOUSING ASSISTANCE COUNCIL: THESE FUNDS ARE FOR THE PURCHASE OF LOTS FOR THE SELF-HELP HOUSING PROGRAM. THE FUNDS ARE DRAWN DOWN AT THE TIME OF PURCHASE. WHEN THE LOTS ARE SOLD, 75 PERCENT OF THE FUNDS ARE HELD IN AREVOLVING FUND FOR FUTURE LOT PURCHASES WITH THE REMAINING 25 PERCENT RETURNED TO THE HOUSING ASSISTANCE COUNCIL. HOUSING AND URBAN DEVELOPMENT: THESE FUNDS ARE ALLOCATED FOR USE AS SPECIFIED BY THE GRANT AGREEMENTS. FUNDS RECEIVED BY THE CLINIC ARE FOR THE PURCHASE OF LOTS TO BE SOLD TO FAMILIES IN THE SELF-HELP PROGRAM AND ARE INCLUDED IN A REVOLVING ACCOUNT UNTIL IT IS NO LONGER USED FOR LOT PURCHASES OR SUBSIDIES, AT WHICH TIME IT IS TO BE RETURNED TO HOUSING AND URBAN DEVELOPMENT. COMMUNITY HOUSING DEVELOPMENT ORGANIZATION: THESE FUNDS ARE TO BE RETURNED SHOULD THE HOME BE SOLD OR FORECLOSED BEFORE THE MINIMUM AFFORDIBILITY PERIOD ENDS, WHICH VARIES BETWEEN 5 AND 15 YEARS BASED ON THE COST OF THE UNIT. AFTER THE MINIMUM AFFORDIBILITY PERIOD HAS BEEN ACHIEVED, THE ASSOCIATED DEBT IS FORGIVEN AND THE FUNDS ARE RECOGNIZED AS REVENUE BY THE CLINIC. |
| PART X, LINE 2: | THE CLINIC HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED THE CLINICS' TAX POSITIONS AND CONCLUDED THAT THE CLINIC HAD TAKEN NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | NET INVESTMENT INCOME 163,618. BAD DEBT EXPENSE 199,039. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 199,039. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD WILLIAMS | ||||||||||||||
| PHYSICIAN | $475,331 | $0 | $43,492 | $0 | $19,500 | $0 | $7,788 | $0 | $569 | $0 | $546,680 | $0 | $0 | $0 |
| HALA MADI | ||||||||||||||
| PHYSICIAN | $388,961 | $0 | $0 | $0 | $1 | $0 | $0 | $0 | $138 | $0 | $389,100 | $0 | $0 | $0 |
| SRINIVAS MASCAL | ||||||||||||||
| PHYSICIAN | $256,153 | $0 | $94,951 | $0 | $20,850 | $0 | $8,249 | $0 | $307 | $0 | $380,510 | $0 | $0 | $0 |
| KENDAL SNIDER | ||||||||||||||
| PHYSICIAN | $240,784 | $0 | $0 | $0 | $25,124 | $0 | $7,851 | $0 | $0 | $0 | $273,759 | $0 | $0 | $0 |
| LAURIE ZIMMERMAN | ||||||||||||||
| PHYSICIAN | $225,874 | $0 | $12,000 | $0 | $24,923 | $0 | $7,851 | $0 | $201 | $0 | $270,849 | $0 | $0 | $0 |
| JIM DAVIS | ||||||||||||||
| CEO | $190,471 | $0 | $0 | $0 | $29,150 | $0 | $6,854 | $0 | $2,292 | $0 | $228,767 | $0 | $0 | $0 |
| AMANDA LANG | ||||||||||||||
| MEDICAL DIRECTOR | $163,580 | $0 | $15,040 | $0 | $19,500 | $0 | $5,584 | $0 | $607 | $0 | $204,311 | $0 | $0 | $0 |
| BRIAN SCHUR | ||||||||||||||
| DENTAL DIRECTOR | $185,107 | $0 | $6,000 | $0 | $0 | $0 | $5,887 | $0 | $415 | $0 | $197,409 | $0 | $0 | $0 |
| JIM MERRILL | ||||||||||||||
| CFO | $163,791 | $0 | $16,500 | $0 | $10,603 | $0 | $5,831 | $0 | $187 | $0 | $196,912 | $0 | $0 | $0 |
| RICHARD LEIGH | ||||||||||||||
| PHARMACY DIRECTOR | $128,498 | $0 | $0 | $0 | $26,000 | $0 | $4,578 | $0 | $2,160 | $0 | $161,236 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 35 | ContributionCnt |
| Noncash Contributions Rpt F990 | $352,197 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE GOVERNING BOARD, THE IMMEDIATE PAST CHAIR OF THE BOARD, AND ONE OTHER BOARD MEMBER TO BE DESIGNATED BY THE BOARD CHAIR. THE EXECUTIVE COMMITTEE IS THE ONLY COMMITTEE AUTHORIZED TO REVIEW AND TAKE ANY NECESSARY ACTION, WHICH, IN THE OPINION OF A MAJORITY OF THE COMMITTEE UPON VOTE WHERE FOUR MEMBERS ARE PRESENT, CANNOT WAIT FOR THE NEXT REGULARLY SCHEDULED BOARD MEETING OR WHERE CALLING A SPECIAL BOARD MEETING IS NOT PRACTICAL. ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE MUST BE RATIFIED BY THE FULL BOARD AT THE NEXT BOARD MEETING AND DOCUMENTED IN THE MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS REVIEWED BY THE CFO AND ANY COMMENTS OR QUESTIONS WERE ADDRESSED WITH THE PREPARER. A FINAL DRAFT WAS PRESENTED TO THE CEO, WHO THEN APPROVED THE 990. ONCE MANAGEMENT WAS SATISFIED WITH THE 990, IT WAS REVIEWED BY THE FINANCE COMMITTEE. THE FORM 990 WAS THEN DISTRIBUTED TO ALL BOARD MEMBERS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST AT THE TIME OF APPOINTMENT TO THE BOARD OR THROUGH SELF-DISCLOSURE IN THE INTERIM. 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 GIVE RISE TO A CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE HUMAN RESOURCE DEPARTMENT REGULARY CONDUCTS SALARY REVIEWS AND SURVEYS FOR ALL POSITIONS, INCLUDING KEY EMPLOYEES AND OFFICERS, AND ADVISES THE BOARD OF DIRECTORS OF THEIR FINDINGS UPON REQUEST. THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE CEO'S COMPENSATION. THE CEO REVIEWS AND APPROVES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES, ALTHOUGH THE BOARD OF DIRECTORS APPROVES THE SALARY RANGES OF ALL POSITIONS IN THE ORGANIZATION EVERY THREE YEARS. THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN 2021. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CLINIC MAKES ITS GOVERINING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-CITIES COMMUNITY HEALTH FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1452 | AddressLine1Txt |
| City | PASCO | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 851217043 | EIN |
| Primary Activities | FUNDRAISING TO SUPPORT TRI-CITIES COMMUNITY HEALTH | PrimaryActivitiesTxt |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-CITIES COMMUNITY HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |