2021-04-08T08:22:55-05:00 2020-05-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2019-06-01 911138675 TRI-CITIES COMMUNITY HEALTH TRI- 5095472204 PO BOX 1452 PASCO WA 99301 JIM DAVIS CEO 5092420874 2021-04-01 1 KURT BENNION P01469618 4252506100 2021-04-01 2019 2022-09-23 18:48:47Z JIM DAVIS PO BOX 1452 PASCO WA 99301 42641421 0 X WWW.MYTCCH.ORG X 1981 WA DELIVER THE HIGHEST QUALITY HEALTH CARE TO EVERY PERSON, EVERY TIME. 9 9 414 14 0 0 10405212 8181194 26136017 33455452 31367 27065 334552 977710 36907148 42641421 0 8540 0 0 23661694 25874033 0 0 0 11235589 13441422 34897283 39323995 2009865 3317426 28769104 35477192 7418784 10754565 21350320 24722627 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. 0 0 26649714 8540 27970995 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 $3,304,746 FOR THE FISCAL YEAR ENDED 5/31/2020. THE CLINIC PROVIDED 82,540 MEDICAL ENCOUNTERS, 21,968 DENTAL ENCOUNTERS, AND 7,718 VISION ENCOUNTERS DURING THE FISCAL YEAR. 3913240 0 4107257 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 16,680 MENTAL HEALTH ENCOUNTERS AND 3,177 SUBSTANCE ABUSE ENCOUNTERS DURING THE FISCAL YEAR. 1312145 0 1377201 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 3,407 ENCOUNTERS DURING THE FISCAL YEAR. THESE PROGRAMS IMPROVE ACCESS TO CARE AND PROMOTE PROACTIVE HEALTH CARE MESSAGES TO IMPROVE HEALTHY DELIVERIES AND LIVING. 31875099 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 27 0 414 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X JIM MERRILL 5095432772 PO BOX 1452 PASCO WA 99301 RICHARD WILLIAMS PHYSICIAN 40.00 0.00 X 476009 0 8546 KENDAL SNIDER PHYSICIAN 40.00 0.00 X 389436 0 4689 BRUCE WILSON PHYSICIAN 40.00 0.00 X 338953 0 8528 SRINIVAS MASCAL PHYSICIAN 40.00 0.00 X 300456 0 7863 LAURIE ZIMMERMAN PHYSICIAN 40.00 0.00 X 254891 0 7715 JIM DAVIS CEO 40.00 0.25 X 234194 0 7397 AMANDA LANG MEDICAL DIRECTOR 40.00 0.00 X 200160 0 5248 BRIAN SCHUR DENTAL DIRECTOR 40.00 0.00 X 181614 0 5863 RICK BALLARD DIRECTOR OF FACILITIES & SUPPORT SERVICES 40.00 0.00 X 114984 0 3827 JIM MERRILL CFO 40.00 0.25 X 88074 0 2766 ANA RUIZ RAMIREZ CHAIR 1.00 0.25 X X 0 0 0 JEANNE MCPHERSON VICE CHAIR (THROUGH MARCH 2020) 1.00 0.00 X X 0 0 0 RUDY MENDOZA VICE CHAIR 1.00 0.00 X X 0 0 0 RICHA SIGDEL SECRETARY (THROUGH NOV 2019) 1.00 0.00 X X 0 0 0 KRISTINE TAGGARES SERGEANT-AT-ARMS & SECRETARY 1.00 0.25 X X 0 0 0 MONIKA MOO-YOUNG TREASURER (THROUGH AUG 2019) 1.00 0.00 X X 0 0 0 MICHAEL TUOHY BOARD MEMBER & TREASURER 1.00 0.00 X X 0 0 0 FILIPE GARCIA BOARD MEMBER 1.00 0.00 X 0 0 0 PHIL HILL BOARD MEMBER 1.00 0.00 X 0 0 0 DR GUY JONES BOARD MEMBER 1.00 0.00 X 0 0 0 CHAD LETTRICK BOARD MEMBER (THROUGH AUG 2019) 1.00 0.00 X 0 0 0 CYNTHIA PEREZ BOARD MEMBER 1.00 0.00 X 0 0 0 NIKKI TORRES BOARD MEMBER & SERGEANT-AT-ARMS 1.00 0.00 X 0 0 0 YOLANDA VALENCIA-UBAY BOARD MEMBER (THROUGH JUNE 2019) 1.00 0.00 X 0 0 0 2578771 0 62442 41 0 1 0 MEDICUS HEALTHCARE SOLUTIONS 22 ROULSTON ROAD WINDHAM NH 03087 LOCUM TENENS 1823004 BOOTH AND SONS CONSTRUCTION PO BOX 608 RICHLAND WA 99352 CONSTRUCTION 226404 ELITE CONSTRUCTION & DEVELOPMENT 5804 ROAD 90 SUITE A PASCO WA 99301 CONSTRUCTION 168182 COMMUNITY LINK CONSULTING PO BOX 276 NEWMAN LAKE WA 99025 FINANCIAL SERVICES 160916 STRATUS INDEMAND PO BOX 675248 DETROIT MI 48267 INTERPRETING SERVICES 122008 7 8181194 713110 8181194 PATIENT SERVICE REVENUE, NET 624100 29825699 29825699 CAPITATION REVENUE 624100 3328442 3328442 EHR INCENTIVE 624100 301311 301311 33455452 23421 23421 3644 0 3644 3644 3644 RISK POOL REVENUE 900099 827154 827154 OTHER REVENUE 900099 150556 150556 977710 42641421 33455452 0 1004775 X 8300 8300 240 240 759257 759257 20460367 17279527 3180840 300730 300730 2913837 2550099 363738 1439842 1250308 189534 203067 203067 44495 44495 4275188 3331635 943553 287886 269359 18527 397763 285957 111806 198384 142621 55763 725909 611504 114405 146816 78822 67994 98792 53039 45753 79033 31250 47783 1402763 787077 615686 101704 101704 MEDICAL SUPPLIES 4384967 4375736 9231 EQUIPMENT LEASE, REPAIR 483726 250921 232805 MISCELLANEOUS 294967 111470 183497 STAFF DEVELOPMENT 154579 82989 71590 161383 73515 87868 39323995 31875099 7448896 0 5556308 11546356 370734 608733 2117927 3501927 641680 574832 314102 445146 452265 538585 27873682 12081985 16374353 15791697 1065681 1133968 1876054 1335948 28769104 35477192 2178962 2668585 813595 509929 2146357 1497488 2279870 1858994 3609142 0 610427 7418784 10754565 X 21350320 24722627 21350320 24722627 28769104 35477192 3317426 54881 0 X 0 1 X 1 1 1 X 1 25020 74894 88079 11835 1 X 576977 576977 20467851 7044063 13423788 236544 90578 145966 6036422 4947344 1089078 555888 555888 15791697 REFUNDABLE PRF GRANT 610427 610427 X 42614356 54881 54881 42559475 81946 81946 42641421 39323995 0 39323995 0 39323995 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 THE CLINIC 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 A REVOLVING 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 78,302. GAIN ON DISPOSAL OF EQUIPMENT 3,644. 1 PART I, LINE 2: TCCH GIVES SPONSORSHIP DONATIONS TO NUMEROUS COMMUNITY ORGANIZATIONS. PRIOR TO MAKING A PAYMENT, TCCH CONFIRMS THAT THE RECIPIENT IS A QUALIFIED GOVERNMENTAL AGENCY OR 501(C)(3) ORGANIZATION. TCCH DOES NOT OTHERWISE FOLLOW UP WITH RECIPIENTS TO EVALUATE HOW THE MONEY WAS SPENT. X X X 0 0 0 0 0 0 0 0 0 RICHARD WILLIAMS PHYSICIAN 378531 0 76550 0 20928 0 8400 0 146 0 484555 0 0 0 KENDAL SNIDER PHYSICIAN 274206 0 88050 0 27180 0 4618 0 71 0 394125 0 0 0 BRUCE WILSON PHYSICIAN 229016 0 71832 0 38105 0 8400 0 128 0 347481 0 0 0 SRINIVAS MASCAL PHYSICIAN 233303 0 46668 0 20485 0 7863 0 0 0 308319 0 0 0 LAURIE ZIMMERMAN PHYSICIAN 218789 0 12000 0 24102 0 7569 0 146 0 262606 0 0 0 JIM DAVIS CEO 191734 0 20000 0 22460 0 7175 0 222 0 241591 0 0 0 AMANDA LANG MEDICAL DIRECTOR 134372 0 46788 0 19000 0 5177 0 71 0 205408 0 0 0 BRIAN SCHUR DENTAL DIRECTOR 157389 0 6000 0 18225 0 5576 0 287 0 187477 0 0 0 X 44 713110 COST 0 0 1 0 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 2020. 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. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 3,331,635. MANAGEMENT AND GENERAL EXPENSES 943,553. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,275,188. TRI-CITIES COMMUNITY HEALTH FOUNDATION PO BOX 1452 PASCO WA 99301 851217043 FUNDRAISING TO SUPPORT TRI-CITIES COMMUNITY HEALTH WA 501(C)(3) LINE 7 TRI-CITIES COMMUNITY HEALTH 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0