2020-03-27T12:16:20-07:00 2019-06-30 472251777 CHW LLP 7797 N First Street Suite 15 Fresno CA 93720 990 2018-07-01 237255435 Tri-City Health Center Inc TRI- 5107708133 39500 Liberty Street Fremont CA 94538 Zettie Page Chief Executive Officer 5595495400 2020-01-17 1 Jeremy Ware P00642659 5595495400 2020-01-08 172.58.35.78 2018 2020-09-23 17:36:50Z Jagat Sheth 39500 Liberty Street Fremont CA 94538 41155450 0 X www.tri-cityhealth.org X 1970 CA TRI-CITY IS A FISCALLY RESPONSIBLE NON-PROFIT HEALTH CENTER PROVIDING A DIVERSE SPECTRUM OF EDUCATION, HEALTHCARE AND SOCIAL SERVICES. WE ARE A FREE STANDING COMMUNITY HEALTH CENTER AND MEMBER OF A KEY SERVICE PROVIDER NETWORK WHO SERVE EVERYONE WITHOUT REGARD TO FINANCIAL POSITION, ETHNICITY, LANGUAGE, CULTURE, SEXUAL ORIENTATION OR ANY OTHER CRITERION. WITH A COMMITMENT TO SERVE IN A CARING, NURTURING ATMOSPHERE, WE STRIVE TO PROMOTE OPTIMAL HEALTH, ELIMINATE PREVENTABLE DISEASES, AND IMPROVE THE QUALITY OF LIFE FOR EVERY INDIVIDUAL AND FAMILY IN OUR SOUTH, EASTERN AND CENTRAL ALAMEDA COUNTY COMMUNITY. 12 12 399 0 0 0 10969328 11496419 24674053 27406448 14546 63367 2550482 2189216 38208409 41155450 0 0 0 0 20840647 23237074 0 187969 622661 16315301 17526292 37155948 40951335 1052461 204115 35602247 35065089 18878099 18136826 16724148 16928263 TRI-CITY IS A FISCALLY RESPONSIBLE NON-PROFIT HEALTH CENTER PROVIDING A DIVERSE SPECTRUM OF EDUCATION, HEALTHCARE AND SOCIAL SERVICES. 0 0 29524913 0 0 TRI-CITY IS A FISCALLY RESPONSIBLE NON-PROFIT HEALTH CENTER PROVIDING A DIVERSE SPECTRUM OF EDUCATION, HEALTHCARE AND SOCIAL SERVICES. WE ARE A FREE STANDING COMMUNITY HEALTH CENTER AND MEMBER OF A KEY SERVICE PROVIDER NETWORK WHO SERVE EVERYONE WITHOUT REGARD TO FINANCIAL POSITION, ETHNICITY, LANGUAGE, CULTURE, SEXUAL ORIENTATION OR ANY OTHER CRITERION. WITH A COMMITMENT TO SERVE IN A CARING, NURTURING ATMOSPHERE, WE STRIVE TO PROMOTE OPTIMAL HEALTH, ELIMINATE PREVENTABLE DISEASES, AND IMPROVE THE QUALITY OF LIFE FOR EVERY INDIVIDUAL AND FAMILY IN OUR SOUTH, EASTERN AND CENTRAL ALAMEDA COUNTY COMMUNITY. FOR CALENDAR YEAR 2018, TRI-CITY SERVED over 26,000 PATIENTS WITH A TOTAL OF over 169,000 VISITS. 0 0 0 29524913 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 75 0 1 399 1 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X Tri-City Health Center 5107708133 39500 Liberty Street Fremont CA 94538 Robert Wyckoff Chair 1 0 X 0 0 0 Kobin Lee Vice Chair 1 0 X 0 0 0 Jackie Belser Welch Secretary 1 0 X 0 0 0 David Perez Board Member 1 0 X 0 0 0 Brenda Quillin Board Member 1 0 X 0 0 0 Steve Zhu Board Member 1 0 X 0 0 0 Najia Hamid Board Member 1 0 X 0 0 0 Marvin Wong Board Member 1 0 X 0 0 0 Jenny Feng Board Member 1 0 X 0 0 0 Elaine Nagel Board Member 1 0 X 0 0 0 Stephanie Reddell Board Member 1 0 X 0 0 0 Jagat Sheth CFO 40 0 X 191933 0 3779 Zettie Page CEO 40 0 X 283727 0 11349 Harsha Ramchandani CMO 40 0 X 270513 0 4910 Lene Martinez Physician 1 0 X 202890 0 4058 Magnus Yang Clinic Director 40 0 X 202245 0 3906 Gemma Jamena Clinic Director 40 0 X 199298 0 3986 Suksham Puri-Kumar Clinic Director 40 0 X 193238 0 7730 1543844 0 39718 37 0 1 0 Provider HealthCare 2455 E Parleys Way Salt Lake UT 84109 Contracted Providers 1284474 M Barakzoy DDS Inc 38056 Martha Avenue Fremont CA 94536 Dental Contractor 2458709 BayMed Inc 1590 Oakland Road San Jose CA 95131 Contracted Providers 648660 BAB Facilities Group 3360 De La Cruz Boulevard Santa Clara CA 95054 Construction 570770 Teamwrkx Construction 1855 Park Avenue San Jose CA 95131 Construction 744858 11 0 0 0 0 7363206 4133213 0 11496419 Net patient service revenue 621400 25814494 25814494 0 0 1591954 1591954 0 0 27406448 63367 0 0 63367 0 0 0 0 0 0 0 0 231591 0 0 0 231591 0 231591 0 0 231591 0 0 0 1957625 1957625 0 0 1957625 41155450 29364073 0 294958 X 2513526 1175634 1227583 110309 14922944 12480116 2250018 192810 446671 332044 110930 3697 3954865 1577737 2353225 23903 1399068 1092427 282439 24202 1095483 550239 545244 45470 45470 364771 8 364763 187969 187969 6787783 6426307 361476 48640 14554 18819 15267 951312 588382 331695 31235 1612413 942307 668247 1859 175557 86324 78968 10265 112332 50830 55809 5693 722046 71409 650637 997203 813075 184128 120735 120735 Supplies 3229847 3178037 45941 5869 Professional Fees 864921 145483 709855 9583 397779 397779 40951335 29524913 10803761 622661 7570310 4243216 1871064 2794091 2707114 3215814 144862 160212 261810 285885 28689064 5749494 22076082 22939570 971005 1426301 35602247 35065089 2568240 3049841 108458 367532 13623398 13067640 2578003 1651813 0 0 18878099 18136826 X 16694923 16924231 29225 4032 0 0 16724148 16928263 35602247 35065089 204115 0 0 0 0 0 X 0 1 X 1 1 1 X 7949203 9457370 9591758 10969328 11413911 49381570 7949203 9457370 9591758 10969328 11413911 49381570 49381570 1366 2863 5710 14546 63367 87852 0 0 0 49469422 0.99822 0.99947 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 4353191 4353191 0 19777478 3244817 16532661 0 1092316 223725 868591 0 3210031 2280952 929079 0 256048 0 256048 22939570 0 X 41155450 0 0 0 0 0 41155450 0 0 0 41155450 40951335 0 0 0 0 0 40951335 0 0 0 40951335 Schedule D, Part X, Line 2 The Center has been recognized by the Internal Revenue Service as a non-profit corporation as described in Sec. 501(c)(3) of the Internal Revenue Code (IRC) and is exempt from federal and state income taxes on related income pursuant to Sec 501(a) of the IRC and California Revenue and Taxation Code Sec 23701(d). The Center files a United States federal tax return and a California state tax return and has determined that its major tax jurisdictions are the United States and California. The Center's returns are subject to examination by federal and state taxing authorities generally for three years after they are filed. X 0 CA X 0 0 0 0 0 0 0 0 0 Zettie Page CEO 283727 0 0 0 0 0 0 0 0 0 283727 0 0 0 Form 990, Part VI, Section B, Line 11b Form 990 is reviewed by the audit committee, as delegated by the board of directors, before it is filed. The Form 990 is made available to the full board of directors prior to filing. Form 990, Part VI, Section B, Line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy. All employees sign a conflict of interest questionnaire when hired. Form 990, Part VI, Section B, Line 15 Pay grades are established through independent entities, market research, and employment agencies. Form 990, Part VI, Section C, Line 19 Available upon request. Form 990, Part IX, Line 11g Purchased and professional fees.