2024-09-30T15:34:47-05:00 2023-11-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2022-12-01 910896701 COLUMBIA BASIN HEALTH ASSOCIATION COLU 5094885256 1515 E COLUMBIA STREET OTHELLO WA 99344 NIEVES GOMEZ CEO 5094885256 2024-09-28 1 0 KURT BENNION CPA P01469618 4252506100 2024-09-28 2022 2024-10-15 13:58:12Z NIEVES GOMEZ 1515 E COLUMBIA STREET OTHELLO WA 99344 128515082 0 X WWW.CBHA.ORG X 1973 WA TO PROVIDE EQUAL ACCESS TO QUALITY HEALTH CARE TO ALL PERSONS. 12 12 544 14 0 0 16292978 43513554 50664738 54993615 1123780 2151404 -34703 3973242 68046793 104631815 23155 32503050 0 0 38962417 41029981 0 0 0 19213044 20888901 58198616 94421932 9848177 10209883 110075194 121259260 10897434 12019339 99177760 109239921 X TO PROVIDE EQUAL ACCESS TO QUALITY HEALTH CARE TO ALL PERSONS REGARDLESS OF AGE, SEX, COLOR, ETHNICITY, NATIONAL ORIGIN, OR THE ABILITY TO PAY.PRIMARY ACTIVITIES: MEDICAL, DENTAL, VISION AND RELATED HEALTHCARE SERVICES. 1 0 47792525 18934618 30512209 MEDICAL CARE - COLUMBIA BASIN HEALTH ASSOCIATION (CBHA) SERVED A TOTAL OF 38,472 INDIVIDUALS IN OUR SERVICE AREA - INCLUDING OTHELLO, MATTAWA, CONNELL, AND PASCO - FOR THE YEAR ENDED NOVEMBER 30, 2023. THE ORGANIZATION ALSO HAS A POLICY OF PROVIDIED CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS REDUCED FEE PROGRAM WITHOUT A CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. DURING THE YEAR THE ORGANIZATION PROVIDED $2,283,222 OF DISCOUNTED MEDICAL SERVICES. 16870529 6683828 9950089 DENTAL CARE - CBHA SERVED A TOTAL OF 18,903 INDIVIDUALS IN OUR SERVICE AREA - INCLUDING OTHELLO, MATTAWA, CONNELL, AND ROYAL CITY - FORTHE YEAR ENDED NOVEMBER 30, 2023. THE ORGANIZATION ALSO HAS A POLICY OF PROVIDIED CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITSREDUCED FEE PROGRAM WITHOUT A CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. DURING THE YEAR THE ORGANIZATION PROVIDED$2,124,173 OF DISCOUNTED DENTAL SERVICES. 10781044 4271274 10472057 PHARMACY SERVICES - CBHA DISPENSED 257,121 SCRIPTS TO PATIENTS DURING THE YEAR ENDED NOVEMBER 30, 2023. 6091443 2613330 4059260 OTHER HEALTH PROGRAMS INCLUDE VISION SERVICES, WHICH PROVIDES EYE CARE FOR PATIENTS OF ALL AGES, AS WELL REVENUE FROM OUR CAFEOPERATIONS. 6091443 2613330 4059260 81535541 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 0 0 1 51 0 544 1 0 0 0 0 0 1 1 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 0 0 X X JOSHUA BUNCH 5094885256 1515 E COLUMBIA STREET OTHELLO WA 99344 DR HUNG MIU CMO 50.00 0.00 X 879134 0 52414 DR BASHAR ELALI PHYSICIAN 40.00 0.00 X 484376 0 24992 DR CATHERINE DINGLASAN PHYSICIAN 40.00 0.00 X 417074 0 25538 DR JI H CHOI CDO 40.00 0.00 X 385555 0 43376 NIEVES GOMEZ CEO 50.00 1.00 X 374326 0 85156 RANDEL STEVENS CIO 40.00 0.00 X 373492 0 21743 DR SYED GILLANI PHYSICIAN 40.00 0.00 X 370501 0 17507 DR MATTHEW PAINTER PHYSICIAN 40.00 0.00 X 364111 0 7064 DR ALAA ATFEH PHYSICIAN 40.00 0.00 X 316443 0 28632 JOSHUA BUNCH CFO 50.00 0.00 X 224563 0 45974 KELLY CARLSON CAO 40.00 0.00 X 196204 0 53390 JONATHAN MADERA VP OF OPERATIONS 40.00 0.00 X 151746 0 39437 JANELLE ANDERSON BOARD MEMBER 1.50 0.00 X 500 0 0 DEBORAH BUSS BOARD VICE CHAIR & TREASURER 2.25 0.00 X X 350 0 0 DORA BERAZA BOARD MEMBER & SECRETARY 1.50 0.00 X X 350 0 0 MARTIN GALLARDO BOARD MEMBER 1.50 0.00 X 350 0 0 MARTHA HOLT BOARD SECRETARY & MEMBER 2.25 0.00 X X 350 0 0 MARIA ROSALES BOARD MEMBER 1.50 0.00 X 350 0 0 JOE MONTEMAYOR BOARD TREASURER & CHAIR 2.25 0.00 X X 300 0 0 SCOTT HARRIS BOARD MEMBER & VICE-CHAIR 2.25 0.00 X X 300 0 0 GLORIA OCHOA BOARD MEMBER 1.50 0.00 X 300 0 0 MARIA QUEZADA BOARD MEMBER 1.50 0.00 X 300 0 0 MIKE GARZA BOARD CHAIR (THROUGH JULY 2023) 1.50 0.00 X X 250 0 0 JANELLE BOGDEN BOARD MEMBER 1.50 0.00 X 250 0 0 ENRIQUE MIRON BOARD MEMBER 1.50 0.00 X 250 0 0 MARISOL QUEZADA BOARD MEMBER 1.50 0.00 X 150 0 0 4541875 0 445223 68 0 1 0 INLAND NORTHWEST IMAGING PS 801 S STEVENS ST SPOKANE WA 99204 RADIOLOGY SERVICES 298871 INTERPATH LABORATORY INC PO BOX 1208 PENDLETON OR 97801 LABORATORY TESTING SERVICES 271606 NUVODIA LLC 2818 N SULLIVAN ROAD SUITE 120 SPOKANE VALLEY WA 99216 RADIOLOGY & TECHNOLOGY SERVICES 219558 COMMUNITY CLINIC NETWORK 502 ORONDO AVENUE WENATCHEE WA 98801 PROFESSIONAL SERVICES 144327 GAMACHE MAINTENANCE LLC 1212 COLUMBIA PARK TRAIL SUITE 107 RICHLAND WA 99352 LANDSCAPING SERVICES 143572 7 71813 25736642 12162317 5542782 25736642 43513554 PATIENT SERVICES 621400 30512209 30512209 PHARMACY 621400 10472057 10472057 DENTAL 621400 9950089 9950089 OTHER HEALTH PROGRAMS 621400 4059260 4059260 54993615 1374000 1374000 22533375 2064760 21756720 2064011 776655 749 777404 777404 0 71813 62536 -62536 -62536 NMTC DISSOLUTION GAIN 900099 4035778 4035778 4035778 104631815 54993615 0 6124646 32503050 32503050 2585021 1058255 1526766 29886570 25972180 3914390 2267257 1581992 685265 3753807 2764924 988883 2537326 1868907 668419 122698 122698 54123 54123 177988 177988 2290423 1717297 573126 821730 195916 625814 2149057 1554816 594241 450353 313463 136890 1454267 873985 580282 278541 146375 132166 245930 162844 83086 3099173 2512161 587012 173930 96451 77479 PHARMACEUTICAL SUPPLIES 2957903 2957903 PROGRAM SUPPLIES 2620872 2394084 226788 REPAIRS AND MAINTENANCE 2216345 1700154 516191 BAD DEBT 584742 584742 1190826 576042 614784 94421932 81535541 12886391 0 16395239 12483261 5429513 15604884 1024082 1450013 2799382 3536986 21724625 531497 589991 1256154 1634997 80672186 29689740 23729913 50982446 34518601 32564154 1768609 1208671 897579 1203857 110075194 121259260 10775413 11565387 122021 0 453952 10897434 12019339 X 99177760 109239921 99177760 109239921 110075194 121259260 10209883 -147722 0 X X 0 1 X 1 1 1 X 8851298 10230894 14593115 16292978 43513554 93481839 41092153 41970003 48351619 50664738 54993615 237072128 49943451 52200897 62944734 66957716 98507169 330553967 0 0 0 330553967 1420365 1272543 1042765 1202401 1374000 6312074 1420365 1272543 1042765 1202401 1374000 6312074 4620 4035778 4040398 51363816 53473440 63987499 68164737 103916947 340906439 0.96960 0.97950 0.01850 0.02050 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: RAFFLE TICKET SALES - 2021 AMOUNT: $ 4,620. GAIN ON NEW MARKETS TAX CREDIT DISSOLUTION - 2022 AMOUNT: $ 4,035,778. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4600 4600 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO WACH, ACH, AND NWRPCA A PORTION OF WHICH IS USED BY THOSE ORGANIZATIONS TO LOBBY ON BEHALF OF THEIR MEMBERS. 6523488 6523488 58745991 22003228 36742763 369571 369571 12841430 7686512 5154918 2191706 2191706 50982446 RIGHT-OF-USE LEASE LIABILITIES 453952 453952 X 66771933 -147722 62536 -85186 66857119 177988 37596708 37774696 104631815 61418688 62536 62536 61356152 177988 32887792 33065780 94421932 PART X, LINE 2: UNDER PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, THE ASSOCIATION IS EXEMPT FROM FEDERAL INCOME TAXES, EXCEPT FOR NET INCOME FROM UNRELATED BUSINESS ACTIVITIES. AS OF NOVEMBER 30, 2023 AND 2022, THE ASSOCIATION HAD NO UNRELATED BUSINESS ACTIVITIES SUBJECT TO FEDERAL INCOME TAXES. MANAGEMENT EVALUATED THE ASSOCIATION'S TAX POSITIONS AND CONCLUDED THAT THE ASSOCIATION HAD TAKEN NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. THE ASSOCIATION'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 62,536. PART XI, LINE 4B - OTHER ADJUSTMENTS: NET INVESTMENT INCOME 1,824,945. GAIN ON DISPOSAL OF ASSETS 749. OTHER REVENUE 698,727. BAD DEBT EXPENSE 584,742. DISSOLUTION OF NEW MARKETS TAX CREDIT PROJECT 34,487,545. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 62,536. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 584,742. DISSOLUTION OF NET MARKETS TAX CREDIT PROJECT 32,303,050. COLOR RUN 71813 71813 464 6478 55594 71813 71813 464 6478 55594 62536 -62536 1 WAHLUKE SCHOOL DISTRICT 411 E SADDLE MOUNTAIN DRIVE MATTAWA WA 99349 916018970 WAHLUKE SCHOOL DIST. 200000 0 PURCHASE OF PORTABLE BUILDING COLUMBIA BASIN CIRCLE OF CARE 1515 E COLUMBIA STREET OTHELLO WA 99344 811037696 501(C)(3) 32303050 0 DISSOLUTION OF NET MARKETS TAX CREDIT PROJECT 2 0 PART I, LINE 2: BEFORE CBHA DONATES MONEY TO ANOTHER ORGANIZATION, CBHA CONFIRMS THAT THE RECIPIENT ORGANIZATION IS A 501(C)(3) ORGANIZATION. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 DR HUNG MIU CMO 333835 0 268490 0 276809 0 45446 0 6968 0 931548 0 101500 0 DR BASHAR ELALI PHYSICIAN 248301 0 184832 0 51243 0 11082 0 13910 0 509368 0 0 0 DR CATHERINE DINGLASAN PHYSICIAN 244410 0 143075 0 29589 0 11263 0 14275 0 442612 0 0 0 DR JI H CHOI CDO 205385 0 56750 0 123420 0 42352 0 1024 0 428931 0 0 0 NIEVES GOMEZ CEO 274860 0 86750 0 12716 0 73731 0 11425 0 459482 0 0 0 RANDEL STEVENS CIO 183181 0 41750 0 148561 0 14841 0 6902 0 395235 0 101500 0 DR SYED GILLANI PHYSICIAN 234220 0 97325 0 38956 0 10662 0 6845 0 388008 0 0 0 DR MATTHEW PAINTER PHYSICIAN 234002 0 73841 0 56268 0 0 0 7064 0 371175 0 0 0 DR ALAA ATFEH PHYSICIAN 230481 0 70047 0 15915 0 9899 0 18733 0 345075 0 0 0 JOSHUA BUNCH CFO 181313 0 36750 0 6500 0 34609 0 11365 0 270537 0 0 0 KELLY CARLSON CAO 140594 0 48750 0 6860 0 33558 0 19832 0 249594 0 0 0 JONATHAN MADERA VP OF OPERATIONS 123775 0 26250 0 1721 0 32768 0 6669 0 191183 0 0 0 PART I, LINE 1A THE ORGANIZATION WILL PAY FOR ANY EMPLOYEE'S MONTHLY GYM MEMBERSHIP FEE IF THE EMPLOYEE VISITS THE GYM AT LEAST 12 TIMES IN A MONTH. OTHERWISE, THE FEE IS DEDUCTED FROM THEIR PAYROLL. PART I, LINE 4B THE DEFERRED COMPENSATION PLAN WAS ORIGINALLY CREATED AS A 457(B) PLAN. IRS REQUIREMENTS AND THE PLAN ADMINISTRATION REQUIRED THE PLAN TO BE CONVERTED TO A 457(F) PLAN. THIS CHANGE REQUIRED PARTICIPANTS TO TAKE PAYOUTS FROM THE PLAN ON THE VESTING SCHEDULE OF 5 YEARS. REQUIRED 457(F) CONTRIBUTIONS IN CALENDAR YEAR 2022 INCLUDED THE FOLLOWING: NIEVES GOMEZ, CEO - $65,500 JOSHUA BUNCH, CFO - $27,000 DR. HUNG MIU, CMO - $27,000 DR. JI CHOI, CDO - $27,000 KELLY CARLSON, VP OF ADMINISTRATIVE SERVICES - $27,000 RANDEL STEVENS, CIO - $27,000 JONATHAN MADERA, VP OF OPERATIONS - $27,000 457(F) DISTRIBUTIONS IN CALENDAR YEAR 2022 INCLUDED THE FOLLOWING: DR. HUNG MIU, CMO - $125,656 RANDEL STEVENS, CIO - $147,060 MYRNA GOMEZ SPOUSE OF NIEVES GOMEZ 26615 EMPLOYEE COMPENSATION 0 KRISTEN STEVENS SPOUSE OF RANDEL STEVENS 70257 EMPLOYEE COMPENSATION 0 JUDE ALSARRAJ SPOUSE OF BASHAR ELALI 60898 EMPLOYEE COMPENSATION 0 X 1 24383183 NET BOOK VALUE X EQUIPMENT 1 1353459 NET BOOK VALUE 0 0 0 0 FORM 990, PART III, LINE 2 IN THE FALL OF 2023, CBHA OPENED TWO NEW REDUCED SERVICE SITES IN PASCO (MEDICAL AND BEHAVIORAL HEALTH ONLY) AND ROYAL CITY (DENTAL ONLY). FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE CONSIST OF THE BOARD'S OFFICERS, PLUS TWO BOARD MEMEBERS-AT-LARGE APPOINTED BY THE PRESIDENT AND APPROVED BY THE BOARD. THE BOARD OF DIRECTORS HAS RESPONSBILITY AND THE AUTHORITY TO DELEGATE ALL OR A PORTION OF ITS POWERS TO THE EXECUTIVE COMMITTEE FROM TIME TO TIME. SUCH DELEGATION IS ACCOMPLISHED EITHER BY RESOLUTION OR BY MOTION OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY THE INDEPENDENT AUDITOR AND PRESENTED TO SENIOR MANAGEMENT, THE FINANCE COMMITTEE, AND THE BOARD OF DIRECTORS FOR FINAL REVIEW AND APPROVAL BEFORE FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND ENFORCED WHEN DISCLOSURES ARISE. SUBJECT TO SECTION 2 SUBSECTION F OF THIS ARTICLE ANY POSSIBLE CONFLICT OF INTEREST ON THE PART OF A BOARD MEMBER SHALL BE DISCLOSED TO THE BOARD. WHEN ANY SUCH INTEREST BECOMES A MATTER OF BOARD ACTION, SUCH MEMBER SHALL NOT VOTE OR USE PERSONAL INFLUENCE ON THE MATTER, AND SHALL NOT BE COUNTED IN THE QUORUM FOR A MEETING AT WHICH BOARD ACTION IS TO BE TAKEN ON THE INTEREST. THE MEMBER MAY, HOWEVER, BRIEFLY STATE A POSITION ON THE MATTER, AND ANSWER PERTINENT QUESTIONS OF BOARD MEMBERS. THE MINUTES OF ALL ACTIONS TAKEN ON SUCH MATTERS SHALL CLEARLY REFLECT THAT THESE REQUIREMENTS HAVE BEEN MET. FORM 990, PART VI, SECTION B, LINE 15A A CONSULTING FIRM (MERCES, INC) HAS HELPED ESTABLISH A PAY STRUCTURE OF PAY GRADES WITHIN THE ORGANIZATION. ALL POSITIONS EXCLUDING PROVIDERS ARE EVALUATED ON A VARIETY OF MEASURES TO CREATE THE PAY GRADES. THERE ARE THREE PAY RANGES IN EACH SCALE THAT ARE REVIEWED ANNUALLY FOR ADJUSTMENT. PAY WITHIN A GRADE IS DETERMINED FROM PERFORMANCE EVALUATIONS. IN ADDITION, CBHA PARTICIPATES IN THE MILLIMAN USA COMPENSATION SURVEYS ANNUALLY FOR THE 50TH PERCENTILE COMPENSATION COMPARISONS AND/OR CALCULATIONS. THE CEO'S COMPENSATION IS SET BY THE BOARD OF DIRECTORS. OTHER OFFICERS' COMPENSATION IS SET BY THE CEO. THIS PROCESS WAS LAST COMPLETED IN 2024. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. PART XII, LINE 2C: THE PROCESS OF, AND RESPONSIBILITIES FOR, SELECTING THE FINANCIAL STATEMENT AUDITOR AND OVERSEEING THE FINANCIAL STATEMENT AUDIT DID NOT CHANGE DURING THE FISCAL YEAR. COLUMBIA BASIN CIRCLE OF CARE 1515 E COLUMBIA STREET OTHELLO WA 99344 811037696 SUPPORTING ORGANIZATION WA 501(C)(3) LINE 12C, III-FI N/A 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0