2025-10-13T14:20:52-05:00 2024-11-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2023-12-01 910896701 COLUMBIA BASIN HEALTH ASSOCIATION COLU 5094885256 1515 E COLUMBIA STREET OTHELLO WA 99344 NIEVES GOMEZ CEO 5094885256 2025-10-11 1 1 KURT BENNION CPA P01469618 4252506100 2025-10-11 2023 2025-03-06 01:10:19Z NIEVES GOMEZ 1515 E COLUMBIA STREET OTHELLO WA 99344 76474069 0 X WWW.CBHA.ORG X 1973 WA TO PROVIDE EQUAL ACCESS TO QUALITY HEALTH CARE TO ALL PERSONS. 12 12 566 11 0 0 43513554 11444215 54993615 62554099 2151404 2388139 3973242 3687 104631815 76390140 32503050 22000 0 0 41029981 44108114 0 0 0 20888901 23124962 94421932 67255076 10209883 9135064 121259260 138327740 12019339 17172689 109239921 121155051 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. 0 0 31309365 0 35652508 MEDICAL CARE - COLUMBIA BASIN HEALTH ASSOCIATION (CBHA) SERVED A TOTAL OF 40,776 INDIVIDUALS IN OUR SERVICE AREA - INCLUDING OTHELLO, MATTAWA, CONNELL, AND PASCO - FOR THE YEAR ENDED NOVEMBER 30, 2024. THE ORGANIZATION ALSO HAS A POLICY OF PROVIDING 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 $2,296,164 OF DISCOUNTED MEDICAL SERVICES. 10759646 0 10860340 DENTAL CARE - CBHA SERVED A TOTAL OF 20,137 INDIVIDUALS IN OUR SERVICE AREA - INCLUDING OTHELLO, MATTAWA, CONNELL, AND ROYAL CITY - FOR THE YEAR ENDED NOVEMBER 30, 2024. THE ORGANIZATION ALSO HAS A POLICY OF PROVIDING 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 $2,019,879 OF DISCOUNTED DENTAL SERVICES. 8233178 0 11486895 PHARMACY SERVICES - CBHA DISPENSED 257,588 SCRIPTS TO PATIENTS DURING THE YEAR ENDED NOVEMBER 30, 2024. 3928012 22000 4554356 OTHER HEALTH PROGRAMS INCLUDE VISION SERVICES, WHICH PROVIDES EYE CARE FOR PATIENTS OF ALL AGES, AS WELL AS REVENUE FROM OUR CAFE OPERATIONS. 3928012 22000 4554356 54230201 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 0 0 0 0 0 1 0 0 0 1 53 0 566 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 MARIA QUEZADA BOARD MEMBER 1.50 0.00 X 750 0 0 MARTHA HOLT BOARD MEMBER 2.25 0.00 X 650 0 0 JOE MONTEMAYOR BOARD CHAIR 2.25 0.00 X X 850 0 0 JANELLE BOGDEN BOARD MEMBER 1.50 0.00 X 500 0 0 MARIA ROSALES BOARD MEMBER 1.50 0.00 X 850 0 0 ENRIQUE MIRON BOARD MEMBER 1.50 0.00 X 450 0 0 GLORIA OCHOA BOARD MEMBER 1.50 0.00 X 700 0 0 DORA BERAZA BOARD SECRETARY 1.50 0.00 X X 850 0 0 DEBORAH BUSS BOARD TREASURER 2.25 0.00 X X 700 0 0 SCOTT HARRIS BOARD VICE CHAIR 2.25 0.00 X X 750 0 0 MARTIN GALLARDO BOARD MEMBER 1.50 0.00 X 600 0 0 MARISOL QUEZADA BOARD MEMBER 1.50 0.00 X 700 0 0 JOSHUA BUNCH CFO 50.00 0.00 X 366657 0 8742 NIEVES GOMEZ CEO 50.00 0.10 X 438457 0 84030 JONATHAN MADERA VP OF OPERATIONS 40.00 0.00 X 174048 0 36745 KELLY CARLSON CAO 40.00 0.00 X 188121 0 36805 STACEY SHORT VP OF QUALITY & VALUE-BASED SOLUTIONS 40.00 0.00 X 161247 0 30638 RANDEL STEVENS CIO 40.00 0.00 X 229569 0 39154 DR JI H CHOI CDO 40.00 0.00 X 337300 0 43492 DR HUNG MIU CMO 50.00 0.00 X 760308 0 50230 SYED GILLANI PHYSICIAN 40.00 0.00 X 387947 0 10354 ALAA ATFEH PHYSICIAN 40.00 0.00 X 329837 0 10902 MATTHEW PAINTER PHYSICIAN 40.00 0.00 X 364062 0 0 CATHERINE DINGLASAN PHYSICIAN 40.00 0.00 X 441834 0 13014 BASHAR ELALI PHYSICIAN 40.00 0.00 X 519242 0 11639 4706979 0 375745 67 0 1 0 INLAND NORTHWEST IMAGING PS 801 S STEVENS STREET SPOKANE WA 99204 RADIOLOGY SERVICES 303677 INTERPATH LABORATORY INC PO BOX 1208 PENDLETON OR 97801 LABORATORY TESTING SERVICES 291836 COMMUNITY CLINIC NETWORK 502 ORONDO AVENUE WENATCHEE WA 98801 PROFESSIONAL SERVICES 167492 NUVODIA LLC 801 S STEVENS STREET SPOKANE WA 99204 PROFESSIONAL SERVICES 158951 GAMACHE MAINTENANCE LLC 1212 COLUMBIA PARK TRAIL SUITE 107 RICHLAND WA 99352 LANDSCAPING SERVICES 154516 8 77198 11035605 331412 11444215 PATIENT SERVICES 621400 35652508 35652508 PHARMACY 621400 11486895 11486895 DENTAL 621400 10860340 10860340 OTHER HEALTH PROGRAMS 621400 4554356 4554356 62554099 2162949 2162949 36139 0 36139 36139 36139 209777 63000 0 47587 209777 15413 225190 225190 0 77198 36342 -36342 -36342 3890 0 3890 3890 76390140 62554099 0 2391826 22000 22000 2993891 1132792 1861099 33168344 29051044 4117300 2126327 1629683 496644 2974099 2373496 600603 2845453 2244240 601213 98050 98050 133051 133051 205068 205068 2801105 1843660 957445 815130 334294 480836 2602333 1954270 648063 449439 273271 176168 1190099 683875 506224 282077 144881 137196 173329 99537 73792 3441009 2740265 700744 173751 99845 73906 PHARMACEUTICAL SUPPLIES 4367741 4367741 PROGRAM SUPPLIES 2682312 2474227 208085 REPAIRS AND MAINTENANCE 2140777 1683028 457749 BAD DEBT 486874 486874 1082817 591178 491639 67255076 54230201 13024875 0 12483261 5568569 15604884 3456807 1450013 1060742 3536986 4110985 589991 759773 1634997 1576232 88052914 32050182 50982446 56002732 32564154 63561326 1208671 1207907 1203857 1022667 121259260 138327740 11565387 16500257 400366 453952 272066 12019339 17172689 X 109239921 121155051 109239921 121155051 121259260 138327740 9135064 2780066 0 X X 0 1 X 1 1 1 X 10230894 14593115 16293138 43508654 11444215 96070016 41970003 48351619 50664738 54993615 62554099 258534074 52200897 62944734 66957876 98502269 73998314 354604090 0 0 0 354604090 1272543 1042765 1202401 1374000 2199088 7090797 1272543 1042765 1202401 1374000 2199088 7090797 4460 4040678 3890 4049028 53473440 63987499 68164737 103916947 76201292 365743915 0.96950 0.96960 0.01940 0.01850 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: RAFFLE TICKET SALES - 2021 AMOUNT: $ 4,460. 2022 AMOUNT: $ 4,900. 2023 AMOUNT: $ 3,890. 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 9175 9175 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 58940181 23727108 35213073 272926 272926 0 14798224 8050148 6748076 7518095 7518095 56002732 RIGHT-OF-USE LEASE LIABILITIES 272066 272066 X 72791874 2780066 36342 2816408 69975466 205068 6209606 6414674 76390140 66599476 36342 36342 66563134 205068 486874 691942 67255076 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, 2024 AND 2023, 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 36,342. PART XI, LINE 4B - OTHER ADJUSTMENTS: NET INVESTMENT INCOME 4,947,724. GAIN ON DISPOSAL OF ASSETS 15,413. GRANTS AND CONTRIBUTIONS FOR CAPITAL PURCHASES 759,595. BAD DEBT EXPENSE 486,874. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 36,342. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 486,874. COLOR RUN 77198 77198 758 900 34684 77198 77198 758 900 34684 36342 -36342 1 WAHLUKE SCHOOL DISTRICT 411 E SADDLE MOUNTAIN DRIVE MATTAWA WA 99349 600141835 WAHLUKE SCHOOL DIST. 22000 0 PURCHASE OF PORTABLE BUILDING 1 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 347308 0 246498 0 166502 0 30000 0 20230 0 810538 0 0 0 BASHAR ELALI PHYSICIAN 263101 0 223884 0 32257 0 0 0 11639 0 530881 0 0 0 NIEVES GOMEZ CEO 288204 0 91500 0 58753 0 75000 0 9030 0 522487 0 0 0 CATHERINE DINGLASAN PHYSICIAN 245192 0 183233 0 13409 0 0 0 13014 0 454848 0 0 0 SYED GILLANI PHYSICIAN 228899 0 138995 0 20053 0 0 0 10354 0 398301 0 0 0 DR JI H CHOI CDO 207981 0 31000 0 98319 0 30000 0 13492 0 380792 0 0 0 JOSHUA BUNCH CFO 188270 0 38500 0 139887 0 0 0 8742 0 375399 0 120000 0 MATTHEW PAINTER PHYSICIAN 230481 0 69988 0 63593 0 0 0 0 0 364062 0 0 0 ALAA ATFEH PHYSICIAN 228959 0 100878 0 0 0 0 0 10902 0 340739 0 0 0 RANDEL STEVENS CIO 187729 0 38200 0 3640 0 30000 0 9154 0 268723 0 0 0 KELLY CARLSON CAO 151621 0 36500 0 0 0 30000 0 6805 0 224926 0 0 0 JONATHAN MADERA VP OF OPERATIONS 131675 0 26900 0 15473 0 30000 0 6745 0 210793 0 0 0 STACEY SHORT VP OF QUALITY & VALUE-BASED SOLUTIONS 157025 0 4000 0 222 0 30000 0 638 0 191885 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 2023 INCLUDED THE FOLLOWING: NIEVES GOMEZ, CEO - $75,000 JOSHUA BUNCH, CFO - $30,000 DR. HUNG MIU, CMO - $30,000 DR. JI CHOI, CDO - $30,000 RANDEL STEVENS, CIO - $30,000 KELLY CARLSON, CAO - $30,000 JONATHAN MADERA, VP OF OPERATIONS - $30,000 SHANNON WALKER, VP OF HEALTH EQUITY - $30,000 STACEY SHORT, VP OF QUALITY & VALUE-BASED SOLUTIONS - $30,000 457(F) DISTRIBUTIONS IN CALENDAR YEAR 2023 INCLUDED THE FOLLOWING: JOSHUA BUNCH, CFO - $120,000 MYRNA GOMEZ SPOUSE OF NIEVES GOMEZ, CEO 39027 EMPLOYEE COMPENSATION 0 KRISTEN STEVENS SPOUSE OF RANDEL STEVENS, CIO 69168 EMPLOYEE COMPENSATION 0 JUDE ALSARRAJ SPOUSE OF BASHAR ELALI, PHYSICIAN 68520 EMPLOYEE COMPENSATION 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0