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Nonprofiteer
← TRI-STATE MEMORIAL HOSPITAL

Form 990 for tax year 2023

Filed by TRI-STATE MEMORIAL HOSPITAL.

Totals

Total revenue
$131,505,892
Total expenses
$129,094,438
Contributions and grants received
$3,399,350
Grants paid
$9,650
Program service revenue
$128,105,569
Investment income
$1,277,046
Other revenue
-$1,276,073
Total assets, end of year
$141,894,222
Total liabilities, end of year
$60,511,381
Net assets or fund balances, end of year
$81,382,841
Program services expenses (Part IX)
$114,469,964
Management and general expenses
$14,624,474
Fundraising expenses
$0
Program service expenses (Part III)
$114,469,964

Program services were 88.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $3,399,350

  • 2a · Program service revenue: NET PATIENT SERVICE

    total $125,563,086 · related or exempt $125,563,086

  • 2b · Program service revenue: 340B REVENUE

    total $1,618,326 · related or exempt $1,618,326

  • 2c · Program service revenue: MOB RENTAL INCOME

    total $40,126 · related or exempt $40,126

  • 2f · All other program service revenue

    total $884,031 · related or exempt $884,031

  • 3 · Investment income

    total $1,264,380 · excluded $1,264,380

  • 6a · Gross rents

    real property $423,949

  • 6b · Less rental expenses

    real property $775,430

  • 6c · Rental income or loss

    real property -$351,481

  • 6d · Net rental income or loss

    total -$351,481 · unrelated business -$351,481

  • 7a · Gross sales of assets other than inventory

    securities $12,666

  • 7b · Less cost or other basis and sales expenses

    securities $0

  • 7c · Gain or loss

    securities $12,666

  • 7d · Net gain or loss

    total $12,666 · excluded $12,666

  • 11a · Other revenue: INCOME ON INVESTMENT IN SUBSIDIAR

    total -$3,157,922 · related or exempt -$3,157,922

  • 11d · All other revenue

    total $2,233,330 · excluded $2,233,330

  • 11e · Other revenue, total

    -$924,592

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $9,650 · program services $9,650

  • 5 · Compensation of officers, directors and key employees

    total $1,360,639 · program services $397,622 · management and general $963,017

  • 7 · Other salaries and wages

    total $46,715,722 · program services $40,139,975 · management and general $6,575,747

  • 8 · Pension plan contributions

    total $1,352,023 · program services $1,111,552 · management and general $240,471

  • 9 · Other employee benefits

    total $7,046,292 · program services $5,851,554 · management and general $1,194,738

  • 10 · Payroll taxes

    total $3,729,674 · program services $3,079,271 · management and general $650,403

  • 11b · Fees: legal

    total $65,238 · management and general $65,238

  • 11c · Fees: accounting

    total $48,000 · management and general $48,000

  • 11g · Fees: other

    total $26,389,557 · program services $24,575,699 · management and general $1,813,858

  • 13 · Office expenses

    total $870,613 · program services $700,393 · management and general $170,220

  • 16 · Occupancy

    total $3,381,336 · program services $2,508,280 · management and general $873,056

  • 17 · Travel

    total $53,205 · program services $53,205

  • 20 · Interest

    total $369,446 · program services $369,446

  • 22 · Depreciation, depletion and amortization

    total $4,284,004 · program services $4,284,004

  • 23 · Insurance

    total $1,064,771 · program services $1,064,771

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $24,974,363 · program services $24,974,363

  • 24b · Other expenses: BAD DEBT

    total $2,026,937 · program services $2,026,937

  • 24c · Other expenses: 304B EXPENSES

    total $1,122,737 · program services $1,122,737

  • 24d · Other expenses: LICENSES AND TAXES

    total $1,024,128 · program services $1,024,128

  • 24e · All other expenses

    total $3,206,103 · program services $1,176,377 · management and general $2,029,726

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $7,420,226 · end of year $6,507,778

  • 2 · Savings and temporary cash investments

    beginning of year $6,449,073 · end of year $6,735,278

  • 4 · Accounts receivable

    beginning of year $14,453,426 · end of year $15,441,009

  • 7 · Other notes and loans receivable

    beginning of year $277,588 · end of year $365,469

  • 8 · Inventories for sale or use

    beginning of year $3,024,974 · end of year $3,294,726

  • 9 · Prepaid expenses and deferred charges

    beginning of year $802,340 · end of year $1,176,870

  • 10a · Land, buildings and equipment: cost or other basis

    $134,664,295

  • 10b · Land, buildings and equipment: accumulated depreciation

    $67,246,529

  • 10c · Land, buildings and equipment, net

    beginning of year $54,850,681 · end of year $67,417,766

  • 11 · Investments: publicly traded securities

    beginning of year $15,461,551 · end of year $28,858,313

  • 12 · Investments: other securities

    beginning of year $114,366 · end of year $117,923

  • 14 · Intangible assets

    beginning of year $3,384,400 · end of year $3,384,400

  • 15 · Other assets

    beginning of year $10,551,896 · end of year $8,594,690

  • 17 · Accounts payable and accrued expenses

    beginning of year $11,155,371 · end of year $12,730,953

  • 23 · Secured mortgages and notes payable

    beginning of year $13,890,447 · end of year $32,639,015

  • 25 · Other liabilities

    beginning of year $13,094,148 · end of year $15,141,413

  • 27 · Net assets without donor restrictions

    beginning of year $72,135,794 · end of year $76,242,106

  • 28 · Net assets with donor restrictions

    beginning of year $6,514,761 · end of year $5,140,735

Mission and programs · 2023

Mission

FROM OUR FIRST DAY OF OPERATION UNTIL TODAY, WE ARE PROUD TO SAY THAT OUR MISSION HAS ALWAYS REMAINED THE SAME: THE PATIENT IS OUR FIRST PRIORITY.

Activities or mission (Part I)

TRI-STATE MEMORIAL HOSPITAL, A 62 BED LICENSED NOT-FOR-PROFIT COMMUNITY OWNED HOSPITAL, IS CURRENTLY OPERATING AS A 25 BED CRITICAL ACCESS HOSPITAL. THE HOSPITAL SERVES A 10 COUNTY REGION IN THREE STATES (WASHINGTON, OREGON, AND IDAHO).

  • THE HOSPITAL PROVIDED 4099 DAYS OF CARE TO 1,031 PATIENTS IN 2023. IN ADDITION, THE HOSPITAL PROVIDED APPROXIMATELY 346,026 OUTPATIENT VISITS IN THE EMERGENCY ROOM, RENTAL DIALYSIS, SURGICAL, AND OTHER PATIENT SERVICE CENTERS. THE HOSPITAL PROVIDED APPROXIMATELY $2,292,734 IN CHARITABLE SERVICES TO PATIENTS UNABLE TO PAY FOR HEALTHCARE SERVICES.

    Expenses $114,469,964 · Grants $9,650 · Revenue $128,105,569

As filed on the 2023 return.

Listed in Part VII

  • KIMBERLY BLEWETT

    BOARD MEMBER

    Total calculated
    $313,791
    From this org
    $287,021
    From related orgs
    $0
    Other
    $26,770
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $255,105
    Bonus
    $28,595
    Other
    $3,321
    Deferred
    $13,620
    Nontaxable benefits
    $13,150
    Filer's total
    $313,791

  • JOHN RUDOLPH MD

    BOARD MEMBER (THRU 7/23)

    Total calculated
    $397,622
    From this org
    $370,568
    From related orgs
    $0
    Other
    $27,054
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $319,622
    Other
    $50,946
    Deferred
    $13,918
    Nontaxable benefits
    $13,136
    Filer's total
    $397,622

  • MIKE MARTIN

    PRESIDENT

    Total calculated
    $0
    Hours/week
    1

  • K DAVID HAGEN

    SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    1

  • ROBIN ALBERS

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • SCOTT ARNONE

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • DEBRA R AUSMAN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • MICHELE BEEHLER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • STEVE CLAASSEN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • E WAYNE DAY MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • DICK FLERCHINGER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • PAUL JELINEK

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • DAN KLAVEANO

    BOARD MEMBER (THRU 7/23)

    Total calculated
    $0
    Hours/week
    1

  • DON MCQUARY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • RICK WASEM

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • KYM CLIFT

    CEO

    Total calculated
    $392,461
    From this org
    $373,264
    From related orgs
    $0
    Other
    $19,197
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $352,764
    Bonus
    $20,500
    Other
    $0
    Deferred
    $5,799
    Nontaxable benefits
    $13,398
    Filer's total
    $392,461

  • JIM HEILSBERG

    CFO

    Total calculated
    $256,765
    From this org
    $241,359
    From related orgs
    $0
    Other
    $15,406
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $232,780
    Bonus
    $0
    Other
    $8,579
    Deferred
    $4,034
    Nontaxable benefits
    $11,372
    Filer's total
    $256,765

  • CRAIG FLINDERS

    PHYSICIAN

    Total calculated
    $589,520
    From this org
    $556,556
    From related orgs
    $0
    Other
    $32,964
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $556,556
    Other
    $0
    Deferred
    $19,800
    Nontaxable benefits
    $13,164
    Filer's total
    $589,520

  • LEROY SMITH

    PHYSICIAN

    Total calculated
    $538,859
    From this org
    $521,095
    From related orgs
    $0
    Other
    $17,764
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $412,115
    Bonus
    $0
    Other
    $108,980
    Deferred
    $0
    Nontaxable benefits
    $17,764
    Filer's total
    $538,859

  • ELINA CHERNYAK

    PHYSICIAN

    Total calculated
    $605,852
    From this org
    $579,560
    From related orgs
    $0
    Other
    $26,292
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $327,418
    Bonus
    $243,342
    Other
    $8,800
    Deferred
    $10,890
    Nontaxable benefits
    $15,402
    Filer's total
    $605,852

  • DUNCAN HARRIS

    PHYSICIAN

    Total calculated
    $542,475
    From this org
    $529,520
    From related orgs
    $0
    Other
    $12,955
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $522,563
    Bonus
    $0
    Other
    $6,957
    Deferred
    $0
    Nontaxable benefits
    $12,955
    Filer's total
    $542,475

  • KENNETH BERGER

    PHYSICIAN

    Total calculated
    $581,237
    From this org
    $560,111
    From related orgs
    $0
    Other
    $21,126
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $521,453
    Bonus
    $21,619
    Other
    $17,039
    Deferred
    $3,362
    Nontaxable benefits
    $17,764
    Filer's total
    $581,237

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Form 990 of other organizations
  • 3 · Written employment contract
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

  • AQUAVIA

    REAL ESTATE RENTAL · WA · income -$351,479 · assets $5,449,045

    Directly controlled by TRI-STATE MEMORIAL HOSPITAL

  • VANNVEI LLC

    HEALTH SERVICES · WA · income -$1,995,354 · assets $1,247,763

    Directly controlled by TRI-STATE MEMORIAL HOSPITAL

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2023
Filed
8 November 2024
IRS schema version
2023v5.1
Source object
202433209349304468

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