2024-11-15T18:17:08-06:00 2023-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2023-01-01 680046750 NORTHBAY HEALTHCARE CORPORATION NORT 7076463400 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 JOSEPH D'ANGINA CHIEF FINANCIAL OFFICER 7076463400 2024-11-14 1 0 MICHAEL LUMSDEN P01262236 4159561500 2024-11-14 2023 2024-10-15 13:58:12Z MARK BEHL 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 98668407 0 X WWW.NORTHBAY.ORG X 1984 CA MANAGEMENT AND OTHER SUPPORT SERVICES FOR NORTHBAY HEALTHCARE AFFILIATED ORGANIZATIONS. 7 6 3059 0 0 0 90000 9500 94073844 98651106 5301 7801 1418 0 94170563 98668407 90000 115000 0 0 35885861 35609891 0 0 0 57960882 63807732 93936743 99532623 233820 -864216 81988832 67209935 75787362 98849458 6201470 -31639523 COMPASSIONATE CARE, ADVANCED MEDICINE, CLOSE TO HOME. 0 0 71180959 115000 98651106 NORTHBAY HEALTHCARE CORPORATION (NBHC) IS THE PARENT ORGANIZATION OF THREE CALIFORNIA NON-PROFIT PUBLIC BENEFIT CORPORATIONS; ONE OF THOSE CORPORATIONS, NORTHBAY HEALTHCARE GROUP, OWNS AND OPERATES NON-PROFIT COMMUNITY HOSPITALS IN FAIRFIELD AND VACAVILLE. THE PURPOSE OF NBHC IS TO SUPPORT AND HELP CARRY OUT THE PURPOSES AND FUNCTIONS OF NORTHBAY HEALTHCARE GROUP, NORTHBAY HEALTH ADVANTAGE, AND NORTHBAY HEALTHCARE FOUNDATION. THIS IS ACCOMPLISHED THROUGH PROVIDING COORDINATION, MANAGEMENT, AND OTHER SUPPORT SERVICES TO THE NON-PROFIT HOSPITALS AND OTHER RELATED COMMUNITY HEALTHCARE PROGRAMS. THESE SERVICES INCLUDE MARKETING, RESEARCH OF NEW CLINICAL SERVICE AREAS, MANAGING CONTRACTS BETWEEN PROVIDERS AND PAYORS, AND FINANCING. 71180959 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 3059 1 0 0 0 0 0 0 0 0 0 0 1 0 X 7 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X JOSEPH D'ANGINA 7076463111 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 B KONARD JONES PRESIDENT & CEO THROUGH 12/2023 30.00 20.00 X X 2316091 0 57834 MARK BEHL PRESIDENT & CEO START 10/2023 30.00 20.00 X X 447232 0 22353 MARK SIEVERS CHAIR 1.00 1.00 X X 0 17502 0 STEPHEN J POWER VICE CHAIR 1.00 0.00 X X 0 17502 0 CHRIS SWEENEY SECRETARY - TREASURER START 5/2023 1.00 0.00 X X 0 17515 0 GARY FALATI DIRECTOR 1.00 1.00 X 0 9364 0 ARCHIE HUMPHREY DIRECTOR 1.00 1.00 X 0 17274 0 MURRAY WOOLF MD DIRECTOR 1.00 0.00 X 0 17225 0 MARY MANCINI SECRETARY - TREASURER THROUGH 5/2023 1.00 0.00 X X 0 15333 0 JOSEPH D'ANGINA CHIEF FINANCIAL OFFICER START 1/2023 5.00 45.00 X 701077 0 79055 TIMOTHY MAURICE INTERIM CFO THROUGH 1/2023 5.00 45.00 X 87232 0 0 TIMOTHY WILLIAMS VP, AMBULATORY SERVICES 0.00 50.00 X 247017 0 14659 CHRISTOPHER TIMBERS CHIEF INFORMATION OFFICER 10.00 40.00 X 700529 0 89424 JIM ANDERSEN CHIEF HUMAN RESOURCES OFFICER 5.00 45.00 X 436552 0 154843 TRACY GEDDIS CHIEF OPERATING OFFICER 5.00 45.00 X 484602 0 130831 HEATHER RESSEGER CHIEF NURSING OFFICER 0.00 50.00 X 463039 0 134844 SETH KAUFMAN MD CHIEF MEDICAL & QUALITY OFFICER 0.00 50.00 X 568413 0 194292 PAUL MCGINTY PRES NBHF & CHIEF EXPERIENCE OFFICER 0.00 50.00 X 371817 0 144429 SHENIECE SMITH CAO & GENERAL COUNSEL THRU 11/2023 5.00 45.00 X 512567 0 130016 THERESA BARTOLI CLINICAL COORDINATOR 0.00 40.00 X 361959 0 55134 THEO RALLIS ASSISTANT VICE PRESIDENT, FINANCE 5.00 45.00 X 353423 0 79290 ANDREA FRANCIS ROBOTIC SURGICAL SYSTEMS PROG COORD 0.00 40.00 X 316468 0 31942 SETH BARGER CLINICAL COORDINATOR 0.00 40.00 X 309695 0 43278 DUSTIN DATOC CERTIFIED REGISTERED NURSE FIRST ASSISTANT 0.00 40.00 X 311122 0 49385 SCOTT DAVIS FORMER VP, CHIEF STRATEGY OFFICER 0.00 0.00 X 130410 0 0 9119245 111715 1411609 1102 1 1 0 OPTUM360 LLC PO BOX 88050 CHICAGO IL 606801050 REVENUE SERVICES 20688404 RECEIVABLE SOLUTIONS LLC 800 DUTCH SQUARE BLVD 100 COLUMBIA SC 29210 COLLECTIONS SERVICES 4979044 CERNER CORPORATION PO BOX 959156 ST LOUIS MO 631959156 IT SERVICES 3344657 ORACLE CREDIT CORPORATION PO BOX 412622 BOSTON MA 02241 IT SERVICES 1110555 CANTATA HEALTH SOLUTIONS PO BOX 93955 LAS VEGAS NV 89193 IT SERVICES 665921 40 9500 9500 MANAGEMENT SERVICES REVENUE 541900 98649573 98649573 REBATES & REFUNDS 541900 1533 1533 98651106 7801 0 7801 7801 7801 98668407 98651106 0 7801 X 115000 115000 7726047 1905134 5820913 22761058 13615163 9145895 1503565 610723 892842 2770054 1898422 871632 849167 1053583 -204416 1795962 1025756 770206 282003 282003 40934465 38069082 2865383 446543 15333 431210 833008 735738 97270 2595578 2595578 4434034 4059158 374876 78043 23259 54784 15869 10417 5452 96256 86556 9700 3377371 3370045 7326 3424477 3424477 RECRUITING 804918 142904 662014 TAXES/LICENSES 338675 278709 59966 DUES & SUBSCRIPTIONS 280026 45133 234893 PUBLIC RELATIONS 80868 80868 3989636 1444398 2545238 99532623 71180959 28351664 0 579446 11213704 187151 805775 12139 15246 5105038 6102061 67106082 53586664 12512949 13519418 100 100 63592009 35553631 81988832 67209935 49536656 41979550 4923 4923 103719 1953657 26142064 54911328 75787362 98849458 X 6190616 -31650377 10854 10854 6201470 -31639523 81988832 67209935 X -864216 -36976777 X 0 1 X 1 0 X X 1 NORTHBAY HEALTHCARE GROUP 941458282 3 1 0 97650593 1 0 97650593 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PART I, SECTION A, LINE 12G, COLUMN (VI): THE ORGANIZATION PROVIDES COORDINATION, MANAGEMENT, AND OTHER SUPPORT SERVICES TO NORTHBAY HEALTHCARE GROUP. THESE SERVICES INCLUDE MARKETING, RESEARCH OF NEW CLINICAL SERVICE AREAS, MANAGING CONTRACTS BETWEEN PROVIDERS AND PAYORS, AND FINANCING. PART IV, SECTION C, LINE 1: NORTHBAY HEALTHCARE CORPORATION (NBHC) IS THE SOLE CORPORATE MEMBER OF NORTHBAY HEALTHCARE GROUP (NBHG), AS WELL AS NBHG'S OTHER SUPPORTING ORGANIZATIONS (NORTHBAY HEALTH ADVANTAGE AND NORTHBAY HEALTHCARE FOUNDATION). NBHC SERVES AS THE PARENT AND SUPPORTS AND CARRIES OUT THE PURPOSES AND FUNCTIONS OF NBHG. NBHC, A TYPE II SUPPORTING ORGANIZATION, HAS A HISTORICAL AND CONTINUOUS WORKING RELATIONSHIP WITH ITS SUPPORTED ORGANIZATION, NBHG, IN THAT TWO MEMBERS OF NBHC'S BOARD AND THE CEO OF NBHC SERVE AS VOTING DIRECTORS OF NBHG, THUS ENSURING NBHC WILL BE RESPONSIVE TO THE NEEDS OF NBHG. 0 0 0 0 0 0 0 0 1 19225 19225 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE CALIFORNIA HOSPITAL ASSOCIATION / CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS; A PORTION OF THOSE DUES ARE ATTRIBUTABLE TO LOBBYING, WHICH SUPPORTS CERTAIN INITIATIVES THAT ARE HEALTHCARE RELATED AND CONSISTENT WITH ITS MISSION OF PROMOTING HEALTHCARE WITHIN ITS COMMUNITY. 710938 710938 0 1242479 1148542 93937 64127522 50909780 13217742 1025143 817404 207739 13519418 OPERATING LEASE RIGHT-OF-USE ASSETS 31675375 DEFERRED COMPENSATION PLAN INVESTMENTS 3878256 35553631 WORKERS COMP RESERVE 5440495 OPERATING LEASE LIABILITIES 32336343 ADVANCED PAYMENT/SETTLEMENT LIABILITY 13302685 OTHER DEPOSITS 83423 DEFERRED COMPENSATION PLAN LIABILITIES 3748382 54911328 1 VACAVILLE SOLANO SERVICES CORPORATION PO BOX 6593 VACAVILLE CA 95688 680364021 501(C)(3) 25000 0 SPONSORSHIP AND GENERAL SUPPORT FOR OPPORTUNITY HOUSE SOLANO COUNTY LIBRARY FOUNDATION 601 KENTUCKY STREET FAIRFIELD CA 94533 680342423 501(C)(3) 15000 0 SPONSORSHIP OF REACH OUT AND READ SOLANO ECONOMIC DEVELOPMENT CORP 5050 BUSINESS CENTER DRIVE 200 FAIRFIELD CA 94534 942912759 501(C)(3) 50000 0 SPONSORSHIP AND GENERAL SUPPORT - SOLANO EDC GOLD CLASSIC SOLANO LAND TRUST 198 DOBBINS STREET SUITE A VACAVILLE CA 95688 943015363 501(C)(3) 10000 0 SPONSORSHIP AND GENERAL SUPPORT TOURO UNIVERSITY OF CALIFORNIA 1310 CLUB DRIVE VALLEJO CA 94592 133838740 501(C)(3) 15000 0 SPONSORSHIP AND GENERAL SUPPORT 5 0 PART I, LINE 2: NBHC GRANTS FUNDS TO OTHER LOCAL NON-PROFITS AND COMMUNITY ORGANIZATIONS KNOWN TO NBHC TO ASSIST WITH THEIR FUNDRAISING ENDEAVORS. NBHC DOES NOT MONITOR USE OF THESE GRANT FUNDS, AS GRANT FUNDS ARE UNRESTRICTED. X X X X 0 1 0 0 0 0 0 1 0 B KONARD JONES PRESIDENT & CEO THROUGH 12/2023 1013240 0 784654 0 518197 0 15877 0 41957 0 2373925 0 492461 0 CHRISTOPHER TIMBERS CHIEF INFORMATION OFFICER 432433 0 191726 0 76370 0 17903 0 71521 0 789953 0 55570 0 JOSEPH D'ANGINA CHIEF FINANCIAL OFFICER START 1/2023 600788 0 90000 0 10289 0 1600 0 77455 0 780132 0 0 0 SETH KAUFMAN MD CHIEF MEDICAL & QUALITY OFFICER 503457 0 51000 0 13956 0 72117 0 122175 0 762705 0 0 0 SHENIECE SMITH CAO & GENERAL COUNSEL THRU 11/2023 447217 0 51000 0 14350 0 55979 0 74037 0 642583 0 0 0 TRACY GEDDIS CHIEF OPERATING OFFICER 423762 0 51000 0 9840 0 52526 0 78305 0 615433 0 0 0 HEATHER RESSEGER CHIEF NURSING OFFICER 392039 0 71000 0 0 0 57521 0 77323 0 597883 0 0 0 JIM ANDERSEN CHIEF HUMAN RESOURCES OFFICER 375119 0 51000 0 10433 0 61404 0 93439 0 591395 0 0 0 PAUL MCGINTY PRES NBHF & CHIEF EXPERIENCE OFFICER 333452 0 31000 0 7365 0 47693 0 96736 0 516246 0 0 0 MARK BEHL PRESIDENT & CEO START 10/2023 211540 0 0 0 235692 0 2115 0 20238 0 469585 0 0 0 THEO RALLIS ASSISTANT VICE PRESIDENT, FINANCE 249463 0 103960 0 0 0 19253 0 60037 0 432713 0 0 0 THERESA BARTOLI CLINICAL COORDINATOR 357787 0 1000 0 3172 0 17309 0 37825 0 417093 0 0 0 DUSTIN DATOC CERTIFIED REGISTERED NURSE FIRST ASS 310122 0 1000 0 0 0 7527 0 41858 0 360507 0 0 0 SETH BARGER CLINICAL COORDINATOR 308695 0 1000 0 0 0 11098 0 32180 0 352973 0 0 0 ANDREA FRANCIS ROBOTIC SURGICAL SYSTEMS PROG COORD 315468 0 1000 0 0 0 9158 0 22784 0 348410 0 0 0 TIMOTHY WILLIAMS VP, AMBULATORY SERVICES 186928 0 60000 0 89 0 1869 0 12790 0 261676 0 0 0 SCOTT DAVIS FORMER VP, CHIEF STRATEGY OFFICER 0 0 0 0 130410 0 0 0 0 0 130410 0 130410 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE ORGANIZATION'S SUPPLEMENTAL 457(F) RETIREMENT PLAN. EMPLOYER CONTRIBUTIONS TO THE PLAN DURING THE 2023 CALENDAR YEAR ARE AS FOLLOWS, WHICH HAS BEEN REPORTED AS "RETIREMENT AND OTHER DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C): SETH KAUFMAN, MD - $58,917 SHENIECE SMITH - $49,441 TRACY GEDDIS - $45,525 HEATHER RESSEGER - $44,321 JIM ANDERSEN - $48,204 PAUL MCGINTY - $49,441 ADDITIONALLY, DUE TO VESTING OF THE 457(F) PLAN, THE FOLLOWING INDIVIDUALS RECOGNIZED THE FOLLOWING AMOUNTS AS TAXABLE COMPENSATION, WHICH HAS BEEN REPORTED WITHIN "OTHER REPORTABLE COMPENSATION" ON SCHEDULE J, PART II, COLUMN (B)(III) AS WELL AS WITHIN "COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED ON PRIOR FORM 990" ON SCHEDULE J, PART II, COLUMN F: B. KONARD JONES - $492,461 CHRISTOPHER TIMBERS - $55,570 SCOTT DAVIS - $130,410 PART I, LINE 7 THE SENIOR MANAGEMENT INCENTIVE PROGRAM INCLUDES SPECIFIC CRITERIA WHICH MUST BE MET IN ORDER FOR SUCH INDIVIDUALS TO RECEIVE ADDITIONAL COMPENSATION; SOME OF THIS CRITERIA REQUIRES SUPERVISORS AND/OR THE BOARD TO EXERCISE DISCRETION (IN PART) WHEN CALCULATING THE AMOUNT OF PAYMENT OR DECIDING WHETHER TO MAKE SUCH A PAYMENT. FORM 990, PART V, LINES 1A AND 2A: ALL FORM 1099S FOR NORTHBAY HEALTHCARE CORPORATION WERE FILED BY NORTHBAY HEALTHCARE GROUP, A RELATED ORGANIZATION. ACCORDINGLY, THE AMOUNT REPORTED ON FORM 990, PART V, LINE 1A (IN REGARDS TO THE AMOUNT REPORTED ON THE 2023 FORM 1096, BOX 3) REFLECTS ZERO. ADDITIONALLY, ALL FORM W-2S FOR NORTHBAY HEALTHCARE SYSTEM WERE FILED BY NORTHBAY HEALTHCARE CORPORATION, WHICH IS THE BASIS FOR THE NUMBER OF EMPLOYEES REPORTED ON FORM 990, PART V, LINE 2A. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT TAX ACCOUNTANT AND REVIEWED BY THE CHIEF FINANCIAL OFFICER; ADJUSTMENTS ARE MADE, AS NECESSARY. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE GOVERNING BODY FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUESTS ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND MEMBERS OF COMMITTEES APPOINTED BY THE BOARD OF DIRECTORS TO SELF-MONITOR COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY; IN ADDITION, EACH OFFICER AND BOARD MEMBERS MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST STATEMENT. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND ALL RESPONSES FILED. IF A POTENTIAL CONFLICT ARISES, BOARD MEMBERS AND EMPLOYEES ARE REQUIRED TO SELF-DISCLOSE THE CONFLICT TO THE CORPORATE COMPLIANCE OFFICER. PROCESSES AND PROCEDURES ARE IN PLACE TO EVALUATE AND DETERMINE IF A POSSIBLE CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WILL PRESENT RELEVANT INFORMATION TO THE BOARD. AFTER SUCH PRESENTATION, THE INDIVIDUAL SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 AN AD HOC COMPENSATION COMMITTEE OF THE HEALTH SYSTEM BOARD REVIEWS EXECUTIVE COMPENSATION, INCLUDING THAT OF THE ORGANIZATION'S CEO, OTHER OFFICERS, AND KEY EMPLOYEES; THEY ARE ASSISTED BY INDEPENDENT CONSULTANTS. THE ORGANIZATION USES INDEPENDENT LOCAL SURVEYS AS A MEANS TO SUBSTANTIATE COMPENSATION DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE DIGITAL ASSURANCE CORPORATION WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G TEMPORARY LABOR: PROGRAM SERVICE EXPENSES 281,477. MANAGEMENT AND GENERAL EXPENSES 13,207. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 294,684. CONSULTING FEES: PROGRAM SERVICE EXPENSES 368,266. MANAGEMENT AND GENERAL EXPENSES 743,793. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,112,059. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 23,516. MANAGEMENT AND GENERAL EXPENSES 204,013. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 227,529. PURCHASED SERVICES - OTHER: PROGRAM SERVICE EXPENSES 37,395,823. MANAGEMENT AND GENERAL EXPENSES 1,904,370. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,300,193. FORM 990, PART XI, LINE 9: INTERCOMPANY EQUITY TRANSFERS 18,750,860. RELIEF OF DUE FROM RELATED ORGANIZATIONS -55,727,637. NORTHBAY HEALTH ADVANTAGE 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 942495998 MANAGES REAL ESTATE FOR NORTHBAY HEALTHCARE GROUP & AFFILIATES CA 501(C)(3) LINE 12B, II NORTHBAY HEALTHCARE CORPORATION 1 NORTHBAY HEALTHCARE GROUP 1200 B GALE WILSON BOULEVARD FAIRFIELD CA 94533 941458282 OPERATES TWO NONPROFIT HOSPITALS CA 501(C)(3) LINE 3 NORTHBAY HEALTHCARE CORPORATION 1 NORTHBAY HEALTHCARE FOUNDATION 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 942995085 PROVIDES FUNDRAISING FOR NORTHBAY HEALTHCARE GROUP & AFFILIATES CA 501(C)(3) LINE 12B, II NORTHBAY HEALTHCARE CORPORATION 1 SOLANO DIAGNOSTIC PARTNERS 1101 B GALE WILSON BLVD FAIRFIELD CA 94533 931013774 DIAGNOSTIC IMAGING CA NORTHBAY HEALTH ADVANTAGE RELATED 11140 210127 0 0 0.05000 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 0 NORTHBAY HEALTH ADVANTAGE L 144358 BOOK VALUE NORTHBAY HEALTHCARE GROUP L 97650593 BOOK VALUE NORTHBAY HEALTHCARE FOUNDATION L 99202 BOOK VALUE SOLANO DIAGNOSTIC PARTNERS L 755420 BOOK VALUE