2023-11-15T11:15:55-06:00 2022-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2022-01-01 940382780 CHINESE HOSPITAL ASSOCIATION CHIN 4156772440 845 JACKSON STREET SAN FRANCISCO CA 94133 CHI-KUO CHUNG PRESIDENT & CFO 4156772440 2023-11-14 1 CHI-KUO CHUNG 999009999 0 MICHAEL LUMSDEN P01262236 4159561500 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DR JIAN ZHANG 845 JACKSON STREET SAN FRANCISCO CA 94133 150144809 0 X WWW.CHINESEHOSPITAL-SF.ORG X 1925 CA COST EFFECTIVE HEALTH CARE WHICH IS RESPONSIVE TO THE COMMUNITY'S ETHNIC AND CULTURAL UNIQUENESS. 16 16 578 39 1904320 667696 11090584 23345543 110619273 123367111 1262669 923725 2215737 2150539 125188263 149786918 110000 110000 0 0 51921939 57021565 0 0 606131 83318319 94405023 135350258 151536588 -10161995 -1749670 303436312 300335964 153418393 150757308 150017919 149578656 X CHINESE HOSPITAL, A COMMUNITY-OWNED, NOT-FOR-PROFIT ORGANIZATION, EXISTS PRIMARILY TO DELIVER QUALITY HEALTH CARE IN A COST EFFECTIVE WAY, RESPONSIVE TO THE COMMUNITY'S ETHNIC AND CULTURAL UNIQUENESS, PROVIDING ACCESS TO HEALTH CARE AND ACCEPTABILITY TO ALL SOCIOECONOMIC LEVELS. 0 0 109256176 110000 123367111 CHINESE HOSPITAL IS AN 88-BED NON-PROFIT COMMUNITY HOSPITAL AND AFFILIATED COMMUNITY CLINICS OFFERING A WIDE RANGE OF MEDICAL, SURGICAL, AND SPECIALTY CARE TO A MULTICULTURAL COMMUNITY. CHINESE HOSPITAL AIMS TO DELIVER QUALITY HEALTH CARE IN A COST-EFFECTIVE WAY, RESPOND TO OUR COMMUNITY'S ETHNIC AND CULTURAL UNIQUENESS, AND OFFER ACCESS TO HEALTH CARE TO ALL SOCIOECONOMIC LEVELS. SERVICES OFFERED AT CHINESE HOSPITAL INCLUDE ACUPUNCTURE, CARDIOPULMONARY, EMERGENCY CARE, HEALTH PROGRAMS (INCLUDING IMMUNIZATIONS, HEPATITIS B SERVICES, A DIABETES CENTER, AND PALLIATIVE CARE), LABORATORY, NURSING CARE, OPTOMETRY, PHARMACY, RADIOLOGY/IMAGING, AND SURGERY. 109256176 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 221 0 1 578 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 16 16 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X CHI-KUO (MICHAEL) CHUNG 4156772494 445 GRANT AVENUE SUITE 200 SAN FRANCISCO CA 94108 DR JIAN ZHANG CHIEF EXECUTIVE OFFICER 40.00 X 644916 80000 95899 CHI-KUO MICHAEL CHUNG PRESIDENT & CHIEF FINANCIAL OFFICER 40.00 X 447347 0 27817 ANDERSON D ENG MD MEDICAL PHYSICIAN 40.00 X 343384 0 30903 ALSON TOY REGISTERED NURSE, SURGERY 40.00 X 313328 0 57890 SYLVIA MUNGUIA PITTMAN MSHR CHIEF HUMAN RESOURCE OFFICER 40.00 X 317604 0 39877 PATRICIA CHUNG MHA CPMSM HACP VP OF QUALITY, MEDICAL STAFF & COMPLIANCE 40.00 X 268863 0 83875 AUNG KYAW S MAUNG MD MEDICAL PHYSICIAN 40.00 X 297000 0 37671 NIA LENDARIS MSN CNS RN CHIEF NURSING OFFICER 40.00 X 307551 0 23714 FRANK CHEN MD MEDICAL PHYSICIAN 40.00 X 299038 0 21920 GINA KO YAM PHARMD VICE PRESIDENT OF OPERATIONS 40.00 X 278155 0 40513 SCOTT L HUANG MD MEDICAL DIRECTOR / PHYSICIAN 40.00 X 291876 0 22612 CHARLES CELEVANTE REGISTERED NURSE, SURGERY 40.00 X 274573 0 32896 KITMAN CHAN CHAIR 5.00 X X 0 0 0 HARVEY LOUIE VICE CHAIR 5.00 X X 0 0 0 THOMAS T NG SECRETARY 5.00 X X 0 0 0 JACK SIT ASSISTANT SECRETARY 5.00 X X 0 0 0 KIN F YEE DDS TREASURER 5.00 X X 0 0 0 DI AN CHEN BOARD MEMBER 2.00 X 0 0 0 ROBERT CHIANG BOARD MEMBER 2.00 X 0 0 0 CHARLES C CHOW BOARD MEMBER 2.00 X 0 0 0 ROGER S ENG MD BOARD MEMBER 2.00 X 0 0 0 JACK LEE FONG BOARD MEMBER 2.00 X 0 0 0 DING BONG LEE BOARD MEMBER 2.00 X 0 0 0 CLIFTON LEUNG BOARD MEMBER 2.00 X 0 0 0 DONALD LUU BOARD MEMBER 2.00 X 0 0 0 KENNY TSE BOARD MEMBER 2.00 X 0 0 0 LAWRENCE WONG BOARD MEMBER 2.00 X 0 0 0 ROBERT WONG BOARD MEMBER 2.00 X 0 0 0 4083635 80000 515587 141 0 1 0 MAR CON COMPANY 8108A CAPWELL DRIVE OAKLAND CA 94621 CONSTRUCTION SERVICES 4587499 CA EMERGENCY ASSOCIATES PO BOX 677979 DALLAS TX 752677979 ER PHYSICIANS GROUP 1481184 HENRY HU MD A PROFESSIONAL CORP 911 PARROTT DRIVE HILLSBOROUGH CA 94010 ANESTHESIOLOGISTS GROUP 1454338 CERNER HEALTH SERVICES INC PO BOX 959156 ST LOUIS MO 631959156 HEALTH INFORMATION TECHNOLOGY 1368950 SAN FRANCISCO UNIFIED PHYSICIAN GROUP 2440 16TH ST 108 SAN FRANCISCO CA 94103 HOSPITALISTS 1136250 33 943086 9750238 12652219 5040000 23345543 NET PATIENT SERVICE REVENUE 621110 52856496 52856496 CAPITATION REVENUE 621110 49680117 49680117 PHARMACY REVENUE 456110 16654758 14804065 1850693 CLINIC REVENUE 621110 3136014 3136014 PAY FOR PERFORMANCE 621110 475695 475695 564031 551655 12376 123367111 923725 923725 308677 157831 150846 150846 41251 109595 79266 943086 200060 -120794 -120794 MANAGEMENT FEE 900099 1805060 1805060 PARKING REVENUE 561000 280766 280766 CAFETERIA 722514 34661 34661 2120487 149786918 121504042 1904320 3033013 X 110000 110000 2878561 997253 1881308 33465361 24990191 8341038 134132 3503005 2189785 1294698 18522 14071202 8739356 5312668 19178 3103436 2215868 875081 12487 943672 162240 491570 289862 319233 303241 15992 211720 211720 18217 18217 19796010 14666421 5083066 46523 17363 8917 6582 1864 1520093 176532 1288456 55105 1216129 1216129 2955886 314556 2629991 11339 11481 2233 9248 8803005 8803005 9721158 9561005 160153 507292 506592 700 MEDICAL CLAIMS EXPENSE 26903815 26903815 MEDICAL SUPPLIES 19435984 18217764 1217793 427 PROVIDER FEES 1811287 240 1811047 INCOME TAX EXPENSE 204724 204724 7954 7954 151536588 109256176 41674281 606131 3200 3200 2891516 6786374 3054595 16666045 17138737 1513898 1890411 1430990 772604 329331311 97268850 231346211 232062461 47610398 31823233 400000 400000 1574054 6404349 303436312 300335964 13473220 13551256 9003389 4721933 55404744 36908420 35158641 64413684 9585992 0 30792407 31162015 153418393 150757308 X 149261019 146821756 756900 2756900 150017919 149578656 303436312 300335964 X -1749670 -5257210 6567617 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 28245 28245 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE HOSPITAL COUNCIL - NORTHERN AND CENTRAL CALIFORNIA, AN ORGANIZATION WHICH ADVOCATE FOR CALIFORNIA'S HOSPITALS AND HEALTH SYSTEMS; A PORTION ($28,245) OF THOSE MEMBERSHIP DUES HAVE BEEN INDICATED AS USED FOR LOBBYING PURPOSES. 6197597 6197597 1810000 271172346 59253121 213729225 37589537 30723482 6866055 12561831 7292247 5269584 232062461 ACCRUED MEDICAL CLAIMS 9249992 PENSION LIABILITY 19654926 OPERATING LEASE LIABILITIES 2257097 31162015 GOLF TOURNAMENT 778052 720207 57845 72035 52370 5475 14813 123RD ANNIVERSARY 244300 222879 21421 12118 13767 7654 21828 1022352 943086 79266 84153 66137 13129 36641 200060 -120794 1 1 X 1 X 1 X 1 1 1 0 1 1 923749 923749 0.00610 10386962 9896375 490587 0.00320 11310711 9896375 1414336 0.00930 4988463 4319149 669314 0.00440 110000 110000 0.00070 5098463 4319149 779314 0.00510 16409174 14215524 2193650 0.01440 1 769170 109317 45120205 75912593 -30792388 X 1 1 1 1 CHINESE HOSPITAL ASSOCIATION 845 JACKSON STREET SAN FRANCISCO CA 94133 WWW.CHINESEHOSPITAL-SF.ORG 220000122 X X X CHINESE HOSPITAL ASSOCIATION 0 0 1 X X X X X X X X 22 1 1 1 1 X HTTPS://CHINESEHOSPITAL-SF.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X 1 22 1 HTTPS://CHINESEHOSPITAL-SF.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X HTTPS://CHINESEHOSPITAL-SF.ORG/FINANCIAL-ASSISTANCE/ X HTTPS://CHINESEHOSPITAL-SF.ORG/FINANCIAL-ASSISTANCE/ X HTTPS://CHINESEHOSPITAL-SF.ORG/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: THE CHINESE HOSPITAL SUPPLEMENTAL CHNA WAS CONDUCTED THROUGH FOCUS GROUPS DESIGNED TO ASSESS THE HEALTH STATUS, CONCERNS, AND ACCESS AMONG THE CHINESE POPULATION THAT CHINESE HOSPITAL SERVES IN THE CITY AND COUNTY OF SAN FRANCISCO. THE RECRUITMENT OF THESE FOCUS GROUPS WAS CONDUCTED THROUGH ETHNIC MEDIA PRESS RELEASES, CCHP MEMBER SERVICES, AS WELL AS THROUGH POPULAR CHINESE SOCIAL MEDIA APP, WECHAT. THE FOCUS GROUP PARTICIPANTS WERE RECRUITED FROM OVER 19 DIFFERENT ZIP CODE NEIGHBORHOODS.A SERIES OF SEVEN (7) FOCUS GROUPS WERE CONDUCTED TO ASSESS AND IDENTIFY THE PREDOMINANT HEALTH CONCERNS OF THE CHINESE-SPEAKING POPULATION. THE FOCUS GROUPS WERE CONDUCTED BETWEEN MARCH 24 APRIL 12, 2022. TWO FOCUS GROUPS TOOK PLACE AT CHINESE HOSPITAL WITH AN AVERAGE OF 12 PARTICIPANTS PER GROUP. FIVE (5) FOCUS GROUPS WERE HELD VIA ZOOM WITH AN AVERAGE OF 6 PARTICIPANTS PER GROUP. ALL SEVEN (7) FOCUS GROUPS WERE CONDUCTED IN CANTONESE CHINESE, THE PREFERRED CHINESE DIALECT OF THE PARTICIPANTS. ALL PARTICIPANTS COMPLETED A DEMOGRAPHIC SURVEY, AND THE FOCUS GROUP SESSIONS WERE AUDIO/VIDEO RECORDED WITH PARTICIPANTS' CONSENT. THE FACILITATORS UTILIZED A QUESTION GUIDE TO SOLICIT FEEDBACK FROM PARTICIPANTS THROUGH A SEMI-STRUCTURED FOCUS GROUP FORMAT. THE FACILITATORS HAND RECORDED THE MEETING NOTES. PARTICIPANTS WERE ASKED TO RANK THEIR HEALTH NEEDS FROM 1-5, WITH 1 BEING THE MOST IMPORTANT. THE FACILITATOR OF THE FOCUS GROUPS WERE BILINGUAL, TRAINED HEALTH EDUCATORS WITH MORE THAN 10 YEARS OF EXPERIENCE IN CONDUCTING QUALITATIVE INTERVIEW SESSIONS. CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6A: CHINESE HOSPITAL ASSOCIATION IS A PART OF SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP (SFHIP), WHICH IS A COLLABORATIVE BODY WHOSE MISSION IS TO EMBRACE COLLECTIVE IMPACT AND TO IMPROVE COMMUNITY HEALTH AND WELLNESS IN SAN FRANCISCO. SFHIP (WHOSE MEMBERS INCLUDE SAN FRANCISCO'S NON-PROFIT HOSPITALS) COMPLETES A CITYWIDE CHNA, WHICH IS THE FOUNDATION FOR EACH OF SAN FRANCISCO'S NON-PROFIT HOSPITALS' CHNA. IN ADDENDUM TO THE SFHIP CHNA, CHINESE HOSPITAL ALSO COMPLETES A SUPPLEMENTAL CHNA WITH A FOCUS ON THE CHINESE SUBPOPULATION IN SAN FRANCISCO. CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: NON-HOSPITAL MEMBERS OF SFHIP (WHO COMPLETED THE SAN FRANCISCO CITY-WIDE CHNA WHICH SERVES AS THE FOUNDATION FOR CHINESE HOSPITAL'S CHNA) INCLUDE THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, SAN FRANCISCO UNIFIED SCHOOL DISTRICT, THE OFFICE OF THE MAYOR, AND COMMUNITY REPRESENTATIVES FROM: THE ASIAN AND PACIFIC ISLANDER HEALTH PARITY COALITION; HUMAN SERVICES NETWORK; CHICANO/LATINO/INDIGENA HEALTH EQUITY COALITION; AFRICAN AMERICAN COMMUNITY HEALTH COUNCIL; COMMUNITY CLINIC CONSORTIUM; AS WELL AS OTHER FAITH-BASED AND OTHER PHILANTHROPIC PARTNERS. CHINESE HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: AMONG ALL THE COMMUNITY HEALTH NEEDS IDENTIFIED BY CHINESE HOSPITAL 2022 SUPPLEMENTAL CHNA, BASED ON THE RESOURCES AVAILABLE, CHINESE HOSPITAL SELECTS THE FOLLOWING 3 MAIN AREAS AS OUR PRIORITIES TO ADDRESS IN THE NEXT THREE YEARS:1. MENTAL HEALTH2. COMMUNITY SAFETY AND ACCESS TO HEALTH3. IN-LANGUAGE HEALTH EDUCATIONMENTAL HEALTH: BASED ON THE FINDINGS FROM THIS QUALITATIVE HEALTH NEEDS ASSESSMENT, MENTAL HEALTH WAS AMONG THE TOP CONCERNS. THE NEED FOR ACCESSIBLE, CULTURALLY, AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH INFORMATION AND PROGRAMS IN COMMUNITIES CHINESE HOSPITAL SERVES REMAINED HIGH. TO MEET THESE DEMANDS, WE WILL CONTINUE TO EXPAND THE CHINESE HOSPITAL'S PROGRAMS AND SERVICES AS FOLLOWS:A. PROMOTE THE SYSTEM-WIDE MENTAL/BEHAVIORAL HEALTH SERVICES. CHINESE HOSPITAL PROMOTES MENTAL HEALTH SERVICES THROUGH COMMUNICATIONS (SUCH AS SYSTEM-WIDE ANNOUNCEMENT FLYERS, NEWSLETTERS, WEBSITES, ETC.) TO THE COMMUNITY ON A REGULAR BASIS. B. CONTINUE TO WORK WITH OUR PARTNER, CHINESE COMMUNITY HEALTH RESOURCE CENTER (CCHRC) TO EXPAND CULTURALLY AND LINGUISTICALLY APPROPRIATE EDUCATIONAL PROGRAMS ON MENTAL HEALTH INCLUDING VIDEO CONFERENCING FOR SUPPORT. CHINESE HOSPITAL CLINICS OUTPATIENT MENTAL HEALTH PROGRAM PROVIDES OUTPATIENT PSYCHIATRIC AND MENTAL HEALTH THERAPY SERVICES INCLUDING VIDEO CONFERENCING (WEBEX). TO INCREASE ACCESS TO MENTAL HEALTH PROVIDERS, VIDEO CONFERENCING WILL CONNECT PATIENTS WITH THEIR CARE TEAM REMOTELY. THROUGH THE PARTNERSHIP WITH CCHRC, ONLINE SEMINARS ON MENTAL HEALTH, STRESS MANAGEMENT, AND HEALTHY LIVING WILL CONTINUE TO BE OFFERED TO THE COMMUNITY FREE OF CHARGE.C. EXPAND THE OUTPATIENT MENTAL HEALTH SERVICES. CHINESE HOSPITAL CLINICS ARE ACTIVELY EXPLORING COLLABORATIONS TO EXPAND THE OUTPATIENT MENTAL HEALTH SERVICES WITH A FUTURE DIRECTION OF BUILDING A BILINGUAL MENTAL HEALTH CENTER IN OUR COMMUNITY.COMMUNITY SAFETY AND ACCESS TO HEALTH: FOCUS GROUP PARTICIPANTS IDENTIFIED THE NEED FOR INFORMATION ON COMMUNITY SAFETY AND ACCESS TO HEALTH AS ONE OF THE TOP CONCERNS. TO ADDRESS THIS HEALTH NEED, CHINESE HOSPITAL WILL:A. PROVIDE EDUCATIONAL PROGRAMS ON RAISING AWARENESS OF COMMUNITY AND PERSONAL SAFETY ALONG WITH PROVIDING INFORMATION ON COMMUNITY RESOURCES. CHINESE HOSPITAL WILL WORK WITH CCHRC TO CONTINUE TO PROVIDE EDUCATION SEMINARS ON THE TOPIC OF COMMUNITY SAFETY, STRESS MANAGEMENT, AND DEPRESSION AWARENESS AS WELL AS TO PROVIDE NAVIGATION FOR ACCESSING RELEVANT COMMUNITY RESOURCES AND INFORMATION. B. ADVOCATE FOR A SAFER COMMUNITY THROUGH PARTNERSHIP WITH LOCAL CITY DEPARTMENTS AND COMMUNITY ORGANIZATION. CHINESE HOSPITAL AND CCHRC WILL PARTICIPATE ON COMMUNITY ADVISORY BOARDS TO ADVOCATE FOR COMMUNITY SAFETY AND ENSURE ACCESS TO HEALTH.IN-LANGUAGE HEALTH EDUCATION:BASED ON THE CONCERNS OF THE UNMET NEEDS OF CULTURALLY AND LINGUISTICALLY COMPETENT HEALTH EDUCATION INFORMATION, PROGRAMS, AND SERVICES, CHINESE HOSPITAL WILL: A. CONTINUE TO WORK WITH CCHRC TO EXPAND THE BILINGUAL (CHINESE & ENGLISH) HEALTH EDUCATION MATERIALS ON THE HEALTH TOPICS OF COMMUNITY'S CONCERN. CHINESE HOSPITAL AND CCHRC WILL EXPAND THE FREE BILINGUAL (CHINESE & ENGLISH) HEALTH EDUCATION MATERIALS TO INCLUDE THE HEALTH CONCERNS IDENTIFIED BY THE FOCUS GROUPS ON MENTAL HEALTH, COMMUNITY SAFETY, AND OTHER HEALTH CONCERNS. B. WORK WITH OUR PARTNER, CCHRC TO DELIVER HEALTH EDUCATION MATERIALS AND PROGRAMS INCLUDING THROUGH WEBSITES AND SOCIAL MEDIA. BASED ON THE RECOMMENDATIONS OF USING TECHNOLOGY TO DELIVER HEALTH INFORMATION, CHINESE HOSPITAL WILL WORK WITH CCHRC AND WILL CONTINUE TO MAKE BILINGUAL (CHINESE & ENGLISH) EDUCATIONAL WEBSITES (WWW.CHINESEHOSPITAL-SF.ORG AND WWW.CCHRHCHEALTH.ORG). GIVEN THE FEEDBACK RECEIVED FROM THE CONDUCTED FOCUS GROUPS, WECHAT IS REGULARLY USED WITHIN THE CHINESE COMMUNITY OF SAN FRANCISCO. WHEN ABLE TO, WE WILL INCORPORATE WECHAT AS A TOOL TO INFORM AND ENGAGE PATIENTS IN PROGRAMS OFFERED BY THE HOSPITAL. IN THE COVID-19 ERA, CHINESE HOSPITAL AND CCHRC WILL OFFER BILINGUAL HEALTH EDUCATION PROGRAMS AND SERVICES THROUGH WEBSITES, CULTURALLY APPROPRIATE SOCIAL MEDIA (I.E., WECHAT), TEXT MESSAGES, AND ONLINE SEMINARS (I.E., ZOOM). IN-PERSON EDUCATIONAL PROGRAMS AND SERVICES ALONG WITH COMMUNITY HEALTH EVENTS ARE AVAILABLE FOR COMMUNITY MEMBERS WHO ARE READY AND COMFORTABLE TO PARTICIPATE. IN THE EFFORT TO INCREASE ACCESS TO COMMUNITY RESOURCES, TRAINED BILINGUAL PATIENT/ COMMUNITY NAVIGATORS WHO ARE FROM THE CHINESE IMMIGRANT COMMUNITY WILL ASSIST IN NAVIGATING EXISTING INFORMATION AND/OR RESOURCES TO SERVE THE COMMUNITY MEMBERS IN NEED. 4 1 - SUNSET HEALTH SERVICES 1800 31ST AVE SAN FRANCISCO CA 94122 OUTPATIENT HEALTH SERVICES / MEDICAL CLINIC 2 - EXCELSIOR HEALTH SERVICESEAST WEST HEAL 888 PARIS STREET SUITE 202 SAN FRANCISCO CA 94112 OUTPATIENT HEALTH SERVICES / MEDICAL CLINIC 3 - GELLERT HEALTH SERVICESEAST WEST HEALTH 388 GELLERT BLVD DALY CITY CA 94015 OUTPATIENT HEALTH SERVICES / MEDICAL CLINIC 4 - EAST WEST HEALTH SERVICES - SAN FRANCISC 445 GRANT AVE G/F SAN FRANCISCO CA 94108 OUTPATIENT HEALTH SERVICES / MEDICAL CLINIC PART I, LINE 7: A COST-TO-CHARGE RATIO WAS UTILIZED TO DETERMINE THE AMOUNTS ON SCHEDULE H, PART I, LINE 7. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDES MANAGED CARE SERVICES. PART III, LINE 3: THE HOSPITAL RUNS A CREDIT SCORE AND COLLECTS TAX RETURNS FOR PATIENTS APPLYING FOR FINANCIAL ASSISTANCE; BASED OFF THIS INFORMATION, AN ESTIMATE IS MADE TO DETERMINE HOW MUCH OF THE BAD DEBT EXPENSE ON PART III, LINE 3 WOULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. IN ADDITION, SOME OF THE BAD DEBT EXPENSE IS RELATED TO HOMELESS PATIENTS, WHICH WOULD BE ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND CO-INSURANCE FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGES BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY AND DEEMED UNCOLLECTIBLE ARE RECORDED AS BAD DEBT EXPENSE. PART III, LINE 4: THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DOES NOT HAVE A SEPARATE FOOTNOTE ADDRESSING BAD DEBT EXPENSE; HOWEVER, THE FOOTNOTE WHICH ADDRESSES PATIENT ACCOUNTS RECEIVABLE CAN BE FOUND ON PAGE PATIENT ACCOUNTS RECEIVABLE CAN BE FOUND ON PAGES 9 AND 16 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H, PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT AS MEDICARE RATES ARE NON-NEGOTIABLE AND SOMETIMES OUT-OF-LINE WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS. BY CONTINUING TO TREAT PATIENTS ELIGIBLE TO MEDICARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES. ADDITIONALLY, IRS REV. RUL. 69-545 STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.A COST-TO-CHARGE IS UTILIZED TO DETERMINE THE AMOUNTS ON SCHEDULE H, PART III, LINES 6. PART III, LINE 9B: AT LEAST 30 DAYS PRIOR TO INITIATING ECAS, CHINESE HOSPITAL OR ITS AUTHORIZED VENDOR WILL PROVIDE THE PATIENT WITH A WRITTEN NOTICE ("ECA NOTICE") THAT WILL: (A) INDICATE THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR ELIGIBLE INDIVIDUALS; (B) IDENTIFY THE ECA(S) THAT THE HOSPITAL FACILITY OR AUTHORIZED VENDOR INTENDS TO INITIATE TO OBTAIN PAYMENT FOR THE CARE; (C) STATE A DEADLINE AFTER WHICH SUCH ECA(S) MAY BE INITIATED THAT IS NO EARLIER THAN 30 DAYS AFTER THE DATE THAT THE WRITTEN ECA NOTICE IS PROVIDED; (D) INCLUDE THE FOLLOWING STATEMENT OR ANY FURTHER STATEMENT REQUIRED BY AN AMENDMENT TO CALIFORNIA HEALTH & SAFETY CODE 127430: "STATE AND FEDERAL LAW REQUIRE DEBT COLLECTORS TO TREAT YOU FAIRLY AND PROHIBIT DEBT COLLECTORS FROM MAKING FALSE STATEMENTS OR THREATS OF VIOLENCE, USING OBSCENE OR PROFANE LANGUAGE, AND MAKING IMPROPER COMMUNICATIONS WITH THIRD PARTIES, INCLUDING YOUR EMPLOYER. EXCEPT UNDER UNUSUAL CIRCUMSTANCES, DEBT COLLECTORS MAY NOT CONTACT YOU BEFORE 8:00 A.M. OR AFTER 9:00 P.M. IN GENERAL, A DEBT COLLECTOR MAY NOT GIVE INFORMATION ABOUT YOUR DEBT TO ANOTHER PERSON, OTHER THAN YOUR ATTORNEY OR SPOUSE. A DEBT COLLECTOR MAY CONTACT ANOTHER PERSON TO CONFIRM YOUR LOCATION OR TO ENFORCE A JUDGMENT. FOR MORE INFORMATION ABOUT DEBT COLLECTION ACTIVITIES, YOU MAY CONTACT THE FEDERAL TRADE COMMISSION BY TELEPHONE AT 1- 877-FTC-HELP (382-4357) OR ONLINE AT WWW.FTC.GOV.; CHINESE HOSPITAL OR ITS AUTHORIZED VENDORS MAY EMPLOY THE FOLLOWING ECAS, SUBJECT TO ANY RESTRICTIONS DESCRIBED BELOW: 1. CREDIT REPORTING(A) FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, NEITHER CHINESE HOSPITAL NOR ANY OF ITS AUTHORIZED VENDORS WILL REPORT ADVERSE INFORMATION TO A CONSUMER CREDIT REPORTING AGENCY FOR NON-PAYMENTS AT ANY TIME PRIOR TO 150 DAYS AFTER THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. 2. CIVIL ACTIONS (E.G., LITIGATION, DEBTOR'S EXAMS)(A) FOR UNINSURED PATIENTS OR PATIENTS WITH HIGH MEDICAL COSTS (AS DEFINED IN CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY), NEITHER CHINESE HOSPITAL NOR ANY OF ITS AUTHORIZED VENDORS WILL COMMENCE CIVIL ACTION FOR NON-PAYMENTS AT ANY TIME PRIOR TO 150 DAYS AFTER THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. (B) THIS RESTRICTION DOES NOT PRECLUDE CHINESE HOSPITAL FACILITIES FROM PURSUING REIMBURSEMENT FROM THIRD-PARTY LIABILITY SETTLEMENTS, TORTFEASORS, OR OTHER LEGALLY RESPONSIBLE PARTIES. (C) THE COSTS, INCLUDING ATTORNEY FEES, ASSOCIATED WITH ANY LEGAL ACTION THAT CHINESE HOSPITAL OR ITS AUTHORIZED VENDORS IS REQUIRED TO TAKE MAY ALSO BE THE RESPONSIBILITY OF THE PATIENT. 3. RENEWAL OF EXISTING JUDGMENTS4. PROPERTY LIENS(A) CHINESE HOSPITAL AND ITS AUTHORIZED VENDORS THAT ARE AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT PLACE LIENS ON THE PRIMARY RESIDENCE OF A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS. (B) AUTHORIZED VENDORS THAT ARE NOT AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT NOTICE OR CONDUCT A SALE OF THE PRIMARY RESIDENCE OF A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS. 5. WAGE GARNISHMENTS (A) CHINESE HOSPITAL OR ITS AUTHORIZED VENDORS THAT ARE AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT FILE A WRIT OF GARNISHMENT AGAINST A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS. (B) CHINESE HOSPITAL'S AUTHORIZED VENDORS THAT ARE NOT AFFILIATES OR SUBSIDIARIES OF CHINESE HOSPITAL WILL NOT FILE A WRIT OF GARNISHMENT AGAINST A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY, UNLESS SUCH WRIT IS BY ORDER OF THE COURT UPON NOTICED MOTION, SUPPORTED BY A DECLARATION FILED BY THE MOVANT IDENTIFYING THE BASIS FOR WHICH IT BELIEVES THE PATIENT HAS THE ABILITY TO MAKE PAYMENTS ON THE JUDGMENT UNDER THE WAGE GARNISHMENT. (C) WAGE GARNISHMENT AMOUNTS WILL NOT EXCEED LIMITS PERMITTED UNDER STATE LAWS. PART VI, LINE 2: THE CHINESE HOSPITAL SUPPLEMENTAL COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED THROUGH FOCUS GROUPS DESIGNED TO ASSESS THE HEALTH STATUS, CONCERNS, AND ACCESS AMONG THE CHINESE POPULATION THAT CHINESE HOSPITAL SERVES IN THE CITY AND COUNTY OF SAN FRANCISCO. AS CHINESE-SPEAKING RESIDENTS ARE THE PRIMARY TARGET POPULATION STUDY, ALL OF OUR FOCUS GROUP INDIVIDUALS WHO REPORTED THEIR BIRTHPLACE INDICATED THEY WERE FOREIGN BORN. IN ADDITION, CHINESE HOSPITAL HOLDS VARIOUS COMMUNITY EVENTS AND SCREENINGS, WHICH ALLOWS IT TO FURTHER ASSESS THE HEALTH NEEDS OF THE COMMUNITY. PART VI, LINE 3: THE HOSPITAL POSTS ITS FINANCIAL ASSISTANCE POLICY WITHIN ADMITTING AND REGISTRATION AREAS, THE EMERGENCY DEPARTMENT, AND THE BUSINESS OFFICE. ALL ADMITS TO THE HOSPITAL ARE ALSO PROVIDED THE FINANCIAL ASSISTANCE/CHARITY CARE POLICIES IN THE PRIMARY LANGUAGE OF THE PATIENT.CHINESE HOSPITAL ALSO MAKES REASONABLE EFFORTS TO PROVIDE ALL PATIENTS WHO RECEIVE CARE (WHETHER EMERGENCY, INPATIENT, OR OUTPATIENT) FROM A CHINESE HOSPITAL FACILITY, AND MAY BE BILLED FOR THAT CARE, WITH A CONSPICUOUS WRITTEN NOTICE ON EACH BILLING STATEMENT THAT INCLUDES THE FOLLOWING: (I) INFORMATION ABOUT THE AVAILABILITY OF CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND OTHER DISCOUNTS AVAILABLE FROM CHINESE HOSPITAL; (II) INFORMATION ABOUT ELIGIBILITY FOR FINANCIAL ASSISTANCE AND OTHER DISCOUNTS; (III) CONTACT INFORMATION FOR A HOSPITAL EMPLOYEE OR OFFICE FROM WHICH THE PERSON MAY OBTAIN FURTHER INFORMATION ABOUT CHINESE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND OTHER DISCOUNTS; AND (IV) THE DIRECT WEBSITE WHERE COPIES OF THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY CAN BE OBTAINED.IF A PATIENT HAS NOT PROVIDED PROOF OF HEALTH COVERAGE BY A THIRD PARTY AT THE TIME CARE IS PROVIDED OR BY THE TIME THE PATIENT IS DISCHARGED, CHINESE HOSPITAL'S FIRST POST-DISCHARGE BILL WILL PROVIDE THE PATIENT WITH A BILL THAT CONTAINS A CLEAR AND CONSPICUOUS STATEMENT THAT, IF THE PATIENT DOES NOT HAVE HEALTH INSURANCE COVERAGE FOR THE CHARGES, THE PATIENT MAY BE ELIGIBLE FOR (I) A GOVERNMENT-SPONSORED HEALTHCARE PROGRAM, SUCH AS MEDICARE, MEDICAID, OR CHIP, (II) COVERAGE OFFERED THROUGH A HEALTH BENEFITS EXCHANGE; (III) COVERAGE THROUGH OTHER STATE-OR COUNTY-FUNDED HEALTH PROGRAMS (E.G. CALIFORNIA CHILDREN'S SERVICES PROGRAM), OR (IV) FINANCIAL ASSISTANCE FROM CHINESE HOSPITAL UNDER ITS FINANCIAL ASSISTANCE POLICY. A STATEMENT IS ALSO INCLUDING INDICATING HOW PATIENTS MAY OBTAIN APPLICATIONS FOR THE AFOREMENTIONED PROGRAMS AND THAT THE HOSPITAL WILL PROVIDE THE APPLICATIONS. THE HOSPITAL SERVES A LARGE POPULATION OF LOW-INCOME. APPROXIMATELY 90% OF OUR MEDICARE PATIENTS MEET THE FEDERAL CRITERIA FOR "LOW-INCOME". ITS WHOLLY OWNED SUBSIDIARY, CCHP, OFFERS A LOW-COST COMMERCIAL INSURANCE PRODUCT FOR INDIVIDUALS AND EMPLOYER GROUPS, MOST OF WHICH REPRESENT SMALL ASIAN BUSINESSES. OUR INTEGRATED HEALTHCARE DELIVERY SYSTEM ALSO SERVES MANAGED CARE MEDICAID ENROLLEES (SAN FRANCISCO HEALTH PLAN) IN THE COMMUNITY, WHICH BECAME THE FIRST PRIVATE SECTOR ORGANIZATION TO OFFER A MEDICAL HOME TO INDIVIDUALS PARTICIPATING IN THE HEALTHY SAN FRANCISCO PROGRAM FOR INDIVIDUALS WITH INCOMES THAT ARE LESS THAN 300% OF THE FPL. ALL THESE PROGRAMS ARE WIDELY PUBLICIZED IN BOTH ENGLISH AND CHINESE (ELECTRONICALLY AND IN HARD-COPY) TO THE COMMUNITY. THIS INFORMATION IS ON THE WEBSITES OF THE THREE ORGANIZATIONS THAT MAKE UP THE INTEGRATED DELIVERY SYSTEM, CHINESE HOSPITAL ASSOCIATION, CCHP, AND JADE HEALTH CARE MEDICAL GROUP. PART VI, LINE 4: THE COMMUNITY CHINESE HOSPITAL SERVES HAS A MAJORITY OF LOW-INCOME, MONOLINGUAL OR LINGUISTICALLY ISOLATED SENIOR POPULATION. OF THE INPATIENT POPULATION AT CHINESE HOSPITAL, 88% ARE OF CHINESE ANCESTRY, 87% ARE OVER THE AGE OF 60, AND 91% ARE MEDICARE/MEDI-CAL BENEFICIARIES.THE PRIMARY SERVICE AREA IS THE GREATER CHINATOWN NEIGHBORHOOD OF SAN FRANCISCO (94108). THE POPULATION OF THE CHINATOWN IS 13,535, WITH 49.7% OF THE POPULATION BEING FOREIGN-BORN. POPULATION BY RACE IS AS FOLLOWS: ASIAN (54.3%), LATINO (4.1%), WHITE (36.5%), BLACK OR AFRICAN AMERICAN (1.8%), AMERICAN INDIAN AND ALASKA NATIVE (.4%), NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND (.3%), OTHER (2.3%) AND MULTIETHNIC (4.4%). THE CHINESE POPULATION WITHIN CHINATOWN IS 6,142, WHICH REPRESENTS 45.4% OF THE TOTAL POPULATION. THE PER CAPITA INCOME IS $57,624, WITH THE MEDIAN HOUSEHOLD INCOME BEING $64,908. THE PERCENTAGE OF PERSONS 65 YEARS AND OVER IS 23.0%, AND 18% OF INDIVIDUALS WITHIN CHINATOWN ARE BELOW THE POVERTY LEVEL.BECAUSE OF OUR UNIQUE BILINGUAL PROGRAMS AND SENSITIVITY TO CULTURAL TRADITIONS, RESIDENTS FROM OTHER SAN FRANCISCO NEIGHBORHOODS AND CITIES OF THE BAY AREA TRAVEL TO CHINESE HOSPITAL. ADDITIONAL INFORMATION REGARDING THESE SERVICE AREAS CAN BE FOUND IN THE ORGANIZATION'S CHNA REPORT POSTED TO ITS WEBSITE AT HTTPS://CHINESEHOSPITAL-SF.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/. PART VI, LINE 5: A MAJORITY OF THE HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL PHYSICIANS IN THE COMMUNITY WHO APPLY FOR SUCH PRIVILEGES AND MEET THE REQUIRED MEDICAL QUALIFICATIONS. THE HOSPITAL'S SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH, AS DETERMINED BY THE GOVERNING BODY'S FINANCE COMMITTEE. PART VI, LINE 6: THE CHINESE HOSPITAL HEALTH SYSTEM IS AN INTEGRATIVE HEALTH SYSTEM CONSISTING OF CHINESE HOSPITAL AND CLINICS, CHINESE COMMUNITY HEALTH PLAN (CCHP), AND JADE HEALTH CARE MEDICAL GROUP. EACH ENTITY PERFORMS AN IMPORTANT ROLE IN ACHIEVING THE COMMON GOAL OF PROVIDING THE COMMUNITY WITH QUALITY AFFORDABLE CARE THAT IS CULTURALLY COMPETENT AND LINGUISTICALLY APPROPRIATE. CCHP IS LICENSED WITH THE CALIFORNIA DEPARTMENT OF MANAGED CARE TO OFFER COMMERCIAL HEALTH PLANS AND MAINTAIN A CONTRACT WITH CENTERS FOR MEDICARE AND MEDICAID TO OFFER MEDICARE ADVANTAGE PLANS; CCHP OFFERS A HIGH QUALITY, RIGHT-SIZED ALTERNATIVE FOR HEALTH COVERAGE. JADE HEALTH CARE MEDICAL GROUP IS A MEDICAL GROUP DELIVERING CULTURALLY SENSITIVE, BILINGUAL MANAGED HEALTH CARE IN THE SAN FRANCISCO BAY AREA. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 CHINESE COMMUNITY HEALTH RESOURCE CENTER INC 818 JACKSON STREET SAN FRANCISCO CA 94133 204251913 501(C)(3) 110000 0 TO SUPPORT BILINGUAL HEALTH EDUCATION SERVICES TO THE CHINESE COMMUNITY 1 0 PART I, LINE 2: PROPER USE OF GRANT FUNDS AWARDED TO CHINESE COMMUNITY HEALTH RESOURCE CENTER (CCHRC) IS MONITORED VIA WITNESSING THE WORK OF CCHRC IN THE CHINESE COMMUNITY SURROUNDING THE HOSPITAL, AS WELL AS VIA A CLOSE, CONTINUOUS, WORKING RELATIONSHIP BETWEEN THE TWO ORGANIZATIONS. X X X X 0 0 0 0 0 0 0 0 0 DR JIAN ZHANG CHIEF EXECUTIVE OFFICER 536733 80000 108183 0 0 0 71880 0 24019 0 740815 80000 0 0 CHI-KUO MICHAEL CHUNG PRESIDENT & CHIEF FINANCIAL OFFICER 408307 0 39040 0 0 0 19542 0 8275 0 475164 0 0 0 ANDERSON D ENG MD MEDICAL PHYSICIAN 289421 0 53963 0 0 0 14379 0 16524 0 374287 0 0 0 ALSON TOY REGISTERED NURSE, SURGERY 313252 0 76 0 0 0 48948 0 8942 0 371218 0 0 0 SYLVIA MUNGUIA PITTMAN MSHR CHIEF HUMAN RESOURCE OFFICER 288324 0 29280 0 0 0 15858 0 24019 0 357481 0 0 0 PATRICIA CHUNG MHA CPMSM HACP VP OF QUALITY, MEDICAL STAFF & COMPL 245399 0 23464 0 0 0 59856 0 24019 0 352738 0 0 0 AUNG KYAW S MAUNG MD MEDICAL PHYSICIAN 273031 0 23969 0 0 0 13652 0 24019 0 334671 0 0 0 NIA LENDARIS MSN CNS RN CHIEF NURSING OFFICER 280711 0 26840 0 0 0 15439 0 8275 0 331265 0 0 0 FRANK CHEN MD MEDICAL PHYSICIAN 274475 0 24563 0 0 0 13645 0 8275 0 320958 0 0 0 GINA KO YAM PHARMD VICE PRESIDENT OF OPERATIONS 253755 0 24400 0 0 0 16494 0 24019 0 318668 0 0 0 SCOTT L HUANG MD MEDICAL DIRECTOR / PHYSICIAN 263751 0 28125 0 0 0 14337 0 8275 0 314488 0 0 0 CHARLES CELEVANTE REGISTERED NURSE, SURGERY 274265 0 308 0 0 0 8876 0 24020 0 307469 0 0 0 A CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 2022-01-27 37575014 REFUND TAXABLE BONDS ISSUED 10/8/2019 0 0 0 A 37575014 396891 27178123 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 X 1 3990000 FAIR MARKET VALUE X 1 1050000 FAIR MARKET VALUE 1 0 1 1 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN SCHEDULE M, PART I, COLUMN (B). PART I, LINE 32B: CHINESE HOSPITAL ENLISTED SEQUOIA COMMERCIAL GROUP TO MANAGE AND SELL DONATED REAL ESTATE DURING 2022. FORM 990, PART VI, SECTION A, LINE 6 CHA DOES NOT HAVE "MEMBERS" BY DEFINITION OF THE BYLAWS. HOWEVER, THE FORM 990 INSTRUCTIONS ALSO DEFINE "MEMBERS" AS ANY PERSON (INCLUDING A CORPORATION OR OTHER LEGAL ENTITY) WITH THE POWER TO ELECT MEMBER OF THE GOVERNING BODY. ACCORDINGLY, CHA HAS SIXTEEN (16) MEMBERS: (1) CHINESE CONSOLIDATED BENEVOLENT ASSOCIATION; (2) NING YUNG BENEVOLENT ASSOCIATION; (3) SUE HING BENEVOLENT ASSOCIATION; (4) HOP WO BENEVOLENT ASSOCIATION; (5) KONG CHOW BENEVOLENT ASSOCIATION; (6) YEONG WO BENEVOLENT ASSOCIATION; (7) SAM YUP BENEVOLENT ASSOCIATION; (8) YAN WO BENEVOLENT ASSOCIATION; (9) CHINESE CHAMBER OF COMMERCE; (10) CHINESE AMERICAN CITIZENS ALLIANCE; (11) KUOMINTANG OF CHINA; (12) CHEE KUNG TONG; (13) CHINESE DEMOCRATIC CONSTITUTIONALIST PARTY; (14) CHINATOWN Y.M.C.A; (15) CHINESE CHRISTIAN UNION OF SAN FRANCISCO; AND (16) CHINESE HOSPITAL MEDICAL STAFF. FORM 990, PART VI, SECTION A, LINE 7A EACH OF THE ORGANIZATION'S MEMBERS HAS THE POWER TO DESIGNATE ONE MEMBER OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT TAX ACCOUNTANT, IN CONJUNCTION WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING DEPARTMENT. THE FORM 990 IS THEN REVIEWED BY THE ORGANIZATION'S PRESIDENT & CHIEF FINANCIAL OFFICER; ADJUSTMENTS ARE MADE, AS NECESSARY. THE FORM 990 IS THEN MADE AVAILABLE TO THE MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL CONFLICT OF INTEREST SURVEY AND DECLARATION. IN ADDITION TO THE ANNUAL CONFLICT OF INTEREST STATEMENT THAT DIRECTORS, OFFICERS, AND KEY EMPLOYEES COMPLETE, VOLUNTARY DISCLOSURE OF ANY POTENTIAL CONFLICTS AS DISCUSSIONS OF PENDING TRANSACTIONS OCCUR IS REQUIRED. THE LEGAL DEPARTMENT AND CFO REVIEW THE CONFLICT OF INTEREST STATEMENTS. IF A CONFLICT OF INTEREST ARISES, THE PERSON WITH THE CONFLICT RECUSES HIM/HERSELF FROM THE DELIBERATIONS AND DECISION-MAKING PROCESS REGARDING THAT PARTICULAR MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION AND BENEFITS PACKAGE OF THE CEO IS EVALUATED AND REVIEWED BY AN INDEPENDENT COMPENSATION COMMITTEE APPOINTED BY THE PRESIDENT AND VICE PRESIDENT OF THE BOARD. AS A PART OF THIS PROCESS, AN INDEPENDENT CONSULTANT WAS USED TO PROVIDE COMPARABLE DATA OF EQUIVALENT EMPLOYEES AT SIMILARLY SIZED HOSPITALS AND HEALTH PLANS; THE OVERALL COMPENSATION PACKAGE FOR THE CEO WAS THEN REVIEWED AND APPROVED BY INDEPENDENT MEMBERS OF THE BOARD. THE COMPENSATION AND BENEFITS PACKAGE FOR OTHER OFFICERS AND KEY EMPLOYEES IS ALSO EVALUATED AND REVIEWED BY AN INDEPENDENT COMPENSATION COMMITTEE APPOINTED BY THE PRESIDENT AND VICE PRESIDENT OF THE BOARD, WHICH UTILIZED COMPARABLE DATA FOR SIMILAR EMPLOYEES AT SIMILARLY SIZED HOSPITALS AND HEALTH PLANS. FORM 990, PART VI, SECTION C, LINE 19 FEDERAL LAW DOES NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY BE MADE AVAILABLE FOR PUBLIC INSPECTION; ACCORDINGLY, THESE DOCUMENTS ARE CURRENTLY NOT MADE AVAILABLE TO THE PUBLIC. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE UPON REQUEST, AND ARE ALSO ATTACHED TO A COPY OF THIS FORM 990. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,646,485. MANAGEMENT AND GENERAL EXPENSES 3,949,691. FUNDRAISING EXPENSES 46,523. TOTAL EXPENSES 7,642,699. TPA FEES: PROGRAM SERVICE EXPENSES 6,103,687. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,103,687. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 4,916,249. MANAGEMENT AND GENERAL EXPENSES 1,133,375. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,049,624. FORM 990, PART XI, LINE 9: CHANGES IN PENSION LIABILITY 3,066,614. RETIREMENT PLAN BENEFIT GAIN 2,641,003. RETURN OF CAPITAL FROM CHINESE COMMUNITY HEALTH PLAN 860,000. CHINESE COMMUNITY HEALTH PLAN 445 GRANT AVENUE SUITE 700 SAN FRANCISCO CA 94108 943021419 INSURANCE CA CHA C 124628756 49716929 1.00000 1 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 CHINESE COMMUNITY HEALTH PLAN A 44472 BOOK VALUE CHINESE COMMUNITY HEALTH PLAN D 700528 BOOK VALUE CHINESE COMMUNITY HEALTH PLAN K 293452 BOOK VALUE CHINESE COMMUNITY HEALTH PLAN L 1890306 BOOK VALUE CHINESE COMMUNITY HEALTH PLAN M 5343915 BOOK VALUE CHINESE COMMUNITY HEALTH PLAN P 246441 BOOK VALUE CHINESE COMMUNITY HEALTH PLAN Q 3935091 BOOK VALUE CHINESE COMMUNITY HEALTH PLAN S 860000 BOOK VALUE