2022-07-12T11:27:53-05:00 2021-08-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2020-09-01 852103299 COMMUNITY HEALTH PARTNERS COMM 5594596000 45 RIVER PARK PLACE WEST NO 507 FRESNO CA 93720 DEBORAH MOFFETT VP, FINANCE 5594596000 2022-07-11 1 DEBORAH MOFFETT 999009999 TRACY S PAGLIA P00366884 2099556100 2022-07-11 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z X X SEE SCHEDULE O PATRICK RAMIREZ 7257 N FRESNO STREET FRESNO CA 93720 13910348 0 X WWW.COMMUNITYHEALTHPARTNERS.ORG X 2020 CA COMMUNITY HEALTH PARTNERS' ACTIVITIES INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: PROMOTE COMMUNITY HEALTH THROUGH THE PROVISION OF HEALTH CARE SERVICES, AND TO ESTABLISH, EQUIP, AND MAINTAIN GEOGRAPHICALLY DISPERSED OUTPATIENT LOCATIONS AT WHICH SUCH SERVICES WILL BE PROVIDED; PROVIDE ACCESS TO HEALTH CARE SERVICES FOR INDIVIDUALS WHO ARE UNABLE TO AFFORD THEM, AND PARTICIPATE IN PROGRAMS OPERATED PURSUANT TO TITLES XVII AND XIX OF THE SOCIAL SECURITY ACT; CONTRIBUTE TO THE GROWTH AND DEVELOPMENT OF FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER. 6 3 10 3 0 0 0 0 0 13885988 0 0 0 -10990 0 13874998 0 0 0 0 0 5860191 0 0 0 0 35393999 0 41254190 0 -27379192 0 16440509 0 43819701 0 -27379192 X COMMUNITY HEALTH PARTNERS' MISSION IS TO BUILD THE VALLEY'S PREMIER INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT RELIABLY MEETS THE HEALTHCARE NEEDS OF OUR REGION WHILE EXCEEDING PATIENT EXPECTATIONS. 0 0 33502769 0 13885988 DURING THE TAX YEAR, COMMUNITY HEALTH PARTNERS (CHP) OPENED EIGHT CLINICS LOCATED IN NORTHERN FRESNO, CLOVIS (A CITY CONTIGUOUS TO THE CITY OF FRESNO), AND VISALIA (A CITY AROUND 42 MILES SOUTH OF FRESNO). THE CLINICS ARE OPERATED BY CHP UNDER A SPECIFIC EXEMPTION FROM LICENSURE PROVIDED BY SECTION 1206(I) OF THE CALIFORNIA HEALTH & SAFETY CODE. IN THESE OFFICES CHP SERVES THE CENTRAL VALLEY COMMUNITY BY PROVIDING THE FOLLOWING MEDICAL SERVICES: (I) FAMILY MEDICINE, (II) GENERAL SURGERY, (III) GYNECOLOGIC ONCOLOGY, (IV) MEDICAL ONCOLOGY, (V) NEUROLOGY - INTERVENTIONAL, (VI) NEUROSURGERY, (VII) PEDIATRIC CARDIOLOGY, (VIII) PEDIATRIC GASTROENTEROLOGY, (IX) PEDIATRIC ENDOCRINOLOGY, (X) PEDIATRIC NEUROLOGY, (XI) PEDIATRIC PULMONOLOGY, (XII) PERINATOLOGY, AND (XIII) SPINE SURGERY. IN ADDITION TO THESE SERVICES, CHP ALSO OFFERS ANESTHESIOLOGY SERVICES AT FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER TO SUPPORT ITS HOSPITALS AND FURTHER SERVE THE COMMUNITY. CHP HAS ADOPTED A FINANCIAL ASSISTANCE POLICY THAT ALLOWS PATIENTS WHO CANNOT AFFORD HEALTHCARE TO RECEIVE FREE OR DISCOUNTED CARE WHILE TREATED AT ITS CLINICS. 33502769 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 10 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 3 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 CA X DEBORAH MOFFETT 5594596000 1560 E SHAW AVENUE FRESNO CA 93710 CRAIG WAGONER CHAIR 1.90 60.00 X X 0 1359660 31510 ALDO DE LA TORRE BOARD MEMBER 1.90 55.00 X 0 872513 35447 CARLA MILTON SECRETARY 1.90 55.00 X X 0 668932 35326 PATRICK RAMIREZ PRESIDENT, CHIEF EXECUTIVE OFFICER 60.00 0.00 X 375224 0 34641 BENJAMIN ARMFIELD - VPCHIEF FINANCIAL OFFICER/TREASURER 60.00 0.00 X 285909 0 28850 SHERRY HUGHES DIR PRACTICE MANAGEMENT 50.00 0.00 X 191043 0 13750 ANAND RAJANI MD CHIEF MEDICAL OFFICER 60.00 0.00 X 80336 0 1978 JOSEPH CASTRO BOARD MEMBER 1.90 0.00 X 0 0 0 THOMAS GORDON BOARD MEMBER 1.90 0.00 X 0 0 0 ROGER STURDEVANT BOARD MEMBER 1.90 1.90 X 0 0 0 932512 2901105 181502 3 0 1 0 CCFMG 2625 E DIVISADERO ST FRESNO CA 93721 MEDICAL 5474703 SANTE HEALTH SYSTEMS 7370 N PALM AVE FRESNO CA 93720 MEDICAL 3532717 COMMUNITY PHYSICIANS GROUP 45 RIVER PARK PLACE SUITE 570 FRESNO CA 93720 MEDICAL SERVICES 1548150 SANTE MEDICAL ONCOLOGY 7370 N PALM AVE FRESNO CA 93720 MEDICAL 651688 JONES DAY 555 SOUTH FLOWER ST FIFTH FLOOR LOS ANGELES CA 90071 LEGAL SERVICES 161095 6 MEDICAL SERVICE 622110 13885988 13885988 13885988 24360 35350 -10990 -10990 -10990 13874998 13885988 0 -10990 X 1191225 1191225 3703297 2642994 1060303 159803 131476 28327 487390 373731 113659 318476 207357 111119 360530 360530 31110173 27314663 3795510 241158 655 240503 244112 198844 45268 1622347 1465787 156560 8517 8517 4820 4820 167499 167393 106 16588 16588 MINOR EQUIPMENT 1459146 871714 587432 MEDICAL SUPPLIES 108768 108768 50341 10870 39471 41254190 33502769 7751421 0 0 7410386 0 4264563 0 110005 4823054 167499 0 4655555 0 16440509 0 3053792 0 40765909 0 43819701 X -27379192 0 -27379192 0 16440509 -27379192 0 X 0 1 X 1 0 X 898979 167499 731480 3924075 3924075 4655555 PAYABLE TO AFFILIATES 37034495 LEASE LIABILITY 3731414 40765909 0 1 0 1 1 1 1 0 0 CRAIG WAGONER CHAIR 0 846375 0 299561 0 213724 0 17100 0 14410 0 1391170 0 92490 ALDO DE LA TORRE BOARD MEMBER 0 533818 0 191521 0 147174 0 14250 0 21197 0 907960 0 63055 CARLA MILTON SECRETARY 0 452929 0 153690 0 62313 0 17100 0 18226 0 704258 0 47160 PATRICK RAMIREZ PRESIDENT, CHIEF EXECUTIVE OFFICER 290752 0 73823 0 10649 0 14250 0 20391 0 409865 0 0 0 BENJAMIN ARMFIELD - VPCHIEF FINANCIAL OFFICER/TREASURER 221436 0 46036 0 18437 0 11412 0 17438 0 314759 0 0 0 SHERRY HUGHES DIR PRACTICE MANAGEMENT 100353 0 18658 0 72032 0 7162 0 6588 0 204793 0 0 0 PART I, LINE 3 THE FILING ORGANIZATION RELIED ON COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE THE COMPENSATION FOR ITS TOP MANAGEMENT OFFICIAL. THE RELATED ORGANIZATION USED ONE OR MORE METHODS IN LINE 3 TO DETERMINE THE COMPENSATION FOR THE PRESIDENT/CHIEF EXECUTIVE OFFICER. PART I, LINE 4B LINE 4B: DURING THE YEAR, COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED ORGANIZATION, MADE THE FOLLOWING DISTRIBUTIONS FROM A SERP PLAN FOR THE FOLLOWING INDIVIDUALS: - CRAIG WAGONER $92,490 - ALDO DE LA TORRE $63,055 - CARLA MILTON $47,160 PART I, LINE 5 THE ORGANIZATION'S EXECUTIVE INCENTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD KEY MEMBERS OF THE EXECUTIVE TEAM FOR MEETING SPECIFIC AND MEASURABLE GOALS AT COMMUNITY HEALTH SYSTEM (CHS) AND INDIVIDUAL LEVELS. THE MAIN OBJECTIVES ARE: - MOTIVATE EXECUTIVES AND REWARD THEM FOR IMPROVING CHS'S OPERATIONAL PERFORMANCE; - INCREASE COMMUNITY INVOLVEMENT AND EFFECTIVENESS; - INCREASE EXECUTIVE COMMITMENT TO CHS'S SHORT AND LONG TERM GOALS; - PROVIDE EXECUTIVES WITH COMPETITIVE BUT REASONABLE COMPENSATION; - ATTRACT AND RETAIN HIGHLY TALENTED EXECUTIVES THAT ARE CRITICALLY IMPORTANT TO THE SUCCESS OF THE ORGANIZATION PART I, LINE 6 SEE RESPONSE FOR QUESTION 5. HEADING, BOX C: OTHER DBAS USED: COMMUNITY DIABETES & ENDOCRINE SPECIALIST; COMMUNITY GYNECOLOGIC ONCOLOGY SPECIALIST; COMMUNITY MEDICAL ONCOLOGY SPECIALISTS; COMMUNITY NEUROSCIENCES INSTITUTE; COMMUNITY NEUROSCIENCES INSTITUTE-VISALIA, COMMUNITY PEDIATRIC SPECIALISTS; COMMUNITY PERINATOLOGY; COMMUNITY SPECIALTY SURGERY ASSOCIATES; COMMUNITY SPINE & NEUROSURGERY; M2 ONCOLOGY, A MEMBER OF COMMUNITY HEALTH PARTNERS; COMMUNITY SPINE CENTER; COMMUNITY PRIMARY CARE - ALI M. FAYED, M.D FORM 990, PART V, LINES 1 & 2: COMMUNITY HOPSITALS OF CENTRAL CALIFORNIA IS THE COMMON PAYMASTER FOR ITSELF, COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION, COMMUNITY HEALTH PARTNERS, AND FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER IS THE SOLE MEMBER OF CHP. IT HAS THE SOLE AND EXCLUSIVE RIGHT TO APPOINT ALL OF THE MEMBERS OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER (FCH&MC) IS THE SOLE MEMBER OF THIS ENTITY. AS SUCH, IT HAS THE RIGHTS OF MEMBERS CONFERRED BY CHAPTER 3 OF THE NONPROFIT PUBLIC BENEFIT CORPORATION LAW, SECTIONS 5310 - 5354, WHICH INCLUDES THE RIGHTS TO APPROVE AMENDMENTS TO THE ARTICLES, BYLAWS AND SALE OF ASSETS OUTSIDE THE NORMAL COURSE OF BUSINESS. THE ARTICLES OF INCORPORATION PROVIDES THAT UPON DISSOLUTION ALL REMAINING ASSETS WILL BE DISTRIBUTED TO FCH&MC OR ITS SUCCESSORS PROVIDED THESE ENTITIES ARE DESCRIBED IN SECTION 501(C)(3) OF THE CODE. FORM 990, PART VI, SECTION B, LINE 11B UPON COMPLETION OF AN INITIAL REVIEW BY SENIOR MANAGEMENT, THE FORM IS REVIEWED AT A MEETING OF THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES OF CHP'S SOLE MEMBER, FCH&MC. THE FINALIZED FORM 990 THEN BECOMES A RECORD OF THE ORGANIZATION'S BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATION'S BOARD OF TRUSTEES ADOPTED A CONFLICT OF INTEREST POLICY THAT REQUIRES EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF COMMITTEE WITH BOARD DELEGATED POWERS TO DISCLOSE TO THE CORPORATION ANY RELATIONSHIP INTEREST OR FINANCIAL INTEREST THAT MAY GIVE RISE TO AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. THEREAFTER, EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS WILL SIGN A STATEMENT ANNUALLY WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. PURSUANT TO THE CONFLICT OF INTEREST POLICY, EACH NEW DIRECTOR, PRINCIPAL OFFICER AND MEMBER COMMITTEE WITH BOARD DELEGATED POWERS WILL ALSO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT PRIOR TO THE ASSIGNMENT OF THEIR DUTIES AND THEREAFTER ON AN ANNUAL BASIS. THE STATEMENT ASKS SPECIFIC QUESTIONS THAT WOULD DETERMINE IF THERE ARE CONFLICTS OF INTERESTS. THE CHIEF ETHICS AND COMPLIANCE OFFICER AND VICE PRESIDENT OF LEGAL SERVICES WILL REVIEW THE RESPONSES AND DETERMINE WHETHER THERE IS A CONFLICT BASED ON POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE DIRECTOR, PRINCIPAL OFFICER, OR MEMBER COMMITTEE WITH BOARD DELEGATED POWERS WILL BE REMOVED FROM DECISION MAKING AS IT PERTAINS TO THAT CONFLICT. TO ENSURE THAT THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS ARE CONDUCTED. THE PERIODIC REVIEWS, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARM'S-LENGTH BARGAINING; 2) WHETHER ARRANGEMENTS FOR PHYSICIAN AND OTHER PROVIDER OF SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; 3) WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; AND 4) WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. FORM 990, PART VI, SECTION B, LINE 15 RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION FOR COMMUNITY HEALTH PARTNERS RESTS WITH COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA (CHCC), A RELATED TAX-EXEMPT ORGANIZATION. CHCC'S BOARD EXECUTIVE COMPENSATION SUBCOMMITTEE WILL "CONSIDER ALL MATTERS INVOLVING COMPENSATION AND BENEFITS OF (I) CORPORATE OFFICERS WHO ARE CLASSIFIED AS "DISQUALIFIED PERSONS" PURSUANT TO INTERNAL REVENUE CODE SECTION 4958; (II) ALL OTHER CORPORATE OFFICERS WHO ARE SENIOR VICE PRESIDENTS AND EXECUTIVE VICE PRESIDENTS AND (III) THE PRESIDENT/CHIEF EXECUTIVE OFFICER." THROUGH THE CHCC EXECUTIVE COMPENSATION SUBCOMMITTEE, THE CHCC BOARD HAS ENGAGED SULLIVAN, COTTER AND ASSOCIATES, INC. TO CONDUCT A TOTAL COMPENSATION REVIEW FOR THOSE INDIVIDUALS IDENTIFIED IN THEIR SCOPE OF RESPONSIBILITY WHICH INCLUDED THE USE OF COMPARABILITY DATA AND DOCUMENTATION OF THE FINDINGS REPORTED TO THE COMMITTEE. THIS PROCESS WAS MOST RECENTLY COMPLETED IN OCTOBER, 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 23,289,440. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,289,440. MEDICAL PURCHASED SERVICE: PROGRAM SERVICE EXPENSES 1,470. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,470. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 4,023,753. MANAGEMENT AND GENERAL EXPENSES 3,795,510. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,819,263. COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA 1560 E SHAW AVENUE FRESNO CA 93710 942864615 SUPPORTING ORGANIZATION CA 501(C)(3) LINE 12B, II N/A 1 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION 1560 E SHAW AVENUE FRESNO CA 93710 770191730 SUPPORTING ORGANIZATION CA 501(C)(3) LINE 7 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA 1 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER 1560 E SHAW AVENUE FRESNO CA 93710 941156276 HOSPITAL CA 501(C)(3) LINE 3 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA 1 AMI REALTY PARTNERS LP 1560 E SHAW AVENUE FRESNO CA 93710 203709876 REAL PROPERTY RENTAL CA N/A 0 0 COMMUNITY HEALTH ENTERPRISES INC 789 N MEDICAL CENTER DRIVE EAST CLOVIS CA 93611 770175659 PHARMACY SALES CA N/A C 0 COMMUNITY HEALTH CARE PLAN INC 789 N MEDICAL CENTER DRIVE EAST CLOVIS CA 93611 770246798 HEALTH CARE PLAN CA N/A C 0 COMMUNITY INSURANCE SERVICES COMPANY 789 N MEDICAL CENTER DRIVE EAST CLOVIS CA 93611 980674776 INSURANCE CJ N/A C 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 1 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER K 1072778 CASH COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA K 334592 CASH