2021-11-15T12:51:12-06:00 2020-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2020-01-01 680046750 NORTHBAY HEALTHCARE CORPORATION NORT 7076463400 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 MICHELE BOUIT VP, FINANCE/CFO 7076463400 2021-11-12 1 MICHELE BOUIT 999009999 MICHAEL LUMSDEN P01262236 4159561500 2021-11-11 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z B KONARD JONES 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 74503596 0 X WWW.NORTHBAY.ORG X 1984 CA MANAGEMENT AND OTHER SUPPORT SERVICES FOR NORTHBAY HEALTHCARE AFFILIATED ORGANIZATIONS. 8 1 370 0 0 0 14970 0 76148982 74450451 2172 2945 185364 50200 76351488 74503596 381865 79109 0 0 40633353 42419588 0 0 0 35366296 32011265 76381514 74509962 -30026 -6366 23101221 21427121 24999295 22397201 -1898074 -970080 COMPASSIONATE CARE, ADVANCED MEDICINE, CLOSE TO HOME. 0 0 56504383 79109 74450451 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. 0 0 0 NORTHBAY GUILD IS THE VOLUNTEER GROUP FOR NORTHBAY HEALTHCARE GROUP. THE PURPOSE OF THE NORTHBAY GUILD IS TO SUPPORT AND HELP CARRY OUT THE PURPOSE AND FUNCTIONS OF NORTHBAY HEALTHCARE GROUP IN PROMOTING THE HEALTH OF THE COMMUNITY. THIS IS ACCOMPLISHED THROUGH PROVIDING FUNDRAISING SUPPORT TO THE NORTHBAY HEALTHCARE FOUNDATION, AS WELL AS SCHOLARSHIPS TO MEMBERS OF THE COMMUNITY. 56504383 1 0 0 1 0 0 0 0 0 1 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 0 0 370 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MICHELE BOUIT 7076463400 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 B KONARD JONES DIRECTOR, PRESIDENT & CEO 30.00 20.00 X X 1071129 0 390833 AIMEE BREWER PRESIDENT, NORTHBAY HEALTHCARE GROUP 0.00 50.00 X 759255 0 112695 CHRISTOPHER TIMBERS VP, CHIEF INFORMATION OFFICER 10.00 40.00 X 686437 0 113227 NICOLE BROCATO VP, CHIEF QUALITY OFFICER 0.00 50.00 X 571246 0 73831 ROBERT COSCIONE VP, PAYER STRATEGY 0.00 50.00 X 497752 0 47256 JIM ANDERSEN VP, HUMAN RESOURCES 5.00 45.00 X 430843 0 67556 STEVE HUDDLESTON VP, PUBLIC AFFAIRS 5.00 45.00 X 445629 0 43947 THEO RALLIS INT VP, FINANCE & CFO / CONTROLLER 8.00 42.00 X 443723 0 41677 SCOTT DAVIS VP, CHIEF STRATEGY OFFICER/PRES NBHA 10.00 40.00 X 475942 0 6942 MICHELE BOUIT VICE PRESIDENT & CFO START 8/2020 8.00 42.00 X 212325 0 2532 MARY MANCINI MD SECRETARY-TREASURER 1.00 0.00 X X 0 24448 0 CHRISTOPHER SWEENEY DIRECTOR 1.00 1.00 X 0 20692 0 MARK SIEVERS CHAIR 1.00 1.00 X X 0 16569 0 STEPHEN POWER VICE CHAIR 1.00 0.00 X X 0 16569 0 MURRAY WOOLF MD DIRECTOR 1.00 0.00 X 0 16515 0 ARCHIE HUMPHREY DIRECTOR 1.00 1.00 X 0 16461 0 GARY FALATI DIRECTOR 1.00 1.00 X 0 8894 0 5594281 120148 900496 132 0 1 0 KING & SPAULDING LLP PO BOX 116133 ATLANTA GA 303686133 LEGAL SERVICES 651605 LATHAM & WATKINS PO BOX 894256 LOS ANGELES CA 901894256 LEGAL SERVICES 585720 TOYON ASSOCIATES LLC 1800 SUTTER STREET SUITE 600 CONCORD CA 94520 CONSULTANTS 433059 THE RATCLIFF ARCHITECTS 5856 DOYLE STREET EMERYVILLE CA 94608 ARCHITECTS 421747 ATLANTICON LLC PO BOX 621 FAIRBORN OH 45324 CONSULTANTS 416868 15 MANAGEMENT & ADMIN FEES 541900 74450331 74450331 REBATES & REFUNDS 900099 120 120 74450451 2945 2945 50200 0 50200 50200 50200 74503596 74450451 0 53145 X 79109 79109 3833833 871950 2961883 29987867 23002310 6985557 980154 749464 230690 5201468 4049258 1152210 2416266 1755661 660605 1369493 189300 1180193 99996 99996 15129 15129 87686 87686 14035393 10605161 3430232 407077 406077 1000 1104984 983202 121782 7366802 7355888 10914 3642514 3393518 248996 116267 83859 32408 36605 27207 9398 7231 6037 1194 2322796 2284351 38445 200562 200562 DUES & SUBSCRIPTIONS 424934 292022 132912 RECRUITING 390908 14092 376816 TAXES/LICENSES 61709 3925 57784 PUBLIC RELATIONS 56384 51117 5267 264795 100313 164482 74509962 56504383 18005579 0 176137 313747 81571 57404 177537 177537 3061080 3466990 47306187 41598951 6632193 5707236 2460160 3349494 100 100 10512443 8354613 23101221 21427121 12242794 11067194 236131 171003 12520370 11159004 24999295 22397201 X -1898094 -963734 20 -6346 -1898074 -970080 23101221 21427121 X -6366 934360 X 0 1 X 1 0 X X 1 NORTHBAY HEALTHCARE GROUP 941458282 3 1 0 0 1 0 0 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 CONTINUING RELATIONSHIP WITH ITS SUPPORTED ORGANIZATION, NBHG, IN THAT TWO MEMBERS OF NBHC'S BOARD AND THE CEO OF NBHC SERVES AS A VOTING DIRECTOR OF NBHG, THUS ENSURING NBHC WILL BE RESPONSIVE TO THE NEEDS OF NBHG. 0 0 0 0 0 0 0 0 1 15129 15129 0 PART II-B, LINE 1: NORTHBAY HEALTHCARE CORPORATION SUPPORTS CERTAIN INITIATIVES AND ISSUES THAT ARE HEALTHCARE RELATED AND CONSISTENT WITH ITS MISSION OF PROMOTING HEALTHCARE IN ITS COMMUNITY. EXPENDITURES INCURRED TO SUPPORT THESE INITIATIVES MAY BE CONSIDERED TO BE LOBBYING EXPENDITURES. AN INDIRECT EXPENDITURE OF A PORTION OF THE MEMBERSHIP DUES PAID TO THE CALIFORNIA HOSPITAL ASSOCIATION WERE USED FOR LOBBYING EXPENDITURES. 20 20 20 20 20 20 20 20 20 20 0.00000 0.00000 1.00000 0 0 710938 708708 2230 1409201 1064815 344386 43986506 39039195 4947311 1199542 786233 413309 5707236 OPERATING LEASE RIGHT-OF-USE ASSETS 8354613 8354613 WORKERS COMP RESERVE 495819 OPERATING LEASE LIABILITIES 9600155 DEFERRED EMPLOYER SOCIAL SECURITY TAX LIABILITY 1063030 11159004 PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED TO SUPPORT THE CERNER USER GROUP ANNUAL TRAINING AND EDUCATION CONFERENCE. 1 THE LEAVEN PROGRAM 2220 BOYNTON AVENUE SUITE A FAIRFIELD CA 94533 263653717 501(C)(3) 16000 GENERAL SUPPORT TOURO UNIVERSITY OF CALIFORNIA 1310 CLUB DRIVE VALLEJO CA 94592 133838740 501(C)(3) 12500 SPONSORSHIP AND GENERAL SUPPORT VACAVILLE CHAMBER OF COMMERCE 300 MAIN STREET VACAVILLE CA 95688 941111162 501(C)(6) 10609 SPONSORSHIP AND GENERAL SUPPORT MEALS ON WHEELS OF SOLANO COUNTY 95 MARINA CENTER SUISUN CA 94585 942453452 501(C)(3) 10000 GENERAL SUPPORT SOLANO EDC GOLD CLASSIC 360 CAMPUS LANE SUITE 102 FAIRFIELD CA 94534 942912759 501(C)(3) 25000 GENERAL SUPPORT 4 1 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 DIRECTOR, PRESIDENT & CEO 750200 0 276619 0 44310 0 372515 0 18318 0 1461962 0 0 0 AIMEE BREWER PRESIDENT, NORTHBAY HEALTHCARE GROUP 577500 0 170625 0 11130 0 85128 0 27567 0 871950 0 0 0 CHRISTOPHER TIMBERS VP, CHIEF INFORMATION OFFICER 388800 0 80496 0 217141 0 60534 0 52693 0 799664 0 0 0 NICOLE BROCATO VP, CHIEF QUALITY OFFICER 358193 0 86232 0 126821 0 38691 0 35140 0 645077 0 0 0 ROBERT COSCIONE VP, PAYER STRATEGY 329136 0 150000 0 18616 0 39971 0 7285 0 545008 0 0 0 JIM ANDERSEN VP, HUMAN RESOURCES 333720 0 83554 0 13569 0 45670 0 21886 0 498399 0 0 0 STEVE HUDDLESTON VP, PUBLIC AFFAIRS 321684 0 79076 0 44869 0 15424 0 28523 0 489576 0 25205 0 THEO RALLIS INT VP, FINANCE & CFO / CONTROLLER 329000 0 111540 0 3183 0 11246 0 30431 0 485400 0 0 0 SCOTT DAVIS VP, CHIEF STRATEGY OFFICER/PRES NBHA 379610 0 85000 0 11332 0 0 0 6942 0 482884 0 0 0 MICHELE BOUIT VICE PRESIDENT & CFO START 8/2020 155772 0 50000 0 6553 0 0 0 2532 0 214857 0 0 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 2020 CALENDAR YEAR ARE AS FOLLOWS, WHICH HAS BEEN REPORTED AS "RETIREMENT AND OTHER DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C): B. KONARD JONES - $361,115 AIMEE BREWER - $73,728 CHRISTOPHER TIMBERS - $51,894 NICOLE BROCATO - $30,731 ROBERT COSCIONE - $39,971 JIM ANDERSEN - $41,715 STEVE HUDDLESTON - $3,200 ADDITIONALLY, DUE TO VESTING OF THE 457(F) RETIREMENT PLAN, STEVE HUDDLESTON RECOGNIZED $25,205 OF TAXABLE COMPENSATION, WHICH HAS BEEN REPORTED AS "OTHER REPORTABLE COMPENSATION" IN SCHEDULE J, PART II, COLUMN (B)(III) AND "COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED ON PRIOR FORM 990" IN SCHEDULE J, PART II, COLUMN (F). 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 TO EXERCISE DISCRETION WHEN CALCULATING THE AMOUNT OF PAYMENT OR DECIDING WHETHER TO MAKE SUCH A PAYMENT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE VICE PRESIDENT/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 1,100,157. MANAGEMENT AND GENERAL EXPENSES 148,768. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,248,925. PROFESSIONAL FEES - MEDICAL: PROGRAM SERVICE EXPENSES 183,655. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 183,655. CONSULTING FEES: PROGRAM SERVICE EXPENSES 1,288,093. MANAGEMENT AND GENERAL EXPENSES 857,406. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,145,499. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 10,798. MANAGEMENT AND GENERAL EXPENSES 128,370. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 139,168. PURCHASED SERVICES - OTHER: PROGRAM SERVICE EXPENSES 8,022,458. MANAGEMENT AND GENERAL EXPENSES 2,295,688. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,318,146. FORM 990, PART XI, LINE 9: RELIEF OF DUE TO/DUE FROM RELATED ORGANIZATIONS 934,360. 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 1325 175759 1 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 214454 BOOK VALUE NORTHBAY HEALTHCARE GROUP L 73397546 BOOK VALUE SOLANO DIAGNOSTIC PARTNERS L 891478 BOOK VALUE