2019-11-15T10:28:44-06:00 2018-12-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2018-01-01 941498697 CALIFORNIA HEALTH FOUNDATION AND TRUST CALI 9165527629 1215 K STREET NO 800 SACRAMENTO CA 95814 JENNIFER NEWMAN CFO 9165527629 2019-11-07 1 TRACY S PAGLIA P00366884 2099556100 2019-11-07 172.9.161.112 2019-11-07 16:47:09 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 2CA4604677747A1B8287DC7DD1B2F222DAF5CAE3 2018 2020-04-17 16:48:07Z CARMELA COYLE 1215 K STREET NO 800 SACRAMENTO CA 95814 57494685 0 X N/A X 1956 CA SUPPORT ACCESS, RESEARCH, AND EDUCATION IN THE HEALTHCARE FIELD 13 12 0 0 0 0 76061234 57209276 0 0 97145 181835 176669 103574 76335048 57494685 38854988 20672212 0 0 65721 57882 0 0 0 1341021 8090580 40261730 28820674 36073318 28674011 114208248 120950494 38774866 11797807 75433382 109152687 X SUPPORT ACCESS, RESEARCH, AND EDUCATION IN THE FIELD OF HEALTHCARE DELIVERY, FINANCING, AND PATIENT CARE. 0 0 22149439 20470378 0 2017-2019 HOSPITAL GRANT PROGRAM:STATEWIDE EFFORT TO ASSIST HOSPITALS AND HOSPITAL HEALTH SYSTEMS IN CALIFORNIA TO CONTINUE TO PROVIDE ACCESS TO CARE FOR UNINSURED AND UNDERINSURED PEOPLE, PRESERVE PHYSICAL ACCESS TO CARE, AND PROVIDE COMMUNITY SERVICES SUCH AS MENTAL HEALTH ACCESS, WELLNESS, AND PREVENTION PROGRAMS. THE PROGRAM RECOVERS 3 BILLION OF THE 7 BILLION SHORT FALL ANNUALLY IN MEDI-CAL PAYMENTS. 5901647 0 0 2014-2016 HOSPITAL GRANT PROGRAM:STATEWIDE EFFORT TO ASSIST HOSPITALS AND HOSPITAL HEALTH SYSTEMS IN CALIFORNIA TO CONTINUE TO PROVIDE ACCESS TO CARE FOR UNINSURED AND UNDERINSURED PEOPLE, PRESERVE PHYSICAL ACCESS TO CARE, AND PROVIDE COMMUNITY SERVICES SUCH AS MENTAL HEALTH ACCESS, WELLNESS, AND PREVENTION PROGRAMS. THE PROGRAM RECOVERS 3 BILLION OF THE 7 BILLION SHORT FALL ANNUALLY IN MEDI-CAL PAYMENTS. 286724 69955 0 CRITICAL ACCESS HOSPITALS GRANT PROGRAM:TO RETAIN EXPERT SERVICES AND PROVIDE TECHNICAL SUPPORT TO CRITICAL ACCESS HOSPITALS UNDER THE MEDICARE RURAL HOSPITAL FLEXIBILITY PROGRAM. 382042 131879 0 OTHER PROGRAM SERVICES IN SUPPORT OF MISSION. 382042 131879 0 28719852 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 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 0 0 0 1 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X JENNIFER NEWMAN CFO 9165527629 1215 K STREET SUITE 800 SACRAMENTO CA 95814 CARMELA COYLE PRESIDENT 1.00 39.00 X X 0 1289805 20742 ANN MADDEN RICE PAST CHAIR (THRU 10/18) 1.00 2.00 X X 0 0 0 RICHARD F AFABLE MD CHAIR 1.00 2.00 X X 0 0 0 CALVIN CAL KNIGHT CHAIR-ELECT 1.00 2.00 X X 0 0 0 GARY K WILDE SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 ELAINE BATCHLOR MD TRUSTEE 1.00 1.00 X 0 0 0 LINDA BRADLEY TRUSTEE 1.00 1.00 X 0 0 0 PETE DELGADO TRUSTEE 1.00 1.00 X 0 0 0 NATALIE GERMUSKA TRUSTEE 1.00 1.00 X 0 0 0 LAWRENCE E LEWIS TRUSTEE 1.00 1.00 X 0 0 0 MICHAEL J MADDEN TRUSTEE 1.00 1.00 X 0 0 0 SUZANNE RICHARDS RN TRUSTEE (THRU 07/18) 1.00 1.00 X 0 0 0 JON VAN BOENING TRUSTEE 1.00 1.00 X 0 0 0 VICKI J VEAL TRUSTEE 1.00 1.00 X 0 0 0 AVI E ZARAYA TRUSTEE 1.00 1.00 X 0 0 0 JENNIFER M NEWMAN CFO 2.80 37.20 X 0 347784 58320 0 1637589 79062 0 0 1 0 CA ASSN OF HOSPITALS AND HEALTH SYSTEMS 1215 K STREET SUITE 800 SACRAMENTO CA 95814 PROFESSIONAL SERVICES 2387873 WESTERN HEALTHCARE ALLIANCE PO BOX 2907 GRAND JUNCTION CO 815022907 PROFESSIONAL SERVICES 199983 RURAL HEALTH SOLUTIONS 1535 SHANNON DRIVE WOODBURY MN 55125 PROFESSIONAL SERVICES 100085 3 189250 286724 56733302 57209276 181835 181835 GROUP PURCHASING 900099 34011 34011 CRQAR REVENUE 900099 8074 8074 61489 61489 103574 57494685 0 0 285409 20672212 20672212 48641 48641 9241 9241 5312552 5312552 33978 33978 2641393 2618502 22891 1979 1979 14962 14962 43742 43742 12827 12827 29147 29147 28820674 28719852 100822 0 66355669 100424408 47368881 20201090 230623 79503 9333 2665 243742 242828 114208248 120950494 412033 2573207 38362833 9224600 38774866 11797807 X 1420901 1536501 73787481 107391186 225000 225000 75433382 109152687 114208248 120950494 X 28674011 -613 5045907 X 0 1 X 1 0 X 150031462 36381386 23919217 76061234 57209276 343602575 150031462 36381386 23919217 76061234 57209276 343602575 153038302 190564273 82572 166317 164568 97145 181835 692437 223149 176669 103574 503392 344798404 0.55270 0.57870 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2016 AMOUNT: $ 18,786. 2017 AMOUNT: $ 62,148. 2018 AMOUNT: $ 61,489. CRQAR REVENUE - 2016 AMOUNT: $ 115,075. 2017 AMOUNT: $ 29,160. 2018 AMOUNT: $ 8,074. GROUP PURCHASING - 2016 AMOUNT: $ 89,288. 2017 AMOUNT: $ 85,361. 2018 AMOUNT: $ 34,011. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 237477 5581 243058 249351 5126 17000 237477 243904 5447 249351 256362 4542 17000 243904 252350 4012 256362 0.00000 0.92570 0.07430 0 0 0 X 57263559 -613 -230513 -231126 57494685 0 57494685 23544254 0 23544254 5276420 5276420 28820674 PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED FOR THE WALKER/SULLIVAN ENDOWMENT WHICH FUNDS GRANTS TO STUDY HEALTHCARE OPERATIONS. PART X, LINE 2: CHFT IS A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAX CODE SECTION 23701D. ACCORDINGLY, THE FINANCIAL STATEMENTS DO NOT REFLECT ANY PROVISION FOR INCOME TAXES. IN THE EVENT CHFT HAD A TAX PROVISION THAT WAS UNCERTAIN OF BEING SUSTAINED, CHFT WOULD APPLY THE MINIMUM PROBABILITY THRESHOLD TO DETERMINE WHETHER A FINANCIAL STATEMENT LIABILITY OR BENEFIT SHOULD BE RECOGNIZED. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVERSAL OF CONTRIBUTION REVENUE -230,513. PART XII, LINE 4B - OTHER ADJUSTMENTS: REVERSE PRIOR YEAR GRANTS EXPENSE 5,276,420. 1 GLENN MEDICAL CENTER 1133 WEST SYCAMORE STREET WILLOWS CA 959882745 680000503 501(C)(3) 10000 TO PROVIDE QUALITY AND OPERATIONAL IMPROVEMENTS THROUGH CLINICAL TRAINING AND CONTINUING EDUCATION MAMMOTH HOSPITAL PO BOX 660 MAMMOTH LAKES CA 93546 202601653 501(C)(3) 15000 TO PROVIDE TRAINING FOR ORGANIZATION EFFICIENCY BY MINIMIZING VARIANCES BETWEEN ACTUAL AND TARGET PRODUCTIVE HOURS MARK TWAIN ST JOSEPHS HOSPITAL 768 MOUNTAIN RANCH ROAD SAN ANDREAS CA 95247 680127677 501(C)(3) 7935 TO HELP IMPROVEMENTS IN PATIENT COMMUNICATIONS AND DISCHARGE PLANNING MENDOCINO COAST DISTRICT HOSPITAL 700 RIVER DRIVE FORT BRAGG CA 95437 952627981 GOV'T 7000 TO PROVIDE A THREE DAY INTENSIVE TRAINING ON MEDICARE COVERAGE, BILLING, CODING, AND PAYMENT OJAI VALLEY COMMUNITY HOSPITAL 1306 MARICOPA HIGHWAY OJAI CA 93023 201982135 501(C)(3) 9000 TO IMPROVE PATIENT SATISFACTION THROUGH ESTABLISHING A QUIETNESS CAMPAIGN FOR OVERALL ENHANCED PATIENT EXPERIENCE AND OPTIMAL HEALING PALO VERDE HOSPITAL 250 NORTH 1ST STREET BLYTHE CA 92225 900214335 GOV'T 7500 TO PROVIDE ANALYSIS FOR CHANGING FROM A RURAL HOSPITAL TO A CRITICAL ACCESS HOSPITAL CHINESE HOSPITAL 845 JACKSON STREET SAN FRANCISCO CA 94133 940382780 501(C)(3) 822086 TO PROVIDE CULTURALLY AND LINGUISTICALLY QUALITY CARE AND ACCESS TO THE MONOLINGUAL, LOW INCOME CHINESE POPULATION IN SF COUNTY EISENHOWER MEDICAL CENTER 420 MONTGOMERY STREET SAN FRANCISCO CA 94104 956130458 501(C)(3) 13209967 TO FOCUS ON IMPROVING HEALTH EDUCATION, PROMOTION, AND WELLNESS WITH INCREASED ACCESS OF OUTPATIENT SURGICAL SERVICES HENRY MAYO NEWHALL 23845 MCBEAN PARKWAY VALENCIA CA 91355 952821104 501(C)(3) 4122801 UTILIZED TO FUND MEDICAL LOSSES METHODIST HOSPITAL OF SOUTHERN CALIFORNIA 300 WEST HUNTINGTON DRIVE ARCADIA CA 91007 951643336 501(C)(3) 2330923 TO PROVIDE HEALTH CARE TO UNDER/UNINSURED AND UNDERSERVED POPULATION AND PROVIDE COMMUNITY BENEFIT WITH HEALTH EDUCATION, PREVENTATIVE SCREENINGS, AND IMMUNIZATIONS OROVILLE HOSPITAL 2767 OLIVE HIGHWAY OROVILLE CA 95966 941634554 501(C)(3) 10000 TO ASSIST EMPLOYEES AFFECTED BY THE CA FIRES HCA HOPE FUND PO BOX 440252 NASHVILLE TN 37244 470957872 501(C)(3) 10000 TO ASSIST EMPLOYEES AFFECTED BY THE CA FIRES ENLOE HEALTH FOUNDATION 249 WEST SIXTH AVENUE CHICO CA 95926 942985552 501(C)(3) 25000 TO ASSIST EMPLOYEES AFFECTED BY THE CA FIRES ADVENTIST HEALTH SYSTEM 2100 DOUGLAS BOULEVARD ROSEVILLE CA 95661 953484589 501(C)(3) 80000 TO ASSIST EMPLOYEES AFFECTED BY THE CA FIRES 14 0 PART I, LINE 2: GRANTEES ARE REQUIRED TO SIGN RECIPIENT AGREEMENTS WHICH DETERMINE THE ALLOWABLE USE OF GRANT FUNDS AND REPORTING REQUIREMENTS. 0 1 0 0 0 0 0 0 0 CARMELA COYLE PRESIDENT 0 843089 0 418500 0 28216 0 19250 0 1492 0 1310547 0 0 JENNIFER M NEWMAN CFO 0 280367 0 65000 0 2417 0 37750 0 20570 0 406104 0 0 PART I, LINE 3 CALIFORNIA HEALTH FOUNDATION AND TRUST (CHFT) RELIES ON CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (CAHHS), A RELATED ORGANIZATION, TO ESTABLISH COMPENSATION FOR THE PRESIDENT USING ONE OR MORE OF THE METHODS DESCRIBED ON SCHEDULE J, PART I, LINE 3. THE COMPENSATION REPORTED FOR THE OFFICERS OF CHFT IS PAID BY CAHHS AND IS FOR SERVICES PROVIDED TO CAHHS AND CALIFORNIA HOSPITAL ASSOCIATION. PART I, LINE 4B THE ORGANIZATION MAINTAINS A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. THIS PLAN IS INTENDED TO QUALIFY AS AN UNFUNDED PLAN OF DEFERRED COMPENSATION THAT IS MAINTAINED BY AN EMPLOYER PRIMARILY FOR THE PURPOSE OF PROVIDING DEFERRED COMPENSATION FOR THE SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES AS THOSE TERMS ARE DEFINED UNDER THE PROVISIONS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED (ERISA). FUNDING FOR THIS PLAN IS THROUGH ANNUAL EMPLOYER CONTRIBUTIONS AND IS LIMITED TO THE ANNUAL AMOUNT SET FORTH BY THE US TREASURY DEPARTMENT. JENNIFER NEWMAN PARTICIPATED IN THE PLAN AND RECEIVED A BENEFIT OF $18,500 FOR THE YEAR. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER IS CALIFORNIA HOSPITAL ASSOCIATION, A CALIFORNIA NONPROFIT MUTUAL BENEFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A CERTAIN ACTS MUST BE APPROVED BY THE SOLE MEMBER, CALIFORNIA HOSPITAL ASSOCIATION: A. MATERIALLY CHANGING THE PHILOSOPHY, OBJECTIVES AND PURPOSES OF THE CORPORATION; B. ENGAGING IN ANY MERGER, CONSOLIDATION, AFFILIATION, OR DISSOLUTION OF THE CORPORATION; C. ENGAGING IN ANY SALE, LEASE, DISPOSITION OR HYPOTHECATION OF SUBSTANTIALLY ALL OF THE ASSETS OWNED BY THE CORPORATION; D. ADMISSION OF ANY OTHER MEMBERS; E. RELINQUISHING OR ALTERING THE TAX-EXEMPT STATUS OF THE CORPORATION; F. MATERIALLY CHANGING THE CORPORATE STRUCTURE OF THE CORPORATION OR ANY OF ITS COMPONENT PARTS; AND G. AMENDING, RESTATING, OR RESCINDING THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER, CALIFORNIA HOSPITAL ASSOCIATION ELECTS THE BOARD OF DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE AUDIT COMMITTEE REVIEWED THE FORM 990 BEFORE IT WAS FINALIZED OR FILED. EACH MEMBER OF THE CALIFORNIA HEALTH FOUNDATION AND TRUST BOARD OF DIRECTORS WAS SENT A COPY OF THE DRAFT FORM 990 BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS EACH MEMBER OF THE BOARD OF DIRECTORS; THE PRESIDENT/CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, AND CHIEF FINANCIAL OFFICER; KEY EMPLOYEES; ANY PERSON WHO HAS HELD ONE OF THOSE POSITIONS DURING THE PRECEDING FIVE YEARS; FAMILY MEMBERS; AND CERTAIN CONTROLLED ORGANIZATIONS (INTERESTED PERSONS). ALL INTERESTED PERSONS ANNUALLY SIGN A STATEMENT THAT AFFIRMS RECEIPT AND AGREEMENT TO COMPLY WITH THE POLICY AND TO DISCLOSE ANY FINANCIAL INTERESTS OR FAMILY RELATIONSHIPS THAT COULD GIVE RISE TO A CONFLICT OF INTEREST. EACH INTERESTED PERSON IS REQUIRED TO DISCLOSE TO THE BOARD (OR COMMITTEE THEREOF), ALL MATERIAL FACTS REGARDING THE FINANCIAL INTEREST OR RELATIONSHIP IN THE TRANSACTION. WITH REGARD TO AN INTERESTED PERSON, THE BOARD OR COMMITTEE DETERMINES IF A CONFLICT OF INTEREST EXISTS. THE INSIDER(S) INVOLVED WITH THE TRANSACTION WILL NOT BE PRESENT DURING THE BOARD OR COMMITTEE'S DISCUSSION OR DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS, AND MAY NOT VOTE ON THE TRANSACTION OR COUNTED IN DETERMINATION OF A QUORUM. ALL PROCEEDINGS ARE DOCUMENTED IN MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: REVERSAL OF PRIOR YEAR GRANTS 5,276,420. REVERSAL OF CONTRIBUTION REVENUE -230,513. CALIFORNIA HOSPITAL ASSOCIATION 1215 K STREET SUITE 800 SACRAMENTO CA 95814 680343712 REPRESENT HOSPITAL INTEREST BEFORE LEGISLATORS AND REGULATORS CA 501(C)(6) N/A 0 CALIFORNIA ASSOCIATION OF HOSPITALS HEALTH SYSTEMS 1215 K STREET SUITE 800 SACRAMENTO CA 95814 941205908 REPRESENT HOSPITAL INTEREST BEFORE LEGISLATORS AND REGULATORS CA 501(C)(6) CALIFORNIA HOSPITAL ASSOCIATION 0 CALIFORNIA HOSPITALS COMMITTEE ON ISSUES 1127 11TH STREET SUITE 300 SACRAMENTO CA 95814 680148902 BALLOT INITIATIVES CA 501(C)(6) N/A 0 CALIFORNIA HOSPITAL ASSOCIATION POLITICAL ACTION COMMITTEE 1215 K STREET SUITE 800 SACRAMENTO CA 95814 942723946 POLITICAL ACTION COMMITTEE CA 527 N/A 0 HEALTH PROPERTY ASSOCIATES 1215 K STREET SUITE 800 SACRAMENTO CA 95814 680177130 GROUND LEASE CA N/A CALIFORNIA INVESTMENTS & PUBLICATIONS INC 1215 K STREET SUITE 800 SACRAMENTO CA 95814 680114819 INACTIVE CA N/A C 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 1 0 0 0 CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS M 2387873 FMV