2018-07-13T12:50:23-05:00 2017-08-31 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2016-09-01 942864615 Community Hospitals of Central California COMM 5597244124 1560 E Shaw Avenue Fresno CA 93710 Roger Fretwell Controller 5597244124 2018-07-10 1 Tracy S Paglia P00366884 2099556100 2018-07-10 2016 2022-09-23 18:48:47Z X Tim Joslin 1560 E Shaw Avenue Fresno CA 93710 161194704 0 X www.communitymedical.org X 1982 CA CHCC'S MISSION IS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY AND TO PROMOTE MEDICAL EDUCATION. 15 11 807 18 0 0 347223 278551 142239277 153931132 3397191 58414 491686 520751 146475377 154788848 102500 279340 0 0 74242662 79055055 0 0 0 71543918 74933702 145889080 154268097 586297 520751 126132083 145610471 222595393 231402381 -96463310 -85791910 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA'S MISSION IS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY AND TO PROMOTE MEDICAL EDUCATION. 0 0 119781036 279340 153931132 MANAGEMENT FEES FROM AFFILIATED 501(C)(3) HOSPITALS AND FOUNDATION FOR EXECUTIVE MANAGEMENT AND GENERAL ADMINISTRATIVE COSTS. 119781036 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 807 0 1 807 1 0 0 0 0 0 0 0 0 0 0 X 15 11 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X ROGER FRETWELL 5594596000 1560 E SHAW AVENUE FRESNO CA 93710 Susan Abundis Board Member 0.20 1.70 X 0 0 0 Ajit Arora MD Board Member 0.20 1.70 X 72334 0 0 Terry Bradley Board Member 0.20 1.70 X 0 0 0 Jerry Cook Board Member 0.20 1.70 X 0 0 0 Manuel Cunha Jr Board Member 0.20 1.70 X 0 0 0 Ren Imai MD Board Member 0.20 1.70 X 0 0 0 John McGregor Board Member 0.20 1.70 X 0 0 0 Michael Peterson MD Board Member (thru 1/17) 0.20 1.70 X 0 0 0 Ruthie Quinto Board Member 0.20 1.70 X 0 0 0 David Slater MD Board Member 0.20 1.70 X 12000 0 0 Roger Sturdevant Board Member 0.20 1.70 X 0 0 0 Michael Synn MD Board Member 0.20 1.70 X 0 0 0 Jeffrey Thomas MD Board Member (thru 12/16) 0.20 1.70 X 155000 0 0 Chandrasekar Venugopal MD Board Member 0.20 1.70 X 0 0 0 Linzie Daniel Chair 0.20 1.70 X X 0 0 0 Farid Assemi Chair-Elect 0.20 1.70 X X 0 0 0 Vong Mouanoutoua Secretary 0.20 1.70 X X 0 0 0 Florence Dunn Board Member (thru 12/16) 0.20 0.70 X 0 0 0 Tim Joslin Chief Executive Officer 5.00 55.00 X 1644266 0 28423 Patrick Rafferty EVP Chief Operations Officer 5.00 55.00 X 1104389 0 342031 Joseph Nowicki SVP Financial Svcs 5.00 55.00 X 774942 0 85597 Aldo De La Torre Senior VP for Network Development and Insurance S 5.00 50.00 X 675186 0 72242 Margaret Breen SVP Human Resources 5.00 50.00 X 617067 0 60987 Judi Binderman VP Chief Medical Info off- CMIO 5.00 50.00 X 483399 0 19410 John Zelezny SVP Communications 5.00 50.00 X 482694 0 58991 James Franklin Chief Program Mgmt Officer 5.00 50.00 X 421583 0 54416 George Vasquez SVP Chief Information Officer 5.00 50.00 X 385089 0 28392 Debra Muscio SVP Audit and Compliance 5.00 50.00 X 406880 0 53230 Deborah Moffett VP Finance 5.00 50.00 X 363981 0 25454 Vicki Anderson VP Managed Care 5.00 50.00 X 322816 0 32016 Michele Earnhart VP Patient Financial Services 5.00 50.00 X 306120 0 18454 James Cole Director of Reimbursement 5.00 50.00 X 292166 0 6761 Stephen Walter Former SVP CFO (thru 2/15) 5.00 55.00 X 336236 0 9317 Robert Ward thru 216 Former SVP Chief Legal off 5.00 50.00 X 1035982 0 12674 9892130 0 908395 160 1 1 0 COMP SPEC 425 E COLORADO ST STE 410 GLENDALE CA 912051675 FINANCIAL SERVICES 2904700 DELOITTE AND TOUCHE LLP PO BOX 844708 DALLAS TX 752844708 CONSULTING 2085481 IT1 SOURCE LLC PO BOX 413006 SALT LAKE CITY UT 841413006 TECHNOLOGY 1956629 CONVERGENT REVENUE CYCLE MGMT PO BOX 714668 CINCINNATI OH 452714668 FINANCIAL SERVICES 1557320 STEPHENSON ACQUISTO & COLMAN 303 N GLENOAKS BLVD STE 700 BURBANK CA 91502 CONSULTING 1120369 49 215551 63000 278551 Management fees 900099 149034295 149034295 application revenue 900099 209725 209725 Special services revenue 900099 157080 157080 Income From Sante 900099 97693 97693 Program Service Rental 900099 11000 11000 4421339 4421339 153931132 53502 53502 7918 7918 6886456 6365705 520751 520751 520751 37145 40151 -3006 -3006 -3006 154788848 153931132 0 579165 X 279340 279340 791871 791871 84956 84956 65771881 55248380 10523501 774281 650396 123885 7351907 6175602 1176305 4280159 3595334 684825 3017821 3017821 283692 283692 921612 921612 643384 276655 366729 21064872 9454188 11610684 1576634 1576634 4157791 2993609 1164182 20687893 20687893 3054574 2565842 488732 1348379 1348379 177131 177131 218743 218743 14193320 11922389 2270931 1753188 1693188 60000 Other Operating Expense 1493622 746811 746811 Repairs and Maintenance 235209 117604 117605 Lease and Rental Paymen 105837 52918 52919 154268097 119781036 34487061 0 215768 596502 3336308 4179624 420280 374059 6142553 6598196 274778220 146878912 110582612 127899308 1988096 2840947 2868431 2966124 578035 155711 126132083 145610471 24132101 19675359 94594 106725 6393419 5958519 2926361 2579790 189048918 203081988 222595393 231402381 X -96463310 -85791910 -96463310 -85791910 126132083 145610471 X 520751 10150649 X 0 1 X 1 0 X X 2 Fresno Community Hospital & Medical Center 941156276 3 0 0 0 Sierra Hospital Foundation 941431181 3 0 0 0 2 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 Part IV, Section A, line 1 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA'S (CHCC) BOARD APPROVED MISSION IS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY AND TO PROMOTE MEDICAL EDUCATION. CHCC IS THE CENTRALIZED SHARED SERVICES ENTITY FOR THE AFFILIATED GROUP, WHICH ARE UNDER COMMON CONTROL. CHCC HAS HAD A HISTORIC AND CONTINUING RELATIONSHIP WITH FCH&MC AND SHF SINCE IT WAS FORMED IN 1988. Part IV, Section A, Line 6: CHCC provided grants to several non-supported organizations during the year to support the community at large. The grant to Sante Health Foundation was made to promote scientific and medical research, educational activities related to the care of the sick, injured and disabled, and community health through health care services. All grants made were in furtherance of health care purposes consistent with FCH&MC's exempt purpose, and would have been made directly by FCH&MC if they had not be made by CHCC. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 921612 0 0 921612 0 Part II-B, Line 1: CHCC MAINTAINS A GOVERNMENT RELATIONS DEPARTMENT TO MONITOR PENDING LEGISLATION AND TO INFLUENCE LEGISLATORS AND PUBLIC OPINION ON HEALTH CARE ISSUES. PAYMENTS MADE TO LOBBYISTS ARE DISCLOSED BELOW. THE FORHAN COMPANY: PROFESSIONAL FEES WERE PAID FOR FEDERAL, STATE OF CALIFORNIA, COUNTY OF FRESNO AND CITY OF FRESNO FOR GOVERNMENT RELATIONS AND ADVOCACY SERVICES. CJ LAKE: PROFESSIONAL FEES WERE PAID FOR FEDERAL GOVERNMENT RELATIONS AND ADVOCACY SERVICES. PEACH: A PORTION OF DUES PAID DIRECTLY RELATE TO LOBBYING ACTIVITY. CALIFORNIA HOSPITAL COUNCIL: A PORTION OF DUES PAID DIRECTLY RELATE TO LOBBYING ACTIVITY. HOOPER, LUNDY & BOOKM: A PORTION OF DUES PAID DIRECTLY RELATE TO LOBBYING ACTIVITY. 22193385 22193385 88061580 34089112 53972468 1742250 1732815 9435 157936536 111056985 46879551 4844469 4844469 127899308 Payables to affiliates 181537407 Pension Liability 18029254 Covidien Lease 2565089 Medtronic Lease 950238 203081988 FORM 990, SCHEDULE D, PART X, LINE 2: THERE IS NO FOOTNOTE FOR FIN 48 IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DUE TO IMMATERIALITY. 0 Central Valley Community Foundation 5250 N Palm Ave Suite 424 Fresno CA 93704 770478025 501(c)(3) 25000 Armenia Exchange Fund Central Valley Community Foundation 5250 N Palm Ave Suite 424 Fresno CA 93704 770478025 501(c)(3) 20000 Scholarship Gala Presentation Sponsorship Fresno Chamber Of Commerce 2331 Fresno St Fresno CA 93721 940489640 501(c)(3) 15000 Sponsor The Foundation FCOE 1111 Van Ness Third Floor Fresno CA 93721 800381096 501(c)(3) 10000 For Respite Beds Fresno Rescue Mission PO Box 1422 Fresno CA 93716 941279785 501(c)(3) 51480 Keynote Speaker Sponsor UCSF Foundation 155 N Fresno St Fresno CA 93721 942829914 501(c)(3) 40000 Medical Education 5 0 Part I, Line 2: The organization does not have a grant procedure for monitoring the use of funds. X X X 1 1 X X X X 1 1 0 1 1 1 1 0 0 Jeffrey Thomas MD Board Member (thru 12/16) 155000 0 0 0 0 0 0 0 0 0 155000 0 0 0 Tim Joslin Chief Executive Officer 1012174 0 456231 0 175861 0 15900 0 12523 0 1672689 0 0 0 Patrick Rafferty EVP Chief Operations Officer 680071 0 342512 0 81806 0 330704 0 11327 0 1446420 0 0 0 Joseph Nowicki SVP Financial Svcs 512825 0 216138 0 45979 0 68539 0 17058 0 860539 0 0 0 Aldo De La Torre Senior VP for Network Development a 418537 0 190359 0 66290 0 55535 0 16707 0 747428 0 0 0 Margaret Breen SVP Human Resources 419797 0 174187 0 23083 0 53690 0 7297 0 678054 0 0 0 Judi Binderman VP Chief Medical Info off- CMIO 360478 0 103398 0 19523 0 7316 0 12094 0 502809 0 0 0 John Zelezny SVP Communications 324790 0 151554 0 6350 0 51888 0 7103 0 541685 0 0 0 James Franklin Chief Program Mgmt Officer 300154 0 107722 0 13707 0 47252 0 7164 0 475999 0 0 0 George Vasquez SVP Chief Information Officer 286991 0 88756 0 9342 0 15900 0 12492 0 413481 0 0 0 Debra Muscio SVP Audit and Compliance 275019 0 109413 0 22448 0 41465 0 11765 0 460110 0 0 0 Deborah Moffett VP Finance 271558 0 92423 0 0 0 18550 0 6904 0 389435 0 0 0 Vicki Anderson VP Managed Care 245009 0 70081 0 7726 0 19677 0 12339 0 354832 0 0 0 Michele Earnhart VP Patient Financial Services 233838 0 66622 0 5660 0 11692 0 6762 0 324574 0 0 0 James Cole Director of Reimbursement 233460 0 53068 0 5638 0 0 0 6761 0 298927 0 0 0 Stephen Walter Former SVP CFO (thru 2/15) 0 0 0 0 336236 0 0 0 9317 0 345553 0 0 0 Robert Ward thru 216 Former SVP Chief Legal off 26730 0 0 0 1009252 0 1871 0 10803 0 1048656 0 458519 0 Part I, Line 1a First-class travel on certain long-term or overnight flights is allowed for the CEO, COO, and CFO. As a recruiting tool, CHCC will pay a temporary housing allowance to certain new employees under special circumstances. CHCC also leases a condominium to Mark Kestner, CMIO. CHCC pays for social club dues for Tim Joslin, Patrick Rafferty and Aldo De La Torre. These dues are taxable compensation. Part I, Lines 4a-b LINE 4A: THE ORGANIZATION AND ROBERT WARD, CHIEF LEGAL OFFICER, ENTERED INTO A SEVERANCE AGREEMENT WHEREBY MR. WARD WILL RECEIVE 52 BIWEEKLY PAYMENTS OF $17,820 BEGINNING FEBRUARY 2016. THE ORGANIZATION AND STEVE WALTER, CFO, ENTERED INTO A SEVERANCE AGREEMENT WHEREBY MR. WALTER RECEIVED 39 BIWEEKLY PAYMENTS OF $22,470 BEGINNING FEBRUARY 2015. LINE 4B: DURING THE YEAR, CONTRIBUTIONS WERE MADE TO THE PLAN FOR THE FOLLOWING INDIVIDUALS: - PATRICK RAFFERTY $314,804 - JOSEPH NOWICKI $52,639 - MARGARET BREEN $43,090 - JOHN ZELEZNY $33,338 - DEBRA MUSCIO $28,215 - ALDO DE LA TORRE $44,935 - James Franklin $34,002 THE FOLLOWING EMPLOYEES RECEIVED PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: - Robert Ward $458,519 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 the Health System and individual levels. The main objectives are: - Motivate executives and reward them for improving CMC's operational performance; - Increase community involvement and effectiveness; - increase executive commitment to CMC's short and long term goals; - provide executives with competitive but reasonable compensation; - and 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. Katherine McGregor Family member of John McGregor, board member 18721 Salaries and Wages 0 Form 990, Part VI, Section B, line 11b Upon completion of an initial review by senior management, the Chairman of the Board of Trustees forwards the form to the Executive Committee of the Board of Trustees for final review. The finalized Form 990 then becomes a record of the organization's Board of Trustees. Form 990, Part VI, Section B, line 12c Annually each director, principal officer and member of committee with board delegated powers sign a statement 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. 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 acquisitions of physician practices and other provider 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 rests with the board's Executive Compensation Subcommittee. The committee 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 Executive Compensation Subcommittee, the board has engaged Sullivan, Cotter and Associates, INC. to conduct a total compensation review for those individuals identified in their scope of responsibility. Form 990, Part VI, Section C, line 19 IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, THE ORGANIZATION CONSOLIDATES THE RESULTS OF ITS FINANCIAL OPERATIONS WITH THOSE OF ITS NONPROFIT AND FORPROFIT AFFILIATES TO ISSUE CONSOLIDATED FINANCIAL STATEMENTS UNDER THE BUSINESS NAME COMMUNITY MEDICAL CENTER. THESE AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE THROUGH ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) AT EMMA.MSRB.ORG. Form 990, Part IX, line 11g MD Supervisory Fees: Program service expenses 245,576. Management and general expenses 325,531. Fundraising expenses 0. Total expenses 571,107. Collection Agencies: Program service expenses 247,914. Management and general expenses 328,630. Fundraising expenses 0. Total expenses 576,544. Other Professional Fees: Program service expenses 975,161. Management and general expenses 1,292,655. Fundraising expenses 0. Total expenses 2,267,816. Other Purchased Services: Program service expenses 7,854,251. Management and general expenses 9,489,837. Fundraising expenses 0. Total expenses 17,344,088. Consult & Mgmt Fees: Program service expenses 131,286. Management and general expenses 174,031. Fundraising expenses 0. Total expenses 305,317. Form 990, Part XI, line 9: Change in unfunded accumulated pension benefit obligation 10,150,649. Fresno Community Hospital and Medical Center 798 N MEDICAL CENTER DRIVE EAST CLOVIS CA 93611 941156276 Hospital CA 501(c)(3) Line 3 Community Hospitals Of Central California 1 Sierra Hospital Foundation PO Box 1232 Fresno CA 93715 941431181 Inactive CA 501(c)(3) Line 3 community Hospitals Of Central California 1 Community Hospitals of Central California Foundation PO Box 1232 Fresno CA 93715 770191730 Supporting Organization CA 501(c)(3) Line 7 community Hospitals Of Central California 1 Community Health Enterprises Inc 798 N MEDICAL CENTER DRIVE EAST CLOVIS CA 93611 770175659 Pharmacy Sales CA N/A C 0 Community Care Health Plan Inc 798 NMEDICAL CENTER DRIVE EAST CLOVIS CA 93611 770246798 Health Care Plan CA N/A C 0 SANTE HEALTH Services INC 6051 N Fresno Street Fresno CA 93710 200382364 Inactive CA N/A C 0 Community Insurance Services Company 798 NMEDICAL CENTER DRIVE EAST CLOVIS CA 93611 980674776 Insurance CJ N/A C 0 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 fresno Community Hospital & Medical Center Q 146998473 cost cOmmunity Health Enterprises Inc Q 443139 cost cOMMUNITY HOspitals of Central California Foundation Q 871097 cOST cOMMUNITY HOspitals of Central California Foundation C 215551 cOST