2017-11-14T18:13:07-06:00 2016-12-31 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2016-01-01 680046750 Northbay Healthcare Corporation NORT 7076463116 4500 Business Center Drive Fairfield CA 94534 Arthur e Denio Chief Financial Officer 7076463116 2017-11-14 1 Joua V Lo P01225144 4159561500 73.90.207.107 2017-11-14 01:58:26 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 189799C539B232A8D1FA5D0851A612580EB85C47 2016 2017-02-10 21:41:12Z Konard Jones 4500 Business Center Drive Fairfield CA 94534 68826831 0 X www.northbay.org X 1984 CA THE CORPORATION IS ORGANIZED TO SUPPORT, ACT FOR THE BENEFIT OF, PERFORM FUNCTIONS OF, AND CARRY OUT THE PURPOSES OF NORTHBAY HEALTHCARE GROUP, NORTHBAY HEALTH ADVANTAGE, AND NORTHBAY HEALTHCARE FOUNDATION, ALL OF WHICH ARE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3), AND ORGANIZATIONS DESCRIBED IN SECTION 509(A)(1) OR (2) OF THE INTERNAL REVENUE CODE. 7 1 429 0 0 0 22904 24009 61272873 68308576 49 2648 -1562508 293871 59733318 68629104 160425 336519 0 0 28948811 34751359 0 0 0 25339989 32329995 54449225 67417873 5284093 1211231 28787774 30435545 10667152 11103692 18120622 19331853 Compassionate Care, Advanced Medicine, Close to Home. 0 0 44545474 222214 68308576 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. 114305 114305 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 SCHOLARSHIPS TO MEMBERS OF THE COMMUNITY. 44659779 1 1 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 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 429 1 0 0 0 0 0 0 0 0 0 0 X 7 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X ARTHUR E DENIO 7076463110 4500 BUSINESS CENTER DRIVE Fairfield CA 94534 G Ben Huber Chairman 1.00 1.00 X X 14590 0 0 Stephen J Power Vice Chair 1.00 0.00 X X 14700 0 0 Mary Mancini MD Secretary/Treasurer 1.00 0.00 X X 21708 0 0 Gary Falati Director 1.00 0.00 X 7927 0 0 Murray Woolf MD Director 1.00 1.00 X 21708 0 0 Mark Sievers Director 1.00 1.00 X 0 14700 0 Archie Humphrey Director 1.00 1.00 X 0 14618 0 Gary Passama President and CEO 30.00 20.00 X 1100282 0 21060 Arthur Denio Vice President and CFO 8.00 42.00 X 627752 0 16770 Konard Jones President NB Healthcare Group 4.00 46.00 X 595533 0 63269 Aimee Brewer President Ambulatory Division 4.00 46.00 X 483776 0 55766 Christopher Timbers Chief Information Officer 50.00 0.00 X 386003 0 45817 Nicole Brocato Vice President Chief Quality Officer 50.00 0.00 X 365041 0 29536 Elnora Cameron Vice President Strategic Development 50.00 0.00 X 440357 0 22603 Steven Huddleston Vice President Public Affairs 50.00 0.00 X 357425 0 35642 Brett Johnson President NB Foundation 0.00 50.00 X 344981 0 37671 Kenneth McCullum Vice President Human Resources 50.00 0.00 X 388370 0 15280 5170153 29318 343414 85 0 1 0 Latham and Watkins PO Box 894256 Los Angeles CA 90189 Legal Services 1612023 Cain Brothers & Company LLC 360 Madison Ave New York NY 10017 Consulting Services 499254 Murphy Austin Adams Schoenfeld 555 Capitol Mall Suite 850 Sacramento CA 95814 Legal Services 360467 Toyon Associates Inc 1800 Sutter Street Ste 600 Concord CA 94520 Consulting Services 351130 PriceWaterhouse Coopers LLP PO Box 514038 Los Angeles CA 90051 Consulting Services 344528 17 24009 24009 Management & Admin Fees 900099 68308576 68308576 68308576 2648 2648 123244 89199 34045 34045 34045 263708 108528 155180 155180 Rebates & Refunds 900099 52423 52423 Other Revenue 900099 52223 52223 104646 68629104 68308576 0 296519 X 326519 326519 10000 10000 3476661 3476661 22992470 16259679 6732791 1113388 707167 406221 5496998 4067936 1429062 1671842 1210320 461522 3722915 625226 3097689 101253 101253 74871 74871 13277510 8370814 4906696 315452 303793 11659 1204974 1039172 165802 5868713 5831187 37526 3088377 2791270 297107 157744 96717 61027 279674 205579 74095 2080663 2047507 33156 89613 89613 Dues & Subscriptions 468056 248760 219296 Recruiting 367496 120222 247274 Public Relations 164673 53598 111075 Taxes/Licenses 19573 3940 15633 1048438 340373 708065 67417873 44659779 22758094 0 204738 277009 3202156 153620 114575 135853 4325094 2871019 40979697 32421863 6558200 8557834 1220092 1506655 100 100 13162819 16933455 28787774 30435545 7085088 7339831 3582064 3763861 10667152 11103692 X 18120602 19331833 20 20 18120622 19331853 28787774 30435545 1211231 0 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 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. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 11680 11680 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 American Hospital Association & 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 1729048 1332129 396919 1708632 1230574 478058 34322871 29161938 5160933 3219146 697222 2521924 8557834 Due from Solano Diagnostic Partners 16527625 Due from North Bay Health Advantage 405830 16933455 Deferred Rent Liability 3227511 Workers Comp Reserve 536350 3763861 Part V, Line 4: The use of the endowment funds are to support Cerner User Group annual training and education conference. 1 NORTHBAY HEALTHCARE FOUNDATION 4500 BUSINESS CENTER DRIVE Fairfield CA 94534 942995085 501(c)(3) 104305 General Support Child Haven Inc 801 Empire Street Fairfield CA 94533 910402430 501(c)(3) 7100 Fundraising Sponsorships Fairfield Police Activities 2195 Union Ave Fairfield CA 94533 261184406 501(c)(3) 15000 Fundraising Sponsorships Fairfield-Suisun Chamber of Commerce 1111 Webster Street Fairfield CA 94533 941059185 501(c)(6) 17925 General Support Vacaville Fiesta Days PO Box 5263 Vacaville CA 95696 942877561 501(c)(4) 5400 General Support The Leaven Program 2320 Courage Drive Suite 111 Fairfield CA 94533 263653717 501(c)(3) 28000 38244 Fair Market Value General Support, Fundraising Sponsorship, Transit Donations Vacaville Social Services Corporation 1000 New Horizons Way Vacaville CA 95688 680364021 501(c)(3) 6400 Fundraising Sponsorships Solano Coalition for Better Health One Harbor Way Suite 270 Suisun City CA 94585 943189914 501(c)(3) 15000 Fundraising Sponsorships Solano County Library Foundation 601 Kentucky Street Fairfield CA 94533 680342423 501(c)(3) 15000 Fundraising Sponsorships Solano Economic Development Corp 360 Campus Lane Suite 102 Fairfield CA 94534 942912759 501(c)(3) 9000 General Support Touro University of California 1310 Club Drive Vallejo CA 94592 133838740 501(c)(3) 16750 General Support Vacaville Chambebr of Commerce 300 Main Street Vacaville CA 95688 941111162 501(c)(6) 21495 General Support The Reporter 916 Cotting Lane Vacaville CA 95688 911955932 6900 Event Sponsorship 9 4 Scholarships 10 10000 Part I, Line 2: Northbay Healthcare Corporation grants funds to Northbay Healthcare Foundation and other local non-profits and community organizations to assist with their fundraising endeavors. NBHC does not monitor the use of these grant funds; however, they have procedures to determine the amount of grant funds issued to Northbay Healthcare Foundation. NorthBay Healthcare Corporation also grants funds to local college and university students. Teen volunteer scholarship application forms to apply for the scholarship are submitted each year. Recipients are slected from the pool of applications submitted by members of the NorthBay Hospital Guild (a division of NorthBay Healthcare Corporation). Each grant/assistance request requires documentation as to the use of the funds and the disbursement of those funds must be approved by the NorthBay Guild volunteers and auxiliary director. X X X X 0 1 0 0 0 0 0 1 0 Gary Passama President and CEO 697683 0 260130 0 142469 0 19875 0 1185 0 1121342 0 0 0 Arthur Denio Vice President and CFO 421466 0 128375 0 77911 0 13035 0 3735 0 644522 0 0 0 Konard Jones President NB Healthcare Group 448140 0 131040 0 16353 0 62084 0 1185 0 658802 0 0 0 Aimee Brewer President Ambulatory Division 373450 0 109200 0 1126 0 52890 0 2876 0 539542 0 0 0 Christopher Timbers Chief Information Officer 303402 0 72399 0 10202 0 44516 0 1301 0 431820 0 0 0 Nicole Brocato Vice President Chief Quality Officer 293426 0 58630 0 12985 0 28850 0 686 0 394577 0 0 0 Elnora Cameron Vice President Strategic Development 312901 0 77776 0 49680 0 19875 0 2728 0 462960 0 0 0 Steven Huddleston Vice President Public Affairs 277420 0 67600 0 12405 0 32032 0 3610 0 393067 0 0 0 Brett Johnson President NB Foundation 277420 0 59488 0 8073 0 35672 0 1999 0 382652 0 0 0 Kenneth McCullum Vice President Human Resources 277420 0 59488 0 51462 0 11595 0 3685 0 403650 0 0 0 Part I, Line 4b The following individuals participated in the organization's 457(f) plan: Gary J. Passama - $103,558 Arthur E. DeNio - $53,130 Kenneth D. McCollum - $21,538 Elnora Cameron - $24,851 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 an individual 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 Chief Financial Officer and will be presented to the Board of Directors of NorthBay Healthcare Corporation. A hard copy of the Form 990 will be sent via US Postal service to all voting members for their review and comments before 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 363,648. Management and general expenses 257,785. Fundraising expenses 0. Total expenses 621,433. Professional Fees - Physician Fees: Program service expenses 352,654. Management and general expenses 0. Fundraising expenses 0. Total expenses 352,654. Consulting Fees: Program service expenses 1,891,791. Management and general expenses 1,335,808. Fundraising expenses 0. Total expenses 3,227,599. Other Professional Services: Program service expenses 122,940. Management and general expenses 122,237. Fundraising expenses 0. Total expenses 245,177. Purchased Services: Program service expenses 5,639,781. Management and general expenses 3,190,866. Fundraising expenses 0. Total expenses 8,830,647. 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 106414 334143 1 0 0.05000 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 NorthBay Healthcare Foundation B 104305 Book Value Solano Diagnostic Partners D 16527625 Book Value NorthBay Health Advantage D 405830 Book Value NorthBay Healthcare Group P 957695 book Value NorthBay Health Advantage Q 429474 Book Value