2017-11-01T02:36:04-05:00 2016-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 462045108 990 2016-01-01 942650855 JOHN MUIR HEALTH FOUNDATION JOHN 9259393000 1400 TREAT BOULEVARD NO 300 WALNUT CREEK CA 94597 CHRISTIAN PASS CFO 9259393000 2017-10-31 1 JEFFREY D FRANK P00287234 3174648600 2017-10-30 12.203.115.26 2017-10-31 14:21:12 ED P 4C47607E32D75D7EF49820AB9BB71A2F0D308FBB 60D0446F6E1D975CBF976F6C19882A85B48EB9B2 2016 2021-01-29 14:40:06Z CHRISTIAN PASS 1400 TREAT BOULEVARD NO 300 WALNUT CREEK CA 94597 8623123 0 X WWW.JOHNMUIRHEALTH.COM X 1979 CA TO SOLICIT AND MANAGE FUNDS FOR JOHN MUIR HEALTH. 17 15 0 50 0 0 15388393 7204516 1065864 839499 222455 225222 -126597 -256438 16550115 8012799 6005541 8552877 0 0 0 0 66426 76800 561484 4306510 4662363 10378477 13292040 6171638 -5279241 34880032 34609214 4432819 10366169 30447213 24243045 TO SOLICIT AND MANAGE FUNDS FOR JOHN MUIR HEALTH. 0 0 11619346 8552877 839499 ALL EXPENSES ARE RELATED TO THE ACTIVITIES OF ARRANGING FOR, AND THE SOLICITATION OF, FUNDS AND CONTRIBUTIONS FOR, AND ON BEHALF OF, JOHN MUIR HEALTH. 11619346 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 17 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X X CHRISTIAN PASS 9259393000 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 RICHARD O VANDENBERG JR DIRECTOR 5.00 0.00 X 0 0 0 ELLIOT D STEIN DIRECTOR 5.00 0.00 X 0 0 0 MARGARET S MURPHY DIRECTOR 5.00 0.00 X 0 0 0 REV DWANE MICHAEL DIRECTOR 5.00 0.00 X 0 0 0 PAUL R GRAY DIRECTOR 5.00 0.00 X 0 0 0 KATE BENNETT MD DIRECTOR 5.00 0.00 X 0 0 0 LAURIE DOYLE DIRECTOR 5.00 0.00 X 0 0 0 LOLITA LOPEZ DIRECTOR 5.00 0.00 X 0 0 0 ALICE HUNTER MD DIRECTOR 5.00 0.00 X 0 0 0 BEVERLY A JONES OFFICER AT LARGE 5.00 0.00 X X 0 0 0 F RYAN ANDERSON MD OFFICER AT LARGE 5.00 0.00 X X 0 0 0 JACK E THOMPSON CHAIRMAN, GOVERNANCE 5.00 0.00 X X 0 0 0 RICHARD M DEL MONTE SECRETARY/TREASURER 5.00 0.00 X X 0 0 0 PATRICK CAREW DIRECTOR/PRESIDENT 60.00 0.00 X X 0 668380 213676 CALVIN KNIGHT CEO/DIRECTOR/PRESIDENT 5.00 70.00 X X 0 2897014 1252373 JOHN C SAYRES OFFICER AT LARGE 5.00 0.00 X X 0 0 0 DAVID D WOODWORTH CHAIRMAN 5.00 0.00 X X 0 0 0 CHRISTIAN PASS CFO 5.00 70.00 X 0 635111 243155 MICHAEL MOODY FORMER OFFICER 0.00 60.00 X 0 974257 405871 0 5174762 2115075 0 1 1 0 0 1473160 181650 70950 5478756 7204516 PROGRAM SERVICE REVENU 900099 839499 839499 839499 225222 225222 353886 1473160 610324 -256438 -256438 8012799 839499 0 -31216 8552877 8552877 76800 76800 3063 1776 1287 169342 126855 42487 PURCHASED SERVICES 3435477 2146980 803813 484684 SUPPLIES 54321 40741 13580 1000160 750117 250043 13292040 11619346 1111210 561484 8856000 8385962 20395781 20654743 4369251 5568509 1259000 34880032 34609214 46595 120630 4386224 10245539 4432819 10366169 X 5856382 577141 16564232 15639305 8026599 8026599 30447213 24243045 34880032 34609214 -5279241 -924927 0 X 0 1 X 1 0 X 2037125 7293234 11819089 15388393 7204516 43742357 2037125 7293234 11819089 15388393 7204516 43742357 8199550 35542807 113484 89169 202000 222455 225222 852330 44594687 5570526 0.79700 0.82440 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 24590268 5853636 514043 4733453 26224494 20078896 11033372 -691000 5831000 24590268 16987785 8119089 590899 5618877 20078896 16353302 4208174 1183086 4756777 16987785 17002903 2037125 859349 3546075 16353302 0.45040 0.54960 0 0 0 PAYABLE TO AFFILIATES 10245539 10245539 X PART V, LINE 4: FURTHERANCE OF THE MISSION AND MOST SIGNIFICANT ACTIVITIES OF JOHN MUIR HEALTH. PART X, LINE 2: JOHN MUIR HEALTH FOUNDATION IS INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF JOHN MUIR HEALTH AND SUBSIDIARIES. THE FOLLOWING REFLECTS JOHN MUIR HEALTH'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740: JOHN MUIR HEALTH FOUNDATION IS A NONPROFIT PUBLIC BENEFIT CORPORATION AND HAS BEEN RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAXATION PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(A)(1) OF THE INTERNAL REVENUE CODE. HOWEVER, JOHN MUIR HEALTH FOUNDATION IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS AND NOT IN FURTHERANCE OF THE PURPOSES FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS, IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE FINANCIAL STATEMENTS TAKEN AS A WHOLE. JOHN MUIR HEALTH FOUNDATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED USING THE LARGEST AMOUNT THAT EXCEEDS A 50% PROBABILITY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN ESTIMATED OCCURS. X X 1 JAMES CRAWFORD 1800 PARK NEWPORT STE 308 NEWPORT BEACH CA 92660 MAIL AND PHONE SOLICITATIONS 0 867812 76300 791512 867812 76300 791512 CA GALA EVENT 1827046 1473160 353886 200556 409768 1827046 1473160 353886 200556 409768 610324 -256438 SCHEDULE G, PART I, LINE 2B, COLUMN (V) POSTAGE AND RELATED FEES BILLED SEPARATELY FROM FUNDRAISING FEES. 1 JOHN MUIR HEALTH 1400 TREAT BOULEVARD SUITE 300 WALNUT CREEK CA 94597 941461843 501(C)(3) 7826877 RESTRICTED FUNDS JOHN MUIR PHYSICIAN NETWORK 1400 TREAT BOULEVARD SUITE 400 WALNUT CREEK CA 94597 680360801 501(C)(3) 726000 RESTRICTED FUNDS 2 0 PART I, LINE 2: JOHN MUIR HEALTH FOUNDATION AND JOHN MUIR HEALTH FINANCIAL MANAGEMENT MONITOR AND APPROVE THE USE OF THE RESTRICTED FUNDS TO MEET THE INTENDED PURPOSES. 0 1 0 0 0 0 0 0 0 PATRICK CAREW DIRECTOR/PRESIDENT 0 369491 0 156480 0 142409 0 203702 0 9974 0 882056 0 156480 CALVIN KNIGHT CEO/DIRECTOR/PRESIDENT 0 1085768 0 734507 0 1076739 0 1234038 0 18335 0 4149387 0 734507 CHRISTIAN PASS CFO 0 419238 0 179011 0 36862 0 218876 0 24279 0 878266 0 179011 MICHAEL MOODY FORMER OFFICER 0 488856 0 294267 0 191134 0 380845 0 25026 0 1380128 0 294267 PART I, LINE 3 JOHN MUIR HEALTH, A RELATED TAX-EXEMPT ORGANIZATION OF JOHN MUIR HEALTH FOUNDATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B PATRICK CAREW $52,651 RESTORATION PLAN CALVIN KNIGHT $495,473 SERP PLAN CHRISTIAN PASS $42,143 RESTORATION PLAN SCHEDULE J, PART II, COLUMN B(III): JMH IMPLEMENTED A "PAID TIME OFF CAP" THAT WAS EFFECTIVE BEGINNING IN 2014. PTO CAPS WERE INSTALLED FOR ALL EMPLOYEES WITH THE EXCEPTION OF THOSE REPRESENTED BY COLLECTIVE BARGAINING AGREEMENTS. IN CONNECTION WITH THE POLICY TO LIMIT A BENEFIT-ELIGIBLE EMPLOYEE AT 125% OF THEIR TOTAL PAID TIME OFF ACCRUAL VALUE (BASED ON YEARS OF SERVICE), JMH CASHED OUT EMPLOYEE BALANCES IN EXCESS OF 100% OF THEIR PAID TIME OFF ACCRUAL CAPS. THE POLICY IS EFFECTIVE AT JMH AND ALL JMH SUBSIDIARIES. STARTING SEPTEMBER 19, 2016, ALL JMH EXECUTIVES AT THE LEVEL OF VICE PRESIDENT AND ABOVE STOPPED ACCRUING PTO HOURS. ANY PTO HOURS EARNED BUT NOT YET USED WERE PAID OUT WITH THE PAYCHECK DATED OCTOBER 7, 2016. AMY ANDERSON SPOUSE OF F. RYAN ANDERSON, M.D. (DIRECTOR & OFFICER) 80682 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 6 JOHN MUIR HEALTH IS THE SOLE CORPORATE MEMBER OF JOHN MUIR HEALTH FOUNDATION, AND, IN SUCH CAPACITY, HAS THE RIGHT TO APPROVE THE ELECTION OF ALL OF THE DIRECTORS OF JOHN MUIR HEALTH FOUNDATION (OTHER THAN CERTAIN DIRECTORS WHO SERVE EX-OFFICIO), AS WELL AS THE RIGHT TO APPROVE CERTAIN SIGNIFICANT CORPORATE ACTIONS. FORM 990, PART VI, SECTION A, LINE 7A JOHN MUIR HEALTH IS THE SOLE CORPORATE MEMBER OF JOHN MUIR HEALTH FOUNDATION, AND, IN SUCH CAPACITY, HAS THE RIGHT TO APPROVE THE ELECTION OF ALL OF THE DIRECTORS OF JOHN MUIR HEALTH FOUNDATION (OTHER THAN CERTAIN DIRECTORS WHO SERVE EX-OFFICIO), AS WELL AS THE RIGHT TO APPROVE CERTAIN SIGNIFICANT CORPORATE ACTIONS. FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS OF JOHN MUIR HEALTH FOUNDATION PROVIDE THAT (1) JOHN MUIR HEALTH SHALL APPROVE THE ELECTION OF ALL OF THE DIRECTORS OF JOHN MUIR HEALTH FOUNDATION (OTHER THAN THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF JOHN MUIR HEALTH, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF JOHN MUIR HEALTH FOUNDATION, THE PRESIDENT OF THE JOHN MUIR MEDICAL CENTER - WALNUT CREEK CAMPUS AUXILIARY, AND THE PRESIDENT OF JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS VOLUNTEERS, EACH OF WHOM SERVE EX-OFFICIO AS A MEMBER OF THE JOHN MUIR HEALTH FOUNDATION BOARD OF DIRECTORS), (II) JOHN MUIR HEALTH MAY REMOVE ANY OR ALL OF THE MEMBERS OF THE BOARD OF DIRECTORS OF JOHN MUIR HEALTH FOUNDATION AT ANY TIME, (III) JOHN MUIR HEALTH FOUNDATION MAY NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE PRIOR APPROVAL OF JOHN MUIR HEALTH: (A) THE MERGER, CONSOLIDATION OR DISSOLUTION OF JOHN MUIR HEALTH FOUNDATION; (B) THE AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF JOHN MUIR HEALTH FOUNDATION; (C) THE APPROVAL OF OPERATING AND CAPITAL BUDGETS, ALTHOUGH THE BOARD IS EMPOWERED TO DEVELOP ITS OWN BUDGET WITHIN THE GUIDELINES AND OBJECTIVES SET BY JOHN MUIR HEALTH; (D) ANY BORROWING OR INDEBTEDNESS (INCLUDING BUT NOT LIMITED TO LEASE AGREEMENTS AND CONTRACTS OF SALE); (E) THE PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE AND ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL IN EXCESS OF $250,000 OR SUCH GREATER AMOUNT AS MAY BE DETERMINED BY JOHN MUIR HEALTH FROM TIME TO TIME; (F) THE APPOINTMENT OF AN INDEPENDENT AUDITOR AND CORPORATE COUNSEL; (G) THE APPROVAL OF TRANSACTIONS OF JOHN MUIR HEALTH FOUNDATION IN WHICH A DIRECTOR OR OFFICER OF JOHN MUIR HEALTH FOUNDATION HAS A MATERIAL FINANCIAL INTEREST; AND (H) ANY OTHER ACTIVITIES OF JOHN MUIR HEALTH FOUNDATION WHICH JOHN MUIR HEALTH DETERMINES REPRESENT MAJOR TRANSACTIONS OR MAJOR POLICIES. FORM 990, PART VI, SECTION B, LINE 11B THE COMPLETED FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE A DETAILED AND CONSCIENTIOUS REVIEW BY ALL MEMBERS. AN OVERVIEW OF THE FORM 990, WITH SUFFICIENT DETAIL, IS PRESENTED TO THE BOARD WITH THE COMPLETED FORM 990. ALL QUESTIONS AND CONCERNS OF THE BOARD OF DIRECTORS WILL BE ADDRESSED BY THE CHIEF FINANCIAL OFFICER OR THEIR DESIGNEE AND INCORPORATED INTO THE FORM 990 AS APPROPRIATE. AFTER ALL OF THE INPUT FROM THE BOARD OF DIRECTORS HAS BEEN APPROPRIATELY ADDRESSED, SENIOR MANAGEMENT OF JOHN MUIR HEALTH FOUNDATION WILL FILE THE FINAL FORM 990 AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, BOARD MEMBERS ARE PROVIDED WITH A COPY OF THE CONFLICT OF INTEREST POLICY AND THEY ARE ASKED TO SIGN A STATEMENT ACKNOWLEDGING THEY HAVE READ THE POLICY AND AGREE TO COMPLY WITH ITS TERMS, INCLUDING THE DISCLOSURE OF ANY POTENTIAL CONFLICTS. THE JOHN MUIR HEALTH FOUNDATION PRESIDENT MONITORS ANY POTENTIAL CONFLICTS OF INTEREST AND DISCUSSES THEM WITH THE BOARD MEMBERS AND OFFICERS. IF A POTENTIAL CONFLICT AROSE, THE BOARD MEMBERS WOULD BE EXCUSED FROM THE MEETING FOR THE DISCUSSION AND VOTE. IN THE EVENT A BOARD MEMBER FAILED TO DISCLOSE A POTENTIAL CONFLICT, THE EXECUTIVE COMMITTEE WOULD DETERMINE ANY ACTION TO BE TAKEN. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL, OTHER OFFICERS AND KEY EMPLOYEES ARE ESTABLISHED ANNUALLY BY THE BOARD OF DIRECTORS OF JOHN MUIR HEALTH. THE BOARD OF DIRECTORS UTILIZES AN OUTSIDE CONSULTANT WHO IS A COMPENSATION EXPERT. THE OUTSIDE CONSULTANT PROVIDES MARKET DATA FOR EACH INDIVIDUAL BASED UPON THEIR LEVEL OF RESPONSIBILITIES AND THAT DATA IS USED BY THE BOARD OF DIRECTORS TO ESTABLISH THE ANNUAL COMPENSATION PACKAGE FOR EACH INDIVIDUAL. IT IS THE PHILOSOPHY OF THE ORGANIZATION TO ESTABLISH A COMPENSATION PACKAGE FOR EACH INDIVIDUAL THAT REFLECTS THE MEDIAN OF THE MARKET AS ESTABLISHED BY THE OUTSIDE CONSULTANT. FORM 990, PART VI, SECTION C, LINE 19 JOHN MUIR HEALTH PROVIDES FINANCIAL INFORMATION ON A QUARTERLY BASIS THROUGH VARIOUS BOND DISCLOSURE DATABASES. THIS FINANCIAL INFORMATION IS AVAILABLE FOR JOHN MUIR HEALTH ON A CONSOLIDATED AND CONSOLIDATING BASIS, INCLUDING SUBSIDIARIES. REQUEST FOR THE PROVISION OF OUR GOVERNING DOCUMENTS AND OUR CONFLICT OF INTEREST POLICY ARE DIRECTED TO THE JOHN MUIR HEALTH CHIEF GOVERNANCE OFFICER FOR THE APPROPRIATE RESPONSE. JOHN MUIRMT DIABLO COMMUNITY HEALTH FUND 1399 YGNACIO VALLEY ROAD SUITE 36 WALNUT CREEK CA 94598 911788973 PROVIDE GRANTS THAT ENHANCE HEALTHCARE SERVICES TO UNDERSERVED CA 501(C)(3) 12, TYPE III JOHN MUIR HEALTH 1 JOHN MUIR BEHAVIORAL HEALTH 1400 TREAT BOULEVARD SUITE 300 WALNUT CREEK CA 94597 680249685 PROVIDE BEHAVIORAL HEALTH SERVICES INCLUDING MENTAL HEALTH & SUBSTANCE ABUSE CA 501(C)(3) 3 JOHN MUIR HEALTH 1 JOHN MUIR PHYSICIAN NETWORK 1400 TREAT BOULEVARD SUITE 400 WALNUT CREEK CA 94597 680360801 PROVIDE CLINIC SERVICES & MANAGE HEALTHCARE RISK OPERATIONS WITH JMH CA 501(C)(3) 12, TYPE I JOHN MUIR HEALTH 1 JOHN MUIR HEALTH 1400 TREAT BOULEVARD SUITE 300 WALNUT CREEK CA 94597 941461843 PROVISION OF HEALTHCARE SERVICES TO THE COMMUNITY CA 501(C)(3) 3 N/A 0 JOHN MUIR MAGNETIC IMAGING 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 680202020 DIAGNOSTIC IMAGING CA N/A NEUROSCAN 115 LA CASA VIA SUITE 202 WALNUT CREEK CA 94597 680017617 DIAGNOSTIC IMAGING CA N/A BAY AREA SURGICAL VENTURES 30 S WACKER DRIVE SUITE 2302 CHICAGO IL 60606 203052802 MEDICAL SERVICES CA N/A CARIDIAN PHYSICIAN SERVICES INC 700 YGNACIO VALLEY BLVD WALNUT CREEK CA 94596 680297913 INACTIVE CA N/A C 0 MT DIABLO PRACTICE MGMT 1400 TREAT BLVD WALNUT CREEK CA 94597 680031326 INACTIVE CA N/A C 0 JOHN MUIRMT DIABLO PARENT COMPANY 1400 TREAT BLVD WALNUT CREEK CA 94597 900060434 INACTIVE CA N/A C 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 JOHN MUIR HEALTH B 7826877 FMV JOHN MUIR PHYSICIAN NETWORK B 726000 FMV JOHN MUIR HEALTH C 172150 FMV