2017-07-12T13:43:50-05:00 2016-08-31 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2015-09-01 942864615 Community Hospitals of Central California COMM 5594596000 789 N Medical Center Drive East Clovis CA 93611 Roger Fretwell Controller 5594596000 2017-07-10 1 Tracy S Paglia P00366884 2099556100 2017-07-10 2015 2021-01-29 14:40:06Z Tim Joslin 789 N Medical Center Drive East Clovis CA 93611 152444989 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 12 652 17 0 0 285378 347223 138794830 142239277 66217 3397191 218207 491686 139364632 146475377 10367000 102500 0 0 63160282 74242662 0 0 0 65619142 71543918 139146424 145889080 218208 586297 144026332 126132083 234707939 222595393 -90681607 -96463310 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA'S MISSION IS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY AND TO PROMOTE MEDICAL EDUCATION. 0 0 107525071 102500 142239277 MANAGEMENT FEES FROM AFFILIATED 501(C)(3) HOSPITALS AND FOUNDATION FOR EXECUTIVE MANAGEMENT AND GENERAL ADMINISTRATIVE COSTS. 107525071 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 0 0 0 0 0 0 0 1 1 1 0 0 1 620 0 1 652 1 0 0 0 0 0 0 0 0 0 0 X 15 12 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 Farid Assemi Chair-Elect 0.20 1.70 X X 0 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 Linzie Daniel Chair 0.20 1.70 X X 0 0 0 Florence Dunn Chair (thru 12/15) 0.20 1.70 X X 0 0 0 Gregory Hendey MD Board Member (thru 4/16) 0.20 1.70 X 0 0 0 Ren Imai MD Board Member 0.20 1.70 X 0 0 0 John McGregor Esquire Secretary 0.20 1.70 X X 0 0 0 Vong Mouanoutoua Board Member 0.20 1.70 X 0 0 0 Michael Peterson MD Board Member 0.20 1.70 X 0 0 0 Ruth Quinto Board Member 0.20 1.70 X 0 0 0 David Slater MD Board Member 0.20 1.70 X 14906 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 0.20 1.70 X 146998 0 0 Chandrasekar Venugopal MD Board Member 0.20 1.70 X 0 0 0 Tim Joslin Chief Executive Officer 5.00 55.00 X 1420584 0 22803 Patrick Rafferty EVP Chief Operations Officer 5.00 55.00 X 1047293 0 316680 Joseph Nowicki SVP Chief Financial Officer 5.00 55.00 X 747427 0 78366 Robert Ward SVP Chief Legal Off (thru 2/16) 5.00 50.00 X 624457 0 46853 Margaret Breen SVP Human Resources 5.00 50.00 X 583494 0 56428 John Zelezny SVP Communications 5.00 50.00 X 449008 0 54670 George Vasquez SVP Chief Information Officer 5.00 50.00 X 376758 0 53471 Aldo De La Torre SVP Managed Care 5.00 50.00 X 506287 0 54100 James Franklin Chief Program Mgmt Officer 5.00 50.00 X 312612 0 13291 Debra Muscio SVP Chief Information Officer 5.00 45.00 X 350287 0 47404 Deborah Moffett VP Finance 5.00 45.00 X 327783 0 23231 Vicki Anderson VP Managed Care 5.00 45.00 X 293176 0 4000 James Cole Dir of Reimbursement 5.00 45.00 X 285850 0 4679 Michele Earnhart VP Patient Financial Svc 5.00 45.00 X 285653 0 16371 Stephen Walter former SVP CFO (thru 2/15) 5.00 55.00 X 1276664 0 0 9049237 0 792347 96 1 1 0 MOSS ADAMS LLP PO BOX 748369 LOS ANGELES CA 90074 TAX & AUDITING 525237 TRIAGE CONSULTING GROUP 221 MAIN STREETSUITE 1100 SAN FRANCISCO CA 94105 LEGAL 483245 NATIONAL RESEARCH CORPORATION PO BOX 809030 CHICAGO IL 60680 CONSULTING 449941 DELOITTE AND TOUCHE LLP PO BOX 7247-6446 PHILADELPHIA PA 191706446 CONSULTING 290797 THE FORHAN COMPANY 7081 N MARKS 104 FRESNO CA 93711 LOBBYING 201667 10 204313 142910 347223 Management fees 900099 137899900 137899900 Income From Sante 900099 313437 313437 application revenue 900099 230515 230515 Special services revenue 900099 163470 163470 Program Service Rental 900099 32844 32844 3599111 3599111 142239277 30158 30158 16787 16787 6240251 5748565 491686 491686 491686 3571293 221047 3350246 3350246 3350246 146475377 142239277 0 3888877 X 102500 102500 806492 806492 45128 45128 63111479 53013642 10097837 1107065 1026424 80641 5399233 4539117 860116 3773265 3169543 603722 1866651 1866651 299165 299165 1234016 1234016 1091309 1091309 27492277 11821679 15670598 1722334 1722334 5067440 3648556 1418884 9532181 9532181 3695973 3104617 591356 1229294 1229294 197642 197642 205618 205618 13574235 11402357 2171878 1383351 1333351 50000 Other Operating Expense 1893300 946650 946650 Repairs and Maintenance 1049332 524666 524666 Lease and Rental Paymen 9800 4900 4900 145889080 107525071 38364009 0 131807 215768 2748655 3336308 464585 420280 5334361 6142553 241639230 131056618 111560413 110582612 20520809 1988096 2554994 2868431 710708 578035 144026332 126132083 29731559 24132101 160118 94594 6527078 6393419 3255571 2926361 195033613 189048918 234707939 222595393 X -90681607 -96463310 -90681607 -96463310 144026332 126132083 X 586297 -6368000 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 1234016 0 0 1234016 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. 10596625 10596625 76791251 31944348 44846903 1742250 1727154 15096 149025592 97385116 51640476 3483512 3483512 110582612 Payables to affiliates 149834380 Pension Liability 36131678 Covidien Lease 3082860 189048918 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 Medshare International Inc 3240 Clifton Springs Road Decatur GA 30034 582433968 501(c)(3) 50000 Sponsorship of Ebola Relief Central Valley Community Foundation 5260 N Palm Ave Ste 122 Fresno CA 93704 770478025 501(c)(3) 25000 Support Medical Mission to Armenia Sante Health Foundation 7370 N Palm Ave Fresno CA 93711 200517238 501(c)(3) 20000 Sponsorship of Spring Gala to Recruit Subspecialty Pediatric Physicians 3 0 Part I, Line 2: The organization does not have a grant procedure for monitoring the use of funds. X X 1 1 X X X X X 1 1 0 1 1 1 1 0 0 Tim Joslin Chief Executive Officer 925806 0 393111 0 101667 0 15900 0 6903 0 1443387 0 0 0 Patrick Rafferty EVP Chief Operations Officer 666938 0 308356 0 71999 0 309777 0 6903 0 1363973 0 0 0 Joseph Nowicki SVP Chief Financial Officer 479139 0 229217 0 39071 0 66380 0 11986 0 825793 0 0 0 Robert Ward SVP Chief Legal Off (thru 2/16) 465376 0 154669 0 4412 0 46853 0 0 0 671310 0 0 0 Margaret Breen SVP Human Resources 397089 0 156113 0 30292 0 51216 0 5212 0 639922 0 0 0 John Zelezny SVP Communications 321434 0 127574 0 0 0 49975 0 4695 0 503678 0 0 0 George Vasquez SVP Chief Information Officer 279251 0 86665 0 10842 0 43812 0 9659 0 430229 0 0 0 Aldo De La Torre SVP Managed Care 379946 0 126341 0 0 0 48100 0 6000 0 560387 0 0 0 James Franklin Chief Program Mgmt Officer 239742 0 61269 0 11601 0 13250 0 41 0 325903 0 0 0 Debra Muscio SVP Chief Information Officer 246565 0 89561 0 14161 0 38874 0 8530 0 397691 0 0 0 Deborah Moffett VP Finance 250713 0 77070 0 0 0 18550 0 4681 0 351014 0 0 0 Vicki Anderson VP Managed Care 230040 0 63136 0 0 0 0 0 4000 0 297176 0 0 0 James Cole Dir of Reimbursement 229879 0 55971 0 0 0 0 0 4679 0 290529 0 0 0 Michele Earnhart VP Patient Financial Svc 227942 0 57711 0 0 0 11692 0 4679 0 302024 0 0 0 Stephen Walter former SVP CFO (thru 2/15) 50777 0 0 0 1225887 0 0 0 0 0 1276664 0 655128 0 Part I, Line 1a First-class travel on certain long-term or overnight flights is allowed. As a recruiting tool, CHCC will pay a temporary housing allowance to certain new employees under special circumstances. 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: THE FOLLOWING EMPLOYEES PARTICIPATED IN SERP PLANS. DURING THE YEAR, THE FOLLOWING CONTRIBUTIONS WERE MADE TO THESE PLANS: - PATRICK RAFFERTY $293,877 - JOSEPH NOWICKI $50,480 - ROBERT WARD $44,982 - MARGARET BREEN $40,616 - JOHN ZELEZNY $31,425 - GEORGE VASQUEZ $27,912 - DEBRA MUSCIO $25,624 - ALDO DE LA TORRE $37,500 THE FOLLOWING EMPLOYEES RECEIVED PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR FORM 990 FILINGS. SEE SCHEDULE J, PART II, (F). - STEPHEN WALTER $655,128 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. Form 990, Part VI, Section B, line 11 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 Integrated Healthcare Strategies (IHS) to conduct a total compensation review for those individuals identified in their scope of responsibility. Form 990, Part VI, Section C, line 19 THE ORGANIZATION AND ITS NONPROFIT AFFILIATES COMBINE THE RESULTS OF THEIR FINANCIAL OPERATIONS TO ISSUE CONSOLIDATED FINANCIAL STATEMENTS. THESE AUDITED FINANCIAL STATEMENTS ARE MADE PUBLICLY AVAILABLE THROUGH ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) AND CAN BE FOUND ON THE INTERNET AT ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) AT HTTP://WWW.EMMA.MSRB.ORG. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. Form 990, Part IX, line 11g MD Supervisory Fees: Program service expenses 0. Management and general expenses 559,919. Fundraising expenses 0. Total expenses 559,919. Collection Agencies: Program service expenses 0. Management and general expenses 1,135,044. Fundraising expenses 0. Total expenses 1,135,044. Other Professional Fees: Program service expenses 0. Management and general expenses 4,181,977. Fundraising expenses 0. Total expenses 4,181,977. Other Purchased Services: Program service expenses 11,821,679. Management and general expenses 9,693,788. Fundraising expenses 0. Total expenses 21,515,467. Consult & Mgmt Fees: Program service expenses 0. Management and general expenses 99,870. Fundraising expenses 0. Total expenses 99,870. Form 990, Part XI, line 9: Change in unfunded accumulated pension benefit obligation -6,368,000. 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 135292324 cost Community Health Enterprises Inc Q 1377597 cost Community Hospitals of Central California Foundation Q 633438 cost Community Hospitals of Central California Foundation C 109669 COST