2016-11-10T00:52:24-06:00 2015-12-31 861065772 DELOITTE TAX LLP 555 MISSION STREET san francisco CA 94105 990 2015-01-01 941498697 CALIFORNIA HEALTH FOUNDATION AND TRUST CALI 9165527629 1215 K STREET No 800 SACRAMENTO CA 95814 JENNIFER NEWMAN Sr VP & CFO 9165527629 2016-11-01 1 JOAN S MCMAHON P00966494 4157834000 2015 2017-02-10 21:41:12Z c duane dauner 1215 K STREET No 800 SACRAMENTO CA 95814 36547703 0 X N/A X 1956 CA SUPPORT ACCESS, RESEARCH, AND EDUCATION IN THE HEALTHCARE FIELD 13 12 0 0 0 0 150031462 36381386 0 0 82572 166317 0 0 150114034 36547703 65523727 54720503 0 0 542217 76437 0 0 0 6445169 2667427 72511113 57464367 77602921 -20916664 192906936 122506549 64461869 14978146 128445067 107528403 X SUPPORT ACCESS, RESEARCH, AND EDUCATION IN THE FIELD OF HEALTHCARE DELIVERY, FINANCING, AND PATIENT CARE. 0 0 48191442 46325255 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. 8528900 8288806 30 and 21 MONTH 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. 278047 89442 CRITICAL ACCESS HOSPITALS GRANT PROGRAM:TO RETAIN EXPERT SERVICES AND PROVIDE TECHNICAL SUPPORT TO CRITICAL ACCESS HOSPITALS UNDER THE MEDICARE RURAL HOSPITAL FLEXIbILITY PROGRAM. 375835 17000 OTHER PROGRAM SERVICES IN SUPPORT OF MISSION 375835 17000 57374224 1 1 0 1 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 1 0 1 6 0 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X JENNIFER NEWMAN 9165527629 1215 K STREET SUITE 800 SACRAMENTO CA 95814 GREGORY A ADAMS chair 1.00 X X 0 0 0 JAMES R HOLMES CHAIR-ELECT 1.00 X X 0 0 0 MARK R LARET past Chair 1.00 X X 0 0 0 ANN M RICE SECRETARY/TREASURER 1.00 X X 0 0 0 C DUANE DAUNER President 1.00 40.00 X X 0 1242356 40600 COrwin N Harper TRUSTEE 1.00 X 0 0 0 JANice Ide TRUSTEE 1.00 X 0 0 0 LAWRENCE E LEWIS TRUSTEE 1.00 X 0 0 0 James E Sauer JR TRUSTEE 1.00 X 0 0 0 JON VAN BOENING TRUSTEE 1.00 X 0 0 0 Richard E Yochum TRUSTEE 1.00 X 0 0 0 RICHARD HART TRUSTEE 1.00 X 0 0 0 WILL GLASPIE TRUSTEE 1.00 X 0 0 0 DEBORAH WEBBER TRUSTEE 1.00 X 0 0 0 JENNIFER M NEWMAN SENIOR VP/CFO 1.00 40.00 X 0 274175 50169 LOIS M SUDER Exec VP/Coo (THROUGH JULY 2015) 1.00 40.00 X 0 208437 30128 0 1724968 120897 0 0 1 0 western healthcare alliance po box 2907 grand junction CO 81502 Professional services 313805 CA ASSN OF HOSPITALS & HEALTH SYStems 1215 K STREET SuitE 800 SACRAMENTO CA 95814 Professional services 138651 2 202500 278047 35900839 36381386 166317 166317 36547703 0 0 166317 54720503 54720503 76437 76437 2069269 2069269 37722 37722 44534 44534 31940 31940 10956 10956 7887 7887 HOSPITAL admin FEE 37012 37012 428107 428107 57464367 57374224 90143 0 17200000 15000000 25608497 98450293 149297650 8268642 70442 34994 5347 7620 725000 745000 192906936 122506549 87070 118267 64374799 14859879 64461869 14978146 X 699420 942254 127520647 106361149 225000 225000 128445067 107528403 192906936 122506549 -20916664 0 X 0 1 X 1 1 1 X 54012799 206445634 60116844 150031462 36381386 506988125 54012799 206445634 60116844 150031462 36381386 506988125 18573116 488415009 2171 10910 243797 82572 166317 505767 507493892 0.96240 0.97580 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 2000000 0 0 0 2000000 0 part ii-B LINE 1F GRANT TO SUPPORT ENACTMENT OF LEGISLATION. 0 256362 4542 17000 243904 252350 4012 256362 263351 5999 17000 252350 257317 6034 263351 248333 20493 5491 17000 257317 0.92240 0.07760 0 0 0 X 36547703 0 36547703 0 36547703 57464366 0 57464366 0 57464366 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: SUMMARIZED FIN 48 DISCLOSURE: IN THE EVENT CHFT HAD A TAX PROVISION THAT WAS UNCERTAIN OF BEING SUSTAINED, CHFT WOULD APPLY THE MINIMUM PROBABLITY THRESHOLD TO DETERMINE WHETHER A FINANCIAL STATEMENT LIABILITY OR BENEFIT SHOULD BE RECOGNIZED. THERE WERE NO UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2015. 1 Bear Valley Community Hospital 41870 Garstin Drive BIG BEAR LAKE CA 92315 330294751 115 8000 General support CALIFORNIA HOSPITALS COMMITTEE ON ISSUES 1215 K STREET SUITE 800 SACRAMENTO CA 95814 680104892 501(C)(6) 2000000 GENERAL SUPPORT CFHS Holdings Inc 555 EAST HARDY WAY INGLEWOOD CA 90301 201645949 N/A 1667389 SUPPORT UNCOMPENSATED PATIENT CARE/PATIENT SAFETY CAPITAL NEEDS EASTERN PLUMAS HEALTH CARE 500 FIRST AVENUE PORTOLA CA 96122 941741654 N/A 8000 General support Eisenhower Medical Center 39000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270 956130458 501(c)(3) 16051361 SUPPORT HEALTH EDUCATION AND WELLNESS HMNMH Concentration Account 23845 MCBEAN PARKWAY VALENCIA CA 91355 952821104 501(c)(3) 5209641 GENERAL SUPPORT JEROLD PHELPS COMMUNITY HOSPITAL 733 CEDAR STREET GARBERVILLE CA 95542 942664285 N/A 9000 General support John Muir Health 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 941461843 501(c)(3) 16154512 SUPPORT community benefits expendiTURES MAYERS MEMORIAL HOSPITAL DISTRICT 43563 STATE HIGHWAY 299 EAST FALL RIVER MILLS CA 96028 941634940 N/A 8000 General support MERCY MEDICAL CENTER MTSHASTA 914 PINE STREET MOUNT SHASTA CA 96067 941196203 501(c)(3) 10000 General support Methodist Hospital of Southern CA 300 WEST HUNTINGTON DRIVE ARCADIA CA 91007 951643336 501(c)(3) 6144628 SUPPORT health care FOR under/uniNsured population MODOC MEDICAL CENTER 228 WEST MCDOWELL AVENUE ALTURAS CA 96101 680095320 115 5000 General support NORTHERN INYO HOSPITAL 150 PIONEER LANE BISHOP CA 93514 956005449 N/A 10000 General support Olympia Medical Center 5900 WEST OLYMPIC BOULEVARD LOS ANGELES CA 90036 421643090 N/A 7053810 SUPPORT mission to serve surrounding community ORCHARD HOSPITAL 240 SPRUCE STREET GRIDLEY CA 95948 941049467 501(c)( 3) 8000 General support Tahoe Forest Health System 10121 PINE AVENUE TRUCKEE CA 96161 946004062 115 10000 General support Torrance Memorial Medical Center 3330 LOMITA BOULEVARD TORRANCE CA 90505 951644042 501(c)(3) 9323834 support charity care efforTs/communtiy health education VALLEYCARE HEALTH SYSYTEM 1111 E Stanley Blvd Livermore CA 94550 941429628 N/A 161216 To Provide Continual access to our community of our services with restrictions and without. 8 10 SCHEDULE I, PART 1, LINE 1: Hospital Fee grantees are required to submit grant application forms to describe the purpose of the grant, and also write up a narrative of how grants funds will be used. To enable the Foundation to evaluate the effectiveness of this Grant, the Grantee shall submit to the Foundation a written report one year after the last disbursement from CHFT to grantee occurs, CHFT sends the report form to grantee at the one year anniversary. The grantee report will contain the following: 1) progress made on accomplishing Grant objectives, and 2) how grant funds were expended. SCHEDULE I, PART 1, LINE 2: GRANTEES ARE REQUIRED TO SIGN RECIPIENT AGREEMENTS WHICH DETERMINE THE ALLOWABLE USE OF GRANT FUNDS AND REPORTING REQUIREMENTS. 0 0 0 0 0 0 0 0 0 C DUANE DAUNER President 0 845696 0 335890 0 60770 0 18550 0 22050 0 1282956 0 0 JENNIFER M NEWMAN SENIOR VP/CFO 0 233017 0 40000 0 1158 0 24800 0 25369 0 324344 0 0 LOIS M SUDER Exec VP/Coo (THROUGH JULY 2015) 0 206335 0 0 0 2102 0 14314 0 15814 0 238565 0 0 Part I, Line 3 CHA relies on CAHHS, a related organization, to establish compensation for the CEO and officers. CAHHS utilizes the following methods in establishing compensation: compensation committee, independent compensation consultant, written employment contract, compensation survey or study, approval by the board or compensation committee. THE COMPENSATION REPORTED FOR THE OFFICERS OF CHFT IS PAID BY CAHHS AND IS FOR SERVICES PROVIDED TO CAHHS AND CALIFORNIA HOSPITAL ASSOCIATION. Form 990, Part VI, Section B, line 11 EACH MEMBER OF THE CALIFORNIA HEALTH FOUNDATION AND TRUST BOARD OF DIRECTORS WAS SENT A COPY OF THE DRAFT 990 BEFORE IT WAS FILED. IN ADDITION, THE AUDIT COMMITTEE REVIEWED AND APPROVED THE FORM BEFORE IT WAS FINALIZED OR FILED. Form 990, Part VI, Section B, line 12c ANNUAL DISCLOSURE MUST BE SIGNED BY OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES AND REPORTED TO THE AUDIT COMMITTEE IF A CONFLICT EXISTS. Form 990, Part VI, Section B, line 15 See Schedule J, Part III Form 990, Part VI, Section C, line 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. TANGIBLE PROPERTY REGULATIONS ELECTION STATEMENTS TAXPAYER HEREBY MAKES THE DE MINIMIS SAFE HARBOR ELECTION UNDER TREASURY REGULATION 1.263(A)-1(F) FOR ALL ELIGIBLE AMOUNTS PAID OR INCURRED DURING THE TAXABLE YEAR. TAXPAYER HEREBY ELECTS TO CAPITALIZE REPAIRS AND MAINTENANCE COSTS UNDER TREASURY REGULATION 1.263(A)-1(N). THE COSTS WERE INCURRED DURING THE TAXABLE YEAR IN THE ELECTING TAXPAYER'S TRADE OR BUSINESS AND THE ELECTING TAXPAYER TREATS SUCH COSTS AS CAPITAL EXPENDITURE ON ITS BOOKS AND RECORDS. CALIFORNIA HOSPITAL ASSOCIATION 1215 K STREET SUITE 800 SACRAMENTO CA 95814 REPRESENT HOSPITAL INTEREST before legislators and regulators CA 501(c)(6) cha 0 CALIFORNIA ASSOCIATION OF HOSPITALS HEALTH SYSTEMS 1215 K STREET SUITE 800 SACRAMENTO CA 95814 REPRESENT HOSPITAL INTEREST BEFORE legislators and regulators CA 501(c)(6) N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 0 0 california association of hospitals and health systems M 50871 actual california association of hospitals and health systems P 125240 actual