2015-11-13T19:22:34-06:00 2014-12-31 861065772 DELOITTE TAX LLP 555 MISSION STREET SAN FRANCISCO CA 94105 990 2014-01-01 941498697 CALIFORNIA HEALTH FOUNDATION AND TRUST CALI 9165527629 1215 K STREET NO 800 SACRAMENTO CA 95814 JENNIFER NEWMAN SENIOR VP & CFO 9165527629 2015-11-11 1 JOAN S MCMAHON P00966494 4157834000 2014 2016-03-07 17:11:31Z C DUANE DAUNER 1215 K STREET NO 800 SACRAMENTO CA 95814 150114034 0 X N/A X 1956 CA SUPPORT ACCESS, RESEARCH, AND EDUCATION IN THE HEALTHCARE FIELD 14 13 0 0 0 0 60116844 150031462 0 0 243797 82572 0 0 60360641 150114034 86473627 65523727 0 0 2143740 542217 0 0 0 3619315 6445169 92236682 72511113 -31876041 77602921 52447020 192906936 1604875 64461869 50842145 128445067 X SUPPORT ACCESS, RESEARCH, AND EDUCATION IN THE FIELD OF HEALTHCARE DELIVERY, FINANCING, AND PATIENT CARE 0 0 58022739 58022739 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. 13027300 7394953 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. 655109 HOSPITAL PREPAREDNESS PROGRAM:TO PROVIDE SERVICES AND PRODUCTS TO ALL HOSPITALS REGARDING EMERGENCY PREPAREDNESS THROUGH TECHNICAL ASSISTANCE, RELATIONSHIP DEVELOPMENT AND COORDINATION OF HOSPITALS AND HEALTH CARE SYSTEMS WITH LOCAL, REGIONAL AND STATE PLANNING PARTNERS. 624982 106035 OTHER PROGRAM SERVICES IN SUPPORT OF MISSION 624982 106035 72330130 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 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 4 0 0 0 0 0 0 0 0 0 0 0 0 X 14 13 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 MARK R LARET CHAIR 1.00 X X 0 0 0 MICHAEL H COVERT CHAIR-ELECT 1.00 X X 0 0 0 ROGER E SEAVER PAST CHAIR 1.00 X X 0 0 0 GREGORY A ADAMS SECRETARY/TREASURER 1.00 X X 0 0 0 C DUANE DAUNER PRESIDENT/CEO 1.00 40.00 X X 0 1085699 40274 MICHAEL HUNN SECRETARY/TREASURER 1.00 X X 0 0 0 JAMES WHIPPLE TRUSTEE 1.00 X 0 0 0 JANICE IDE TRUSTEE 1.00 X 0 0 0 JAMES SAUER TRUSTEE 1.00 X 0 0 0 JON VAN BOENING TRUSTEE 1.00 X 0 0 0 CORWIN N HARPER TRUSTEE 1.00 X 0 0 0 LOUIS PELTIER TRUSTEE 1.00 X 0 0 0 RICHARD E YOCHUM TRUSTEE 1.00 X 0 0 0 CRAIG LEACH TRUSTEE 1.00 X 0 0 0 MARIA STRMSEK TRUSTEE 1.00 X 0 0 0 PETER FRIEDMAN TRUSTEE 1.00 X 0 0 0 LOIS M SUDER EXECUTIVE VP / COO 1.00 40.00 X 0 414705 52971 JENNIFER NEWMAN CFO 1.00 40.00 X 0 234216 42665 0 1734620 135910 0 0 1 0 CA ASSN OF HOSPITALS & HEALTH SYSTEMS 1215 K STREET SUITE 800 SACRAMENTO CA 95814 PROFESSIONAL SERVICES 5405410 WESTERN HEALTHCARE ALLIANCE PO BOX 2907 GRAND JUNCTION CO 81502 PROFESSIONAL SERVICES 398068 2 154000 965870 148911592 150031462 82572 82572 150114034 0 0 82572 65523727 65523727 437263 362655 74608 23151 19201 3950 52249 43335 8914 29554 24511 5043 1233507 1233507 58448 58448 15476 15476 3500 3500 61055 61055 162593 162593 11044 11044 HOSPITAL ADMIN FEE 4389578 4389578 509968 509968 72511113 72330130 180983 0 46095624 42808497 4952183 149297650 1189951 70442 9262 5347 200000 725000 52447020 192906936 552005 87070 64374799 1052870 0 1604875 64461869 X 547137 699420 50070008 127520647 225000 225000 50842145 128445067 52447020 192906936 77602921 0 X 0 1 X 1 1 1 X 131605279 54012799 206445634 60116844 150031462 602212018 131605279 54012799 206445634 60116844 150031462 602212018 14234718 587977300 18114 2171 10910 243797 82572 357564 602569582 0.97580 0.98660 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 252350 4012 256362 263351 5999 17000 252350 257317 6034 263351 248333 20493 5491 17000 257317 241823 6510 248333 0.87770 0.12230 0 0 0 150114034 0 150114034 0 150114034 72511113 0 72511113 0 72511113 PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED FOR THE WALKER/SULLIVAN ENDOWMENT WHICH FUNDS GRANTS TO STUDY HEALTHCARE OPERATIONS. 1 MERCY MEDICAL CENTER MT SHASTA 914 PINE STREET MOUNT SHASTA CA 96067 941196203 501 (C) (3) 20000 GENERAL SUPPORT GLENN MEDICAL CENTER 1133 WEST SYCAMORE STREET WILLOWS CA 95988 680000503 501 (C) (3) 6000 GENERAL SUPPORT CATALINA ISLAND MEDICAL CENTER PO BOX 1563 AVALON CA 90704 330222508 501 (C) (3) 9000 GENERAL SUPPORT RIDGECREST REGIONAL HOSPITAL 1081 NORTH CHINA LAKE BOULEVARD RIDGECREST CA 93555 952082686 501 (C) (3) 21000 GENERAL SUPPORT TEHACHAPI VALLEY HEALTHCARE 115 WEST E STREET TEHACHAPI CA 93561 952563734 115 13500 GENERAL SUPPORT CFHS HOLDINGS INC 4650 LINCOLN BOULEVARD MARINA DEL REY CA 90292 201645949 N/A 3857731 PROVIDES UNCOMPENSATED PATIENT CARE, PATIENT SAFETY CAPITAL NEEDS AND EMERGENCY SERVICES CAPITAL NEEDS. COLORADO RIVER MEDICAL CENTER 1401 BAILEY AVENUE NEEDLES CA 92363 621694530 N/A 5000 GENERAL SUPPORT DOCTORS HOSPITAL OF WEST COVINA INC 11661 SAN VINCENTE BOULEVARD LOS ANGELES CA 90049 954236723 N/A 45019 UTILIZE FUNDS TO ALLOCATE APPROPRIATE MONIES TO THE DAILY OPERATION OF THE HOSPITAL TO ENSURE THE COMMITMENT TO PROVIDING HIGH-QUALITY PATIENT CARE. HMNMH CONCENTRATION ACCOUNT 23845 MCBEAN PARKWAY VALENCIA CA 91355 952821104 501 (C) (3) 5241079 UTILIZED TO FUND MEDICAL LOSSES FROM 1/1/14-12/31/16 DOWNEY REGIONAL MEDICAL CENTER 11500 BROOKSHIRE AVENUE DOWNEY CA 90241 951903935 501 (C) (3) 122056 WOULD ALLOW DRMC TO CONTINE TO OFFER SERVICES TO THE COMMUNITY WITHOUT SPRIPPING THEM DOWN SIGNIFICANTLY. JOHN MUIR HEALTH 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 941461843 501 (C) (3) 15660908 TO FUND VARIOUS COMMUNITY BENEFITS EXPENDIUTES MADE BY JOHN MUIR HEALTH TO SUPPORT THE HEALTH OF THE COMMUNITIES THEY SERVE. EISENHOWER MEDICAL CENTER OPERATING ACCOUNT 39000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270 956130458 501 (C) (3) 18429150 TO DEVELOP THE "HEALTH SYSTEM" BY EXPANDING PROGRAMS AND ACCRSS TO HEALTH CARE SERVCES. ALSO HEALTH EDUCATION, PROMOTION AND WELLNESS. KAISER FOUNDATION HOSPITALS 1950 FRANKLIN STREET 6TH FLOOR OAKLAND CA 94612 941105628 501 (C) (3) 2731507 TO PROVIDE VARIOUS CAPITAL AN OPERATING EXPENSES ASOCIATED WITH CLINICAL PROGRAMS, INFORMATION SYSTEMS, SERVICES EXPANSION AND POPULATION WELLNESS. OLYMPIA MEDICAL CENTER 5900 WEST OLYMPIC BOULEVARD LOS ANGELES CA 90036 421643090 N/A 8890489 ASSIST IN ITS ON-GOING MISSION TO SERVE OUR SURROUNDING COMMUNITY, INCLUDING THOSE IN MOST NEED OF CARE. PATIENTS WHO ARE INDIGNET AND THOSE ON MEDI-CAL, AS WELL AS UNINSURED AND UNDER-INSURED PATIENT. SAINT JOHN'S HEALTH CENTER 2121 SANTA MONICA BOULEVARD SANTA MONICA CA 90404 951684082 501 (C) (3) 2958058 TO CONTINUE TO FUND PROGRAMS AND OTHER COMMUNITY PROGRAMS FOR OUR UNDERSERVED,ELDERLY, AND HOMELESS POPULATIONS, IN ADDTION TO SERVICES FOR THE BROADER COMMUNITY INCLUDING HEALTH RESEARCH, EDUCATION AND TRAINING PROGRAMS. VALLEYCARE HEALTH SYSTEM 1111 E STANLEY BOULEVARD LIVERMORE CA 94550 941429628 501 (C) (3) 3388495 TO PROVIDE CONTINUAL ACCESS TO OUR COMMUNITY OF OUR SERVICES WITH RESTRICTION AND WITHOUT CONSIDERATION OF THE PATIENTS ABILITY TO PAY. SOUTHERN HUMBOLDT COMMUNITY 733 CEDAR STREET GARGERVILLE CA 95542 942664285 115 11000 GENERAL SUPPORT SURPRISE VALLEY HEALTH CARE DISTRICT 741 NORTH MAIN STREET CEDARVILLE CA 96104 680008034 115 13000 GENERAL SUPPORT METHODIST HOSPITAL OF SOUTHERN CA 300 W HUNTINGTON ARCADIA CA 91007 951643336 501 (C) (3) 2359037 TO PROVIDE HEALTH CARE TO UNDER/UNISURED POPULATION AND ALSO PROVIDE COMMUNITY BENEFIT EDUCATION , PREVENTATIVE SCREENINGS AND IMMUNIZATION. TORRANCE MEMORIAL MEDICAL CENTER 3330 LOMITA BOULEVARD LOS ANGELES CA 90505 951644042 501 (C) (3) 6037361 TO HELP SUPPORT ON GOING CHARITY CARE EFFORS AND COMMUNTIY HEALTH EDUCATION EFFORTS. MIRACLE MILE MEDICAL CENTER 6000 SAN VICENTE BOULEVARD LOS ANGELES CA 90036 954700640 501 (C) (3) 357646 UTILIZED TO FUND MEDICAL LOSSES FROM 1/1/14-12/31/16 17 4 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/CEO 0 793145 0 236677 0 55877 0 18200 0 22074 0 1125973 0 0 LOIS M SUDER EXECUTIVE VP / COO 0 350163 0 60000 0 4542 0 28200 0 24771 0 467676 0 0 JENNIFER NEWMAN CFO 0 209977 0 23184 0 1055 0 16816 0 25849 0 276881 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 PURSUANT TO THE SMALL BUSINESS EXCEPTION UNDER SECTION 10.11(6)(B)(III) OF REVENUE PROCEDURE 2015-20, THE TAXPAYER IS CHANGING TO ADOPT THE FINAL TANGIBLE PROPERTY REGULATIONS PROSPECTIVELY WITH ITS TAX YEAR BEGINNING JANUARY 1, 2014, AND WITHOUT FILING A FORM 3115. 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 4437061 ACTUAL CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS P 1003795 ACTUAL