2015-11-16T10:33:39-06:00 2014-12-31 330155525 HBLA CERTIFIED PUBLIC ACCOUNTANTS INC 19600 FAIRCHILD STE 320 IRVINE CA 92612 990 2014-01-01 953493611 CITRUS VALLEY HOSPICE INC CITR 6268592263 140 W COLLEGE ST PO BOX 6108 COVINA CA 917225108 RAJESH K SHARMA SR VP & CFO 6269387577 2015-11-11 1 EDWARD E BENOE P00032866 9498332815 2014 2016-04-25 22:37:26Z ROBERT H CURRY 140 W COLLEGE ST PO BOX 6108 COVINA CA 917225108 7954955 0 X CVHP.ORG X 1979 CA SERVICES PROVIDED TO TERMINALLY ILL PATIENTS AND HOME HEALTH CARE NURSING SERVICES. 22 20 92 57 0 0 282834 13911 9023785 7793243 38101 19306 0 0 9344720 7826460 0 0 0 0 5908463 6188516 0 0 0 2737383 2294563 8645846 8483079 698874 -656619 9323016 8803235 1450764 1560231 7872252 7243004 OUR MISSION IS TO HELP PEOPLE KEEP WELL IN BODY, MIND AND SPIRIT BY PROVIDING QUALITY HEALTH CARE SERVICES IN A SAFE, COMPASSIONATE ENVIRONMENT. 0 0 7416833 7793243 HOME HEALTH CARE - A TOTAL OF 11,945 TOTAL HOME VISITS DURING THE YEAR. HOSPICE CARE - A PROGRAM TO PROVIDE HOSPICE CARE AND IN HOUSE SERVICES TO TERMINALLY ILL PATIENTS IN THE COMMUNITY, REGARDLESS OF A PATIENT'S ABILITY TO PAY. 7416833 1 1 0 0 0 0 0 0 0 1 1 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 25 0 1 92 1 0 0 0 0 0 0 0 0 0 0 0 0 X 22 20 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X RAJESH K SHARMA SR VP CFO 6269387577 140 W COLLEGE ST PO BOX 6108 COVINA CA 917225108 ROBERT H CURRY PARENT PRESIDENT, CEO, BOARD OF DIRECTORS 2.00 38.00 X X 0 1099676 28649 HAROLD BORAK SR BOARD OF DIRECTORS 3.00 X 0 0 0 JACQUELINE BRACY MD BOARD OF DIRECTORS 3.00 X 0 43662 0 CLIFFORD CHRIST CHAIR 3.00 X 0 0 0 PATRICIA GOMER LCSW SECRETARY 3.00 X 0 0 0 PATSY GORRELL BOARD OF DIRECTORS 3.00 X 0 0 0 J PAUL HOLLAND MD BOARD OF DIRECTORS 3.00 X 0 0 0 ARTHUR LUDWICK TREASURER 3.00 X 0 0 0 GURJEET KALKAT MD BOARD OF DIRECTORS 3.00 X 0 0 0 BILL W TANG MD BOARD OF DIRECTORS 3.00 X 0 67550 0 EARL WASHINGTON BOARD OF DIRECTORS 3.00 X 0 0 0 OJ RODRIGUEZ BOARD OF DIRECTORS 3.00 X 0 0 0 WALTER ALLEN III VICE CHAIR 3.00 X 0 0 0 ROBERT DUNCAN SECRETARY 3.00 X 0 0 0 PATRICIA HANES PHD BOARD OF DIRECTORS 3.00 X 0 0 0 RAYMOND MATTES IHM BOARD OF DIRECTORS 3.00 X 0 0 0 GORDON SHIPP BOARD OF DIRECTORS 3.00 X 0 0 0 MARY KIRCHEN IHM BOARD OF DIRECTORS 3.00 X 0 0 0 PHILIP MALDONADO DDS BOARD OF DIRECTORS 3.00 X 0 0 0 LANCE WILCHER DNP FNP-BC BOARD OF DIRECTORS 3.00 X 0 0 0 ROBINSON BARON BOARD OF DIRECTORS 3.00 X 0 0 0 JEFFREY SHAPIRO MD BOARD OF DIRECTORS 3.00 X 0 0 0 DONALD BOSS ESQ BOARD OF DIRECTORS 3.00 X 0 0 0 THOMAS BRYAN MD BOARD OF DIRECTORS 3.00 X 0 0 0 RAJESH SHARMA PARENT SR. VP, CFO 2.00 38.00 X 0 571276 27198 MARGARET MONTES CASE MANAGER HH 40.00 X 0 118364 18237 NANETTE VILLANUEVA CASE MANAGER HH 40.00 X 0 118702 18757 CHRISTINA TINCHER HOME HOSPICE R.N. 30.00 X 0 117553 24384 PAMELA HUGHES DIRECTOR CLINICAL SVC. 40.00 X 0 128259 19088 MERYL WEN-SAROYAN PI/UR/EDUCATION COORD 40.00 X 0 114282 18817 0 2379324 155130 14 0 1 0 JONATHAN K LEUNG MD 415 W CARROLL AVE 100 GLENDORA CA 91741 MEDICAL DIRECTOR 105404 1 13911 13911 PATIENT REV/MEDICARE/M 621610 7791824 7791824 OTHER OPERATING REVENU 621610 1419 1419 7793243 15467 15467 132334 128495 3839 3839 3839 7826460 7793243 0 19306 X 86340 84181 2159 4369511 3794481 575030 128136 104697 23439 1242994 1081394 161600 361535 313464 48071 5063 5063 172602 131002 41600 466292 444447 21845 131688 119531 12157 157679 130874 26805 1712 1712 PURCHASED SERVICES 786052 766400 19652 EQUIPMENT RENTAL AND MA 200969 166804 34165 UTILITIES 109228 90659 18569 OTHER EXPENSES 109142 33051 76091 154136 154136 8483079 7416833 1066246 0 1585858 1015942 13896 5923 5899125 5007090 983108 892035 1102330 1123454 5637824 5765881 9323016 8803235 1450764 1560231 1450764 1560231 X 3113033 2480748 51522 44259 4707697 4717997 7872252 7243004 9323016 8803235 X -656619 27371 X X 0 1 X 1 0 X 1077 342248 292262 282834 13911 932332 10385681 9268550 9103654 9023785 7793243 45574913 10386758 9610798 9395916 9306619 7807154 46507245 0 0 0 46507245 67029 23180 24567 18875 15467 149118 67029 23180 24567 18875 15467 149118 10453787 9633978 9420483 9325494 7822621 46656363 0.99680 0.99370 0.00320 0.00630 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4707697 10300 4717997 4707647 50 4707697 4707122 525 4707647 4707097 25 4707122 4706547 550 4707097 1.00000 0 1 1 3830770 3308103 522667 2068355 1698987 369368 892035 UNRESTRICTED INVESTMENTS 1123454 F 1123454 BENEFICIAL INTEREST IN CVHF 5633359 CONSTRUCTION IN PROCESS 132522 5765881 X 7742000 1818 1818 7740182 86278 86278 7826460 8388000 0 8388000 95079 95079 8483079 PART V, LINE 4: PERMANENTLY RESTRICTED ASSETS ARE RESTRICTED INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES. PART X, LINE 2: ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST, OR PENALTIES WAS ACCRUED AT DECEMBER 31, 2014 OR 2013. PART XI, LINE 4B - OTHER ADJUSTMENTS: ROUNDING DIFFERENCE 1,213. CHANGE IN BENEFICIAL INTEREST -23,169. INVESTMENT FEES 5,063. PROVISION FOR BAD DEBTS 89,260. TRANSFERS FROM CITRUS VALLEY HEALTH FOUNDATION 13,911. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES 5,063. ROUNDING DIFFERENCE 756. PROVISION FOR BAD DEBTS 89,260. 0 0 0 0 0 0 0 0 0 ROBERT H CURRY PARENT PRESIDENT, CEO, BOARD OF DIRE 0 730653 0 292738 0 76285 0 8250 0 20399 0 1128325 0 0 RAJESH SHARMA PARENT SR. VP, CFO 0 426023 0 112940 0 32313 0 6904 0 20294 0 598474 0 0 PART I, LINE 3 ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR - CITRUS VALLEY HOSPICE, INC. IS AN AFFILIATE OF CITRUS VALLEY HEALTH PARTNERS, INC. (CVHP). CVHP USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. PLEASE SEE ADDITIONAL EXPLANATION AT SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THIS ORGANIZATION IS CITRUS VALLEY HEALTH PARTNERS, INC., A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THIS ORGANIZATION IS CITRUS VALLEY HEALTH PARTNERS, INC. THE MEMBER THROUGH THE BOARD OF DIRECTORS HAS THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE ORGANIZATION'S SOLE MEMBER, CITRUS VALLEY HEALTH PARTNERS. FORM 990, PART VI, SECTION B, LINE 11 STAFF ACCOUNTANTS, ACCOUNTING MANAGER AND VICE PRESIDENT OF CORPORATE FINANCE REVIEW FORM 990 FOR ACCURACY AND COMPLETENESS UPON RECEIVING IT FROM THE CPA TAX PREPARER. FORM 990 IS FORWARDED TO RAJESH SHARMA, SR. VP & CFO, FOR THE FINAL REVIEW. TAX PREPARER PRESENTS FORM 990 TO THE AUDIT AND COMPLIANCE COMMITTEE FOR APPROVAL. BOARD DELEGATED REVIEW AND APPROVAL TO THE AUDIT AND COMPLIANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS, KEY EMPLOYEES, AND MANAGEMENT ARE COVERED BY THE CONFLICT OF INTEREST POLICY. DETERMINATIONS OF CONFLICT AND REVIEW OF CONFLICT ARE PERFORMED AT THESE VARIOUS LEVELS OF THE ORGANIZATION. APPROPRIATE ACTION DEPENDING ON THE CONFLICT IS TAKEN BY MANAGEMENT, KEY EMPLOYEES, AND THE BOARD. DISCLOSURE FORMS ARE REQUIRED ANNUALLY BY EACH MEMBER OF THE BOARD OF DIRECTORS, KEY EMPLOYEES, AND MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE PAY AT CITRUS VALLEY HEALTH PARTNERS FOLLOWS MARKET-BASED PAY PRACTICES FOR HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND TYPE IN THE SOUTHERN CALIFORNIA AREA. SALARY RANGES FOR EXECUTIVES WORKING AT CVHP FACILITIES FALL WITHIN THE MIDDLE OF THE MARKET, JUST AS THEY DO FOR ALL EMPLOYEES OF OUR ORGANIZATION. EVERY POSITION IN THE ORGANIZATION HAS A SALARY RANGE ATTACHED TO IT THAT REPRESENTS WHAT OTHERS DOING A SIMILAR JOB IN OTHER ORGANIZATIONS ARE LIKELY TO BE PAID. THE LONG-STANDING PAY PHILOSOPHY FOR CVHP HAS BEEN TO POSITION OUR SALARY RANGES IN THE MIDDLE OF OUR LOCAL LABOR MARKET. WE DON'T WANT TO LAG THE LOCAL MARKET, NOR DO WE WANT TO LEAD THE MARKET, SINCE THAT IS NOT A STRATEGY WE CAN AFFORD TO SUSTAIN OVER TIME. WE RELY ON MARKET STUDIES TO DETERMINE WHERE OUR PAY PRACTICES ARE RELATIVE TO OTHER HOSPITALS IN SOUTHERN CALIFORNIA. FOR EXECUTIVE PAY, WE USE THE NATIONALLY-RECOGNIZED AND RESPECTED FIRM, HAYGROUP, TO ANALYZE OUR EXECUTIVE PAY PROGRAM AND DETERMINE WHERE IT FALLS IN OUR MARKET. THIS STUDY IS PERFORMED EVERY OTHER YEAR. THE MOST RECENT EXECUTIVE COMPENSATION DATA IS DATED OCTOBER 2014. AS PART OF THEIR EXECUTIVE COMPENSATION REVIEW, HAYGROUP ALSO ISSUES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE PAY PROGRAM FOR A NOT-FOR-PROFIT ORGANIZATION LIKE OURS THAT IS SUBJECT TO THE REQUIREMENTS OF SECTION 4958 OF THE INTERNAL REVENUE CODE AND UNITED STATES TREASURY DEPARTMENT REGULATIONS. IN THEIR OCTOBER 16, 2014, OPINION LETTER, HAYGROUP WROTE, WE BELIEVE WE HAVE COMPARED THE EXECUTIVE COMPENSATION TO COMPENSATION AND BENEFITS PAID TO EXECUTIVES OF ORGANIZATIONS WITH LIKE SERVICES BY LIKE ENTERPRISES UNDER LIKE CIRCUMSTANCES, AND AS A RESULT, WE BELIEVE THAT COMPENSATION AND BENEFITS PAID TO THE EXECUTIVES ARE REASONABLE WITHIN THE MEANING OF SECTION 53.4958-4(B)(1)(II)(A) OF THE TREASURY REGULATIONS. THE EXECUTIVE POSITIONS THAT ARE INCLUDED IN THE BIENNIAL EXECUTIVE COMPENSATION REVIEW INCLUDE THE PRESIDENT/CEO, CHIEF MEDICAL OFFICER/CHIEF INFORMATION OFFICER, CHIEF FINANCIAL OFFICER, CHIEF NURSING OFFICER, CHIEF HUMAN RESOURCES OFFICER, CHIEF CLINICAL SERVICES OFFICER, CHIEF STRATEGY OFFICER, CHIEF COMPLIANCE OFFICER, CHIEF TRANSFORMATION OFFICER, CHIEF COMMUNICATIONS & ADVOCACY OFFICER, AND CEO (CITRUS VALLEY HEALTH FOUNDATION). FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST AN AUDIT REPORT IS AVAILABLE AS REQUIRED. NO OTHER DOCUMENTS ARE AVAILABLE. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 131,002. MANAGEMENT AND GENERAL EXPENSES 41,600. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 172,602. FORM 990, PART IX, LINE 24E PROVISION FOR BAD DEBTS: PROGRAM SERVICE EXPENSES 89,260. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 89,260. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 64,876. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 64,876. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST CVHF 27,371. FORM 990, PART XII, LINES 2B: AUDITED FINANCIAL STATEMENTS THE FINANCIAL STATEMENTS OF CITRUS VALLEY HEALTH PARTNERS, INC. AND ITS AFFILIATES, CITRUS VALLEY MEDICAL CENTER, INC., CITRUS VALLEY HOSPICE, FOOTHILL PRESBYTERIAN HOSPITAL, CITRUS VALLEY HEALTH FOUNDATION, INC., AND GLENDORA SURGERY CENTER, WERE AUDITED ON A CONSOLIDATED BASIS. FORM 990, PART XII, LINE 2C AUDIT AND COMPLIANCE COMMITTEE THE BOARD OF DIRECTORS HAS CONSTITUTED AN AUDIT AND COMPLIANCE COMMITTEE AND DELEGATED TO THAT COMMITTEE THE RESPONSIBILITY FOR ENGAGING INDEPENDENT AUDITORS AND MONITORING THE AUDIT PROCESS. THIS STRUCTURE HAS BEEN IN EFFECT IN PRIOR YEARS AND WAS NOT CHANGED IN 2014. FORM 990, PART VII, SECTION A, LINE 1A AND SCHEDULE J REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS THE OFFICERS REPORTED ON PART VII OF FORM 990 AND SCHEDULE J ARE COMPENSATED BY AN AFFILIATED ENTITY, CITRUS VALLEY HEALTH PARTNERS (CVHP). THE COMPENSATION AMOUNTS REPORTED IN PART VII OF FORM 990 AND SCHEDULE J REPRESENT 100% OF THE COMPENSATION PAID BY CVHP TO THE OFFICERS. THE OFFICERS ALSO SERVE AS CORPORATE OFFICERS FOR CITRUS VALLEY MEDICAL CENTER, INC., CITRUS VALLEY HOSPICE, INC., FOOTHILL PRESBYTERIAN HOSPITAL AND CITRUS VALLEY HEALTH FOUNDATION, INC., ALL AFFILIATES OF THE TAXPAYER. IN ACCORDANCE WITH OUR UNDERSTANDING OF THE FORM 990 INSTRUCTIONS, SIMILAR PART VII AND SCHEDULE J DISCLOSURES ARE MADE IN EACH OF THE AFOREMENTIONED AFFILIATES 990 RETURNS. PART VII, SECTION A REPORTABLE HOURS FOR RELATED ORGANIZATIONS THE OFFICERS SERVE AS CORPORATE OFFICERS FOR CITRUS VALLEY HEALTH PARTNERS (CVHP), CITRUS VALLEY MEDICAL CENTER, INC. (CVMC), CITRUS VALLEY HOSPICE (CVH), INC., FOOTHILL PRESBYTERIAN HOSPITAL (FPH) AND CITRUS VALLEY HEALTH FOUNDATION, INC. (CVHF), ALL AFFILIATES OF THE TAXPAYER. THE NUMBER OF HOURS (PER WEEK) DEVOTED BY THE CORPORATE OFFICERS TO THE AFFILIATES ARE AS FOLLOWS: ROBERT CURRY DEVOTED 4, 14, 2, 2, AND 18 HOURS TO FPH, CVMC, CVHF, CVH, AND CVHP, RESPECTIVELY. RAJESH SHARMA DEVOTED 4,14, 2, 2, AND 18 HOURS TO FPH, CVMC, CVHF, CVH, AND CVHP, RESPECTIVELY. 990 PART V LINE 7H FILING OF FORM 1098C THE ORGANIZATION DID NOT RECEIVE ANY CONTRIBUTIONS OF AUTOMOBILES, BOATS, AIRPLANES OR OTHER VEHICLES. CONSEQUENTLY NO FORMS 1098C WERE FILED. CITRUS VALLEY HEALTH PARTNERS INC 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 953885523 EXEMPT ORGANIZATION SUPPORT & MANAGEMENT CA 501(C)(3) 11 TYPE II N/A 0 CITRUS VALLEY MEDICAL CENTER INC 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 956006469 ACUTE CARE HOSPITAL CA 501(C)(3) 3 N/A 0 CITRUS VALLEY HEALTH FOUNDATION INC 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 952534063 EXEMPT ORGANIZATION SUPPORT CA 501(C)(3) 11 TYPE I N/A 0 FOOTHILL PRESBYTERIAN HOSPITAL INC 140 W COLLEGE STREET PO BOX 6108 COVINA CA 917225108 952413054 ACUTE CARE HOSPITAL CA 501(C)(3) 3 N/A 0 GLENDORA SURGERY CENTER 315 E ROUTE 66 101 GLENDORA CA 91740 510492499 OUTPATIENT SURGERY CENTER CA N/A S 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 CITRUS VALLEY MEDICAL CENTER O 79272 FAIR MARKET VALUE FORM 990, SCHEDULE R, PART V, NUMBER 2, CODE O: THE EXECUTIVE SALARIES ARE PROCESSED THROUGH CITRUS VALLEY HEALTH PARTNERS. THE SALARIES REPORTED ON FORM 990 ARE PROCESSED THROUGH CITRUS VALLEY HEALTH PARTNERS. CITRUS VALLEY HEALTH PARTNERS ACTS AS A COMMON PAYMASTER FOR AFFILIATED ENTITIES, CITRUS VALLEY MEDICAL CENTER, CITRUS VALLEY HEALTH FOUNDATION AND CITRUS VALLEY HOSPICE. CITRUS VALLEY HEALTH PARTNERS FILED ONE FORM W-3 WHICH SHOWS A COMBINED NUMBER OF 3,066 EMPLOYEES. THE NUMBER OF EMPLOYEES FOR EACH ENTITY IS REPORTED SEPARATELY ON ITS OWN FORM 990 PART I LINE 5. CITRUS VALLEY MEDICAL CENTER'S FORM 990 REPORTED A TOTAL OF 2,570 EMPLOYEES, CITRUS VALLEY HOSPICE'S FORM 990 REPORTED 92 EMPLOYEES, CITRUS VALLEY HEALTH FOUNDATION'S FORM 990 REPORTED 8 EMPLOYEES AND CITRUS VALLEY HEALTH PARTNER'S FORM 990 REPORTED 396 EMPLOYEES. THE FILING ORGANIZATION FILES ITS OWN FORM W-3, HOWEVER AMOUNTS REPORTED ON SCHEDULE R, PART V, NUMBER 2, CODE O REPRESENT SHARED EMPLOYEE EXPENSES THAT OCCUR BETWEEN THE AFFILIATES.