COMMUNITY HEALTH GROUP: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH GROUP (EIN 95-3766170)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201403189349306645
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T15:16:09-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SECOND STREET 9TH FLOOR | AddressLine1 |
| City | SAN FRANCISCO | City |
| State | CA | State |
| ZIP Code | 94105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 953766170 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH GROUP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 6194220422 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2420 FENTON STREET NO 100 | AddressLine1 |
| City | CHULA VISTA | City |
| State | CA | State |
| ZIP Code | 91914 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT CARROLL | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6194220422 | PhoneNum |
| Signature | 2014-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RENIE BURBANK | PreparerPersonNm |
| PTIN | P00159653 | PTIN |
| Phone | 4159561500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SCOTT CARROLL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2420 FENTON STREET NO 100 | AddressLine1 |
| City | CHULA VISTA | City |
| State | CA | State |
| ZIP Code | 91914 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $49,680,193 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.CHGSD.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1982 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | COMMUNITY HEALTH GROUP IS DEDICATED TO MAINTAINING AND IMPROVING THE HEALTH OF OUR MEMBERS BY PROVIDING ACCESS TO QUALITY CARE AND OFFERING EXCEPTIONAL SERVICE TO DIVERSE POPULATIONS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 224 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $71,328 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$188,582 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $39,629,719 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,162,283 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$23,395 | PYInvestmentIncomeAmt |
| CY Investment Income | $320,691 | CYInvestmentIncomeAmt |
| PY Other Revenue | $12,550,021 | PYOtherRevenueAmt |
| CY Other Revenue | $13,425,663 | CYOtherRevenueAmt |
| PY Total Revenue | $52,156,345 | PYTotalRevenueAmt |
| CY Total Revenue | $32,908,637 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,895,930 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,235,734 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $38,963,775 | PYOtherExpensesAmt |
| CY Other Expenses | $23,868,186 | CYOtherExpensesAmt |
| PY Total Expenses | $47,859,705 | PYTotalExpensesAmt |
| CY Total Expenses | $33,103,920 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,296,640 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$195,283 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $36,869,545 | TotalAssetsBOYAmt |
| Total Assets EOY | $32,206,974 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,774,654 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,539,729 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,094,891 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $25,667,245 | NetAssetsOrFundBalancesEOYAmt |
| Mission | COMMUNITY HEALTH GROUP IS DEDICATED TO MAINTAINING AND IMPROVING THE HEALTH OF OUR MEMBERS BY PROVIDING ACCESS TO QUALITY CARE AND OFFERING EXCEPTIONAL SERVICE TO DIVERSE POPULATIONS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,397,626 | ExpenseAmt |
| Revenue | $32,516,618 | RevenueAmt |
| Desc | TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO MEMBERS UNDER THE HEALTHY FAMILIES PROGRAM IN THE COUNTY OF SAN DIEGO AND PORTIONS OF THE COUNTY OF RIVERSIDE UNDER CONTRACT WITH THE STATE OF CALIFORNIA. ALSO TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO MEMBERS UNDER A MEDICARE ADVANTAGE SPECIAL NEEDS PLAN OPEN TO PEOPLE ELIGIBLE FOR MEDI-CAL AND MEDICARE UNDER CONTRACT WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. | Desc |
| Total Program Service Expenses | $16,397,626 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 1927 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 224 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIANE ERK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6194986427 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2420 FENTON STREET | AddressLine1 |
| City | CHULA VISTA | City |
| State | CA | State |
| ZIP Code | 91914 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ALBERT VITELA | ||||||||
| CHAIRMAN OF THE BOARD | 2.00 | 2.00 | Yes (X) | Yes (X) | $12,470 | $0 | $0 | |
| PAUL DATO | ||||||||
| VICE CHAIRMAN OF THE BOARD | 2.00 | 2.00 | Yes (X) | Yes (X) | $7,610 | $0 | $0 | |
| CARLOTA SALAS | ||||||||
| SECRETARY OF THE BOARD | 2.00 | 2.00 | Yes (X) | Yes (X) | $8,550 | $0 | $0 | |
| CARLOS CESENA | ||||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $9,230 | $0 | $0 | ||
| JOSE LUIS VALDIVIA | ||||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $8,880 | $0 | $0 | ||
| GRACE KOJIMA | ||||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $8,110 | $0 | $0 | ||
| TITO CALSADA | ||||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $9,500 | $0 | $0 | ||
| ANITA HOLT | ||||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $8,030 | $0 | $0 | ||
| WILLIAM MACFARLAND | ||||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $100 | $0 | $0 | ||
| NORMA DIAZ | ||||||||
| CHIEF EXECUTIVE OFFICER | 20.00 | 20.00 | Yes (X) | $520,480 | $0 | $20,001 | ||
| EDWARD HUTT | ||||||||
| CHIEF MEDICAL OFFICER | 20.00 | 20.00 | Yes (X) | $422,477 | $0 | $20,029 | ||
| WILLIAM RICE | ||||||||
| CHIEF FINANCIAL OFFICER | 20.00 | 20.00 | Yes (X) | $315,247 | $0 | $19,518 | ||
| JONATHAN TAMAYO | ||||||||
| VP INFORMATION SYSTEMS | 20.00 | 20.00 | Yes (X) | $220,867 | $0 | $22,786 | ||
| ANN WARREN | ||||||||
| CHIEF GOV'T & RELATIONS | 20.00 | 20.00 | Yes (X) | $195,985 | $0 | $20,214 | ||
| MICHAEL MCGARRIGLE | ||||||||
| CHIEF OPERATING OFFICER | 20.00 | 20.00 | Yes (X) | $232,351 | $0 | $18,455 | ||
| DIANE ERK | ||||||||
| DIRECTOR OF FINANCE | 20.00 | 20.00 | $170,064 | $0 | $16,161 | Yes (X) | ||
| NORA PINTADO | ||||||||
| DIRECTOR OF HEALTH PLAN OPERATIONS | 20.00 | 20.00 | $158,833 | $0 | $14,421 | Yes (X) | ||
| DAVID RITCHIE | ||||||||
| DIRECTOR OF CONTRACTING | 20.00 | 20.00 | $133,302 | $0 | $16,782 | Yes (X) | ||
| NOREEN KOIZUMI | ||||||||
| DIRECTOR OF HEALTHCARE OPERATIONS | 20.00 | 20.00 | $143,072 | $0 | $19,004 | Yes (X) | ||
| CAROLE ANDERSON | ||||||||
| DIRECTOR OF CORPORATE QUALITY | 20.00 | 20.00 | $113,204 | $0 | $15,747 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,698,362 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $203,118 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| JAG CONSULTING LLC | |||||
| 4364 BONITA RD SUITE 322 | BONITA | CA | 91902 | CONSULTING SERVICES | $417,662 |
| FOLEY & LARDNER LLP | |||||
| 402 WEST BROADWAY SUITE 2100 | SAN DIEGO | CA | 92101 | LEGAL SERVICES | $167,561 |
| MOSS ADAMS LLP | |||||
| 2030 MAIN STREET SUITE 1400 | IRVINE | CA | 92614 | ACCOUNTING AND AUDITING SERVICES | $127,830 |
| AXENE HEALTH PARTNERS LLC | |||||
| 38975 SKY CANYON DR SUITE 105 | MURRIETA | CA | 92563 | ACTUARIAL SERVICES | $126,569 |
| VERISK HEALTH INC | |||||
| PO BOX 5992 | NEW YORK | NY | 10087 | CONSULTING SERVICES | $112,720 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE REVENUE | 524114 | $18,019,169 | $18,019,169 |
| HEALTHY FAMILY REVENUE | 524114 | $1,143,114 | $1,143,114 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,162,283 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $469,981 | TotalRevenueColumnAmt |
| Exclusion | $469,981 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,622,266 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,771,556 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$149,290 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$149,290 | TotalRevenueColumnAmt |
| Exclusion | -$149,290 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| ADMIN. FEE FROM FNDTN. | 900099 | $13,309,601 | $13,309,601 | |
| TPA ADMIN. INCOME | 900099 | $71,328 | $71,328 | |
| OTHER OPER. REVENUE | 900099 | $44,734 | $44,734 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $13,425,663 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,908,637 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $32,516,618 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $71,328 | UnrelatedBusinessRevenueAmt |
| Exclusion | $320,691 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,100,890 | TotalAmt |
| Management And General | $2,100,890 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,573,599 | TotalAmt |
| Program Services | $202,615 | ProgramServicesAmt |
| Management And General | $5,370,984 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,428 | TotalAmt |
| Management And General | $228,428 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $726,200 | TotalAmt |
| Program Services | $24,465 | ProgramServicesAmt |
| Management And General | $701,735 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $606,617 | TotalAmt |
| Program Services | $13,173 | ProgramServicesAmt |
| Management And General | $593,444 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,780 | TotalAmt |
| Management And General | $250,780 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,400 | TotalAmt |
| Management And General | $131,400 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,422,150 | TotalAmt |
| Management And General | $1,422,150 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,893 | TotalAmt |
| Management And General | $77,893 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,381,046 | TotalAmt |
| Management And General | $1,381,046 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,440,772 | TotalAmt |
| Management And General | $1,440,772 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $666,344 | TotalAmt |
| Management And General | $666,344 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,561 | TotalAmt |
| Management And General | $66,561 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,761 | TotalAmt |
| Management And General | $7,761 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,497 | TotalAmt |
| Program Services | $14,497 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $915,988 | TotalAmt |
| Management And General | $915,988 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,901 | TotalAmt |
| Management And General | $221,901 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| HEALTH FACILITY PYMTS | $5,413,944 | $5,413,944 |
| PHARMACY & MED. SRVCS | $4,976,362 | $4,976,362 |
| PROVIDER PROF. FEES | $3,506,215 | $3,506,215 |
| CAPITATION | $1,696,210 | $1,696,210 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,678,362 | TotalAmt |
| Program Services | $550,145 | ProgramServicesAmt |
| Management And General | $1,128,217 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,103,920 | TotalAmt |
| Program Services | $16,397,626 | ProgramServicesAmt |
| Management And General | $16,706,294 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,753,756 | BOYAmt |
| EOY | $14,739,442 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,242,288 | BOYAmt |
| EOY | $12,294,289 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,032,824 | BOYAmt |
| EOY | $870,109 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $556,857 | BOYAmt |
| EOY | $592,090 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,718,049 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,025,129 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,083,783 | BOYAmt |
| EOY | $3,692,920 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,913 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,124 | BOYAmt |
| EOY | $18,124 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,869,545 | BOYAmt |
| EOY | $32,206,974 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,014,292 | BOYAmt |
| EOY | $5,503,472 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,760,362 | BOYAmt |
| EOY | $1,036,257 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,774,654 | BOYAmt |
| EOY | $6,539,729 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,794,891 | BOYAmt |
| EOY | $25,367,245 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $300,000 | BOYAmt |
| EOY | $300,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,094,891 | BOYAmt |
| EOY | $25,667,245 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,869,545 | BOYAmt |
| EOY | $32,206,974 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$195,283 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$232,363 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,277,653 | OtherCostOrOtherBasisAmt |
| Depreciation | $438,425 | DepreciationAmt |
| Book Value | $839,228 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,440,396 | OtherCostOrOtherBasisAmt |
| Depreciation | $586,704 | DepreciationAmt |
| Book Value | $2,853,692 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,692,920 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO CHG FOUNDATION | Desc |
| Amt | $1,036,257 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,036,257 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $341,171,482 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$232,363 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $308,495,208 | OtherRevenueAmt |
| Revenue Not Reported | $308,262,845 | RevenueNotReportedAmt |
| Revenue Subtotal | $32,908,637 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $32,908,637 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $353,066,026 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $319,962,106 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $319,962,106 | ExpensesNotReportedAmt |
| Expenses Subtotal | $33,103,920 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $33,103,920 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | CHG AND CHG FOUNDATION HAVE EVALUATED THEIR TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF AN AUDIT BY TAXING AUTHORITIES AT THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED ARE RELATED TO CHG'S AND CHG FOUNDATION'S CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE IS UNRELATED BUSINESS INCOME ACTIVITIES CONDUCTED THAT WOULD BE TAXABLE. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS WILL BE SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION; THEREFORE, NO DISCLOSURES OF UNCERTAIN INCOME TAX POSITIONS ARE REQUIRED. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | TOTAL REVENUE ATTRIBUTABLE TO CHG FOUNDATION 323,906,125. MANAGEMENT FEE FROM FOUNDATION (ELIMINATED IN CONSOLIDATION) -13,309,601. CHG FOUNDATION GAIN FROM SALE OF PROPERTY -2,101,316. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | TOTAL EXPENSES ATTRIBUTABLE TO CHG FOUNDATION 335,373,023. MANAGEMENT FEE FROM FOUNDATION (ELIMINATED IN CONSOLIDATION) -13,309,601. CHG FOUNDATION GAIN FROM SALE OF PROPERTY -2,101,316. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NORMA DIAZ | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $520,480 | $0 | $0 | $0 | $0 | $0 | $7,650 | $0 | $12,351 | $0 | $540,481 | $0 | $0 | $0 |
| EDWARD HUTT | ||||||||||||||
| CHIEF MEDICAL OFFICER | $422,477 | $0 | $0 | $0 | $0 | $0 | $7,650 | $0 | $12,379 | $0 | $442,506 | $0 | $0 | $0 |
| WILLIAM RICE | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $315,247 | $0 | $0 | $0 | $0 | $0 | $7,650 | $0 | $11,868 | $0 | $334,765 | $0 | $0 | $0 |
| JONATHAN TAMAYO | ||||||||||||||
| VP INFORMATION SYSTEMS | $220,867 | $0 | $0 | $0 | $0 | $0 | $6,840 | $0 | $15,946 | $0 | $243,653 | $0 | $0 | $0 |
| ANN WARREN | ||||||||||||||
| CHIEF GOV'T & RELATIONS | $195,985 | $0 | $0 | $0 | $0 | $0 | $6,042 | $0 | $14,172 | $0 | $216,199 | $0 | $0 | $0 |
| MICHAEL MCGARRIGLE | ||||||||||||||
| CHIEF OPERATING OFFICER | $232,351 | $0 | $0 | $0 | $0 | $0 | $7,113 | $0 | $11,342 | $0 | $250,806 | $0 | $0 | $0 |
| DIANE ERK | ||||||||||||||
| DIRECTOR OF FINANCE | $170,064 | $0 | $0 | $0 | $0 | $0 | $5,166 | $0 | $10,995 | $0 | $186,225 | $0 | $0 | $0 |
| NORA PINTADO | ||||||||||||||
| DIRECTOR OF HEALTH PLAN OPERATIONS | $158,833 | $0 | $0 | $0 | $0 | $0 | $4,791 | $0 | $9,630 | $0 | $173,254 | $0 | $0 | $0 |
| DAVID RITCHIE | ||||||||||||||
| DIRECTOR OF CONTRACTING | $133,302 | $0 | $0 | $0 | $0 | $0 | $4,115 | $0 | $12,667 | $0 | $150,084 | $0 | $0 | $0 |
| NOREEN KOIZUMI | ||||||||||||||
| DIRECTOR OF HEALTHCARE OPERATIONS | $143,072 | $0 | $0 | $0 | $0 | $0 | $4,467 | $0 | $14,537 | $0 | $162,076 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAG CONSULTING LLC | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | JOSEPH A. GARCIA, FORMER COO AND HUSBAND OF NORMA DIAZ, CEO | RelationshipDescriptionTxt |
| Transaction | $417,662 | TransactionAmt |
| Transaction | HEALTHCARE ADMINISTRATIVE CONSULTING SERVICES | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE BOARD OF DIRECTORS ENGAGES THE SERVICES OF AN INDEPENDENT PUBLIC ACCOUNTING FIRM (MOSS ADAMS, LLP) AS OUTSIDE SERVICE PROVIDERS TO COMPLETE THE ANNUAL CERTIFIED AUDIT. THE CERTIFIED FINANCIAL STATEMENTS ARE REVIEWED WITH AND APPROVED BY THE BOARD OF DIRECTORS. THE SERVICES OF MOSS ADAMS, LLP ARE ALSO ENGAGED TO PREPARE AND COMPLETE FORM 990. THE FORM 990 IS PREPARED UNDER THE DIRECTION, REVIEW AND OVERSIGHT OF COMMUNITY HEALTH GROUPS' FINANCE DEPARTMENT. THE BOARD OF DIRECTORS RELIES ON THE EXPERTISE OF INTERNAL MANAGEMENT AND MOSS ADAMS, LLP. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY THE BOARD OF DIRECTORS AND KEY MANAGEMENT RECEIVE REFRESHER TRAINING, CONDUCTED BY OUTSIDE LEGAL COUNSEL, ON THE IMPORTANCE OF IDENTIFYING ANY CONFLICT OF INTEREST AND THE DISCLOSURE OF ANY REAL OR POTENTIAL CONFLICTS OF INTEREST IS AN INTEGRAL PART OF THE CULTURE AT COMMUNITY HEALTH GROUP. ANY POTENTIAL CONFLICTS ARE REPORTED TO THE COMPLIANCE OFFICER FOR INVESTIGATION AND FOLLOW-UP. |
| FORM 990, PART VI, SECTION B, LINE 15 | A SALARY ANALYSIS IS PREPARED BY THE HUMAN RESOURCES DEPARTMENT USING THE WARREN SURVEY, WHICH IS THE ONLY SURVEY FOR HMO'S. THIS ANALYSIS IS THEN VALIDATED BY AN OUTSIDE CONSULTANT. AN EVALUATION COMMITTEE CONSISTING OF THE CHAIRMAN OF THE BOARD AND FOUR ADDITIONAL BOARD MEMBERS, REVIEWS THIS ANALYSIS AND MAKES A RECOMMENDATION TO THE BOARD OF DIRECTORS, WHO MAKE THE FINAL DECISION. THE ANALYSIS IS DONE ANNUALLY IN DECEMBER. SALARY ANALYSIS ARE PREPARED BY AN OUTSIDE CONSULTANT FOR ALL EXECUTIVE POSITIONS AND SOME MANAGEMENT POSITIONS. RESULTS ARE PRESENTED TO THE HUMAN RESOURCES DEPARTMENT. RECOMMENDATIONS ARE THEN MADE TO THE CEO FOR APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | CONSOLIDATED AUDITED FINANCIAL STATEMENTS, INCLUDING COMMUNITY HEALTH GROUP AND COMMUNITY HEALTH GROUP FOUNDATION, ARE AVAILABLE TO THE PUBLIC ON THE DEPARTMENT OF MANAGED CARE WEBSITE. THE GOVERNING/ORGANIZING DOCUMENTS ARE ON FILE WITH THE DEPARTMENT OF MANAGED HEALTH CARE AND CAN BE OBTAINED UNDER THE CALIFORNIA PUBLIC RECORDS ACT. THE CONFLICT OF INTEREST POLICY IS NOT MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XII, LINE 2C | AUDIT COMMITTEE AND OVERSIGHT: THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR. |
| FORM 990, PART XII, LINE 2 & PART IV, LINE 12 | THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE PREPARED ON A CONSOLIDATED BASIS; HOWEVER, THE ORGANIZATION MAINTAINS SEPARATE FINANCIAL RECORDS FOR EACH ENTITY. THIS SEPARATE FINANCIAL INFORMATION HAS BEEN USED TO COMPLETE THE RECONCILIATION AT PART XI. CONSOLIDATED INFORMATION FROM THE AUDITED FINANCIAL STATEMENTS HAS BEEN USED IN SCHEDULE D, PARTS XI & XII. |
| FORM 990, PART XI, LINE 10 | EXCESS OR (DEFICIT) FOR THE YEAR PER FINANCIAL STATEMENTS: THE AMOUNT AT PART XI, LINE 10 DOES NOT TIE TO THE AUDITED FINANCIAL STATEMENTS AS THE AUDITED FINANCIAL STATEMENTS ARE PREPARED ON A CONSOLIDATED BASIS. THE AMOUNT AT PART XI IS THE EXCESS FOR COMMUNITY HEALTH GROUP ONLY AND DOES NOT INCLUDE THE EXCESS OR DEFICIT ATTRIBUTABLE TO CHG FOUNDATION. THIS IS THE AMOUNT NECESSARY TO PROPERLY ROLL FORWARD NET ASSETS FOR CHG ONLY. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHG FOUNDATION | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2420 FENTON ST SUITE 100 | AddressLine1 |
| City | CHULA VISTA | City |
| State | CA | State |
| ZIP Code | 91914 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330586911 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 9 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH GROUP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CHG FOUNDATION | ||
| E | $1,036,257 | BOOK/ACTUAL VALUE |
| CHG FOUNDATION | ||
| Q | $13,309,601 | BOOK/ACTUAL VALUE |
Comments