2014-11-14T15:16:09-06:00 2013-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2013-01-01 953766170 COMMUNITY HEALTH GROUP COMM 6194220422 2420 FENTON STREET NO 100 CHULA VISTA CA 91914 SCOTT CARROLL CFO 6194220422 2014-11-07 1 RENIE BURBANK P00159653 4159561500 2013 2015-11-30 17:44:51Z SCOTT CARROLL 2420 FENTON STREET NO 100 CHULA VISTA CA 91914 49680193 0 X WWW.CHGSD.COM X 1982 CA 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. 9 9 224 0 71328 -188582 0 0 39629719 19162283 -23395 320691 12550021 13425663 52156345 32908637 0 0 0 0 8895930 9235734 0 0 0 38963775 23868186 47859705 33103920 4296640 -195283 36869545 32206974 10774654 6539729 26094891 25667245 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. 0 0 16397626 32516618 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. 16397626 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 1 0 1 1927 0 1 224 1 1 1 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 1 1 0 CA X DIANE ERK 6194986427 2420 FENTON STREET CHULA VISTA CA 91914 ALBERT VITELA CHAIRMAN OF THE BOARD 2.00 2.00 X X 12470 0 0 PAUL DATO VICE CHAIRMAN OF THE BOARD 2.00 2.00 X X 7610 0 0 CARLOTA SALAS SECRETARY OF THE BOARD 2.00 2.00 X X 8550 0 0 CARLOS CESENA BOARD MEMBER 2.00 2.00 X 9230 0 0 JOSE LUIS VALDIVIA BOARD MEMBER 2.00 2.00 X 8880 0 0 GRACE KOJIMA BOARD MEMBER 2.00 2.00 X 8110 0 0 TITO CALSADA BOARD MEMBER 2.00 2.00 X 9500 0 0 ANITA HOLT BOARD MEMBER 2.00 2.00 X 8030 0 0 WILLIAM MACFARLAND BOARD MEMBER 2.00 2.00 X 100 0 0 NORMA DIAZ CHIEF EXECUTIVE OFFICER 20.00 20.00 X 520480 0 20001 EDWARD HUTT CHIEF MEDICAL OFFICER 20.00 20.00 X 422477 0 20029 WILLIAM RICE CHIEF FINANCIAL OFFICER 20.00 20.00 X 315247 0 19518 JONATHAN TAMAYO VP INFORMATION SYSTEMS 20.00 20.00 X 220867 0 22786 ANN WARREN CHIEF GOV'T & RELATIONS 20.00 20.00 X 195985 0 20214 MICHAEL MCGARRIGLE CHIEF OPERATING OFFICER 20.00 20.00 X 232351 0 18455 DIANE ERK DIRECTOR OF FINANCE 20.00 20.00 X 170064 0 16161 NORA PINTADO DIRECTOR OF HEALTH PLAN OPERATIONS 20.00 20.00 X 158833 0 14421 DAVID RITCHIE DIRECTOR OF CONTRACTING 20.00 20.00 X 133302 0 16782 NOREEN KOIZUMI DIRECTOR OF HEALTHCARE OPERATIONS 20.00 20.00 X 143072 0 19004 CAROLE ANDERSON DIRECTOR OF CORPORATE QUALITY 20.00 20.00 X 113204 0 15747 2698362 0 203118 19 0 1 0 JAG CONSULTING LLC 4364 BONITA RD SUITE 322 BONITA CA 91902 CONSULTING SERVICES 417662 FOLEY & LARDNER LLP 402 WEST BROADWAY SUITE 2100 SAN DIEGO CA 92101 LEGAL SERVICES 167561 MOSS ADAMS LLP 2030 MAIN STREET SUITE 1400 IRVINE CA 92614 ACCOUNTING AND AUDITING SERVICES 127830 AXENE HEALTH PARTNERS LLC 38975 SKY CANYON DR SUITE 105 MURRIETA CA 92563 ACTUARIAL SERVICES 126569 VERISK HEALTH INC PO BOX 5992 NEW YORK NY 10087 CONSULTING SERVICES 112720 5 MEDICARE REVENUE 524114 18019169 18019169 HEALTHY FAMILY REVENUE 524114 1143114 1143114 19162283 469981 469981 16622266 16771556 -149290 -149290 -149290 ADMIN. FEE FROM FNDTN. 900099 13309601 13309601 TPA ADMIN. INCOME 900099 71328 71328 OTHER OPER. REVENUE 900099 44734 44734 13425663 32908637 32516618 71328 320691 2100890 2100890 5573599 202615 5370984 228428 228428 726200 24465 701735 606617 13173 593444 250780 250780 131400 131400 1422150 1422150 77893 77893 1381046 1381046 1440772 1440772 666344 666344 66561 66561 7761 7761 14497 14497 915988 915988 221901 221901 HEALTH FACILITY PYMTS 5413944 5413944 PHARMACY & MED. SRVCS 4976362 4976362 PROVIDER PROF. FEES 3506215 3506215 CAPITATION 1696210 1696210 1678362 550145 1128217 33103920 16397626 16706294 0 3753756 14739442 25242288 12294289 4032824 870109 556857 592090 4718049 1025129 3083783 3692920 181913 0 18124 18124 36869545 32206974 9014292 5503472 1760362 1036257 10774654 6539729 X 25794891 25367245 300000 300000 26094891 25667245 36869545 32206974 -195283 -232363 0 X X 0 1 X 1 0 1277653 438425 839228 3440396 586704 2853692 3692920 DUE TO CHG FOUNDATION 1036257 1036257 X 341171482 -232363 308495208 308262845 32908637 0 32908637 353066026 319962106 319962106 33103920 0 33103920 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. X X X X 0 0 0 0 0 0 0 0 0 NORMA DIAZ CHIEF EXECUTIVE OFFICER 520480 0 0 0 0 0 7650 0 12351 0 540481 0 0 0 EDWARD HUTT CHIEF MEDICAL OFFICER 422477 0 0 0 0 0 7650 0 12379 0 442506 0 0 0 WILLIAM RICE CHIEF FINANCIAL OFFICER 315247 0 0 0 0 0 7650 0 11868 0 334765 0 0 0 JONATHAN TAMAYO VP INFORMATION SYSTEMS 220867 0 0 0 0 0 6840 0 15946 0 243653 0 0 0 ANN WARREN CHIEF GOV'T & RELATIONS 195985 0 0 0 0 0 6042 0 14172 0 216199 0 0 0 MICHAEL MCGARRIGLE CHIEF OPERATING OFFICER 232351 0 0 0 0 0 7113 0 11342 0 250806 0 0 0 DIANE ERK DIRECTOR OF FINANCE 170064 0 0 0 0 0 5166 0 10995 0 186225 0 0 0 NORA PINTADO DIRECTOR OF HEALTH PLAN OPERATIONS 158833 0 0 0 0 0 4791 0 9630 0 173254 0 0 0 DAVID RITCHIE DIRECTOR OF CONTRACTING 133302 0 0 0 0 0 4115 0 12667 0 150084 0 0 0 NOREEN KOIZUMI DIRECTOR OF HEALTHCARE OPERATIONS 143072 0 0 0 0 0 4467 0 14537 0 162076 0 0 0 JAG CONSULTING LLC JOSEPH A. GARCIA, FORMER COO AND HUSBAND OF NORMA DIAZ, CEO 417662 HEALTHCARE ADMINISTRATIVE CONSULTING SERVICES 0 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. CHG FOUNDATION 2420 FENTON ST SUITE 100 CHULA VISTA CA 91914 330586911 HEALTHCARE CA 501(C)(3) 9 COMMUNITY HEALTH GROUP 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 CHG FOUNDATION E 1036257 BOOK/ACTUAL VALUE CHG FOUNDATION Q 13309601 BOOK/ACTUAL VALUE