2014-05-06T16:52:25-05:00 2013-06-30 910189318 MOSS ADAMS LLP 3121 W MARCH LANE SUITE 100 STOCKTON CA 95219 990 2012-07-01 942917251 FREMONT-RIDEOUT HEALTH GROUP FREM 5307401920 989 PLUMAS STREET YUBA CITY CA 95991 L WAYNE MILLS 5307401920 2014-05-02 1 TRACY S PAGLIA P00366884 2099556100 2012 2015-11-30 17:44:51Z RIDEOUT HEALTH L WAYNE MILLS 989 PLUMAS STREET YUBA CITY CA 95991 27816408 0 X HTTP://WWW.FRHG.ORG/ X 1984 CA TO PROVIDE COMPASSIONATE AND SUPERIOR HEALTHCARE TO EVERYONE IN OUR COMMUNITY AND REGION, REGARDLESS OF THE ABILITY TO PAY. 12 6 161 169 29065 -14923 0 0 27164874 27721859 25870 94549 0 0 27190744 27816408 0 0 0 0 16301552 15340974 0 0 0 9975651 10013000 26277203 25353974 913541 2462434 35140606 35435882 29732793 27565635 5407813 7870247 TO PROVIDE COMPASSIONATE AND SUPERIOR HEALTHCARE TO EVERYONE IN OUR COMMUNITY AND REGION, REGARDLESS OF THE ABILITY TO PAY. 0 0 18165026 0 27692794 PROVIDING SHARED MANAGEMENT SERVICES FOR RELATED TAX EXEMPT ENTITIES - RIDEOUT MEMORIAL HOSPITAL AND UNITED COM-SERVE. 18165026 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 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 1 1 0 0 1 327 1 1 161 1 1 1 0 0 0 0 0 0 0 0 0 0 X 12 6 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X CHRIS ROBERTS 5307401920 614 J STREET MARYSVILLE CA 95901 RONALD M SWEENEY 5.00 7.00 X X 0 0 0 JOHN WRIGHT 5.00 7.00 X X 2429 0 0 JOHN WEILER 5.00 7.00 X 0 0 0 LISA DEL PERO 5.00 7.00 X X 24622 0 0 JANICE S NALL 5.00 7.00 X X 17151 0 0 JOHN W CARY 5.00 7.00 X X 10098 0 0 RUPINDER BRAR 5.00 7.00 X 56600 0 0 ROBERT CHASON 5.00 7.00 X 0 0 0 JAMES KENNEDY 5.00 7.00 X 0 0 0 ALEXANDRA REICHMAN 5.00 7.00 X 17151 0 0 DAVID TARKE 5.00 7.00 X 0 0 0 DAVE VAUGHN 5.00 7.00 X 0 0 0 FLOYD BURTON 5.00 7.00 X 0 0 0 THERESA HAMILTON 16.00 54.00 X 2293127 0 28291 L WAYNE MILLS 16.00 44.00 X 346078 0 26681 CHANCE WHITE 10.00 50.00 X 316451 0 26523 ROBERT PLASS 40.00 0.00 X 399231 0 27054 TARUN GHOSH 40.00 0.00 X 327154 0 19023 ANTHONY MODDESETTE 40.00 0.00 X 287165 0 18773 TRESHA MORELAND 40.00 0.00 X 260740 0 5410 THERESA GRASSAU 40.00 0.00 X 205093 0 16888 THOMAS HAYES 8.00 0.00 X 283355 0 17151 4846445 0 185794 21 1 1 0 MCKESSON INFORMATION SOLUTIONS PO BOX 98347 CHICAGO IL 60693 SUPPORT & MAINTENANCE SERVICES 2577439 FOLEY AND LARDNER 555 S FLOWER STREET SUITE 3500 LOS ANGELES CA 90071 LEGAL SERVICES 600873 PRESS GANEY ASSOCIATES INC PO BOX 88335 MILWAUKEE WI 53288 SURVEY & CONSULTING SERVICES 324016 MOSS ADAMS LLP PO BOX 2147 SEATTLE WA 98111 AUDITING & TAX SERVICES 222807 RESOURCES GLOBAL PROFESSIONALS FILE 55221 LOS ANGELES CA 90074 PROFESSIONAL PLACEMENT SERVICES 175886 13 MANAGEMENT FEES 541610 24828824 24775110 53714 INCOME FROM FRD MGMT 541610 3069338 3069338 LOSS FROM SHC 541610 -24649 -24649 LOSS FROM MSO 541610 -42381 -42381 LOSS FROM DRUG PHARMA 541610 -185551 -185551 76278 76278 27721859 94549 94549 27816408 27692794 29065 94549 3085161 2313871 771290 300146 225110 75036 8998303 6748727 2249576 340432 255324 85108 2457652 1843239 614413 159280 119460 39820 935783 935783 198158 198158 1925309 1443982 481327 326185 244639 81546 1533953 1150465 383488 611643 458732 152911 175043 131282 43761 8162 6122 2040 162632 121974 40658 REPAIR AND MAINTENANCE 3797840 2848380 949460 LICENSE/TAXES 338292 253719 84573 25353974 18165026 7188948 0 6399161 8368114 64556 66378 981179 1028259 18141798 21211137 9553912 4761994 35140606 35435882 21931028 20282104 7801765 7283531 29732793 27565635 X 5407813 7870247 5407813 7870247 35140606 35435882 2462434 0 X 0 1 X 1 0 X X X 0 0 0 RIDEOUT MEM HOSPITAL 941387866 3 0 0 1 0 0 INVESTMENT IN FRD MANAGEMENT LLC 21087607 F CAPITAL CONTRIB CHIC 123530 C 21211137 DUE FROM AFFILIATES 1627994 WORKERS COMPENSATION INSURANCE RECOVERIES 3134000 4761994 DUE TO AFFILIATES 7022094 INVESTMENT IN FREMONT-RIDEOUT MSO, INC. 261437 7283531 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IN THE EVENT THE ASSOCIATION HAD A TAX PROVISION THAT WAS UNCERTAIN OF BEING SUSTAINED, THE GROUP WOULD APPLY THE MINIMUM PROBABILITY THRESHOLD SPECIFIED IN THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES TOPIC OF THE ACCOUNTING STANDARDS CODIFICATION TO DETERMINE WHETHER A FINANCIAL STATEMENT LIABILITY OR BENEFIT SHOULD BE RECOGNIZED. THERE WERE NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2013 AND 2012. X 1 1 X X X X 1 1 0 0 0 0 0 0 0 THERESA HAMILTON 450882 0 273800 0 1568445 0 12009 0 16282 0 2321418 0 0 0 L WAYNE MILLS 295774 0 45032 0 5272 0 10399 0 16282 0 372759 0 0 0 CHANCE WHITE 274057 0 40837 0 1557 0 10241 0 16282 0 342974 0 0 0 ROBERT PLASS 335815 0 53012 0 10404 0 10772 0 16282 0 426285 0 0 0 TARUN GHOSH 274057 0 42125 0 10972 0 2741 0 16282 0 346177 0 0 0 ANTHONY MODDESETTE 248124 0 38933 0 108 0 2491 0 16282 0 305938 0 0 0 TRESHA MORELAND 75892 0 0 0 184848 0 2171 0 3239 0 266150 0 0 0 THERESA GRASSAU 176042 0 21014 0 8037 0 6033 0 10855 0 221981 0 0 0 THOMAS HAYES 283355 0 0 0 0 0 0 0 17151 0 300506 0 0 0 PART I, LINE 1A THERESA HAMILTON RECEIVED TAX GROSS UP PAYMENTS AS PART OF A SERP DURING THE YEAR. THE BENEFIT WAS TREATED AS TAXABLE COMPENSATION ON AN AMENDED FORM W-2. PART I, LINES 4A-B LINE 4A: TRESHA MORELAND WAS PAID A SEPARATION AGREEMENT PAYMENT DURING THE YEAR. THE AMOUNT AND TERMS OF THE AGREEMENT ARE SUBJECT TO A CONFIDENTIALITY CLAUSE. DUE TO PUBLIC INSPECTION REQUIREMENTS OF THIS SCHEDULE, DETAILS HAVE NOT BEEN INCLUDED, BUT ARE AVAILABLE UPON REQUEST BY THE IRS. LINE 4B: THERESA HAMILTON, CEO, AS PART OF HER EXECUTIVE COMPENSATION PACKAGE, PARTICIPATES IN THE FRHG EXECUTIVE DEFERRED COMPENSATION PLAN - 457 (F) AND THE FRHG SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), WHICH IS PAID BY THE ORGANIZATION. PART II, LINE (1), COLUMN B (III): OTHER REPORTABLE COMPENSATION FOR THERESA HAMILTON, CEO, PRIMARILY REPRESENTS THE PRESENT VALUE OF FUTURE RETIREMENT BENEFITS. SUPPLEMENTAL INFORMATION PART III ADDITIONAL INFORMATION: THE INCENTIVE PAY PROGRAM IS AVAILABLE FOR ALL EMPLOYEES. PAYMENTS ARE BASED ON ACTUAL PERFORMANCE EXCEEDING PRE-DEFINED FINANCIAL AND QUALITY TARGETS FOR THE FISCAL YEAR. FORM 990, PART VI, SECTION A, LINE 4 REQUIRED NUMBER OF DIRECTORS WAS CHANGED TO BE NO LESS THAN 11 AND NO MORE THAN 15 MEMBERS. PREVIOUSLY IT WAS 13 WITH ONE OF THE MEMBERS REQUIRED TO BE A PHYSICIAN. OFFICE TERM FOR DIRECTORS WAS CHANGED TO 3 YEARS (PREVIOUSLY WAS 1 YEAR). THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER POSITIONS WERE ADDED TO THE LIST OF OFFICERS OF THE CORPORATION ALONG WITH THEIR RESPECTIVE RESPONSIBILITIES. THE TREASURER POSITION WAS REMOVED FROM THE LIST OF OFFICERS. RESPONSIBILITIES OF THE MEMBERS WERE ENHANCED AND UPDATES WERE MADE TO THE RESPONSIBILITIES OF THE EXECUTIVE COMMITTEE, FINANCE COMMITTEE, NOMINATING COMMITTEE, AND AUDIT COMMITTEE. THE PLANNING COMMITTEE WAS REMOVED FROM THE LIST OF COMMITTEES. FORM 990, PART VI, SECTION B, LINE 11 THE AUDIT COMMITTEE WILL PERFORM A DETAILED REVIEW AND BE PART OF THE PRESENTATION BY THE PREPARER (MOSS ADAMS LLP). THE AUDIT COMMITTEE WILL THEN MAKE A RECOMMENDATION TO THE FULL BOARD. A FULL COPY OF THE FORM 990 WILL BE MADE AVAILABLE TO THE FULL BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. IN-HOUSE LEGAL COLLECTS AND REVIEWS THE CONFLICT OF INTEREST STATEMENTS FOR ALL BOARD MEMBERS AND KEY EMPLOYEES. BOARD MEMBERS ARE EXCUSED FROM ANY PORTION OF THE MEETINGS WHERE THEIR PERSONAL INTEREST WOULD CREATE A CONFLICT ON AN ISSUE OR INFLUENCE A VOTE. FORM 990, PART VI, SECTION B, LINE 15 THE GOVERNANCE COMMITTEE DEVELOPS THE EXECUTIVE COMPENSATION POLICY AND STRATEGY TO BE FOLLOWED IN ESTABLISHING THE CEO'S COMPENSATION AND FOR THE CEO TO FOLLOW IN ESTABLISHING COMPENSATION FOR OTHER KEY EMPLOYEES. THE PRIMARY STRATEGY IS TO UTILIZE AN OUTSIDE FIRM TO PROVIDE EXECUTIVE SALARY MARKET DATA WITHIN THE HEALTH CARE INDUSTRY FOR COMPARABILITY WHEN SETTING EXECUTIVE COMPENSATION LEVELS. THE CEO THEN REPORTS SALARY DECISIONS FOR KEY EMPLOYEES UTILIZING THIS DATA TO THE GOVERNANCE COMMITTEE. ANNUALLY THE GOVERNANCE COMMITTEE REPORTS A SUMMARY OF ITS ACTIONS AND ESTABLISHED COMPENSATION PHILOSOPHY TO THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST DURING NORMAL BUSINESS HOURS. CONFLICT OF INTEREST POLICY IS NOT MADE AVAILABLE TO THE PUBLIC. RIDEOUT MEMORIAL HOSPITAL 989 PLUMAS STREET YUBA CITY CA 95991 941387866 ACUTE CARE HOSPITAL CA 501(C)(3) LINE 3 FREMONT-RIDEOUT HEALTH GROUP 1 UNITED COM-SERVE 989 PLUMAS STREET YUBA CITY CA 95991 943015356 SKILLED NURSING/ASSISTED LIVING/HOME HEALTH CA 501(C)(3) LINE 11B, II FREMONT-RIDEOUT HEALTH GROUP 1 FREMONT-RIDEOUT FOUNDATION 989 PLUMAS STREET YUBA CITY CA 95991 237366330 SUPPORT FOR FRHG AND ITS AFFILIATES CA 501(C)(3) LINE 7 FREMONT-RIDEOUT HEALTH GROUP 1 SIERRA HEALTH CARE CENTER PO BOX 2128 MARYSVILLE CA 95901 680040306 DME SALES CA N/A UNRELATED -19348 0 1 1.00000 FRD MANAGEMENT LLC PO BOX 2128 MARYSVILLE CA 95901 943335136 OPERATION OF CANCER CENTER CA N/A RELATED 2700000 21148228 0 0 0.51000 DRUG PHARMA INC 989 PLUMAS STREET YUBA CITY CA 95991 941390716 INVESTMENT CA FRHG C 1.00000 1 FREMONT-RIDEOUT MANAGEMENT SERVICES ORGANIZATION INC 989 PLUMAS STREET YUBA CITY CA 95991 271350379 MANAGEMENT SERVICES CA FRHG C 830207 761258 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 RIDEOUT MEMORIAL HOSPITAL Q 231582281 FMV UNITED COM-SERVE Q 5832004 FMV FREMONT-RIDEOUT FOUNDATION Q 295000 FMV FRD MANAGEMENT LLC Q 7180000 FMV SIERRA HEALTH CARE CENTER Q 974187 FMV RIDEOUT MEMORIAL HOSPITAL L 23547892 FMV UNITED COM-SERVE L 477481 FMV DRUG PHARMA L 153416 FMV DRUG PHARMA Q 353132 FMV SIERRA HEALTH CARE CENTER S 286203 FMV