COMMUNITY HOSPITAL OF CENTRAL CALIFORNIA FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HOSPITAL OF CENTRAL CALIFORNIA FOUNDATION (EIN 77-0191730)
Tax period
2012-09-01 to 2013-08-31
Filed
2014-07-08
IRS object ID
201411899349301096
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2014-07-08T16:29:22-05:00Timestamp
Tax Period End Date2013-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN910189318EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13121 W MARCH LN STE 100AddressLine1
CitySTOCKTONCity
StateCAState
ZIP Code952192303ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN770191730EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HOSPITALS OF CENTRALBusinessNameLine1
Business Name Line2CALIFORNIA FOUNDATIONBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlCOMMNameControl
Phone5594596000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1POST OFFICE BOX 1232AddressLine1
CityFRESNOCity
StateCAState
ZIP Code937154821ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROGER FRETWELLName
TitleCONTROLLERTitle
Phone5594596000Phone
Date Signed2014-07-03DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTRACY S PAGLIAName
PTINP00366884PTIN
Phone2099556100Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTIM JOSLINNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1789 N MEDICAL CENTER DRIVE EASTAddressLine1
CityCLOVISCity
StateCAState
ZIP Code93611ZIPCode
FieldValueIRS element (for citing)
Gross Receipts7864744GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MEDWATCHTODAY.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1989YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionIMPROVE THE HEALTH STATUS OF THE COMMUNITY AND PROMOTE MEDICAL EDUCATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees12TotalNbrEmployees
Total Nbr Volunteers19TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year5270197ContributionsGrantsPriorYear
Contributions Grants Current Year7730454ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year14705InvestmentIncomePriorYear
Investment Income Current Year18335InvestmentIncomeCurrentYear
Other Revenue Prior Year7274OtherRevenuePriorYear
Other Revenue Current Year88960OtherRevenueCurrentYear
Total Revenue Prior Year5292176TotalRevenuePriorYear
Total Revenue Current Year7837749TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4445200GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2693256GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1016000SalariesEtcPriorYear
Salaries Etc Current Year1247000SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year391922TotalFundrsngExpCurrentYear
Other Expense Prior Year439880OtherExpensePriorYear
Other Expenses Current Year494937OtherExpensesCurrentYear
Total Expenses Prior Year5901080TotalExpensesPriorYear
Total Expenses Current Year4435193TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-608904RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3402556RevenuesLessExpensesCY
Total Assets BOY23759784TotalAssetsBOY
Total Assets EOY30965220TotalAssetsEOY
Total Liabilities BOY7791588TotalLiabilitiesBOY
Total Liabilities EOY11594468TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY15968196NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19370752NetAssetsOrFundBalancesEOY
Mission DescriptionCHCC FOUNDATION'S MISSION IS TO SUPPORT COMMUNITY MEDICAL CENTERS' (CMC) OTHER AFFILIATED, NOT-FOR-PROFIT COMPANIES, THEREBY, IMPROVING THE HEALTH STATUS OF THE COMMUNITY AND PROMOTING MEDICAL EDUCATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2693256Expense
Grants2693256Grants
DescriptionTHROUGH THE GENEROUS CONTRIBUTIONS OF THE COMMUNITY, THE ORGANIZATION FUNDED $1,426,629 OF FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER'S AND COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA'S MEDICAL AND OPERATING EQUIPMENT ACQUISITIONS, AND DEFRAYED $879,416 OF ITS PATIENT CARE OPERATING EXPENDITURES. ADDITIONALLY, THE ORGANIZATION WAS ABLE TO PROVIDE TERRY'S HOUSE WITH $387,211 TO DEFRAY ITS OPERATING COSTS AND TO ASSIST FAMILIES WHO CANNOT AFFORD THE NOMINAL NIGHTLY FEE TO STAY THERE. FAMILIES OF CRITICALLY ILL OR INJURED PATIENTS MAY RESIDE AT TERRY'S HOUSE WHEN OTHER ACCOMMODATIONS ARE UNAVAILABLE OR UNAFFORDABLE. TERRY'S HOUSE IS OWNED AND OPERATED BY FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER (94-1156276).Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense869673Expense
DescriptionSUPPORT SERVICES FOR CMC'S AFFILIATED, NOT-FOR-PROFIT COMPANIES.Description
FieldValueIRS element (for citing)
Total Program Service Expense3562929TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming1Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees12NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Excess Business Holdings0ExcessBusinessHoldings
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonROGER FRETWELLNamePerson
Telephone Number5594596000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11925 E DAKOTA STE 206AddressLine1
CityFRESNOCity
StateCAState
ZIP Code937264821ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
BRIAN PACHECO
BOARD MEMBER0.301.60X000
DAVID SLATER MD
BOARD MEMBER0.301.60X0120000
FARID ASSEMI
BOARD MEMBER0.301.60X000
FLORENCE DUNN
BOARD CHAIR0.301.60X000X
JEFFREY THOMAS MD
BOARD MEMBER (THRU 12/31/12)0.301.60X01499250
JOHN MCGREGOR ESQUIRE
SECRETARY0.301.60X000X
KATHERINE FLORES MD
BOARD MEMBER0.301.60X000
LINZIE DANIEL
CHAIR ELECT0.301.60X000X
MANUEL CUNHA JR
BOARD MEMBER0.301.60X000
MARK BORBA
BOARD CHAIR-ELECT (THRU 03/12/13)0.301.60X000X
MICHAEL SYNN MD
BOARD MEMBER0.301.60X02448100
REN IMAI MD
BOARD MEMBER0.301.60X000
RALPH GARCIA
BOARD MEMBER (THRU 12/31/12)0.301.60X000
SUSAN ABUNDIS
BOARD CHAIR (THRU 12/31/12)0.301.60X000X
JERRY COOK
BOARD MEMBER0.301.60X000
TERRANCE BRADLEY EDD
BOARD MEMBER0.301.60X000
VONG MOUANOUTOUA
BOARD MEMBER0.301.60X000
RUTH QUINTO
BOARD MEMBER0.301.60X000
CHANDRASEKAR VENUGOPAL MD
BOARD MEMBER0.301.60X000
TIM JOSLIN
CHIEF EXECUTIVE OFFICER0.0075.0001213560729578X
PATRICK RAFFERTY
EVP CHIEF OPERATIONS OFFICER0.0075.000944024334438X
STEPHEN WALTER
SVP CHIEF FINANCIAL OFFICER0.0075.000789548187053X
ROBERT SAROYAN
VP FOUNDATION61.004.0003104746224X
KATHRYN ZENOVICH
DIRECTOR FOUNDATION40.004.00188304011661X
FieldValueIRS element (for citing)
Total Reportable Comp From Org188304TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3664341TotalReportableCompFrmRltdOrgs
Total Other Compensation1268954TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions7730454AllOtherContributions
Total Contributions7730454TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column18335TotalRevenueColumn
Exclusion$18,335ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming115955GrossIncomeGaming
Gaming Direct Expenses26995GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column88960TotalRevenueColumn
Exclusion$88,960ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column7837749TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$107,295ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2693256Total
Program Services2693256ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total301376Total
Management And General301376ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total746684Total
Program Services464204ProgramServices
Fundraising282480Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total85060Total
Program Services77830ProgramServices
Fundraising7230Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total60458Total
Program Services55319ProgramServices
Fundraising5139Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total53422Total
Program Services48881ProgramServices
Fundraising4541Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total227072Total
Program Services113536ProgramServices
Management And General113536ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total32933Total
Fundraising32933Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total85055Total
Program Services38913ProgramServices
Management And General38912ManagementAndGeneral
Fundraising7230Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3553Total
Program Services3553ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total23857Total
Management And General7952ManagementAndGeneral
Fundraising15905Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total5782Total
Management And General5782ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total22000Total
Program Services22000ProgramServices

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEALS4190020325125020325
DUES & SUBSCRIPTIONS2715513578013577

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total25630Total
Program Services11534ProgramServices
Management And General11534ManagementAndGeneral
Fundraising2562Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4435193Total
Program Services3562929ProgramServices
Management And General480342ManagementAndGeneral
Fundraising391922Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY348BOY
EOY365EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY18101910BOY
EOY22179755EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY5623416BOY
EOY8653667EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY101142EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2000BOY
EOY2000EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis71327LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec43036LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY32110BOY
EOY28291EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY23759784BOY
EOY30965220EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY105635BOY
EOY190070EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY7685953BOY
EOY11404398EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7791588BOY
EOY11594468EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2857868BOY
EOY1676489EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY12726735BOY
EOY17310670EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY383593BOY
EOY383593EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY15968196BOY
EOY19370752EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY23759784BOY
EOY30965220EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses3402556ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1FRESNO COMMUNITY HOSPITAL & MEDICALBusinessNameLine1
FieldValueIRS element (for citing)
EIN941156276EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Amount$2,280,751Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts2280751SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance383593BeginningOfYearBalance
End Of Year Balance383593EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance383593BeginningOfYearBalance
End Of Year Balance383593EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance383593BeginningOfYearBalance
End Of Year Balance383593EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance383593BeginningOfYearBalance
End Of Year Balance383593EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance383593BeginningOfYearBalance
End Of Year Balance383593EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis21500OtherCostOrOtherBasis
Book Value21500BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis49827OtherCostOrOtherBasis
Depreciation43036Depreciation
Book Value6791BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings28291TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionPAYABLE TO AFFILIATESDescription
Amount$11,404,398Amount
FieldValueIRS element (for citing)
Total Of Amounts11404398TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE ENDOWMENT REPORTED IN PART V IS A PERMANENT ENDOWMENT TO PROVIDE A PERMANENT SOURCE OF INCOME TO SUPPORT PATIENT CARE.
FORM 990, SCHEDULE D, PART X, LINE 2: THERE IS NO FOOTNOTE FOR FIN 48 IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DUE TO IMMATERIALITY.

Schedule G IRS990ScheduleG

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming115955GrossRevenueOtherGaming
Non Cash Prizes Other Gaming22447NonCashPrizesOtherGaming
Other Direct Expenses Other Gaming4548OtherDirectExpensesOtherGaming
Volunteer Labor Other Gaming0VolunteerLaborOtherGaming
Gross Revenue Total Gaming115955GrossRevenueTotalGaming
Non Cash Prizes Total Gaming22447NonCashPrizesTotalGaming
Other Direct Expenses Total Gaming4548OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming26995DirectExpenseSummaryGaming
Net Gaming Income Summary88960NetGamingIncomeSummary
FieldValueIRS element (for citing)
States Where Gaming ConductedCAStatesWhereGamingConducted
Licensed1Licensed
License Suspended Etc0LicenseSuspendedEtc
Gaming With Nonmembers0GamingWithNonmembers
Member Of Other Entity0MemberOfOtherEntity
Percentage Of Gaming Own Facility0.00000PercentageOfGamingOwnFacility
Percentage Of Gaming Othr Facility1.00000PercentageOfGamingOthrFacility
Name Of Gaming Rec Keeper PersonROBERT SAROYANNameOfGamingRecKeeperPerson

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line1POST OFFICE BOX 1232AddressLine1
CityFRESNOCity
StateCAState
ZIP Code937154821ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam Rev0ContractWith3rdPartyForGamRev
Gaming Manager Name PersonROBERT SAROYANGamingManagerNamePerson
Gaming Manager Compensation0GamingManagerCompensation
Gaming Manager Services ProvidedROBERT HAS OVERALL SUPERVISION AND MANAGEMENT OF THE GAMING EVENTS, INCLUDING RECORDKEEPING RESPONSIBILITIES.GamingManagerServicesProvided
Gaming Manager Is EmployeeXGamingManagerIsEmployee
Charitable Distrib Required0CharitableDistribRequired

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
PO BOX 1232FRESNOCA93715941156276501(C)(3)2280751OPERATING EXPENSES
COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA
PO BOX 1232FRESNOCA93715942864615501(C)(3)412505OPERATING EXPENSES
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: CHCC FOUNDATION IS GOVERNED BY A BOARD OF TRUSTEES THAT SETS POLICY AND IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF GRANTS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MICHAEL SYNN MD
BOARD MEMBER024481000000000024481000
TIM JOSLIN
CHIEF EXECUTIVE OFFICER0847683029570907016807186780109000194313800
PATRICK RAFFERTY
EVP CHIEF OPERATIONS OFFICER059788202977230484190327427070110127846200
STEPHEN WALTER
SVP CHIEF FINANCIAL OFFICER052723002309280313900176153010900097660100
ROBERT SAROYAN
VP FOUNDATION02320370601870182500006224031669800
KATHRYN ZENOVICH
DIRECTOR FOUNDATION14747403348107349000116610199965000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 4BTIM JOSLIN, CEO; STEPHEN WALTER, CFO; AND PATRICK RAFFERTY, COO, PARTICIPATE IN SERPS. OTHER EXECUTIVES PARTICIPATE IN A SERP STRUCTURED TO PROMOTE RETENTION. THE FOLLOWING CONTRIBUTIONS WERE MADE DURING OR ATTRIBUTABLE TO 2012: - TIM JOSLIN $718,678 - PATRICK RAFFERTY $327,427 - STEPHEN WALTER $176,153
PART IIIPART I, LINE 3: THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THE METHODS TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION.SUPPLEMENTAL INFORMATION

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART V, LINES 1 & 2:CHCC IS THE COMMON PAYMASTER FOR ITSELF, THE ORGANIZATION AND FCH&MC.
FORM 990, PART VI, SECTION A, LINE 6CHCC IS THE SOLE MEMBER OF CHCCF. IT HAS THE SOLE AND EXCLUSIVE RIGHT TO ELECT ALL OF THE MEMBERS OF THE BOARD OF DIRECTORS. CHCC IS THE SOLE MEMBER OF THIS ENTITY. AS SUCH, IT HAS THE RIGHTS OF MEMBERS CONFERRED BY CHAPTER 3 OF THE NONPROFIT PUBLIC BENEFIT CORPORATION LAW, SECTIONS 5310 - 5354, WHICH INCLUDES THE RIGHTS TO APPROVE AMENDMENTS TO THE ARTICLES, BYLAWS AND SALE OF ASSETS OUTSIDE THE NORMAL COURSE OF BUSINESS. THE MOST RECENT AMENDED ARTICLES OF INCORPORATION PROVIDES THAT UPON DISSOLUTION ALL REMAINING ASSETS WILL BE DISTRIBUTED TO CHCC OR ITS SUCCESSOR.
FORM 990, PART VI, SECTION A, LINE 7ACHCC IS THE SOLE MEMBER OF CHCCF. IT HAS THE SOLE AND EXCLUSIVE RIGHT TO ELECT ALL OF THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BCHCC IS THE SOLE MEMBER OF THIS ENTITY. AS SUCH, IT HAS THE RIGHTS OF MEMBERS CONFERRED BY CHAPTER 3 OF THE NONPROFIT PUBLIC BENEFIT CORPORATION LAW, SECTIONS 5310 - 5354, WHICH INCLUDES THE RIGHTS TO APPROVE AMENDMENTS TO THE ARTICLES, BYLAWS AND SALE OF ASSETS OUTSIDE THE NORMAL COURSE OF BUSINESS.
FORM 990, PART VI, SECTION B, LINE 11UPON COMPLETION OF AN INITIAL REVIEW BY SENIOR MANAGEMENT, THE CHAIRMAN OF THE BOARD OF TRUSTEES FORWARDS THE FORM TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES FOR FINAL REVIEW. THE FINALIZED FORM 990 THEN BECOMES A RECORD OF THE ORGANIZATION'S BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF COMMITTEE WITH BOARD DELEGATED POWERS SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. TO ENSURE THAT THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS ARE CONDUCTED. THE PERIODIC REVIEWS, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARM'S-LENGTH BARGAINING; 2) WHETHER ACQUISITIONS OF PHYSICIAN PRACTICES AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; 3) WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; AND 4) WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT.
FORM 990, PART VI, SECTION B, LINE 15BCOMPENSATION FOR THE CEO IS ESTABLISHED BY A RELATED ORGANIZATION. THE COMPENSATION FOR ALL POSITIONS LISTED IN PART VII ARE COMPARED WITH LIKE POSITIONS WITH COMPARABLE COMPANIES IN COMPARABLE MARKETS. THE DATA IS SUPPLIED BY A CONSULTING FIRM. COMPENSATION, INCLUDING INCENTIVE AND BENEFIT PROGRAMS, IS STRUCTURED BASED UPON THIS INPUT.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION AND ITS NONPROFIT AFFILIATES COMBINE THE RESULTS OF THEIR FINANCIAL OPERATIONS TO ISSUE CONSOLIDATED FINANCIAL STATEMENTS. THESE AUDITED FINANCIAL STATEMENTS ARE MADE PUBLICLY AVAILABLE THROUGH ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) AND CAN BE FOUND ON THE INTERNET AT EMMA.MSRB.ORG/SEARCH/SEARCH.ASPX. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
PO BOX 1232FRESNOCA93715941156276HOSPITALCA501(C)(3)LINE 3COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA1
SIERRA HOSPITAL FOUNDATION
PO BOX 1232FRESNOCA93715941431181INACTIVECA501(C)(3)LINE 3COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA1
COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA
PO BOX 1232FRESNOCA93715942864615SUPPORTING ORGCA501(C)(3)LINE 11B, II0N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgLegal Domicile Foreign CountryLegalDomicileForeignCountry
COMMUNITY HEALTH ENTERPRISES INC
1925 E DAKOTA AVE STE 211FRESNOCA93715770175659PHARMACY SALESCAN/AC0
COMMUNITY HEALTH CARE PLAN INC
1925 E DAKOTA AVE STE 211FRESNOCA93715770246798INACTIVECAN/AC0
SANTE HEALTH SERVICES INC
6051 N FRESNO STREETFRESNOCA93710200382364INACTIVECAN/AC0
COMMUNITY INSURANCE SERVICES COMPANY
PO BOX 1232FRESNOCA93715980674776INSURANCEN/AC0CJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1FRESNO COMMUNITY HOSPITAL & MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeBTransactionType
Amount Involved2280751AmountInvolved
Method Of Amt DeterminationCASHMethodOfAmtDetermination

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