COMMUNITY MEDICAL CENTERS INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY MEDICAL CENTERS INC (EIN 94-2437106)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-08
IRS object ID
201301299349300305
Schema version
2011v1.2
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)
Timestamp2013-05-08T19:38:09-07:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Lucy Reimche CPA MBABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11701 W Manor DriveAddressLine1
CityVisaliaCity
StateCAState
ZIP Code93291ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN942437106EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Community Medical Centers IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOMMNameControl
Phone2093732800Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line17210 Murray DriveAddressLine1
CityStocktonCity
StateCAState
ZIP Code95210ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKathleen MarshallName
TitleCEOTitle
Phone2093732828Phone
Date Signed2013-05-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameM L ReimcheName
PTINP01268260PTIN
Phone5593090943Phone
Date Prepared2013-05-08DatePrepared
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKathleen MarshallNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1P O Box 779AddressLine1
CityStocktonCity
StateCAState
ZIP Code95201ZIPCode
FieldValueIRS element (for citing)
Gross Receipts40940082GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.communitymedicalcenters.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionThe organization provides primary medical and dental care to the population of San Joaquin, Solano and Yolo counties with 13 medical sites, 1 dental and 1 administrative location. Services are delivered to adults, children, elderly and include family medicine, ob/gyn, internal medicine, pediatrics, general dentistry, family planning, nutrition (WIC), health education, counseling, and HIV early intervention care and case management. Care is provided to all patients regardless of ability to pay .ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees441TotalNbrEmployees
Total Nbr Volunteers10TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year7970656ContributionsGrantsPriorYear
Contributions Grants Current Year7871022ContributionsGrantsCurrentYear
Program Service Revenue Prior Year28784164ProgramServiceRevenuePriorYear
Program Service Revenue CY32597207ProgramServiceRevenueCY
Investment Income Prior Year102060InvestmentIncomePriorYear
Investment Income Current Year23688InvestmentIncomeCurrentYear
Other Revenue Prior Year2693OtherRevenuePriorYear
Other Revenue Current Year448165OtherRevenueCurrentYear
Total Revenue Prior Year36859573TotalRevenuePriorYear
Total Revenue Current Year40940082TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year24114683SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year36320730OtherExpensePriorYear
Other Expenses Current Year16242041OtherExpensesCurrentYear
Total Expenses Prior Year36320730TotalExpensesPriorYear
Total Expenses Current Year40356724TotalExpensesCurrentYear
Revenues Less Expenses Prior Year538843RevenuesLessExpensesPriorYear
Revenues Less Expenses CY583358RevenuesLessExpensesCY
Total Assets BOY17716375TotalAssetsBOY
Total Assets EOY18311306TotalAssetsEOY
Total Liabilities BOY7196376TotalLiabilitiesBOY
Total Liabilities EOY7207949TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY10519999NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY11103357NetAssetsOrFundBalancesEOY
Mission DescriptionThe organization provides primary medical and dental care to the population of San Joaquin, Solano and Yolo counties with 13 medical sites, 1 dental and 1 administrative location. Services are delivered to adults, children, elderly and include family medicine, ob/gyn, internal medicine, pediatrics, general dentistry, family planning, nutrition (WIC), health education, counseling, and HIV early intervention care and case management. Care is provided to all patients regardless of ability to pay . The organization provided 252,000 patient visits during the fiscal year.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense34609916Expense
Grants0Grants
Revenue40940082Revenue
DescriptionCMC provides primary medical and dental care to people of San Joaquin, Solano and Yolo County regardless of the patients ability to pay. Serves are delivered to audits, children, elderly & include family medicine, OB/GYN, internal medicine, pediatrics, general dentistry, family planning, nutrition (WIC), health eduction, counseling and HIV early intervention and case management.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense34609916TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109623NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees441NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
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 CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Community Medical Centers IncBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2093732838TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17210 Murray DriveAddressLine1
CityStocktonCity
StateCAState
ZIP Code95210ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Rene Verduzco
Board Member2X000
Fred Turchan
Board Member2X000
Martha Dukes RN PHN
Secreatry and Treaurers4X000
Roger I Speed
Vice President2X000
Beatrice Villa
Board Member2X000
Mark McElyea
Board Member2X000
Lily Aman
President2X000
Almus Aldridge
Board Member2X000
Pam Maffei
Board Member2X000
Rebeca Knodt
Board Member2X000
David B Jomaoas
Chief Executive Officer4018072400XXX
Thomas Mahoney MD
Chief Medical Officer4019438000XXX
Michael Kirkpatrick
Chief Executive Officer4023373200XXXX
Aziz Khambati
MD4017600100X
Cha C Thao
MD4017532000X
Marietta Sumaquial
MD4018335600X
Pak-Kei Hui
Pharmasist4017421600X
Benjamin Morrison MD
MD4018060900X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1498338TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K45NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Larry Tamplin MIS
2130 OrioleBakersfieldCA93309Programmer119332
San Joaquin General Hospital
1212 N California StStocktonCA95202OB GYN Providers1534134
Pre-sort Center
3806 Coronado Ave numbe AStocktonCA95204print patient statements174787
Jeffreys Cleaning Service
7210 Murray DriveStocktonCA95210Janitorial122450
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants7112984GovernmentGrants
All Other Contributions758038AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions7871022TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient & Capitation Revenue, (net)Description
Business Code621400BusinessCode
Total Revenue Column32597207TotalRevenueColumn
Related Or Exempt Function Income32597207RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue32597207TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column23688TotalRevenueColumn
Related Or Exempt Function Income23688RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionElectronic Helath records incentive program revenueDescription
Business Code621400BusinessCode
Total Revenue Column446250TotalRevenueColumn
Related Or Exempt Function Income446250RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1915TotalRevenueColumn
Related Or Exempt Function Income1915RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue448165TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column40940082TotalRevenueColumn
Related Or Exempt Function Income33069060RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total608836Total
Program Services194380ProgramServices
Management And General414456ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total19480068Total
Program Services17235593ProgramServices
Management And General2244475ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2518762Total
Program Services1998438ProgramServices
Management And General520324ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1507017Total
Program Services1289860ProgramServices
Management And General217157ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total366181Total
Program Services339792ProgramServices
Management And General26389ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total659546Total
Program Services659546ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1952044Total
Program Services1508355ProgramServices
Management And General443689ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total341441Total
Program Services293000ProgramServices
Management And General48441ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total137402Total
Program Services130002ProgramServices
Management And General7400ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total130300Total
Program Services125910ProgramServices
Management And General4390ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total639455Total
Program Services362191ProgramServices
Management And General277264ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total151525Total
Program Services100500ProgramServices
Management And General51025ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Profiessional Services355614931282834278660
Provision for bad debts2684073268407300
Supplies159796014077881901720
Minor Equipment & repairs1261611126161100

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2764354Total
Program Services1890594ProgramServices
Management And General873760ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total40356724Total
Program Services34609916ProgramServices
Management And General5746808ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY9855BOY
EOY10205EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6170528BOY
EOY6377313EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY695372BOY
EOY1729072EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2063721BOY
EOY1652765EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY29114BOY
EOY44005EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY779140BOY
EOY748056EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6897725LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1969077LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4743812BOY
EOY4928648EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3224833BOY
EOY2821242EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY17716375BOY
EOY18311306EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4487682BOY
EOY4824172EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY263694BOY
EOY98777EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY2445000BOY
EOY2285000EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7196376BOY
EOY7207949EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY10519999BOY
EOY11103357EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10519999BOY
EOY11103357EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY17716375BOY
EOY18311306EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses583358ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6352426CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6866731CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7844350CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7970656CurrentTaxYearMinus1Year
Current Tax Year7871022CurrentTaxYear
Total36905185Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6352426CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6866731CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7844350CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7970656CurrentTaxYearMinus1Year
Current Tax Year7871022CurrentTaxYear
Total36905185Total
FieldValueIRS element (for citing)
Public Support Total17036905185PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years84193CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years71046CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years47503CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year102060CurrentTaxYearMinus1Year
Current Tax Year23688CurrentTaxYear
Total328490Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years23839CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3267CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4823CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2693CurrentTaxYearMinus1Year
Current Tax Year448165CurrentTaxYear
Total482787Total
FieldValueIRS element (for citing)
Total Support37716462TotalSupport
Public Support Pertcentage1700.97849PublicSupportPertcentage170
Public Support Pertcent Prior Year0.98455PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationOther income relates primarily to the electronic health records incentive program relating to meaningful use.GeneralExplanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis242272OtherCostOrOtherBasis
Book Value242272BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis2529713OtherCostOrOtherBasis
Depreciation1159766Depreciation
Book Value1369947BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis1078945OtherCostOrOtherBasis
Depreciation156101Depreciation
Book Value922844BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis3046795OtherCostOrOtherBasis
Depreciation653210Depreciation
Book Value2393585BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4928648TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
Third-party settlements receivables799813
Assets limited as ot use1888400
Bond Issuance Costs133029
FieldValueIRS element (for citing)
Total Book Value Other Assets2821242TotalBookValueOtherAssets
Total Revenue40940082TotalRevenue
Total Expenses40356724TotalExpenses
Excess Or Deficit For Year583358ExcessOrDeficitForYear
Net Unrealized GL On Investments0NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$0OtherAmount
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS583358ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt40940082TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal40940082RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99040940082TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt40356724TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal40356724ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99040356724TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
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 (8 entries)

Base 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
David B Jomaoas
180724000155201006800019234401752290
Thomas Mahoney MD
19438000028101364700020830801878210
Michael Kirkpatrick
233731000381001350700025104802126920
Aziz Khambati
17600100045001191700018836802068760
Cha C Thao
175320000319010564000186203000
Marietta Sumaquial
183356000303301395800020034700
Pak-Kei Hui
1742160001420000017435801809680
Benjamin Morrison MD
18060900023301390300019474501743290

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSchJ_P01_S00_L04Identifier
Return ReferenceSchedule J, Part I, Line 4ReturnReference
ExplanationMichael Kirkpatrick - $60,000 was paid for the period January 1, 2012 through June 30, 2012.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1California Health Facilities Financing AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Date Issued2005-04-01DateIssued
Issue Price22545000IssuePrice
Description Of PurposeRedeem the 1994 Series B Bonds & finance capital improvmentsDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds0TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds0IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0PercentageOfPrvtBusinessReUBI
Total Private Business Use0TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonMark McElyeaNamePerson
FieldValueIRS element (for citing)
RelationshipBoard MemberRelationship
Amount Of Transaction33360AmountOfTransaction
Description Of TransactionSpace rental for WICDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bThe return was reviewed and approved by the CEO prior to filing. A copy is provide to the full board, however, due to the fact that the board meeting is not until the evening of the due date of the return, the return will be filed and if the board has any changes the return will be amended if necessary.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cThe organizations legal counsel has provided assistance to the board to ensure compliance with the conflict of interest and the organizations bylaws. When conflict of interest issues arise the board of directors with the director of their legal counsel address the issues accordingly. The board has been made aware of the conflict of interest requirements by their legal counsel.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15Industry compensation surveys for like organizations in similar geographic area are reviewed by the Board and the CEO to determine key employee compensation adjustments. The Board of Directors established the CEO's salary via a contract with the CEO and uses the same methodology to determine the compensation.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19Upon written request from Administration.

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationThe return is not late, IRS approved an extension until May 15, 2013.Explanation

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