2012-10-17T18:19:01-05:00 2011-12-31 ERNST & YOUNG US LLP 4370 LA JOLLA VILLAGE DR STE 500 SAN DIEGO CA 92122 990 2011-01-01 951683892 COMMUNITY MEMORIAL HEALTH SYSTEM % KATHRYN YAMADA COMM 8056525050 147 NORTH BRENT STREET VENTURA CA 93003 DAVID B GLYER 2012-10-11 8585357200 2011 2016-02-24 21:20:13Z GARY K WILDE 147 NORTH BRENT STREET VENTURA CA 93003 335499332 false X WWW.CMHSHEALTH.ORG X 1933 CA TO HEAL, COMFORT AND PROMOTE HEALTH FOR THE COMMUNITIES WE SERVE. 22 18 2229 447 472244 0 1984715 2849656 304408641 287191515 2662938 5602950 1327303 1729429 310383597 297373550 132190 610103 0 0 139338746 147497820 208867 0 0 144436159 129145734 284115962 277253657 26267635 20119893 275125337 670684547 42517070 422808652 232608267 247875895 X SEE SCHEDULE O. false false 244967643 610103 287191515 PATIENT SERVICES TO INCLUDE 77,092 PATIENT DAYS, 156,442 OUTPATIENT VISITS, AND 224,523 VISITS TO THE CENTERS FOR FAMILY HEALTH (THE HEALTH CARE SYSTEM'S OUTPATIENT CARE CLINICS). SEE SCHEDULE O 886360 COMMUNITY OUTREACH PROGRAMS TO INCLUDE: FREE BREAST CANCER SCREENING FOR WOMEN AGES 35 TO 50 MEETING LOW INCOME GUIDELINES; FREE CERVICAL CANCER SCREENING FOR WOMEN AGES 25 TO 60 MEETING LOW INCOME GUIDELINES; FREE BLOOD PRESSURE CHECKS; CANCER RESOURCE CENTER AND SUPPORT GROUPS; HEART-AWARE PROGRAM THAT PROVIDES FREE RISK EVALUATION, PREVENTATIVE INFORMATION AND RESOURCES; CARING NEWSLETTER, A SEMI-ANNUAL PUBLICATION ISSUED TO 70,000 LOCAL HOUSEHOLDS COVERING THE HEALTH SYSTEM'S SERVICES AND PROGRAMS. 245854003 true true false true false false false false false true false false true true true false true false false false false false false true false true true true false true true false false false false false false false false false true false false false false false true true true false false true 403 0 true 2229 true true true false false false false true true false false false false X 22 18 false false false false false false false true true false false true true true true true true true true true false CA X X KATHRYN YAMADA 8056525012 5855 OLIVAS PARK DRIVE VENTURA CA 93003 X Martin A Pops MD 1.0 X X 903 0 0 Gregory H Smith 1.0 X X 903 0 0 Jeffrey D Paul 1.0 X X 903 0 0 Trudy T Arriaga EdD 1.0 X X 0 0 0 Marc A Beaghler MD 1.0 X 720125 0 0 Ralph R Bennett 1.0 X 0 0 0 Michael D Bradbury 1.0 X 903 0 0 Mary Dial MD 1.0 X 9053 0 0 Philip C Drescher 1.0 X 903 0 0 Timothy J Gallagher 1.0 X 0 0 0 John J Hammer 1.0 X 903 0 0 William L Hart MD 1.0 X 903 0 0 John Hill MD 1.0 X 903 0 0 Fritz R Huntsinger 1.0 X 903 0 0 Harry L Maynard 1.0 X 903 0 0 Judy Miller 1.0 X 0 0 0 F Ted Muegenburg Jr 1.0 X 903 0 0 Richard R Rush PHD 1.0 X 0 0 0 John W Russell 1.0 X 903 0 0 Samuel D Small DO 1.0 X 14653 0 0 Gary L Wolfe 1.0 X 903 0 0 Kathryn Wooburn 1.0 X 903 0 0 Gary Wilde 40.0 X 653990 0 429693 David Glyer 40.0 X 366419 0 115132 Adam Thunell 40.0 X 356115 0 99114 Michael Lurie 40.0 X 260443 0 57560 Diany Klein 40.0 X 243777 0 74104 Haady Lashkari 40.0 X 233076 0 57031 Roberta McCaffrey 40.0 X 269161 0 71316 Cynthia DeMotte 40.0 X 215420 0 55336 Ronald Sandifer 40.0 X 375240 0 0 Emilie Rayman 40.0 X 424728 0 57022 Stanley Frochtzwajg MD 24.0 X 192474 0 5313 Richard Reisman MD 40.0 X 226546 0 11349 Michael Ellingson 40.0 X 228828 0 66547 Mary Schmitz 40.0 X 188763 0 14179 Gary Metelak 40.0 X 195297 0 14440 Abdi Ali 40.0 X 198216 0 8610 Carlos Limon Jr 40.0 X 189926 0 14225 Eugene Day 40.0 X 188627 0 14173 Mary Jo Garrett X 157823 0 1578 5921342 0 1166722 181 true true false Ventura County OB Gyn Inc 2795 Loma Vista Rd VENTURA CA 93003 MEDICAL SERVICES 2429032 Medical Center Associates Inc 308 Shamrock Dr VENTURA CA 93003 MEDICAL SERVICES 2330008 Arent Fox LLP 1050 Connecticut Ave NW WASHINGTON DC 20036 LEGAL SERVICES 1985999 Sound Inpatient Physicians Medical 1123 Pacific Ave TACOMA WA 98402 MEDICAL SERVICES 1836480 Steven K Jones MD 7721 Redondo St VENTURA CA 93004 MEDICAL SERVICES 1169947 84 355868 358761 107703 2027324 19117 2849656 NET PATIENT SERVICE REVENUE 621500 282599300 282159383 439917 HEALTHCARE SERVICES RENTAL INCOME 532000 1303491 1303491 CAFETERIA REVENUE 722210 1260141 1260141 BREAST/PROSTATE CENTER 900099 1170680 1170680 BILLING AND COLLECTION FEES 561000 326132 326132 531771 531771 287191515 2025618 2025618 0 0 94259 229123 -134864 -134864 -134864 41249669 37672337 3577332 3577332 3577332 300403 355868 224322 76081 76081 0 0 REBATES/REFUNDS 900099 1089432 1089432 MEDSTAFF REVENUE 900099 325627 325627 PHARMACY REVENUE 900099 319304 32327 286977 53849 53849 1788212 297373550 286751598 472244 7300052 610103 610103 0 0 0 5592987 958020 4634967 0 95455229 91698119 3757110 0 38077372 37443022 634350 8372232 7859072 513160 1663237 454000 1209237 1568585 3146 1565439 558977 558977 74685 74685 0 0 14770002 13822441 947561 419233 399559 19674 56953361 56159122 794239 5833303 5546563 286740 305944 60774 245170 5337813 5306434 31379 307740 178527 129213 0 391078 205679 185399 72345 72345 0 11166923 10793730 373193 4124024 185655 3938369 PURCHASED SERVICES 18339985 13145162 5194823 RECRUITING 1558583 148813 1409770 DUES & SUBSCRIPTIONS 888926 88109 800817 STATE SALES & USE TAX 628696 621353 7343 4182294 166600 4015694 277253657 245854003 31399654 0 0 0 9138305 10535469 0 0 48067831 54897540 0 0 0 0 6424959 16532548 5777742 5599580 4046073 7037435 281176407 133280762 124283604 147895645 47354576 53547835 7173280 7955394 7144275 7144275 0 0 15714692 359538826 275125337 670684547 32158124 42634453 0 0 0 0 0 349867229 0 0 0 0 2224310 1580077 0 0 8134636 28726893 42517070 422808652 X 231837326 246562206 770941 1313689 0 0 232608267 247875895 275125337 670684547 X 20119893 -4852265 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 74685 74685 false false LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1I THE ORGANIZATION IS A MEMBER OF THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AND THE AMERICAN HOSPITAL ASSOCIATION. IN 2011, $171,612 WAS INCLUDED IN EXPENSES FOR ANNUAL MEMBERSHIP DUES, A PORTION OF WHICH IS DIRECTED BY THESE ORGANIZATIONS TO DIRECT LOBBYING ACTIVITIES. 26207997 26207997 109774542 69493264 40281278 91558177 63787498 27770679 53635691 53635691 147895645 OTHER RECEIVABLES 21108779 OTHER ASSETS 1205919 DUE FROM THIRD PARTIES 4589158 DEPOSITS WITH INSURANCE CO. 8464447 ALTU 3613755 CONSTRUCTION FUNDS 320556768 359538826 0 SELF INSURANCE LIABILITIES 26741999 OTHER LIABILITIES 1984894 28726893 ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LINE 2 THE SYSTEM ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF ASC 740, INCOME TAXES, WHICH PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. UNDER ASC 740, THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS MAY BE RECOGNIZED ONLY IF IT IS MORE-LIKELY-THAN-NOT THE TAX POSITION WILL BE SUSTAINED, BASED SOLELY ON ITS TECHNICAL MERITS, WITH THE TAXING AUTHORITY HAVING FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. THE SYSTEM RECORDS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS FROM UNCERTAIN TAX POSITIONS AS DISCRETE TAX ADJUSTMENTS IN THE FIRST INTERIM PERIOD THAT THE MORE-LIKELY-THAN-NOT THRESHOLD IS NOT MET. THE SYSTEM RECOGNIZES DEFERRED TAX ASSETS AND LIABILITIES FOR TEMPORARY DIFFERENCES BETWEEN THE FINANCIAL REPORTING BASIS AND THE TAX BASIS OF ITS ASSETS AND LIABILITIES ALONG WITH NET OPERATING LOSS AND TAX CREDIT CARRYOVERS FOR TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION CRITERIA. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT DECEMBER 31, 2011 OR 2010. 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147 N BRENT STREET VENTURA CA 93003

X X X 2 OJAI VALLEY COMMUNITY HOSPITAL

1306 MARICOPA HWY OJAI CA 93023

X X X COMMUNITY MEMORIAL HOSPITAL 1 true true 200. true 700. true X X X X true true X true false true X false false OJAI VALLEY COMMUNITY HOSPITAL 2 true true 200. true 700. true X X X X true true X true false true X false false 14 Saviers Center for Family Health

2921S Saviers Road OXNARD CA 93033

OP Clinic Grossman Imaging Center of CMH LLC

2001 N Solar Dr Ste 135 OXNARD CA 93030

Imaging Center Camarillo Center for Family Health

422 B Arneill Road CAMARILLO CA 93010

OP Clinic Vineyard Center for Family Health

2361 Vineyard Ave OXNARD CA 93036

OP Clinic Santa Paula Center for Family Health

242 E Harvard Blvd SANTA PAULA CA 93060

OP Clinic Ashwood Center for Family Health

116 Ashwood VENTURA CA 93003

OP Clinic Main Street Center for Family Health

138 W Main Street VENTURA CA 93001

OP Clinic San Buenaventura Urology Center

2705 Loma Vista Rd Ste 206 VENTURA CA 93003

OP Clinic Fillmore Center for Family Health

852 Ventura Street FILLMORE CA 93015

OP Clinic Airport Marina Center for Family Health

3641 W Fifth Street OXNARD CA 93035

OP Clinic Surfside Pediatrics

2660 E Main St Suite 204 VENTURA CA 93003

OP Clinic Oak View Center for Family Health

655 N Ventura Ave OAK VIEW CA 93022

OP Clinic Keeler Center for the Study of Magraines

1202-A Maricopa Highway OJAI CA 93023

OP Clinic Ojai Center for Family Health

655 N Ventura Ave OAK VIEW CA 93022

OP Clinic PART I, LINE 7G NO AMOUNT ATTRIBUTABLE TO A PHYSICIAN CLINIC AS SUBSIDIZED HEALTH SERVICES ARE ON PART I, LINE 7G. PART I, LINE 7 COSTING METHOD USED IS COST-TO-CHARGE RATIO USING WORKSHEET 2. PART I, LINE 7B UNREIMBURSED MEDICAID THE CALIFORNIA HOSPITAL FEE PROGRAM (THE PROGRAM) WAS SIGNED INTO LAW BY THE GOVERNOR OF CALIFORNIA AND BECAME EFFECTIVE ON JANUARY 1, 2010. AMENDING LEGISLATION, TO CONFORM TO CHANGES REQUESTED BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) DURING THE APPROVAL PROCESS, WAS SIGNED INTO LAW BY THE GOVERNOR OF CALIFORNIA AND BECAME EFFECTIVE SEPTEMBER 8, 2010. THE PRIMARY LEGISLATION (AB 1383) AND AMENDING LEGISLATION (AB 1653) CONTAIN TWO COMPONENTS. THE QUALITY ASSURANCE FEE ACT GOVERNS THE "HOSPITAL FEE" OR "QUALITY ASSURANCE FEE" (QA FEE) PAID BY PARTICIPATING HOSPITALS. THE MEDI-CAL HOSPITAL PROVIDER STABILIZATION ACT GOVERNS SUPPLEMENTAL MEDI-CAL PAYMENTS (SUPPLEMENTAL PAYMENTS) MADE TO PROVIDERS FROM THE FUND. HOSPITAL PARTICIPATION IS MANDATORY WITH LIMITED EXCEPTIONS. THE CALIFORNIA HEALTH FOUNDATION AND TRUST ESTABLISHED A GRANT FUND TO SUPPORT CHARITABLE ACTIVITIES OF VARIOUS HOSPITAL AND HEALTH SYSTEMS IN CALIFORNIA, INCLUDING MEASURES TO ALLEVIATE LOSSES POTENTIALLY RESULTING FROM THE ADMINISTRATION OF THE PROGRAM. AB 1653, THE PROGRAM THAT COVERED THE PERIOD OF APRIL 1, 2009 THROUGH DECEMBER 31, 2010, WAS APPROVED BY CMS IN DECEMBER 2010. THE AMENDED LEGISLATION ALLOWED THE CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES (DHCS) TO BEGIN ASSESSING FEES AND MAKE SUPPLEMENTAL PAYMENTS TO HOSPITALS. IN APRIL 2011, SB 90 WAS SIGNED INTO LAW, WHICH CREATED THE PROVIDER FEE PROGRAM FOR THE PERIOD JANUARY 1, 2011 THROUGH JUNE 30, 2011. THE PROGRAM WAS APPROVED BY CMS IN DECEMBER 2011. THE SYSTEM MADE PAYMENTS TO THE DHCS FOR THE QA FEE IN THE AMOUNT OF $3,642,448 AND $10,787,170 IN 2011 AND 2010, RESPECTIVELY. THE SYSTEM MADE CALIFORNIA HEALTH FOUNDATION AND TRUST PLEDGE PAYMENTS IN THE AMOUNT OF $389,059 AND $861,144 IN 2011 AND 2010, RESPECTIVELY, AND THE PLEDGE PAYMENTS WERE RECORDED WITHIN QA FEE IN OPERATING EXPENSES WITHIN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. THE SYSTEM RECEIVED SUPPLEMENTAL PAYMENTS OF $12,528,691 AND $25,413,960 OVER THE COURSE OF THE PROGRAM IN 2011 AND 2010, RESPECTIVELY, WHICH PERTAINED TO THE SIX-MONTH PROGRAM FROM JANUARY 1, 2011 THROUGH JUNE 30, 2011 AND THE INITIAL PROGRAM FROM APRIL 1, 2009 TO DECEMBER 31, 2010, RESPECTIVELY. THE SYSTEM RECORDED THE SUPPLEMENTAL PAYMENTS AS OPERATING REVENUE WITHIN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. PART III, LINE 4 THE SYSTEM USED WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES, TO DETERMINE THE COST OF ITS BAD DEBT EXPENSE. BAD DEBT FOOTNOTE FROM AUDITED FINANCIAL STATEMENTS: IN JULY 2011, THE FASB ISSUED ASU NO. 2011-07, PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES. THE PROVISIONS OF ASU 2011-07 REQUIRE CERTAIN HEALTH CARE ENTITIES TO PRESENT THE PROVISION FOR BAD DEBTS RELATED TO PATIENT SERVICE REVENUE AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE STATEMENT OF OPERATIONS RATHER THAN AS AN OPERATING EXPENSE. THIS NEW GUIDANCE IS EFFECTIVE FOR FISCAL YEARS AND INTERIM PERIODS WITHIN THOSE FISCAL YEARS BEGINNING AFTER DECEMBER 15, 2011, WITH EARLY ADOPTION PERMITTED. THE SYSTEM EARLY ADOPTED THE PROVISIONS OF ASU 2011-07 AS OF JANUARY 1, 2011, AND RETROSPECTIVELY APPLIED THE PRESENTATION REQUIREMENTS TO ALL PERIODS PRESENTED. THE CHANGE IN PRESENTATION AND ADDITIONAL DISCLOSURES, AS REQUIRED BY ASU 2011-07, ARE REFLECTED IN THE SYSTEM'S CONSOLIDATED STATEMENTS OF OPERATIONS AND NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM MANAGES PATIENT ACCOUNT RECEIVABLES BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES FOR CONTRACTUAL DISCOUNTS AND UNCOLLECTIBLE AMOUNTS. THESE ALLOWANCES ARE BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS FOR EACH MAJOR PAYOR SOURCE, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE SYSTEM'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD SERVICES ARE PROVIDED RELATED TO SELF-PAY PATIENTS, INCLUDING BOTH UNINSURED PATIENTS AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THEIR BALANCE. SIGNIFICANT CHANGES IN PAYER MIX, BUSINESS OFFICE OPERATIONS, GENERAL ECONOMIC CONDITIONS, AND HEALTH CARE COVERAGE PROVIDED BY FEDERAL OR STATE GOVERNMENTS OR PRIVATE INSURERS MAY HAVE A SIGNIFICANT IMPACT ON THE SYSTEM'S ESTIMATES AND SIGNIFICANTLY AFFECT THE SYSTEM'S LIQUIDITY, RESULTS OF OPERATIONS, AND CASH FLOWS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE SYSTEM'S POLICIES. THE SYSTEM DISCOUNTS UNINSURED SELF-PAY PATIENT CHARGES BY 40% AND CLASSIFIES ACCOUNTS PENDING MEDI-CAL APPROVAL AS SELF-PAY ACCOUNTS IN ITS ACCOUNTS RECEIVABLE AGING REPORT AND APPLIES THE STANDARD UNINSURED DISCOUNT. THE NET ACCOUNT BALANCE IS FURTHER SUBJECT TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS RESERVE POLICY. SHOULD THE ACCOUNT QUALIFY FOR MEDI-CAL COVERAGE, THE PREVIOUSLY RECORDED UNINSURED DISCOUNT IS REVERSED AND RECLASSIFIED TO MEDI-CAL ACCOUNTS RECEIVABLE WITH THE APPROPRIATE CONTRACTUAL DISCOUNT RATE APPLIED. SHOULD THE ACCOUNT NOT QUALIFY FOR MEDI-CAL COVERAGE BUT QUALIFY AS CHARITY CARE UNDER THE SYSTEM'S CHARITY CARE POLICY, THE PREVIOUSLY RECORDED UNINSURED DISCOUNT IS REVERSED AND THE ENTIRE ACCOUNT BALANCE IS RECORDED AS A CHARITY CARE DEDUCTION. THE SYSTEM'S COMBINED ALLOWANCE FOR DOUBTFUL ACCOUNTS, UNINSURED DISCOUNTS, AND CHARITY CARE COVERED APPROXIMATELY 97% AND 99% OF THE SYSTEM'S COMBINED UNINSURED AND SELF-PAY ACCOUNTS RECEIVABLE AS OF DECEMBER 31, 2011 AND DECEMBER 31, 2010, RESPECTIVELY. THE SYSTEM'S ALLOWANCE FOR BAD DEBT WAS $37,075,931 AND $50,274,873 AT DECEMBER 31, 2011 AND 2010, RESPECTIVELY. DURING 2011, $14,252,400 OF PRIOR-YEAR PATIENT ACCOUNT BALANCES, PREVIOUSLY RESERVED AS BAD DEBT, WERE DETERMINED TO QUALIFY FOR CHARITY CARE AND WRITTEN OFF. THE SYSTEM'S PROVISION FOR PATIENT BAD DEBTS DECREASED TO $7,090,084 FROM $14,215,683 FOR THE YEARS ENDED DECEMBER 31, 2011 AND DECEMBER 31, 2010, RESPECTIVELY, DUE TO THE SYSTEM'S RECLASSIFICATION OF PATIENT ACCOUNTS RECEIVABLE WRITE-DOWNS FROM BAD DEBT TO CHARITY CARE. PART III, LINE 8 THE ENTIRE SHORTFALL OF MEDICARE EXPENSES OVER MEDICARE REIMBURSEMENTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT EXPENSE. THE MEDICARE COST REPORT WAS USED TO DETERMINE THE COSTS ATTRIBUTABLE TO SERVICE MEDICARE PATIENTS. THE SYSTEM IS REIMBURSED FOR SERVICES PROVIDED TO PATIENTS UNDER CERTAIN PROGRAMS ADMINISTERED BY GOVERNMENTAL AGENCIES, WHICH INCLUDES THE MEDICARE PROGRAM. THE MEDICARE PROGRAM CONSISTS OF 41.1% OF THE SYSTEMS NET REVENUE FOR 2011. HOSPITALS DO NOT DETERMINE THE LEVEL OF PAYMENT FROM THE MEDICARE PROGRAM, AND THE MEDICARE PROGRAM DOES NOT COVER THE COSTS OF TREATING THE SYSTEM'S MEDICARE PATIENTS, ALTHOUGH THE QUALITY OF CARE AND ACCESS TO CARE IS THE SAME FOR ALL PATIENTS, REGARDLESS OF PAYER SOURCE. UNREIMBURSED COST UNDER THE MEDICARE PROGRAM IS A TRUE LOSS TO THE SYSTEM AND THE LOSS IS REFLECTED IN THE SYSTEMS FINANCIAL STATEMENTS. AS SUCH, MEDICARE LOSSES SHOULD BE CONSIDERED A COMMUNITY BENEFIT PROVIDED BY THE SYSTEM. PART III, LINE 9B THE PATIENT'S ABILITY TO PAY IS EVALUATED UPON ADMISSION. A PATIENT FINANCIAL SERVICES STAFF ASSISTS PATIENTS WITH APPLYING FOR LOCAL, STATE AND FEDERAL PROGRAMS WHEN THERE IS NO OTHER SOURCE OF PAYMENT. IN THE EVENT THAT NO THIRD PARTY PAYMENT SOURCE IS AVAILABLE, PATIENTS ARE PROVIDED WITH INFORMATION ON THE SYSTEM'S FINANCIAL ASSISTANCE PROGRAM. FINANCIAL ASSISTANCE AND CHARITY CARE IS BASED ON A SLIDING SCALE FEE SCHEDULE UTILIZING THE CURRENT UNITED STATES FEDERAL POVERTY GUIDELINES. INFORMATION FROM THE APPLICANT'S FINANCIAL APPLICATION AND SUPPORTING DOCUMENTATION IS USED TO DETERMINE THE AMOUNT OF THE QUALIFIED FINANCIAL ASSISTANCE TO BE GRANTED. THE SYSTEM HAS A WRITTEN COLLECTION POLICY TO PROVIDE FOR AN EQUITABLE PROCESS BY WHICH A PATIENT AND/OR RESPONSIBLE PARTY CAN MAKE A PAYMENT OR PAYMENT ARRANGEMENT PRIOR TO OR AT THE TIME OF SERVICE. THE SYSTEM WILL PROACTIVELY DETERMINE THE PATIENT'S ABILITY TO PAY. A DEPOSIT, BASED UPON SELF-PAY LIABILITY IS COLLECTED PRIOR TO ADMISSION OR AT THE TIME OF SERVICE. FOR PATIENTS WHO ARE UNABLE TO PAY THEIR ESTIMATED LIABILITY AT THE TIME OF SERVICE, THE SYSTEM WILL OFFER A FINANCING OPTION. PATIENTS WHO MEET CHARITY OR INDIGENT GUIDELINES WILL BE REFERRED TO A FINANCIAL ADVOCATE FOR FINANCIAL AID. MANAGEMENT COMPANIES AND JOINT VENTURES PART IV, LINE 1 GROSSMAN IMAGING CENTER OF CMH, LLC BUENAVISTA MEDICAL PROPERTIES, LTD VENTURA CARDIOVASCULAR CO-MANAGEMENT COMPANY, LLC PART V, SECTION B, LINE 13G CMHS PUBLICIZES THE FINANCIAL ASSISTANCE POLICY ON THE FACILITY'S WEBSITE. INCLUDED ON THE BACK OF EACH BILLING STATEMENT IS A DISCLAIMER REGARDING FINANCIAL ASSISTANCE BEING AVAILABLE AND A CONTACT NUMBER TO CALL IF INTERESTED. MOREOVER, CMHS HAS SIGNAGE POSTED IN THE ADMITTING AND EMERGENCY ROOM AREAS. A WRITTEN COPY OF THIS POLICY IS AVAILABLE UPON REQUEST, AS INDICATED ON THIS SIGNAGE DISPLAYED. NEEDS ASSESSMENT PART VI, LINE 2 THE SYSTEM UPDATED ITS COMMUNITY NEEDS ASSESSMENT IN 2009 IN COLLABORATION WITH A GROUP OF LOCAL AREA HEALTHCARE PROVIDERS. THE GROUP UTILIZED THE SERVICES OF A NATIONAL PUBLIC OPINION RESEARCH AND STRATEGY FIRM TO CONDUCT THE SURVEY. THE AREA-WIDE STUDY AND HEALTHCARE SURVEY CONSISTED OF AN ANALYSIS OF THE SOCIO-ECONOMIC PROFILE OF VENTURA COUNTY, THE HEALTH CARE STATUS AND NEEDS OF VENTURA COUNTY, AND THE STATUS OF HEALTHCARE DELIVERY AND SERVICES. ASIDE FROM ASSESSING THE HEALTHCARE NEEDS OF VENTURA COUNTY, THE SURVEY MEASURED THE PROGRESS TOWARDS MEETING THOSE NEEDS AS IDENTIFIED BY THE 1995, 1997, 2000, 2003 AND 2006 COMMUNITY NEEDS ASSESSMENT SURVEYS. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 FINANCIAL ASSISTANCE PROGRAM BROCHURES EXPLAINING THE SYSTEM'S POLICY IS POSTED AND MADE AVAILABLE TO PATIENTS AT THE TIME OF ADMITTANCE. SIGNS ALERTING PATIENTS TO THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE PROMINENTLY DISPLAYED. AN INSERT REGARDING FINANCIAL ASSISTANCE ACCOMPANIES EACH INVOICE OF HOSPITAL SERVICES SENT TO EACH PATIENT. COMMUNITY INFORMATION PART VI, LINE 4 THE HEALTH SYSTEM'S TWO HOSPITALS ARE LOCATED IN THE CITY OF VENTURA AND THE CITY OF OJAI. THE HEALTH SYSTEM PROVIDES SERVICES THROUGH ITS HOSPITALS AND CENTERS FOR FAMILY HEALTH TO ALL OF WESTERN VENTURA COUNTY WHICH INCLUDES THE CITIES AND UNINCORPORATED AREAS SURROUNDING VENTURA, OJAI, SANTA PAULA, FILLMORE, OXNARD, PORT HUENEME AND CAMARILLO. THE POPULATION OF WESTERN VENTURA COUNTY IS APPROXIMATELY 500,000 WITH 50.6% OF THE POPULATION CONSISTING OF HISPANICS, 38.8% WHITES AND 10.6% OTHER. THE MEDIAN HOUSEHOLD INCOME FOR WESTERN VENTURA COUNTY IS $63,683. DEMOGRAPHIC VARIABLES SUCH AS RACE AND ETHNICITY ARE MEANINGFUL WHEN PLANNING FOR BOTH INPATIENT AND OUTPATIENT CARE IN ORDER TO ENSURE THAT PATIENT CARE SERVICES ARE SENSITIVE TO THE PROGRAM PLANNING NEEDS OF THE SERVICE AREA POPULATION. IT HAS LONG BEEN ESTABLISHED THAT THERE ARE SIGNIFICANT VARIANCES IN PHYSICAL AND BEHAVIORAL HEALTH PROBLEMS BETWEEN GROUPS BASED ON ETHNICITY, INCOME AND RESIDENCE. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 CMHS IS GOVERNED BY A BOARD OF DIRECTORS WHOSE MEMBERS ARE REPRESENTATIVE OF THE COMMUNITY, HOSPITAL AND MEDICAL STAFF LEADERSHIP. CONSISTENT WITH THE IRS "COMMUNITY BENEFIT STANDARD" A MAJORITY OF THE BOARD OF DIRECTORS ARE NEITHER EMPLOYEES, CONTRACTORS NOR FAMILY MEMBERS OF THE ORGANIZATION. CMHS HAS AN OPEN MEDICAL STAFF, EXTENDING STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS FOR ALL AREAS AND DEPARTMENTS OF ITS FACILITY. THE EMERGENCY DEPARTMENT AT BOTH COMMUNITY MEMORIAL HOSPITAL AND THE OJAI COMMUNITY HOSPITAL TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HEALTH SYSTEM PROVIDES EMERGENCY SERVICES TO ALL PATIENTS, WITH OR WITHOUT INSURANCE, AND CONTRACTS WITH PHYSICIANS TO PROVIDE SPECIALTY EMERGENCY COVERAGE. THIS TEAM INCLUDES BOARD-CERTIFIED EMERGENCY PHYSICIANS, PHYSICIAN ASSISTANTS; BOARD CERTIFIED NURSES, EMERGENCY MEDICAL TECHNICIANS, RESPIRATORY THERAPISTS AND OTHER HIGHLY TRAINED EMERGENCY CARE PROFESSIONALS. ALL ARE DEDICATED TO PROVIDING TECHNOLOGICALLY ADVANCED AND LIFESAVING MEDICAL SERVICES. THROUGH ITS HEALTHY WOMEN'S PROGRAM, CMHS PROVIDES FOR FREE BREAST AND CERVICAL CANCER SCREENING FOR UNINSURED AND UNDER-INSURED PATIENTS WHO LACK THE RESOURCES TO PAY FOR THESE SERVICES. THROUGH THIS PROGRAM, CMHS IS ABLE TO OFFER BREAST CANCER SCREENING AND TREATMENT, AND CERVICAL CANCER SCREENING AND VACCINATIONS TO WOMEN IN THE COMMUNITY WHO LACK ACCESS TO THESE EARLY DETECTION AND LIFE SAVING EXAMS. THE SYSTEM OFFERS FREE EDUCATIONAL SEMINARS TO THE PUBLIC COVERING A WIDE VARIETY OF HEALTH RELATED TOPICS SUCH AS DIABETES, CANCER, AND VASCULAR HEALTH. THE SYSTEM ALSO OFFERS A LARGE VARIETY OF CLASSES AND SUPPORT GROUPS THROUGH ITS CANCER RESOURCE CENTER, MATERNAL CHILD HEALTH, AND HEART AND VASCULAR HEALTH DEPARTMENTS. STATES WITH A COMMUNITY BENEFIT REPORT PART VI, LINE 7 CA false AMERICAN CANCER SOCIETY 2816 KNOLL DRIVE SUITE A VENTURA CA 93003 941170350 501(C)(3) 10500 GENERAL SUPPORT VENTURA EDUCATION PARTNERSHIP 255 W STANLEY AVE VENTURA CA 93001 770141325 501(C)(3) 7500 General Support VENTURA CHAMBER OF COMMERCE 505 POLI ST 2ND FLOOR VENTURA CA 93001 951332204 501(C)(6) 7565 General Support ROTARY CLUB OF OJAI PO BOX 1501 OJAI CA 93024 200606432 501(C)(3) 10000 General Support ALZHEIMERS ASSOCIATION 225 N MICHIGAN AVE STE 1700 CHICAGO IL 60601 363463656 501(C)(3) 181949 GENERAL SUPPORT CALIFORNIA HEALTH FOUNDATION & TRUST 1215 K STREET STE 800 SACRAMENTO CA 95814 941498697 501(C)(3) 389059 CA HOSPITAL FEE PROGRAM 5 1 X true true X X X X X true true false false false false false false false Marc A Beaghler MD 720125 0 0 0 0 0 0 0 0 0 720125 0 0 0 Gary Wilde 553645 0 65000 0 35345 0 423338 0 6355 0 1083683 0 0 0 David Glyer 297797 0 50000 0 18622 0 109933 0 5199 0 481551 0 0 0 Adam Thunell 301445 0 50000 0 4670 0 93759 0 5355 0 455229 0 0 0 Mary Jo Garrett 0 0 0 0 157823 0 1578 0 0 0 159401 0 0 0 Michael Lurie 162921 0 40000 0 57522 0 55361 0 2199 0 318003 0 49079 0 Diany Klein 198558 0 25000 0 20219 0 67547 0 6557 0 317881 0 0 0 Haady Lashkari 184232 0 35000 0 13844 0 54263 0 2768 0 290107 0 0 0 Roberta McCaffrey 231844 0 35000 0 2317 0 69117 0 2199 0 340477 0 0 0 Cynthia DeMotte 178092 0 35000 0 2328 0 54313 0 1023 0 270756 0 0 0 Ronald Sandifer 375240 0 0 0 0 0 0 0 0 0 375240 0 0 0 Emilie Rayman 192516 0 25000 0 207212 0 54823 0 2199 0 481750 0 204887 0 Stanley Frochtzwajg MD 191645 0 0 0 829 0 1958 0 3355 0 197787 0 0 0 Richard Reisman MD 225801 0 0 0 745 0 9150 0 2199 0 237895 0 0 0 Mary Schmitz 188763 0 0 0 0 0 7551 0 6628 0 202942 0 0 0 Gary Metelak 195297 0 0 0 0 0 7812 0 6628 0 209737 0 0 0 Abdi Ali 198216 0 0 0 0 0 1982 0 6628 0 206826 0 0 0 Carlos Limon Jr 189926 0 0 0 0 0 7597 0 6628 0 204151 0 0 0 Eugene Day 188627 0 0 0 0 0 7545 0 6628 0 202800 0 0 0 Michael Ellingson 192516 0 25000 0 11312 0 64348 0 2199 0 295375 0 0 0 SUPPLEMENTAL COMPENSATION INFORMATION PART I, LINE 1A CERTAIN EXECUTIVES ON FORM 99O, PART VII AND SCHEDULE J, PART II RECEIVE AN AUTOMOBILE ALLOWANCE. THE ALLOWANCE IS INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR W-2. SUPPLEMENTAL COMPENSATION INFORMATION PART I, LINE 4A THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING TAX YEAR 2011: MARY JO GARRETT - $157,823 SUPPLEMENTAL COMPENSATION INFORMATION PART I, LINE 4B EFFECTIVE JULY 1, 2001, A NONQUALIFIED DEFERRED COMPENSATION PLAN CALLED THE KEYSOP WAS ESTABLISHED. THE KEYSOP ALLOWED PARTICIPANTS TO DEFER A PORTION OF THEIR COMPENSATION WITH OPTIONS TO PURCHASE SHARES OF SELECTED MUTUAL FUNDS. THE KEYSOP PLAN BECAME INACTIVE AS OF APRIL 1, 2002 WHEN THE 2002 SERP BECAME EFFECTIVE. EFFECTIVE JANUARY 1, 1990, A SERP WAS ESTABLISHED (THE 1990 SERP) TO COVER SENIOR STAFF MEMBERS. THE 1990 SERP WAS FROZEN EFFECTIVE DECEMBER 1, 1999. ON APRIL 1, 2002, A SECOND SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (THE 2002 SERP) BECAME EFFECTIVE. THE 2002 SERP HAS A MONTHLY BENEFIT AT NORMAL RETIREMENT AGE (AGE 65) EQUAL TO THE AVERAGE MONTHLY COMPENSATION FOR THE 3-YEAR PERIOD DURING WHICH COMPENSATION WAS HIGHEST, AT VARIOUS RATES DEFINED BY THE PLAN. PARTICIPANTS VEST AFTER 10 YEARS OR AT THE ATTAINMENT OF AGE 65. THE FOLLOWING INDIVIDUALS RECEIVED A SERP PAYMENT DURING 2011: EMILIE RAYMAN - $204,887 MICHAEL LURIE - $ 49,079 CITY OF SAN BUENAVENTURA 956000807 797049AJ2 2011-08-17 349865548 REPLACEMENT FACILITY false false false 0 0 349865548 31119500 9685594 0 0 0 0 23638329 0 285422125 2015 false false false true false false false false 0.00000 0.00000 0.00000 true false false false 0 false 0 false false RABOBANK JEFFREY PAUL, REG. PRES 182541 BANK, INV FEES, AND INTEREST false JAMES WOODBURN SPOUSE OF BOARD MEMBER 10580 COMPENSATION false BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 TO ESTABLISH, EQUIP AND MAINTAIN ONE OR MORE NONPROFIT HOSPITALS, MEDICAL CENTERS, INSTITUTIONS, CLINICS OR OTHER PLACES FOR THE RECEPTION AND CARE OF THE SICK, INJURED AND DISABLED, WITH PERMANENT FACILITIES THAT INCLUDE INPATIENT BED AND MEDICAL SERVICES; TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTS; AND TO PROVIDE ASSOCIATED SERVICES, OUTPATIENT CARE AND HOME CARE IN FURTHERANCE OF THIS CORPORATION'S CHARITABLE PURPOSES; TO PROMOTE AND CARRY ON EDUCATION ACTIVITIES RELATED TO THE CARE OF SICK, INJURED AND DISABLED, TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY OUT SCIENTIFIC AND MEDICAL RESEARCH RELATED TO THE CARE OF THE SICK, INJURED AND DISABLED; AND TO PROMOTE OR CARRY OUT SUCH OTHER ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A COMMUNITY BENEFIT PLAN IT IS THE GOAL OF CMHS TO PROMOTE THE HEALTH OF THE COMMUNITY BY FOCUSING ON THE FOLLOWING FOUR AREAS: COMMUNITY EDUCATION OUTREACH 1. DISTRIBUTE TO THE COMMUNITY, ON A REGULAR BASIS, A NEWSLETTER (CALLED "CARING") WITH HEAVY EMPHASIS ON HEALTH EDUCATIONAL CONTENT. 2. CONTINUE TO SPONSOR AND PARTICIPATE IN COMMUNITY HEALTH FAIRS AND PUBLIC EXPOS AND OTHER MECHANISMS TO PROMOTE HEALTH SERVICES, HEALTH EDUCATION, AND PREVENTION THROUGHOUT THE COMMUNITY. 3. PROVIDE INDIVIDUALS AND EMPLOYEES OF LOCAL BUSINESSES WITH THE HEARTAWARE HEART DISEASE DETECTION AND SCREENING PROGRAM. 4. CONTINUE TO PARTICIPATE IN THE STATE CPSP PROGRAM TO PROVIDE EDUCATIONAL RESOURCES TO LOW INCOME CHILDREN AND PREGNANT WOMEN. 5. PROVIDE COMMUNITY FORUMS IN VENTURA AND OJAI HIGHLIGHTING THE STATUS OF OUR HEALTH SYSTEM (THE HOSPITALS AND THE CENTERS FOR FAMILY HEALTH), NEW SERVICES AVAILABLE TO BENEFIT RESIDENTS OF THE COMMUNITY, AND COMMUNITY BENEFITS PROVIDED BY THE HEALTH SYSTEM. 6. DISTRIBUTE A HEALTH INFORMATION CARD TO INDIVIDUALS IN THE COMMUNITY TO ASSIST THEM IN KEEPING TRACK OF PERSONAL HEALTH INFORMATION THAT MAY BE VITAL WHEN ACCESSING THE HOSPITAL, AND, IN PARTICULAR, THE EMERGENCY DEPARTMENT. 7. ADD NEW DISEASE DETECTION AND SCREENING SERVICES FOCUSING ON DIFFERENT DISEASE CONDITIONS OF IMPORTANCE (MAJOR CHRONIC DISEASES). 8. CONTINUE TO PROVIDE AT LEAST 3,000 BLOOD PRESSURE CHECKS PER MONTH AT THE KIOSK IN THE PACIFIC VIEW MALL IN VENTURA. ACCESS TO CARE INCREASE ACCESS OF THE UNDERSERVED AND VULNERABLE POPULATION TO PRIMARY AND SECONDARY MEDICAL CARE IN VARIOUS GEOGRAPHIC LOCATIONS THROUGH THE CMHS SERVICE AREA. 1. CONTINUE TO OFFER A FREE PHYSICIAN REFERRAL SERVICE FOR MEMBERS OF THE PUBLIC PROVIDING AT LEAST 1,000 REFERRALS PER YEAR TO LOCAL PHYSICIANS AND OTHER HEALTH SERVICES. 2. CONTINUE EXPANSION OF EXISTING CENTERS FOR FAMILY HEALTH CLINICS AS WARRANTED BY THE GROWTH OF PATIENT VISITS. 3. CONTINUE TO PROVIDE ACCESS THROUGH THE CENTERS FOR FAMILY HEALTH CLINICS TO SIGNIFICANT NUMBERS OF MEDI-CAL AND UNINSURED INDIVIDUALS THROUGHOUT WESTERN VENTURA COUNTY. 4. CONTINUE TO PROVIDE GENERAL MEDICAL, SURGICAL, AND SPECIALTY PROFESSIONAL COVERAGE OF ER PATIENTS THROUGH THE "ER FUND". PROVIDE STIPENDS TO PHYSICIANS, AS NECESSARY, TO INSURE COVERAGE, ESPECIALLY FOR MEDICAL AND UNINSURED PATIENTS, BY ALL MEDICAL SPECIALTIES. 5. CONTINUE TO PROVIDE FREE PROSTATE CENTER SCREENINGS REGARDLESS OF ABILITY TO PAY. 6. PROVIDE FREE BREAST CANCER SCREENING AND TREATMENT TO WOMEN THROUGHOUT THE SERVICE AREA REGARDLESS OF ABILITY TO PAY. 7. THROUGH THE CENTERS FOR FAMILY HEALTH, CONTINUE TO PROVIDE AN EXTENSIVE CHILDHOOD IMMUNIZATION PROGRAM. UNCOMPENSATED AND UNDER FUNDED CARE; 1. CONTINUE TO PROVIDE ACCESS TO A SIGNIFICANT NUMBER OF MEDI-CAL BENEFICIARIES ACROSS A BROAD RANGE OF MEDICAL SERVICES (MEASURED AS A PERCENTAGE OF GROSS REVENUE AND TOTALING AT LEAST 8%). 2. CONTINUE TO PROVIDE A SIGNIFICANT LEVEL OF SUBSIDIZED CARE THROUGH THE CENTERS FOR FAMILY HEALTH. SPONSORSHIP OF COMMUNITY RESOURCES 1. CONTINUE TO SUPPORT THE INTERIM PERMIT NURSING PROGRAM, WITH THE OBJECTIVE OF TRAINING AT LEAST TWENTY (20) RECENTLY GRADUATED NURSES TO BECOME COMPETENT CLINICAL NURSES. 2. CONTINUE TO ASSIST THE VENTURA COUNTY DISTRICT ATTORNEY'S OFFICE IN SUPPORTING VICTIMS OF DOMESTIC ABUSE THROUGH THE "PROJECT SAFE HARBOR" PROGRAM. 3. PROVIDE A ROTATION FOR TRAINING OB/GYN THIRD-YEAR RESIDENTS FROM THE UCLA PROGRAM. 4. CONTINUE TO PROVIDE CHILDREN'S TOURS OF THE HOSPITALS. 5. CONTINUE TO PROVIDE DATA TO A NATIONAL TUMOR REGISTRY THAT SUPPORTS A KNOWLEDGE BASE THAT ENHANCES THE CARE OF CANCER PATIENTS IN OUR COMMUNITY. 6. CONTINUE TO PROVIDE A CANCER CENTER THAT INCLUDES SUPPORT GROUPS TO HELP PATIENTS AND THEIR FAMILIES DEAL WITH THEIR CONDITION AT NO COST. DESCRIBE THE PROCESS USED TO REVIEW 990 FORM 990, PART VI, QUESTION 11B FORM 990 WAS PREPARED BY ERNST & YOUNG AND COMMUNITY MEMORIAL HOSPITAL SYSTEM (CMHS) FINANCE WITH INPUT FROM THE SYSTEM'S PLANNING AND MANAGED CARE OFFICE. FORM 990 WAS REVIEWED BY THE CEO, CFO, CORPORATE COMPLIANCE OFFICER AND AUDIT COMMITTEE. IN ADDITION, A FULL COPY OF THE 990 WAS PROVIDED TO THE BOARD OF TRUSTEES VIA EMAIL IN ADVANCE OF FILING THE FORM 990 WITH THE IRS. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C CONFLICT OF INTEREST STATEMENTS ARE COMPLETED BY AND COLLECTED FROM DIRECTORS, OFFICERS AND KEY EMPLOYEES ON AN ANNUAL BASIS. SUCH STATEMENTS ENSURE FULL DISCLOSURE OF FINANCIAL INTERESTS AND TRANSACTIONS WHERE CONFLICT OF INTEREST IS A POSSIBILITY, AND SHALL ENSURE THE AVOIDANCE OF POTENTIAL CONFLICT OF INTEREST IN CHOOSING NEW DIRECTORS, AND OTHER MATTERS INVOLVING OFFICERS, DIRECTORS, AND KEY EMPLOYEES. IT IS THE POLICY OF CMHS THAT REQUIRES DIRECTORS TO DISQUALIFY HIMSELF/HERSELF FROM MAKING A DECISION WHERE HE/SHE HAS A CONFLICT OF INTEREST. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, QUESTIONS 15A AND 15B THE ORGANIZATION USES AN INDEPENDENT CONSULTANT TO SURVEY EXECUTIVE COMPENSATION ON AN ANNUAL BASIS. TWO NATIONWIDE SURVEYS WERE USED TO COMPARE THE COMPENSATION OF THE HEALTH SYSTEM'S EXECUTIVE STAFF TO THE 50TH PERCENTILE OF THOSE SURVEYED AND BY ORGANIZATIONAL SIZE AND SCOPE. THE BOARD COMPENSATION COMMITTEE IS RESPONSIBLE FOR ENGAGING THE INDEPENDENT COMPENSATION CONSULTANT AND FOR DETERMINING THE COMPENSATION OF THE CEO. THE COMPENSATION FOR ALL OTHER EXECUTIVES IS DETERMINED BY THE CEO AND SUBJECT TO THE APPROVAL BY THE BOARD COMPENSATION COMMITTEE. THE RECOMMENDATION OF THE BOARD COMPENSATION COMMITTEE IS THEN APPROVED BY THE BOARD OF DIRECTORS. THIS PROCESS IS DOCUMENTED IN THE BOARD MINUTES. JOINT VENTURES FORM 990, PART VI, QUESTIONS 16A AND 16B CMHS HAS MAINTAINED A LONG STANDING PRACTICE OF REVIEWING ALL POTENTIAL JOINT VENTURE OR SIMILAR ARRANGEMENTS TO ENSURE THAT CONTRACT TERMS ARE CONSISTENT WITH THE PROTECTION OF ITS TAX-EXEMPT STATUS. PUBLIC DISCLOSURE OF CERTAIN DOCUMENTS FORM 990, PART VI, QUESTION 19 THE AUDITED FINANCIAL STATEMENTS, FORM 990 TAX RETURNS, GOVERNING AND ORGANIZATIONAL DOCUMENTS, AND CONFLICT OF INTEREST POLICY IS AVAILABLE THROUGH THE ADMINISTRATIVE OFFICES AND IS PROVIDED UPON REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990, IN ACCORDANCE WITH THE IRS INSTRUCTIONS. AVERAGE HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A, COLUMN B THE FOLLOWING INDIVIDUALS DEVOTED AN AVERAGE OF 8 HOURS PER WEEK TO COMMUNITY MEMORIAL HEALTH FOUNDATION (CMHF): GARY K. WILDE DAVID B. GLYER MICHAEL ELLINGSON THE FOLLOWING INDIVIDUALS DEVOTED 1 HOUR PER WEEK TO CMHF: KATHRYN M. WOODBURN WILLIAM L. HART, MD HARRY L. MAYNARD JUDY MILLER GARY L. WOLFE RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 5 UNREALIZED GAIN/(LOSS) ON INVESTMENTS $(4,048,991) CHANGE IN PENSION LIABILITY $ (804,826) ROUNDING $ 1,552 -------------- TOTAL $(4,852,265) COMMUNITY MEMORIAL HEALTHCARE FOUNDATION 147 N BRENT STREET VENTURA CA 93003 953847251 FUNDRAISING CA 501(C)(3) 11, I CMHS true GROSSMAN IMAGING CENTER OF CMH LLC 2001 N SOLAR DRIVE SUITE 135 OXNARD CA 93030 371512002 IMAGING CENTER CA NA RELATED -866647 1961963 false 0 false 0.51000 BUENAVISTA MEDICAL PROPERTIES LTD 168 NORTH BRENT STREET VENTURA CA 93003 770275364 RENTAL CA NA N/A false 0.00000 CALIFORNIA HEART INSTITUTE INC 147 N BRENT STREET VENTURA CA 93003 770276145 BILLING SERVICES CA NA C CORP 83606 32625 1.00000 BUENAVISTA MEDICAL PROPERTIES INC 147 N BRENT STREET VENTURA CA 93003 770298516 REAL ESTATE CA NA C CORP 85089 200684 1.00000 true false true true false false false false true false false false true true false true false false GROSSMAN IMAGING CENTER A (i) 326355 ACCRUAL METHOD GROSSMAN IMAGING CENTER i 135912 ACCRUAL METHOD GROSSMAN IMAGING CENTER d 4898709 ACCRUAL METHOD COMMUNITY MEMORIAL HEALTHCARE FDN p 245592 ACCRUAL METHOD COMMUNITY MEMORIAL HEALTHCARE FDN C 358761 ACCRUAL METHOD INFORMATION FOR RELATED ORGANIZATIONS TAXABLE AS PARTNERSHIPS FORM 990, SCHEDULE R, PART III ORGANIZATION NAME: GROSSMAN IMAGING CENTER OF CMH, LLC ORGANIZATION EIN: 37-1512002 U.S. ADDRESS: 2001 N. SOLAR DR., SUITE 135, OXNARD, CA 93030 ORGANIZATION NAME: BUENAVISTA MEDICAL PROPERTIES, LTD. ORGANIZATION EIN: 77-0275364 U.S. ADDRESS: 168 NORTH BRENT STREET, VENTURA, CA 93003