EMANATE HEALTH FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
EMANATE HEALTH FOUNDATION (EIN 95-2534063)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-30
IRS object ID
201243049349301264
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)
Timestamp2012-10-30T17:27:28-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN330155525EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1HBLA CERTIFIED PUBLIC ACCOUNTANTS INCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line119600 FAIRCHILD STE 320AddressLine1
CityIRVINECity
StateCAState
ZIP Code92612ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN952534063EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CITRUS VALLEY HEALTH FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCITRNameControl
Phone6268142421Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1140 W COLLEGE ST PO BOX 6108AddressLine1
CityCOVINACity
StateCAState
ZIP Code917225108ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRAJESH K SHARMA SR VPName
TitleCFOTitle
Phone6269387595Phone
Date Signed2012-10-17DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameEDWARD BENOEName
PTINP00032866PTIN
Phone9498332815Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROBERT H CURRYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1140 W COLLEGE ST PO BOX 6108AddressLine1
CityCOVINACity
StateCAState
ZIP Code917225108ZIPCode
FieldValueIRS element (for citing)
Gross Receipts7467834GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteCVHP.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1967YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionFUND DEVELOPMENT PROGRAMS FOR CITRUS VALLEY MEDICAL CENTER, FOOTHILL PRESBYTERIAN HOSPITAL, AND CITRUS VALLEY HOSPICE.ActivityOrMissionDescription
Nbr Voting Members Governing Body26NbrVotingMembersGoverningBody
Nbr Independent Voting Members22NbrIndependentVotingMembers
Total Nbr Employees10TotalNbrEmployees
Total Nbr Volunteers47TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year914929ContributionsGrantsPriorYear
Contributions Grants Current Year2168025ContributionsGrantsCurrentYear
Program Service Revenue Prior Year29597ProgramServiceRevenuePriorYear
Program Service Revenue CY15050ProgramServiceRevenueCY
Investment Income Prior Year352398InvestmentIncomePriorYear
Investment Income Current Year402819InvestmentIncomeCurrentYear
Other Revenue Prior Year23190OtherRevenuePriorYear
Other Revenue Current Year130318OtherRevenueCurrentYear
Total Revenue Prior Year1320114TotalRevenuePriorYear
Total Revenue Current Year2716212TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year135009GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1181541GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year376018SalariesEtcPriorYear
Salaries Etc Current Year996267SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1293377TotalFundrsngExpCurrentYear
Other Expense Prior Year448152OtherExpensePriorYear
Other Expenses Current Year363169OtherExpensesCurrentYear
Total Expenses Prior Year959179TotalExpensesPriorYear
Total Expenses Current Year2540977TotalExpensesCurrentYear
Revenues Less Expenses Prior Year360935RevenuesLessExpensesPriorYear
Revenues Less Expenses CY175235RevenuesLessExpensesCY
Total Assets BOY12085964TotalAssetsBOY
Total Assets EOY11857450TotalAssetsEOY
Total Liabilities BOY676961TotalLiabilitiesBOY
Total Liabilities EOY696289TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY11409003NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY11161161NetAssetsOrFundBalancesEOY
Mission DescriptionA PHILANTHROPIC ORGANIZATION DEDICATED TO PROVIDING FINANCIAL, EDUCATIONAL, AND OTHER RESOURCES IN ACCOMPLISHING THE MISSION, VISION AND VALUES OF CITRUS VALLEY HEALTH PARTNERS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1181541Expense
Grants1181541Grants
DescriptionFUND DEVELOPMENT PROGRAMS FOR CITRUS VALLEY MEDICAL CENTER, CITRUS VALLEY HOSPICE, AND FOOTHILL PRESBYTERIAN HOSPITAL, WHICH ARE ALSO EXEMPT ENTITIES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense14579Expense
Revenue15050Revenue
DescriptionFUNDING OF ECHO PROGRAM - EVERY CHILD IS HEALTHY ORGANIZATIONDescription
FieldValueIRS element (for citing)
Total Program Service Expense1196120TotalProgramServiceExpense
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 Securities1ReportInvestOthSecurities
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 Activities1FundraisingActivities
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 Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109617NumberFormsTransmittedWith1096
Number W2 G Included3NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees10NumberOfEmployees
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
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Excess Business Holdings0ExcessBusinessHoldings
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members26NbrVotingGoverningBodyMembers
Number Independent Voting Members22NumberIndependentVotingMembers
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 Body1Form990ProvidedToGoverningBody
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 Line1RAJESH K SHARMA SR VP & CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6269387595TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1140 W COLLEGE STREET PO BOX 6108AddressLine1
CityCOVINACity
StateCAState
ZIP Code91722ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
HAROLD J BORAK SR
BOARD MEMBER3.00X000
ADAM CAPITANO
BOARD MEMBER3.00X000
MITCHELL FUERST
BOARD MEMBER3.00X000
PATSY GORRELL
BOARD MEMBER3.00X000
RICHARD JETT
CHAIR6.00X000
DAN KISS MD
BOARD MEMBER3.00X000
GILBERT MARTIN MD
BOARD MEMBER3.00X000
BILL TANG PHARM D MD
BOARD MEMBER3.00X0278000
ANDREW MCINTYRE
BOARD MEMBER3.00X000
ROBERT CURRY
PRESIDENT/CEO/BOARD MEMBER2.00X079470626905X
RICHARD PEDEVILLANO
BOARD MEMBER3.00X000
OJ RODRIGUEZ
BOARD MEMBER3.00X000
DONALD EDWIN BOSS ESQ
BOARD MEMBER3.00X000
MICHAEL O QUINN
VICE-CHAIR3.00X000
ROBERT E DUNCAN
TREASURER3.00X000
DUANE KEENE
BOARD MEMBER3.00X000
IRENE BOURDON
CEO/VP MARKETING CVHP40.00X037458325926X
MARY JANE BETTFREUND
SECRETARY3.00X000
JACQUELINE BRACY MD
BOARD MEMBER3.00X000
DONALD R CANZONERI
BOARD MEMBER3.00X000
JOSE G GUTIERREZ
BOARD MEMBER3.00X000
MICHAEL J STARR
BOARD MEMBER3.00X000
FRAN DELACH
BOARD MEMBER3.00X000
UDAY GADGIL
BOARD MEMBER3.00X0431600
GORDON SHIPP
VICE-CHAIR3.00X000
KURUGANTI VASANTHA REDDY
BOARD MEMBER3.00X000
ELVIA FOULKE
EVP/HC OPR1.00056364314127X
LOIS CONYERS
SVP/CFO2.00041125612523X
RAJESH SHARMA
CFO2.000563362725X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2271484TotalReportableCompFrmRltdOrgs
Total Other Compensation82206TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events257907FundraisingEvents
All Other Contributions1910118AllOtherContributions
Noncash Contributions42851NoncashContributions
Total Contributions2168025TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionECHO PROGRAMDescription
Business Code900099BusinessCode
Total Revenue Column15050TotalRevenueColumn
Related Or Exempt Function Income15050RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue15050TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column223022TotalRevenueColumn
Exclusion$223,022ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1238Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1238Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1238TotalRevenueColumn
Exclusion$1,238ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4786078Securities
Other3Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities4606284Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities179794Securities
Other3Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column179797TotalRevenueColumn
Exclusion$179,797ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events201107GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events257907CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses137350FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column63757TotalRevenueColumn
Exclusion$63,757ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming26353GrossIncomeGaming
Gaming Direct Expenses7988GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column18365TotalRevenueColumn
Exclusion$18,365ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
TRUST INVESTMENT INCOM90009948049$48,049
OTHER INCOME900099232$232
CHANGE IN NPV OF TRUST900099-1323-$1,323
FieldValueIRS element (for citing)
Total Other Revenue46958TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2716212TotalRevenueColumn
Related Or Exempt Function Income15050RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$533,137ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1181541Total
Program Services1181541ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total480175Total
Management And General19207ManagementAndGeneral
Fundraising460968Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total301129Total
Management And General12045ManagementAndGeneral
Fundraising289084Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6736Total
Management And General269ManagementAndGeneral
Fundraising6467Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total155567Total
Management And General6223ManagementAndGeneral
Fundraising149344Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total52660Total
Management And General2106ManagementAndGeneral
Fundraising50554Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total103379Total
Program Services14579ProgramServices
Management And General3552ManagementAndGeneral
Fundraising85248Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total40182Total
Management And General1607ManagementAndGeneral
Fundraising38575Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total19420Total
Management And General778ManagementAndGeneral
Fundraising18642Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total1882Total
Management And General75ManagementAndGeneral
Fundraising1807Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1980Total
Management And General79ManagementAndGeneral
Fundraising1901Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14135Total
Management And General565ManagementAndGeneral
Fundraising13570Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralFundraisingFundraising
PURCHASED SERVICES1120662168109898
OTHER EXPENSES55977224053737
CONTRACT LABOR77013087393
TELEPHONE52942125082

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1153Total
Management And General46ManagementAndGeneral
Fundraising1107Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2540977Total
Program Services1196120ProgramServices
Management And General51480ManagementAndGeneral
Fundraising1293377Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY499BOY
EOY498EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY627818BOY
EOY853849EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY498000BOY
EOY702000EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY188EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY35039BOY
EOY32203EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis748368LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec216085LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY537397BOY
EOY532283EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY10387211BOY
EOY9736429EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY12085964BOY
EOY11857450EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY72433BOY
EOY153376EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY604528BOY
EOY542913EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY676961BOY
EOY696289EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3045430BOY
EOY2014124EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2633685BOY
EOY3404887EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5729888BOY
EOY5742150EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11409003BOY
EOY11161161EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12085964BOY
EOY11857450EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses175235ReconcilationRevenueExpenses
Reconcilation Other Changes-423077ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (4 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
CITRUS VALLEY MEDICAL CENTER INC
9560064693111$533,226
CITRUS VALLEY HOSPICE INC
9534936119111$342,248
CITRUS VALLEY HEALTH PARTNERS INC
95388552311111$0
FOOTHILL HOSPITAL - MORRIS L JOHNSTON MEMORIAL
9524130543111$306,067
FieldValueIRS element (for citing)
Total Number Of Supported Orgs4TotalNumberOfSupportedOrgs
Sum Of Amounts1181541SumOfAmounts

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 Balance5729888BeginningOfYearBalance
Contributions12262Contributions
End Of Year Balance5742150EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance4706547BeginningOfYearBalance
Contributions1023341Contributions
End Of Year Balance5729888EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4706222BeginningOfYearBalance
Contributions325Contributions
End Of Year Balance4706547EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4705572BeginningOfYearBalance
Contributions650Contributions
End Of Year Balance4706222EndOfYearBalance
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 Basis343332OtherCostOrOtherBasis
Book Value343332BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis169418OtherCostOrOtherBasis
Depreciation25413Depreciation
Book Value144005BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis235618OtherCostOrOtherBasis
Depreciation190672Depreciation
Book Value44946BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings532283TotalOfBookValueLandBuildings

Other Securities OtherSecurities (6 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
FIXED INCOME SECURITIES4572515F
ASSETS HELD IN TRUST898809F
MUTUAL FUNDS3534214F
LIQUID ASSETS206341F
LIFE INSURANCE521280F
ACCRUED INCOME3270F
FieldValueIRS element (for citing)
Total Of Book Value Securities9736429TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
PAYABLE TO AFFILIATES$75,965
PAYABLE TO BENEFICIARIES$466,948
FieldValueIRS element (for citing)
Total Of Amounts542913TotalOfAmounts
Total Revenue2716212TotalRevenue
Total Expenses2540977TotalExpenses
Excess Or Deficit For Year175235ExcessOrDeficitForYear
Net Unrealized GL On Investments-420667NetUnrealizedGLOnInvestments
Other-$2,410OtherAmount
Total Adjustments-423077TotalAdjustments
Excess Or Deficit Per FS-247842ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt1013000TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-420667NetUnrealizedGainsInvestments
Other Revenues145338OtherRevenues
Revenue Not Rptd F990-275329RevenueNotRptdF990
Revenue Subtotal1288329RevenueSubtotal
Other Revenues Not Included1427883OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1427883RevenueNotRptdOnFinStmt
Total Revenue Per Form9902716212TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1449000TotExpensesEtcAuditedFinclStmt
Other Expenses Included145338OtherExpensesIncluded
Expenses Not Rptd F990145338ExpensesNotRptdF990
Expenses Subtotal1303662ExpensesSubtotal
Other Expenses Not Included1237315OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1237315ExpensesNotRptdOnFinStmt
Total Expenses Per Form9902540977TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:PERMANENTLY RESTRICTED ASSETS ARE RESTRICTED INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES.
PART XI, LINE 8 - OTHER ADJUSTMENTS:PASSTHROUGH INCOME VARIANCE -2,410.
PART XII, LINE 2D - OTHER ADJUSTMENTS:SPECIAL EVENTS EXPENSE INCLUDED IN REVENUE 145,338.
PART XII, LINE 4B - OTHER ADJUSTMENTS:INVESTMENT FEES EXPENSE INCLUDED IN REVENUES 40,182. RESTRICTED FUND CHANGE IN VALUE OF TRUSTS -1,323. RESTRICTED FUND UNREALIZED GAINS -59,140. RESTRICTED FUND CONTRIBUTIONS 1,384,121. RESTRICTED FUND INVESTMENT LOSS TRUSTS 48,049. ROUNDING DIFFERENCE 1,347. LIFE INSURANCE VALUATION 12,237. PASSTHROUGH INCOME VARIANCE 2,410.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:SPECIAL EVENTS EXPENSE INCLUDED IN REVENUE 145,338.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:INVESTMENT FEES EXPENSE INCLUDED IN REVENUES 40,182. RESTRICTED FUND DISTRIBUTIONS FOR PROGRAM EXPENSES 14,579. ROUNDING DIFFERENCE 1,013. GRANT TO CITRUS VALLEY MEDICAL CENTER, INC. 533,226. GRANT TO CITRUS VALLEY HOSPICE, INC. 342,248. GRANT TO FOOTHILL PRESBYTERIAN HOSPITAL 306,067.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1AUTUMN NOCTURNE DINNER DANCENameOfEvent1
Gross Receipts Event1257895GrossReceiptsEvent1
Charitable Contributions Event1106555CharitableContributionsEvent1
Gross Revenue Event1151340GrossRevenueEvent1
Rent Facility Costs Event112987RentFacilityCostsEvent1
Food And Beverage Event132827FoodAndBeverageEvent1
Entertainment Event15000EntertainmentEvent1
Other Direct Expenses Event140741OtherDirectExpensesEvent1
Name Of Event2GOLF TOURNAMENTNameOfEvent2
Gross Receipts Event2183326GrossReceiptsEvent2
Charitable Contributions Event2150679CharitableContributionsEvent2
Gross Revenue Event232647GrossRevenueEvent2
Rent Facility Costs Event217848RentFacilityCostsEvent2
Food And Beverage Event2364FoodAndBeverageEvent2
Other Direct Expenses Event219086OtherDirectExpensesEvent2
Total Number Of Other Events3TotalNumberOfOtherEvents
Gross Receipts Other Events17793GrossReceiptsOtherEvents
Charitable Contrib Other Events673CharitableContribOtherEvents
Gross Revenue Other Events17120GrossRevenueOtherEvents
Other Direct Expenses Other Events8497OtherDirectExpensesOtherEvents
Gross Receipts Total459014GrossReceiptsTotal
Charitable Contributions Total257907CharitableContributionsTotal
Gross Revenue Total Events201107GrossRevenueTotalEvents
Rent Facility Costs Total Events30835RentFacilityCostsTotalEvents
Food And Beverage Total Events33191FoodAndBeverageTotalEvents
Entertainment Total Events5000EntertainmentTotalEvents
Other Direct Expenses Total Events68324OtherDirectExpensesTotalEvents
Direct Expense Summary Events137350DirectExpenseSummaryEvents
Net Income Summary63757NetIncomeSummary

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming26353GrossRevenueOtherGaming
Cash Prizes Other Gaming6200CashPrizesOtherGaming
Non Cash Prizes Other Gaming1288NonCashPrizesOtherGaming
Other Direct Expenses Other Gaming500OtherDirectExpensesOtherGaming
Volunteer Labor Other Gaming1VolunteerLaborOtherGaming
Volunteer Labor Prcnt Other Gaming0.45000VolunteerLaborPrcntOtherGaming
Gross Revenue Total Gaming26353GrossRevenueTotalGaming
Cash Prizes Total Gaming6200CashPrizesTotalGaming
Non Cash Prizes Total Gaming1288NonCashPrizesTotalGaming
Other Direct Expenses Total Gaming500OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming7988DirectExpenseSummaryGaming
Net Gaming Income Summary18365NetGamingIncomeSummary
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 PersonRON PADILLANameOfGamingRecKeeperPerson

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line1140 W COLLEGE ST PO BOX 6108AddressLine1
CityCOVINACity
StateCAState
ZIP Code917225108ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam Rev0ContractWith3rdPartyForGamRev
Gaming Manager Name PersonPAM PARKINSONGamingManagerNamePerson
Gaming Manager Compensation500GamingManagerCompensation
Gaming Manager Services ProvidedSOLD TICKETS, ACCURATELY COUNTED MONEY AND CHANGE IF NEEDED, DISTRIBUTION OF WINNINGS AND TURN BALANCE OF MONEY OVER FOR DEPOSIT.GamingManagerServicesProvided
Gaming Manager Is EmployeeXGamingManagerIsEmployee
Charitable Distrib Required0CharitableDistribRequired

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationPurpose Of GrantPurposeOfGrant
CITRUS VALLEY MEDICAL CENTER INC
140 W COLLEGE STREET PO BOX 6108COVINACA91722956006469501 (C)(3)533226FMVTO PROVIDE FUNDING TO ASSIST OPERATIONS OF ITS ACUTE CARE FACILITY.
CITRUS VALLEY HOSPICE INC
140 W COLLEGE STREET PO BOX 6108COVINACA91722953493611501 (C)(3)342248FMVTO PROVIDE FUNDING TO ASSIST WITH SERVICES TO TERMINALLY ILL PATIENTS AND HOME HEALTH CARE NURSING SERVICES.
FOOTHILL PRESBYTERIAN HOSPITAL
140 W COLLEGE STREET PO BOX 6108COVINACA91722952413054501 (C)(3)306067FMVTO PROVIDE FUNDING TO ASSIST OPERATIONS OF ITS ACUTE CARE HOSPITAL.
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants

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: CONTRIBUTIONS AND TRANSFERS ARE MADE TO AFFILIATED/SUPPORTED ORGANIZATIONS TO ASSIST WITH THE FUNDING OF EXEMPT PURPOSE ACTIVITIES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
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 (4 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
ROBERT CURRY
05729640119592010215006651020254082161100
IRENE BOURDON
028322105702203434005769020157040050900
ELVIA FOULKE
039486908634508242900014127057777000
LOIS CONYERS
027862707632305630602025010498042377900

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990260160NoncashContribsRptdF990
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)

Non Cash CheckboxNonCashCheckboxDescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
XAUCTION ITEMS - AUTUMN15836175SALES PRICE
XAUCTION ITEMS - GOLF416676SALES PRICE
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF THIS ORGANIZATION IS CITRUS VALLEY HEALTH PARTNERS, INC., A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER OF THIS ORGANIZATION IS CITRUS VALLEY HEALTH PARTNERS, INC. THE MEMBER THROUGH THE BOARD OF DIRECTORS HAS THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7BDECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE ORGANIZATION'S SOLE MEMBER, CITRUS VALLEY HEALTH PARTNERS.
FORM 990, PART VI, SECTION B, LINE 11STAFF ACCOUNTANTS, ACCOUNTING MANAGER AND DIRECTOR OF CORPORATE FINANCE REVIEW FORM 990 FOR ACCURACY AND COMPLETENESS UPON RECEIVING IT FROM THE CPA TAX PREPARER. FORM 990 IS FORWARDED TO RAJESH K. SHARMA, SR. VP & CFO, FOR THE FINAL REVIEW. TAX PREPARER PRESENTS FORM 990 TO THE AUDIT AND COMPLIANCE COMMITTEE FOR APPROVAL. BOARD DELEGATED REVIEW AND APPROVAL TO THE AUDIT AND COMPLIANCE COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 12CALL BOARD MEMBERS, KEY EMPLOYEES, AND MANAGEMENT ARE COVERED BY THE CONFLICT OF INTEREST POLICY. DETERMINATIONS OF CONFLICT AND REVIEW OF CONFLICT ARE PERFORMED AT THESE VARIOUS LEVELS OF THE ORGANIZATION. APPROPRIATE ACTION DEPENDING ON THE CONFLICT IS TAKEN BY MANAGEMENT, KEY EMPLOYEES, AND THE BOARD. DISCLOSURE FORMS ARE REQUIRED ANNUALY BY EACH MEMBER OF THE BOARD OF DIRECTORS, KEY EMPLOYEES, AND MANAGEMENT.
FORM 990, PART VI, SECTION B, LINE 15CVHP UTILIZES THE FOLLOWING TO ESTABLISH REASONABLE COMPENSATION: COMPENSATION COMMITTEE; INDEPENDENT COMPENSATION CONSULTANT; WRITTEN EMPLOYMENT CONTRACT; COMPENSATION SURVEY/STUDIES; APPROVAL BY BOARD OR COMPENSATION COMMITTEE, WHICH APPROVAL IS DOCUMENTED IN CONTEMPORANEOUS WRITTEN MINUTES. EXECUTIVE PAY AT CITRUS VALLEY HEALTH PARTNERS FOLLOWS MARKET-BASED PAY PRACTICES FOR HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND TYPE IN THE SOUTHERN CALIFORNIA AREA. SALARY RANGES FOR EXECUTIVES WORKING AT CVHP FACILITIES FALL WITHIN THE MIDDLE OF THE MARKET, JUST AS THEY DO FOR ALL EMPLOYEES OF OUR ORGANIZATION. EVERY POSITION IN THE ORGANIZATION HAS A SALARY RANGE ATTACHED TO IT THAT REPRESENTS WHAT OTHERS DOING A SIMILAR JOB IN OTHER ORGANIZATIONS ARE LIKELY TO BE PAID. THE LONG-STANDING PAY PHILOSOPHY FOR CVHP HAS BEEN TO POSITION OUR SALARY RANGES IN THE MIDDLE OF OUR LOCAL LABOR MARKET WE DON'T WANT TO LAG THE LOCAL MARKET, NOR DO WE WANT TO LEAD THE MARKET, SINCE THAT IS NOT A STRATEGY WE CAN AFFORD TO SUSTAIN OVER TIME. WE RELY ON MARKET STUDIES TO DETERMINE WHERE OUR PAY PRACTICES ARE RELATIVE TO OTHER HOSPITALS IN SOUTHERN CALIFORNIA. FOR EXECUTIVE PAY, WE USE THE NATIONALLY-RECOGNIZED AND RESPECTED FIRM, HAYGROUP, TO ANALYZE OUR EXECUTIVE PAY PROGRAM AND DETERMINE WHERE IT FALLS IN OUR MARKET. THIS STUDY IS PERFORMED EVERY OTHER YEAR. THE MOST RECENT EXECUTIVE COMPENSATION DATA IS DATED OCTOBER 2010. AS PART OF THEIR EXECUTIVE COMPENSATION REVIEW, HAYGROUP ALSO ISSUES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE PAY PROGRAM FOR A NOT-FOR-PROFIT ORGANIZATION LIKE OURS THAT IS SUBJECT TO THE REQUIREMENTS OF SECTION 4958 OF THE INTERNAL REVENUE CODE AND UNITED STATES TREASURY DEPARTMENT REGULATIONS. IN THEIR FEBRUARY 8, 2011, OPINION LETTER, HAYGROUP WROTE, "WE BELIEVE WE HAVE COMPARED THE EXECUTIVE COMPENSATION TO COMPENSATION AND BENEFITS PAID TO EXECUTIVES OF ORGANIZATIONS WITH LIKE SERVICES BY LIKE ENTERPRISES UNDER LIKE CIRCUMSTANCES, AND AS RESULT, WE BELIEVE THAT COMPENSATION AND BENEFITS PAID TO THE EXECUTIVES ARE REASONABLE WITHIN THE MEANING OF SECTION 53.4958-4(B)(1)(II)(A) OF THE TREASURY REGULATIONS". THE EXECUTIVE POSITIONS THAT ARE INCLUDED IN THE BIENNIAL EXECUTIVE COMPENSATION REVIEW INCLUDE THE PRESIDENT/CEO, EXECUTIVE VICE PRESIDENT/COO, SENIOR VICE PRESIDENT/CFO, SENIOR VICE PRESIDENT/HUMAN RESOURCES, SENIOR VICE PRESIDENT/CIO, CITRUS VALLEY MEDICAL CENTER CHIEF MEDICAL OFFICER AND VICE PRESIDENT MEDICAL AFFAIRS, CEO/CITRUS VALLEY HOSPICE, FOOTHILL PRESBYTERIAN HOSPITAL ADMINISTRATOR/CNE, VICE PRESIDENT/CNE AT CITRUS VALLEY MEDICAL CENTER AND VICE PRESIDENT OF PUBLIC RELATIONS AND COMMUNICATION.
FORM 990, PART VI, SECTION C, LINE 19UPON REQUEST AN AUDIT REPORT IS AVAILABLE AS REQUIRED. NO OTHER DOCUMENTS ARE AVAILABLE.
PART VII, SECTION AIRENE BOURDON IS A BOARD MEMBER AND OFFICER OF CITRUS VALLEY HEALTH FOUNDATION, AN AFFILIATE OF CITRUS VALLEY HEALTH PARTNERS (CVHP) AND RECEIVED COMPENSATION FROM CVHP. SHE DEVOTED 40 HOURS TO THE FILING ORGANIZATION.BOARD MEMBER COMPENSATION
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -420,667. PASSTHROUGH INCOME VARIANCE -2,410. TOTAL TO FORM 990, PART XI, LINE 5: -423,077.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINES 2B AND 2C:THE FINANCIAL STATEMENTS OF CITRUS VALLEY HEALTH PARTNERS, INC. AND ITS AFFILIATES, CITRUS VALLEY MEDICAL CENTER, INC., CITRUS VALLEY HOSPICE, FOOTHILL PRESBYTERIAN HOSPITAL, AND CITRUS VALLEY HEALTH FOUNDATION, INC., WERE AUDITED ON A CONSOLIDATED BASIS.AUDITED FINANCIAL STATEMENTS
FORM 990, PART XII, LINE 2CTHE BOARD OF DIRECTORS HAS CONSTITUTED AN AUDIT AND COMPLIANCE COMMITTEE AND DELEGATED TO THAT COMMITTEE THE RESPONSIBILITY FOR ENGAGING INDEPENDENT AUDITORS AND MONITORING THE AUDIT PROCESS. THIS STRUCTURE HAS BEEN IN EFFECT IN PRIOR YEARS AND WAS NOT CHANGED IN 2011.AUDIT AND COMPLIANCE COMMITTEE
FORM 990, PART VII, SECTION A, LINE 1ATHE OFFICERS REPORTED ON PART VII OF FORM 990 ARE COMPENSATED BY AN AFFILIATED ENTITY, CITRUS VALLEY HEALTH PARTNERS (CVHP). THE COMPENSATION AMOUNTS REPORTED IN PART VII OF FORM 990 REPRESENT 100% OF THE COMPENSATION PAID BY CVHP TO THE OFFICERS. THE OFFICERS ALSO SERVE AS CORPORATE OFFICERS FOR CITRUS VALLEY MEDICAL CENTER, INC., CITRUS VALLEY HOSPICE, INC., FOOTHILL PRESBYTERIAN HOSPITAL AND CITRUS VALLEY HEALTH FOUNDATION, INC., ALL AFFILIATES OF THE TAXPAYER. IN ACCORDANCE WITH OUR UNDERSTANDING OF THE FORM 990 INSTRUCTIONS, SIMILAR PART VII DISCLOSURES ARE MADE IN EACH OF THE AFOREMENTIONED AFFILIATES 990 RETURNS.REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS
PART VII, SECTION ATHE OFFICERS SERVE AS COPORATE OFFICERS FOR CITRUS VALLEY HEALTH PARTNERS (CVHP), CITRUS VALLEY MEDICAL CENTER, INC. (CVMC), CITRUS VALLEY HOSPICE (CVH), INC., FOOTHILL PRESBYTERIAN HOSPITAL (FPH) AND CITRUS VALLEY HEALTH FOUNDATION, INC. (CVHF), ALL AFFILIATES OF THE TAXPAYER. THE NUMBER OF HOURS DEVOTED BY THE CORPORATE OFFICERS TO THE AFFILIATES ARE AS FOLLOWS. ELVIA FOULKE DEVOTED 5, 5, 20, AND 9 HOURS TO FPH, CVH, CVMC, AND CVHP, RESPECTIVELY. LOIS CONYERS DEVOTED 4, 2, 14, AND 18 HOURS TO FPH, CVH, CVMC, AND CVHP, RESPECTIVELY. ROBERT CURRY DEVOTED 4, 2, 14, AND 18 HOURS TO FPH, CVH, CVMC, AND CVHP, RESPECTIVELY. RAJESH SHARMA DEVOTED 4, 2, 14, AND 18 HOURS TO FPH, CVH, CVMC, AND CVHP, RESPECTIVELY.REPORTABLE HOURS FOR RELATED ORGANIZATIONS
990 PART V LINE 7HTHE ORGANIZATION DID NOT RECEIVE ANY CONTRIBUTIONS OF AUTOMOBILES, BOATS, AIRPLANES OR OTHER VEHICLES. CONSEQUENTLY THERE WERE NO FORMS 1098C FILED.FILING OF FORM 1098C

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
CITRUS VALLEY MEDICAL CENTER INC
140 W COLLEGE STREET PO BOX 6108COVINACA91722956006469ACUTE CARE HOSPITALCA501 (C)(3)3N/A0
CITRUS VALLEY HOSPICE INC
140 W COLLEGE STREET PO BOX 6108COVINACA91722953493611HOME HEALTH & HOSPICE CARECA501 (C)(3)9N/A0
CITRUS VALLEY HEALTH PARTNERS INC
140 W COLLEGE STREET PO BOX 6108COVINACA91722953885523EXEMPT ORGANIZATION SUPPORT & MANAGEMENTCA501 (C)(3)11 TYPE IIN/A0
FOOTHILL PRESBYTERIAN HOSPITAL
140 W COLLEGE STREET PO BOX 6108COVINACA91722952413054ACUTE CARE HOSPITALCA501 (C)(3)3N/A0
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
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 Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
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 (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
CITRUS VALLEY MEDICAL CENTER INC
B-533226FAIR MARKET VALUE
CITRUS VALLEY HOSPICE INC
B-342248FAIR MARKET VALUE
FOOTHILL PRESBYTERIAN HOSPITAL
B-306067FAIR MARKET VALUE

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierREPORTABLE COMPENSATION FROM RELATED ORGANIZATIONSIdentifier
Return ReferenceFORM 990, SHEDULE R, PART V, NUMBER 2, CODE N:ReturnReference
ExplanationTHE SALARIES REPORTED ON FORM 990 ARE PROCESSED THROUGH CITRUS VALLEY HEATLH PARTNERS. CITRUS VALLEY HEALTH PARTNERS ACTS AS A COMMON PAYMASTER FOR AFFILIATED ENTITIES, CITRUS VALLEY MEDICAL CENTER, CITRUS VALLEY HEALTH FOUNDATION AND CITRUS VALLEY HOSPICE. CITRUS VALLEY HEALTH PARTNERS FILED ONE FORM W-3 WHICH SHOWS A COMBINED NUMBER OF 3,270 EMPLOYEES. THE NUMBER OF EMPLOYEES FOR EACH ENTITY IS REPORTED SEPARATELY ON ITS OWN FORM 990 PART I LINE 5. CITRUS VALLEY MEDICAL CENTER'S FORM 990 REPORTED A TOTAL OF 2,770 EMPLOYEES, CITRUS VALLEY HOSPICE'S FORM 990 REPORTED 121 EMPLOYEES, CITRUS VALLEY HEALTH FOUNDATION'S FORM 990 REPORTED 10 EMPLOYEES AND CITRUS VALLEY HEALTH PARTNER'S FORM 990 REPORTED 369 EMPLOYEES.Explanation

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