COMMUNITY HOSPITAL OF SAN BERNARDINO: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITAL OF SAN BERNARDINO (EIN 95-1643373)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-05
- IRS object ID
- 201101259349301755
- Schema version
- 2009v1.7
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-05T17:09:33-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 SECOND STREET SUITE 1400 | AddressLine1 |
| City | SAN FRANCISCO | City |
| State | CA | State |
| ZIP Code | 94105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 951643373 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Hospital of San Bernardino | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 9088876333 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1805 Medical Center Drive | AddressLine1 |
| City | San Bernardino | City |
| State | CA | State |
| ZIP Code | 92411 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ED SORENSON | Name |
| Title | CFO | Title |
| Date Signed | 2011-05-04 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4159635100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ED SORENSON CFO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1805 MEDICAL CNTR DRIVE | AddressLine1 |
| City | SAN BERNARDINO | City |
| State | CA | State |
| ZIP Code | 92411 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 163050108 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c | X | Organization501c |
| Web Site | WWW.CHWHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1938 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | Community Hospital of San Bernardino is committed to furthering the healing ministry of Jesus, and to providing high-quality, affordable healthcare to the community we serve. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1561 | TotalNbrEmployees |
| Total Nbr Volunteers | 37 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 804345 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1594697 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 157356829 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 160486970 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 298 | InvestmentIncomePriorYear |
| Investment Income Current Year | 21835 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 837360 | OtherRevenuePriorYear |
| Other Revenue Current Year | 946606 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 158998832 | TotalRevenuePriorYear |
| Total Revenue Current Year | 163050108 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 10000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 3500 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 101885698 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 112379985 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 63161191 | OtherExpensePriorYear |
| Other Expenses Current Year | 66757334 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 165056889 | TotalExpensesPriorYear |
| Total Expenses Current Year | 179140819 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -6058057 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -16090711 | RevenuesLessExpensesCY |
| Total Assets BOY | 52736609 | TotalAssetsBOY |
| Total Assets EOY | 57667325 | TotalAssetsEOY |
| Total Liabilities BOY | 46892996 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 67914424 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 5843613 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -10247099 | NetAssetsOrFundBalancesEOY |
| Mission Description | COMMUNITY HOSPITAL OF SAN BERNARDINO IS A NON-PROFIT, FULL-SERVICE, ACUTE CARE FACILITY IN BUSINESS TO PROVIDE ACUTE INPATIENT CARE, LONG-TERM CARE AND A WIDE RANGE OF ANCILLARY AND THERAPEUTIC CARE TO THE COMMUNITY WE SERVE. OUR VISION IS TO CREATE AND PROVIDE HEALTH CARE SOLUTIONS, AND MEET THE HEALTH CARE NEEDS OF OUR COMMUNITY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 160934496 | Expense |
| Grants | 3500 | Grants |
| Revenue | 160486970 | Revenue |
| Description | COMMUNITY HOSPITAL OF SAN BERNARDINO'S MISSION IS TO CONTRIBUTE TO THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF QUALITY SERVICES DELIVERED IN A COMPASSIONATE AND COST EFFECTIVE MANNER. THE HOSPITAL IS LICENSED FOR 442 BEDS AND CURRENTLY HAS 360 BEDS. THE HOSPITAL HAD 88,212 TOTAL PATIENT DAYS, 11,171 ADMISSIONS, AND 44,258 EMERGENCY ROOM VISITS. INPATIENT SERVICES: ACUTE PATIENT CARE; MATERNAL CHILD CARE; MENTAL HEALTH CARE; NEUROLOGICAL CARE; AND A VARIETY OF OUTPATIENT CARE. | Description |
| Total Program Service Expense | 160934496 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | true | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 140 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1561 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ED SORENSON CFO | NamePerson |
| Telephone Number | 9098876333 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1805 MEDICAL CTR DRIVE | AddressLine1 |
| City | SAN BERNARDINO | City |
| State | CA | State |
| ZIP Code | 92411 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Dr Kumarvelu Bala | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Dr Alvaro Bolivar | ||||||||
| Director | 1.0 | X | 103500 | 0 | 0 | |||
| Dr Betty Daniels | ||||||||
| Director | 1.0 | X | 0 | 8000 | 0 | |||
| Dr Hendrik DeJager | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Margaret Hill | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Dr Bharti Jain | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Dr Albert Karnig | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Peggy Merryman | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Dr Vellore Muraligopal | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Marvin O'Quinn | ||||||||
| Director | 1.0 | X | 0 | 1930097 | 119149 | |||
| Marvin Reiter CPA | ||||||||
| Past Chair | 1.0 | X | 0 | 0 | 0 | |||
| Dr Paul Ryan | ||||||||
| Director | 1.0 | X | 66800 | 0 | ||||
| Elizabeth Shih | ||||||||
| Director | 1.0 | X | 0 | 1807962 | 293626 | |||
| Susan Whitten | ||||||||
| Director | 1.0 | X | 0 | 469787 | 60471 | |||
| Frank Lyman | ||||||||
| Secretary | 1.0 | X | 0 | 0 | 0 | X | ||
| John Nolan Esq | ||||||||
| Chairman | 1.0 | X | 0 | 0 | 0 | X | ||
| Diane Nitta | ||||||||
| Service Area Leader (VP & CNE) | 40.0 | 462015 | 0 | 35036 | X | |||
| Edward Sorenson | ||||||||
| Hospital VP & CFO | 40.0 | 296188 | 0 | 37585 | X | |||
| Kimiko Ford | ||||||||
| VP Mission Services | 40.0 | 224733 | 0 | 33782 | X | |||
| DAVID J EVANS | ||||||||
| Controller | 40.0 | 196778 | 0 | 33727 | X | |||
| LAWRENCE LAWLER | ||||||||
| Sr Dir Neuro/Behavior Svc | 40.0 | 197632 | 0 | 31959 | X | |||
| Marc Marchetti | ||||||||
| VP | 40.0 | 220045 | 0 | 32297 | X | |||
| Martha Mulugeta | ||||||||
| Clinical Nurse II | 40.0 | 201985 | 0 | 25965 | X | |||
| HAROLD NEWTON | ||||||||
| Sr Director of Ancillary Servi | 40.0 | 209851 | 0 | 33522 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2179527 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4215846 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 737119 | TotalOtherCompensation |
| Number Individuals GT100 K | 208 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| TILLER CONSTRUCTORS INC | |||||
| 306 W KATELLA AVE 3A | ORANGE | CA | 92867 | Contractor | 4178182 |
| ANGELICA TEXTILE SERVICES | |||||
| 925 S 8TH ST | COLTON | CA | 92324 | Laundry Services | 922780 |
| SAFEWAY CONSTRUCTION | |||||
| 1474 N MILLER DR | COLTON | CA | 92324 | Contractor | 682335 |
| VALLEY PAINTING DECORATING | |||||
| PO BOX 230 | SAN BERNARDINO | CA | 92402 | Contractor | 432136 |
| EMERG PHYSICIANS MEDICAL GRP | |||||
| 3300 DOUGLAS BLVD SUITE 150 | ROSEVILLE | CA | 956614210 | Medical Services | 291075 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 21 | NumberOfContractorsGT100K |
| Related Organizations | 1163340 | RelatedOrganizations |
| Government Grants | 431357 | GovernmentGrants |
| Total Contributions | 1594697 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT REVENUE/CHARITY CARE | 900099 | 73153285 | 73153285 |
| MEDICAL OFFICE BUILDING | 900099 | 669091 | 669091 |
| EDUCATION | 900099 | 86122 | 86122 |
| MEDICARE/MEDICAID PAYMENTS | 900099 | 86578472 | 86578472 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 160486970 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 21835 | TotalRevenueColumn |
| Exclusion | $21,835 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| CAFETERIA | 900099 | 501908 | $501,908 |
| GIFT SHOPS | 900099 | 231779 | $231,779 |
| COMMISSIONS | 900099 | 115996 | $115,996 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 96923 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $96,923 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 946606 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 163050108 | TotalRevenueColumn |
| Related Or Exempt Function Income | 160486970 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $968,441 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3500 | Total |
| Program Services | 3500 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1257685 | Total |
| Program Services | 1188904 | ProgramServices |
| Management And General | 68781 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87101661 | Total |
| Program Services | 82338220 | ProgramServices |
| Management And General | 4763441 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4999203 | Total |
| Program Services | 4725806 | ProgramServices |
| Management And General | 273397 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12759292 | Total |
| Program Services | 12061300 | ProgramServices |
| Management And General | 697992 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6262144 | Total |
| Program Services | 5896024 | ProgramServices |
| Management And General | 366120 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73388 | Total |
| Management And General | 73388 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68250 | Total |
| Management And General | 68250 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34988 | Total |
| Program Services | 34988 | ProgramServices |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18137657 | Total |
| Program Services | 11267699 | ProgramServices |
| Management And General | 6869958 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 792057 | Total |
| Program Services | 4057 | ProgramServices |
| Management And General | 788000 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6166155 | Total |
| Program Services | 5582886 | ProgramServices |
| Management And General | 583269 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5455754 | Total |
| Program Services | 4901179 | ProgramServices |
| Management And General | 554575 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2043433 | Total |
| Program Services | 1797471 | ProgramServices |
| Management And General | 245962 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 127425 | Total |
| Program Services | 109556 | ProgramServices |
| Management And General | 17869 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115890 | Total |
| Program Services | 46218 | ProgramServices |
| Management And General | 69672 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1603573 | Total |
| Program Services | 1603573 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4220595 | Total |
| Program Services | 3587506 | ProgramServices |
| Management And General | 633089 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 949626 | Total |
| Program Services | 949626 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBT | 11380986 | 11380986 | ||
| DUES & SUBSCRIPTIONS | 364871 | 104747 | 260124 | |
| MEDICAL SUPPLIES | 12043936 | 12043936 | ||
| OVERHEAD CORP ALLOCATION | 1553150 | 1553150 | ||
| OTHER EXPENSES | 1625600 | 1306314 | 319286 | 0 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 179140819 | Total |
| Program Services | 160934496 | ProgramServices |
| Management And General | 18206323 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7185 | BOY |
| EOY | 7185 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -3727706 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12175 | BOY |
| EOY | 180031 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23627165 | BOY |
| EOY | 23567013 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1902451 | BOY |
| EOY | 1925396 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6237528 | BOY |
| EOY | 3039268 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 99406034 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 70551846 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24474565 | BOY |
| EOY | 28854188 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 203246 | BOY |
| EOY | 94244 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52736609 | BOY |
| EOY | 57667325 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12418485 | BOY |
| EOY | 36266852 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2000000 | BOY |
| EOY | 2000000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32474511 | BOY |
| EOY | 29647572 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46892996 | BOY |
| EOY | 67914424 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5843613 | BOY |
| EOY | -10247099 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5843613 | BOY |
| EOY | -10247099 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52736609 | BOY |
| EOY | 57667325 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $34,988 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 34988 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART II-B, LINE 1F | Identifier |
| Explanation | Lobbying expenditures paid directly by the filing organization for annual membership dues: Innovative Federal Stratagies $18,581 Lobbying expenditures paid by the Parent organization for annual membership dues where expenses are allocated to the hospital: American Hospital Association $ 941 Catholic Health Association $ 1,454 California Hospital Association $14,012 ========= TOTAL EXPENDITURES $34,988 ========= | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 799341 | OtherCostOrOtherBasis |
| Book Value | 799341 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 76598100 | OtherCostOrOtherBasis |
| Depreciation | 56214557 | Depreciation |
| Book Value | 20383543 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20079831 | OtherCostOrOtherBasis |
| Depreciation | 14210348 | Depreciation |
| Book Value | 5869483 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1928762 | OtherCostOrOtherBasis |
| Depreciation | 126941 | Depreciation |
| Book Value | 1801821 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 28854188 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO RELATED PARTIES | $24,795,318 |
| PENSION PAYABLE | $4,100,094 |
| DEFERRED COMPENSATION | $80,000 |
| ASSET RET OBLIG LIABILITY | $672,160 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 29647572 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Sch D, PART X | Identifier |
| Explanation | The consolidated audited financial statements did not include a FIN 48 footnote disclosure as the liability was determined not material for reporting purposes. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 500. | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1414 | PersonsServed |
| Total Community Benefit Expense | 4663760 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4663760 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02780 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 40326 | PersonsServed |
| Total Community Benefit Expense | 102591009 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 92781933 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9809076 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05850 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 373 | PersonsServed |
| Total Community Benefit Expense | 1741298 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1061625 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 679673 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00410 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 42113 | PersonsServed |
| Total Community Benefit Expense | 108996067 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 93843558 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15152509 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09040 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 29754 | PersonsServed |
| Total Community Benefit Expense | 1120495 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1120495 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00670 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 285 | PersonsServed |
| Total Community Benefit Expense | 343235 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 343235 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 8300 | PersonsServed |
| Total Community Benefit Expense | 450554 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 450554 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 38339 | PersonsServed |
| Total Community Benefit Expense | 1914284 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1914284 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01140 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 80452 | PersonsServed |
| Total Community Benefit Expense | 110910351 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 93843558 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 17066793 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10180 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6300 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 6300 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6300 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 6300 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $2,411,238 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 25656443 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 26811014 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1154571 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|
| Community Hospital of San Bernardino | |||||||
| 1805 Medical Center Dr | San Barnardino | CA | 92411 | X | X | X | |
| Community Convalescent Center | |||||||
| 1676 Medical Center Dr | San Bernardino | CA | 92411 | Skilled Nursing | |||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Not applicable. Community Hospital of San Bernardino (CHSB) uses Federal Poverty Guidelines (FPG) to determine eligibility. | IncomeBasedCriteria |
| Annual Community Benefit Expln | The organization prepares a separate community benefit report. | AnnualCommunityBenefitExpln |
| Costing Method Used | For purposes of calculating the amounts provided in the table, CHSB uses a cost accounting system that combines relative value units (RVU) and cost to charge ratios (CCR) to allocate costs to the patient level. The cost accounting system algorithm allocates total operating expenses to the procedure charge code level based upon an RVU for procedures that have been studied and assigned an RVU, or based upon a CCR for unstudied procedures that do not have an RVU assigned. When a CCR is used, the system calculates that CCR on a departmental specific basis at the hospital where the services were provided. The calculation is similar to the Worksheet 2 of Schedule H, Ratio of Patient Care Cost to Charges, except it is calculated on a departmental specific basis, not in the aggregate. The allocated procedure charge code level costs are then rolled up to the patient level based upon the billed procedure charge codes associated with those services provided to each specific patient. This is done for all patient segments including inpatient, outpatient, emergency department, private insurance, Medicaid, Medicare, uninsured and self pay. The cost accounting system is utilized to determine the unreimbursed cost of Medicaid and other means-tested government programs. The cost of charity care is calculated by applying the CCR derived from the cost accounting system on a per facility basis, to the charges incurred on patients that qualify for charity care at the respective facility. The actual cost is reported for other community benefit activities such as community health improvement services, community benefit operations, health professions education, subsidized health services, research and cash and in-kind donations. | CostingMethodUsed |
| Subsidized Health Services Expln | CHSB did not have costs attributable to a physician clinic as subsidized health services | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | The amount of bad debt expense included on Form 990, Part IX, line 25, column (A) is $11,380,986 and has been subtracted for purposes of calculating the percentages in column (f). | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | The amount of the organization's bad debt at cost is determined by applying the CCR (see above) to patient charges that are deemed to be uncollectible. This amount represents the cost of services provided to patients who are unable or refuse to pay their bills and do not qualify for free or discounted care, government sponsored programs or other financial assistance, and are otherwise uninsured. Any portion of a patient bill remaining after applying financial, uninsured or other discounts or payments received on the account that are ultimately determined to be uncollectible are written off to bad debt. As noted in Part I, Line 3, CHSB provides free or discounted care to uninsured or under-insured individuals at or below 500% of the Federal Poverty Level. CHSB also provides patients options for prompt pay discounts, discounts for the medically indigent, and interest-free extended payment plans for patients who have demonstrated good faith and are cooperating in resolving their hospital bills. All accounts for eligible uninsured patients receive an automatic uninsured discount of 25% for patients seen at California facilities. The expected patient payment amount on the patient's bill reflects this discount. CHSB makes every effort in determining if a patient qualifies for charity care upon admission. CHSB follows CHW's financial assistance policy. CHW's financial assistance policy is communicated to patients upon admission and is available in the languages primarily spoken in the community. It is also posted in various common areas of the hospital and is provided upon billing if eligibility is not previously determined. Eligibility is reevaluated as needed and amounts are classified as charity as soon as eligibility is known. CHW also utilizes a Payment Assistance Rank Ordering (PARO) scoring system to assist in determining if a patient may qualify for charity care even though they have not applied for it. PARO is a methodology that applies consistent screening and application standards to all patients utilizing historical data to develop a predictive model for healthcare financial assistance. In its development, special attention was paid to those socio-economic factors that might adversely affect those patients deserving the most attention. Other criteria are also utilized to ensure that no services that have qualified as charity are reported as bad debt. As such, CHSB does not believe that any amounts included in Part III, Line 2, are attributable to patients eligible under the organization's charity care policy. The following is an excerpt from CHW and its subordinate corporations' consolidated annual audited financial statements for the year ended June 30, 2010, related to accounts receivable and allowances for charity and doubtful accounts: Patient accounts receivable and net patient service revenue are reported at the net realizable amount from patients, third-party payors, and others for services rendered. CHSB manages its collection risk by regularly reviewing its accounts and contracts and by providing appropriate allowances. Reserves for charity and uncollectible amounts have been established and are netted against patient accounts receivable in the consolidated balance sheet. | BadDebtFootnote |
| Shortfall As Community Benefit | CHSB prepares Medicare cost reports in a manner that comports with Provider Reimbursement Manual (PRM) 15-1, 2150ff and PRM 15-2, 1000ff. As such, the following language per the PRM 15-1 describes the computation of costs per the Medicare Cost Report: Total allowable costs of a provider are apportioned between program beneficiaries and other patients so that the share borne by the program is based upon actual services received by program beneficiaries. The ratio of covered beneficiary charges to total patient charges for the services of each ancillary department is applied to the cost of the department. Added to this amount is the cost of routine services for program beneficiaries, determined on the basis of a separate average cost per diem for all patients for general routine patient care areas. Another factor to be considered is a separate average cost per diem for the intensive care unit, coronary care unit, and other special care inpatient hospital units. CHW believes that the entire Medicare shortfall of $345.6 million, as reported below in Part VI, Line 7, constitutes community benefit. The IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by CHW hospitals in order to continue treating the elderly in our communities. The hospitals provide care regardless of this shortfall and thereby relieve the federal government of the burden of paying the full cost for Medicare beneficiaries. This shortfall includes $1.2 million reported on Part III, Section B, Line 8, primarily for fee for service Medicare patients, as well as the unreimbursed portion of Medicare Managed Care and Medicare Capitated programs for CHSB. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | At time of patient billing, CHSB provides to all Patients information concerning services and charges provided. Information provided includes, patient financial assistance information, uninsured patient discount information, information regarding eligibility Assistance for Government sponsored healthcare and Payment Assistance. CHSB ensures that patient accounts are processed fairly and consistently. CHW's collection policy contains provisions that prohibit the collection of amounts due from patients who the organization knows qualify for charity care. Accounts with incorrect or incomplete demographic information are assigned to a collection agency if CHSB or the billing company retained by CHW is unable to obtain an updated address through skip tracing or other means. For patients who have an application pending for either government-sponsored financial assistance or for assistance under CHW's Patient Payment Assistance Policy, or where the patient is attempting in good faith to settle an outstanding bill with the facility via payment plans, CHW will not knowingly send that patient's bill to an outside collection agency. Legal action will not be pursued to collect debts from patients who have qualified for charity or are cooperating in good faith to resolve their debt. CHW does not impose wage garnishments or liens on primary residences. On self-pay accounts that do not meet the criteria noted above, the initial determination of assignment to a collection agency will vary depending on the nature of the account with the final decision being at the discretion of each hospital patient financial assistance department. Upon assignment of such a patient account to a collection agency, CHW requires the agency to comply with the Fair Debt Collection Practices Act. | DebtCollectionPolicy |
| Number Of Facility Type Expln | ONE SKILLED NURSING FACILITY | NumberOfFacilityTypeExpln |
| Needs Assessment | The passing of California's Community Benefit Law (SB 697) created a process and major tool for CHSB to determine its community benefit plan, which outlines how the hospital will give back to the community in the form of health care and other community services to address unmet community health needs. In the spring of 2008 a Community Needs Assessment (CNA) was carried out in partnership with St. Bernardine Medical Center. It incorporates components of primary data collection and secondary data analysis that focus on the health and social needs of the CHSB Service Area. Additionally, eight focus groups were conducted with residents of communities in the CHSB primary service area. Five of the groups were conducted in English and three in Spanish. Through the participation in this needs assessment and benefits planning process CHSB remains committed to participating in community processes that update and refresh the ongoing quest to understand and to respond to the community's priorities for health and quality of life improvements. The CNA continues to be a focal point and an essential tool in developing the strategic direction of CHSB, along with participatory and solution focused processes which have taken inventory of community assets and resources in our community by the Latino Health Collaborative, the African American Health Institute, and the Loma Linda School of Public Health. | NeedsAssessment |
| Patient Education Assistance | Communication of the Financial Assistance Program to Patients and the Public: Information about CHW's Financial Assistance Program and a contact number are made available to patients and the public. Patients are informed of the facility's charity care program via signage in all admitting areas and in various common areas of the hospital. Financial assistance program information notices are posted in the Emergency and Admitting Departments and at other public places as the hospital may elect. Such information is provided in the primary languages spoken in the communities the hospital serves. The signage includes notification that all uninsured patients with annual incomes less than $250,000 receive an uninsured discount of 25% for services provided and that further discounts may be provided upon the completion and submission of a charity care application. Payment assistance information, government program resource information, tools to assist patients in finding health coverage, answers to frequently asked billing questions, and other such information can also be found on CHW's website at www.chwhealth.org. At the point of registration, all patients receive brochures explaining the facility's charity care program and the availability of government sponsored programs. Uninsured patients receive copies of the charity care and Medicaid applications in addition to the brochure upon admission to the facility. It is CHW's policy that at the time of patient billing, CHSB provides to all uninsured patients the same billing information concerning services and charges provided to all other patients who receive care at CHSB. If financial assistance eligibility is not determined prior to billing, initial billing statements to uninsured patients include a request to the patient to provide any insurance information that was valid for the dates of service billed, a statement informing patients without insurance coverage they may be eligible for a government sponsored program or facility funded charity care, instructions on how to apply for a government program or charity care and the provision of such applications. Additionally, contract terms with collection vendors working on behalf of CHW includes language requiring all initial statements to uninsured patients include verbiage informing patients of the facility's charity care program and a copy of the charity care application. Also, any member of CHSB facility staff or medical staff may make referrals of patients for financial assistance. The patient or a family member, a close friend or an associate of the patient may also make a request for financial assistance. | PatientEducationAssistance |
| Community Information | The CHSB service area includes San Bernardino, Rialto, Colton, Highland, Fontana and Bloomington. - Nielsen Claritas 2009 places the population of the CHSB service area at 652,519 persons (zip codes 92316, 92324, 92335, 92336, 92346, 92376, 92377, 92401, 92404, 92405, 92407, 92408, 92410, 92411) - CHSB serves a very young population with 38.1% being from 0-20 years of age. - Seniors 65+ comprise 6.6% of CHSB's service area population. - There are three other hospitals that serve the community. One, a CHW hospital. The ethnicity of the service area continues to see a growth in Hispanic residents with an increase from 45% in 2000 to 62% in 2009. Within the non-Hispanic ethnic groups, the African American population demonstrates a slight increase from 13% in 2002 to 13.3% in 2005 and then a downward trend to 12.8% in 2007 and 12.4% in 2009. The remaining 2009 population statistics reflect 19% Caucasian, 4% Asian and 3% other. In the overall CHSB Service Area English and Spanish are the two most frequently spoken languages. Spanish is spoken by more residents than English within the communities of Bloomington, Fontana 92335, San Bernardino 92411 and San Bernardino 92410. Every community within the service area has Spanish speakers. Among those who speak Spanish there are considerable numbers who do not speak English at all. In San Bernardino 92410 13.6% of those who speak Spanish, do not speak English. Fontana 92335 and San Bernardino 92410 and 92411 have high rates of households whose members are linguistically isolated. 2009 Nielsen Claritas lists the median household income in the CHSB primary service area at $45,733. Of the service area's 175,902 households San Bernardino hosts the neighborhoods with the lowest median household incomes (92410 - $29,797 and 92411 - $30,817). Data from the 2000 U.S. Bureau of Census reflects that within the CHSB Service Area zip codes 11.9% to 37.3% of the population lives at or below 100% of the Federal Poverty Level. Over one-third of the population residing in San Bernardino 92410 and 92411 live in poverty, more than double the rate of poverty found in the County overall. The data indicates that within the CHSB Service Area poverty increases markedly for the population at or below 200% of the Federal Poverty Level. Many of the neighborhoods served by CHSB have close to half of the residents living at or below 200% of the Federal Poverty Level. In San Bernardino 92410 over two-thirds of the population is at this level of poverty (67.7%), followed closely by San Bernardino 92411 (63.3%). Poverty is more pronounced among families where the female is the head of household (HOH), indicating that a female maintains a household with no husband present. The CHSB Service Area has a greater percentage of female HOH and more poverty than the County or the State. San Bernardino has the largest percentage of families with female HOH and accompanying rates of poverty. | CommunityInformation |
| Community Building Activities | CHSB provides financial and in-kind support for community building activities. In 2010 CHSB provided operational and meeting space to facilitate our collaborative effort to create a sustainable action plan that addresses this highly diverse community's needs with regard to disparity of care and unmet health needs, particularly in the area of chronic lifestyle related conditions such as diabetes, asthma, and chronic heart failure. In 2010 CHSB provided support for: - Assistance League of San Bernardino is a nonprofit organization whose volunteers enrich the lives of children in need by providing school clothing and offering general dentistry - The San Bernardino Black Culture Foundation in which it is culturally diverse and committed to the development and understanding of African - American culture. The organization strives to provide meaningful socio-economic and educational programs for the benefit of the community - Purchased Route 66 Annual Community Event booth space to distribute health awareness information specific to life style related diseases (asthma, diabetes, healthy eating, etc.) - Smiles for Seniors in which alleviated some of the pressure and fear many seniors have of not having enough to survive or having to choose between medication and rent. - San Bernardino Safety Employees Benefit Association whose event mission was to sponsor summer children's fishing event to encourage physical exercise and fun outdoor activities for inner city youth who are influenced by gangs and violence. | CommunityBuildingActivities |
| Other Information | A majority of the CHSB's governing body is comprised of persons who reside in the primary service area and who are neither employees, family members nor contractors of the Hospital. The Hospital extends medical staff privileges to all qualified physicians in the community. CHSB furthers the health of the Community through proactive fiscal year expenditures of $543,353 applied toward no cost community health improvement programs, including emergency case management services, classes, clinics, forums, and fairs. These expenditures address high priority needs consistent with those indentified in the hospital's most recent community needs assessment. Health classes include disease prevention, awareness and management for lifestyle related conditions such as pediatric asthma and diabetes. Mother/infant bonding and breastfeeding instruction/coaching promote better outcomes for healthy babies and children during the economic downturn where food insecurity is extremely high. | OtherInformation |
| Affiliated Health Care System | CHSB is affiliated with CHW. Affiliates of CHW also promote the health of additional communities in Bakersfield, San Bernardino, San Francisco, San Andreas, and Grass Valley/Nevada City, California. These affiliates follow practices similar to those noted above in determining the unmet healthcare needs of their communities. The smmary of Total unsponsored community benefit expense for CHW and its subordinate corporations for the year ended June 30, 2010, is as follows: Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 110,381 142,746,446 1.7% Unpaid Costs of Medicaid/Medi-Cal 944,650 558,385,256 6.5% Other Means-tested Programs 269,294 56,864,415 0.7% Community Services: Community Health Services 553,419 48,887,807 0.5% Health Professions Education 21,746 6,431,872 0.1% Subsidized Health Services 212,434 36,161,087 0.4% Donations 256,564 8,509,998 0.1% Community Building Activities 69,194 1,805,508 0.0% Community Benefit Operations 11,547 5,645,250 0.1% Total Community Services for the poor 1,124,904 107,441,522 1.2% Total Benefits for the Poor 2,449,229 865,437,639 10.1% Benefits for the Broader Community: Community Services: Community Health Services 2,464,586 19,716,268 0.2% Health Professions Education 49,929 46,618,328 0.5% Subsidized Health Services 114,349 13,649,835 0.2% Research 23,285 27,190,380 0.3% Donations 158,111 3,762,689 0.1% Community Building Activities 77,077 6,774,273 0.1% Community Benefit Operations 95,948 2,000,665 0.0% Total Benefits for the Broader Community 2,983,285 119,712,438 1.4% Total Community Benefits 5,432,514 985,150,077 11.5% Unpaid Costs of Medicare 995,245 345,619,895 4.0% Total Community Benefits including Cost of Medicare 6,427,759 1,330,769,972 15.5% | AffiliatedHealthCareSystem |
| Reports Filed With States | CA | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Marvin O'Quinn | |||||||||||||
| 0 | 834172 | 0 | 656502 | 0 | 439423 | 0 | 78027 | 0 | 41122 | 0 | 2049246 | 0 | 0 |
| Elizabeth Shih | |||||||||||||
| 0 | 601159 | 0 | 645632 | 0 | 561171 | 0 | 249716 | 0 | 43910 | 0 | 2101588 | 0 | 527371 |
| Susan Whitten | |||||||||||||
| 0 | 261710 | 0 | 196983 | 0 | 11094 | 0 | 31822 | 0 | 28649 | 0 | 530258 | 0 | 0 |
| Diane Nitta | |||||||||||||
| 244105 | 0 | 206338 | 0 | 11572 | 0 | 31100 | 0 | 3936 | 0 | 497051 | 0 | 0 | 0 |
| Edward Sorenson | |||||||||||||
| 238102 | 0 | 45962 | 0 | 12124 | 0 | 24648 | 0 | 12937 | 0 | 333773 | 0 | 0 | 0 |
| Kimiko Ford | |||||||||||||
| 188221 | 0 | 35606 | 0 | 906 | 0 | 17970 | 0 | 15812 | 0 | 258515 | 0 | 0 | 0 |
| DAVID J EVANS | |||||||||||||
| 166985 | 0 | 21272 | 0 | 8521 | 0 | 17831 | 0 | 15896 | 0 | 230505 | 0 | 0 | 0 |
| LAWRENCE LAWLER | |||||||||||||
| 175387 | 0 | 21917 | 0 | 328 | 0 | 16256 | 0 | 15703 | 0 | 229591 | 0 | 0 | 0 |
| Marc Marchetti | |||||||||||||
| 181583 | 0 | 34524 | 0 | 3938 | 0 | 16536 | 0 | 15761 | 0 | 252342 | 0 | 0 | 0 |
| Martha Mulugeta | |||||||||||||
| 201187 | 0 | 600 | 0 | 198 | 0 | 10605 | 0 | 15360 | 0 | 227950 | 0 | 0 | 0 |
| HAROLD NEWTON | |||||||||||||
| 185075 | 0 | 23137 | 0 | 1639 | 0 | 17200 | 0 | 16322 | 0 | 243373 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Sch J-1 | Paul Ryan's compensation is for Chief of Staff Services provided to the organization from July 2009 through December 2009. Alvaro Bolivar's compensation is for Chief of Staff Services provided to the organization from January 2010 through June 2010. Betty Daniel's compensation is for medical Services provided to the organization. |
| Schedule J, Part I, Line 3 | Although the organization employs personnel, the Organization relied on a related organization, Catholic Healthcare West, that used one or more of the methods described in Schedule J, Part I, Line 3, to establish the Organization's Service Area Leader's compensation. See Schedule O disclosure for Form 990, Part VI, Section B, Line 15a for additional information. |
| PART I, LINE 4a | The organization's key employees and its highest compensated employees participate in a severance plan established by its supported organization. The plan provides fair compensation, ranging from payments of 1 month to 2 years of base compensation, depending on the executive's position, in the event of a position elimination or other involuntary termination, in accordance with the guidelines of the plan. |
| PART I, LINE 4b | Certain listed persons hired prior to June 30, 2006 are eligible to participate in the CHW Executive Deferred Compensation Plan, a nonqualified 457(f) plan which is intended to provide a benefit approximating the difference, if any, between the benefit provided under the CHW Excess Benefit Plan and the benefit provided under the qualified benefit plan that substantially replaced the Excess Plan. No benefit will vest under the 457(f) plan before the later of the attainment of age 62 while employed or the completion of 15 years of service. Certain listed persons participate in the CHW Excess Benefit Plan, a nonqualified supplemental benefit plan limited to participants in the CHW Retirement Plan whose benefits are affected by the limitations imposed by sections 401(a)(17) and 415 of the Internal Revenue Code. Benefit service under this plan was frozen as of January 1, 2008. No payments were made to any listed persons during 2009 pursuant to this plan. Certain listed persons participate in the CHW Key Employee Share Option Plan (KeySOP), which was frozen in May 2002. The KeySOP program was established in 2001 with the purpose of providing additional compensation to eligible employees, commensurate with their contributions to the success of CHW, in a form that would provide incentives and rewards for meritorious performance and encourage the recipients' continuance as employees of CHW. Grants of options could be made to any employee who was eligible for the Company's Key Employee Retention Program. A payment of $270,624 was made to E. Shih during 2009. Certain officers and key employees participate in the CHW supplemental executive retention/retirement plan, a nonqualified supplemental benefit plan which in 2002 was offered to members of the executive management team by the CHW Board of Directors and would be paid only if the executives stayed with the organization for a specified number of years as the primary purpose of this plan is to provide for the retention and ultimate retirement security of the participants. The executive management team was recruited from stable careers in organizations from across the country and from various industries to engineer and lead a financial and operational turnaround after the organization had lost nearly $1 billion in net operating performance. The calculation for the payments to each executive is based on retirement age and service years to the organization, and distribution is only available after a vesting period and while the executive is actively employed with CHW. Vested amounts are reported as deferred compensation in the year vesting occurs (column c) and are reflected again as reportable compensation in the year paid (column b(iii)). Payouts are recorded as reportable compensation in column b(iii) and are also reported in column f, as the deferral of this retirement income was reported in prior years when amounts were vested. Payments made during 2009 pursuant to this plan include $257,107 to E. Shih. The payouts were due to changes in the Internal Revenue Code relating to the treatment of deferred compensation plans. The American Jobs Creation Act of 2004 added Internal Revenue Code (IRC) Sec. 409a to change the treatment of nonqualified deferred compensation plans, including timing of payouts and income recognition to the plan participant. As part of CHW's modification of its nonqualified deferred compensation plans to meet the requirements of IRS Sec. 409a, it was determined that the payouts were necessary as part of this conformity to tax law. |
| PART II - SUPPLEMENTAL DISCLOSURES | The organization's executive compensation philosophy is designed to assist the organization in attracting and retaining the caliber of executives required to enable the organization to fulfill its mission of providing high quality healthcare for all persons regardless of their ability to pay for services, improving the quality of life in the communities the organization serves, promoting employee satisfaction, and ensuring financial stability. A substantial portion of executive compensation is performance based and is linked to organizational goals approved in advance by the compensation and benefits committee. These goals include attainment of annual and long-term financial performance, certain healthcare quality standards and the organization's commitment to serving the poor and disenfranchised in the communities it serves. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 521598225 | IssuerEIN |
| CUSIP Number | 13033FTN0 | CUSIPNumber |
| Date Issued | 2004-05-19 | DateIssued |
| Issue Price | 150000000 | IssuePrice |
| Description Of Purpose | NEW MONEY TO FUND VAR PROJECTS & M | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 2004025 | TotalProceeds |
| Amount In Reserve Fund | 0 | AmountInReserveFund |
| Amount Defeased | 0 | AmountDefeased |
| Amount Unspent | 0 | AmountUnspent |
| Issuance Costs From Proceeds | 0 | IssuanceCostsFromProceeds |
| Working Capital Expenditures | 0 | WorkingCapitalExpenditures |
| Capital Expenditures | 2004025 | CapitalExpenditures |
| Year Of Subst Completion | 2005 | YearOfSubstCompletion |
| Current Refunding | false | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | true | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | true | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | true | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | true | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | true | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | false | Form8038TFiled |
| Variable Rate Issue | true | VariableRateIssue |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | true | GrossProceedsInvested |
| Exception To Rebate | false | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Dan Lyman | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Family Mem of BM F Lyman | Relationship |
| Amount Of Transaction | 220578 | AmountOfTransaction |
| Description Of Transaction | Maintenance of fire doors | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART VI - GOVERNANCE, MANAGEMENT, DISCLOSURE | FORM 990, PART VI, SECTION A, LINE 6 The sole corporate member is Catholic Healthcare West, a 501(c)(3) exempt organization. FORM 990, PART VI, SECTION A, LINE 7a CHW, as the sole corporate member, ratifies the selection of members and the CHW Board approves new Board members of the organization. FORM 990, PART VI, SECTION A, LINE 7b Reserved rights of the corporate member include: Adoption of Mission & Philosophy statements, Amendment or restatement of the Articles of Incorporation and Bylaws; Dissolution of the corporation, acquire another corporation, or create a subsidiary; Merging or consolidating with another corporation; Participation as a general or limited partner in any venture; Incurring long-term indebtedness in excess of normal operating requirements; Ratification of board member appointments & dismissals; Selection or removal of independent auditors; Transactions outside the ordinary course of business. FORM 990, PART VI, SECTION B, LINE 11a THE ORGANIZATION'S CFO AND CONTROLLER WORKED CLOSELY WITH THE PARENT ORGANIZATION AND AN INDEPENDENT ACCOUNTING FIRM ENGAGED TO REVIEW THE RETURN. The Board of Directors has delegated the review of the Form 990 to the Finance Committee. Management presented the draft of the Form 990 to the Finance Committee. The draft was complete except it excluded compensation information for directors who are also key executives of Catholic Healthcare West, the filing organization's sole member. Compensation by Catholic Healthcare West to those directors has been reviewed by the Compensation and Benefits Committee of the Catholic Healthcare West Board of Directors. Subsequent to its review, the Finance and Investment Committee reported back to the Board regarding its review and provided a draft to the Board of Directors, again excluding compensation for certain directors. FORM 990, PART VI, SECTION B, LINE 12C The Organization has adopted CHW's Conflicts of Interest Policy. The Organization's Board is charged with monitoring proposed or ongoing transactions for conflicts of interest and addressing any potential or actual conflicts. Pursuant to the Conflicts of Interest Policy, an annual conflict of interest questionnaire, aimed at determining any family and business relationships and transactions or other transactions that may pose a potential conflict, is distributed to all covered persons (e.g., board members, officers and executive leadership, key employees). Covered persons are required to disclose real or potential conflicts at the time such conflicts arise. When someone becomes a covered person and annually thereafter, each covered person is required to sign a statement affirming that he/she: (1) has received a copy of the Conflicts of Interest Policy; (2) has read the Policy and understands said Policy; and (3) agrees to comply with all requirements of the Policy, including completing the conflicts of interest questionnaire. The completed questionnaires are reviewed by CHW's Legal Department and any persons with actual or potential conflicts are informed via written communication. The procedures for addressing any conflict of interest include, but are not limited to, the following: (1) the conflicting interest is fully disclosed to the Board; (2) the interested person responds to factual questions related to the substance of the transaction or arrangement being considered, after which he/she shall leave the meeting; (3) the person with the conflict of interest is excluded from the discussion and approval of such transaction; (4) alternatives to the proposed transaction are investigated, competitive bids or comparable valuations are obtained; (5) any conflicting issues during the course of a Board meeting which cannot be resolved is referred to the Governance Committee; and (6) the transaction or action must be approved by a majority of disinterested persons. All conflicts of interest, whether resolved or unresolved, are reported in the Organization's Form 990. FORM 990, PART VI, SECTION B, LINE 15A Although the organization employs personnel, the Service Area Leader's compensation is set by a related organization, Catholic Healthcare West (CHW). FOR 2009, CHW's Compensation and Benefits department conductED an annual review and analysis to provide benchmarking data for the total compensation and benefits package of the Service Area Leader. Appropriate comparability data for similar jobs in peer companies (both taxable and tax-exempt) WAS obtained from independent third-party survey sources. FORM 990, PART VI, SECTION B, LINE 15B For 2009 COMPENSATION, The organization's human resources department conducted an annual review and analysis to provide benchmarking data for the total compensation and benefits package of key employees. The compensation for these individuals was based on the qualification and experience of the candidates. Compensation is also reviewed annually as part of the merit increase process. FORM 990, PART VI, SECTION B, LINE 19 Federal tax laws do not mandate that the organization's governing documents, conflict of interest policy and financial statements be made available for public inspection. The organization makes its financial statements available on its website and upon request. |
| SCHEDULE K | PART IV, LINE 1 Arbitrage calculations were performed by an arbitrage consultant. Such consultant determined that there was no rebatable arbitrage liability; accordingly, no form 8038-T was required to be filed. |
| FORM 990, PART VII, SECTION A | The following individuals listed on Form 990 Part VII were compensated by Catholic Healthcare West, a related organization. An estimate of their hours provided to the related organization is provided: Dr Betty Daniels; 8 hours Marvin O'Quinn; 40 hours Elizabeth Shih; 40 hours Susan Whitten; 40 hours |
| Schedule R, Part V, line 2 column (c) | Part V, line 1c - CHSB is supported by one foundation. As a supporting organization, the foundation operate for the benefit of, to raise funds for, or to carry out the purposes of CHSB. As a result, payments are made directly to CHSB from the Foundation or directly to the Foundation from CHSB. Part V, line 1p - Intercompany activity is common among CHSB and its related organizations. Reimbursements for expenses incurred by the organizations are reported as transaction types "o" and/or "p". Amounts reimbursed are at cost. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| Community Hospital Foundation | |||||||||
| 1805 Medical Center Drive | San Bernardino | CA | 92411 | 953051931 | Fund raising | CA | 501(c)(3) | 11; Type I | NA |
| Catholic Healthcare West | |||||||||
| 185 Berry Street | San Francisco | CA | 94107 | 941196203 | Hospital | CA | 501(c)(3) | 3 | NA |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| COMMUNITY HOSP OF SAN BERNARDINO FOUNDATION | |
| c | 300000 |
| COMMUNITY HOSP OF SAN BERNARDINO FOUNDATION | |
| p | 107000 |
Comments