2011-11-15T13:20:53-06:00 2010-12-31 MOSS ADAMS LLP ONE CALIFORNIA STREET 4TH FLOOR SAN FRANCISCO CA 94111 990 2010-01-01 680046750 NORTHBAY HEALTHCARE CORPORATION NORT 7076463111 4500 BUSINESS CTR DR FAIRFIELD CA 94534 ARTHUR E DENIO 7076463111 2011-11-09 1 RENIE BURBANK 4159561500 2010 2016-03-07 17:11:31Z ARTHUR E DENIO 4500 BUSINESS CTR DR FAIRFIELD CA 94534 39451606 0 X WWW.NORTHBAY.ORG X 1984 CA THE CORPORATION IS ORGANIZED TO SUPPORT, ACT FOR THE BENEFIT OF, PERFORM FUNCTIONS OF, AND CARRY OUT THE PURPOSES OF NORTHBAY HEALTHCARE GROUP, NORTHBAY HEALTH ADVANTAGE, AND NORTHBAY HEALTHCARE FOUNDATION, ALL OF WHICH ARE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3), AND ORGANIZATIONS DESCRIBED IN SECTION 509(A)(1) OR (2) OF THE INTERNAL REVENUE CODE. 7 7 327 155 0 0 0 33021 36707029 39188408 7 2722 -178828 175181 36528208 39399332 313030 63931 0 0 18953313 19770756 0 0 55199 17843560 20380723 37109903 40215410 -581695 -816078 21584086 16856044 4636634 6139915 16947452 10716129 X COMPASSIONATE CARE, ADVANCED MEDICINE, CLOSE TO HOME. 0 0 21977608 58931 39188408 NORTHBAY HEALTHCARE CORPORATION (NBHC) IS THE PARENT HOLDING COMPANY OF THREE CALIFORNIA NON-PROFIT PUBLIC BENEFIT CORPORATIONS. ONE OF THOSE CORPORATIONS, NORTHBAY HEALTHCARE GROUP, OWNS AND OPERATES NON-PROFIT COMMUNITY HOSPITALS IN FAIRFIELD AND VACAVILLE. THE PURPOSE OF NBHC IS TO SUPPORT AND HELP CARRY OUT THE PURPOSES AND FUNCTIONS OF NORTHBAY HEALTHCARE GROUP, NORTHBAY HEALTH ADVANTAGE, AND NORTHBAY HEALTHCARE FOUNDATION. THIS IS ACCOMPLISHED THROUGH PROVIDING COORDINATION, MANAGEMENT, AND OTHER SUPPORT SERVICES TO THE NON-PROFIT HOSPITALS AND OTHER RELATED COMMUNITY HEALTHCARE PROGRAMS. THESE SERVICES INCLUDE MARKETING, RESEARCH OF NEW SERVICE AREAS (E.G. GERONTOLOGY, LITHOTRIPSY, SKILLED NURSING FACILITIES), MANAGING PAYOR CONTRACTS BETWEEN PROVIDERS AND PAYORS, AND FINANCING. UPON DISSOLUTION, ALL ASSETS (AFTER PAYMENT FOR DEBT/LIABILITY) WILL BE DISTRIBUTED TO NORTHBAY HEALTHCARE GROUP OR AN ENTITY ORGANIZED AND OPERATED NOT FOR PECUNIARY GAIN OR PROFITS. NBHC IS NOT ORGANIZED NOR OPERATED FOR PECUNIARY GAIN OR PROFITS, NBHC IS DEDICATED IRREVOCABLY TO THE CHARITABLE PURPOSES SET FORTH IN THE ARTICLES OF INCORPORATION. 5000 5000 NORTHBAY GUILD IS THE VOLUNTEER GROUP FOR NORTHBAY HEALTHCARE GROUP. THE PURPOSE OF THE NORTHBAY GUILD IS TO SUPPORT AND HELP CARRY OUT THE PURPOSE AND FUNCTIONS OF NORTHBAY HEALTHCARE GROUP. THIS IS ACCOMPLISHED THROUGH PROVIDING FUNDRAISING SUPPORT TO THE NON-PROFIT HOSPITALS AND OTHER RELATED COMMUNITY HEALTHCARE PROGRAMS. UPON DISSOLUTION, ALL ASSETS (AFTER PAYMENT FOR DEBT/LIABILITY) WILL BE DISTRIBUTED TO NORTHBAY HEALTHCARE GROUP OR AN ENTITY ORGANIZED AND OPERATED NOT FOR PECUNIARY GAIN OR PROFITS. NORTHBAY GUILD IS NOT ORGANIZED NOR OPERATED FOR PECUNIARY GAIN OR PROFITS. NORTHBAY GUILD IS DEDICATED IRREVOCABLY TO THE CHARITABLE PURPOSES SET FORTH IN ARTICLES. 21982608 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X ARTHUR E DENIO 7076463111 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 X BEN HUBER 1.00 X 10608 0 0 MARY MANCINI 1.00 X 15848 0 0 JAMES MCMAHON 1.00 X 10640 0 0 STEPHEN POWER 1.00 X 15848 0 0 ARCHIE HUMPHREY 1.00 X 0 10640 0 GARY FALATI 1.00 X 5838 0 0 MARK SIEVERS 1.00 X 0 0 0 GARY PASSAMA 20.00 X 824992 0 27999 DEBORAH SUGIYAMA 8.00 X 460583 0 69074 ARTHUR DENIO 16.00 X 447163 0 14878 PAUL ALCALA 40.00 X 485393 0 22319 DONALD DENMARK 40.00 X 434665 0 56135 ELNORA CAMERON 36.00 X 348889 0 45539 KATHLEEN RICHERSON 40.00 X 323340 0 38701 KENNETH MCCOLLUM 40.00 X 280649 0 31695 BRIDGIT STRACHAN 40.00 X 274431 0 34533 MARGARET WALBOLT 40.00 X 273655 0 36344 STEVEN HUDDLESTON 40.00 X 248684 0 33823 BRETT JOHNSON 40.00 X 233956 0 35131 JOELYN GROPP 40.00 X 182843 0 8423 ROSE KENNEDY 40.00 X 174665 0 4691 MICHELLE HEARNE 40.00 X 165876 0 11698 PEGGY MORRISON 40.00 X 163972 0 8634 REBECCA LESSLER 40.00 X 151419 0 12881 5533957 10640 492498 52 0 1 0 PRICEWATERHOUSE COOPERS LLP PO BOX 514038 LOS ANGELES CA 90051 SUPPLY CHAIN CONSULTING 610635 LATHAM AND WATKINS 505 MONTGOMERY STREET SAN FRANCISCO CA 94111 LEGAL SERVICES 373873 THOMSON REUTERS HEALTHCARE INC 39353 TREASURY WAY CHICAGO IL 60694 BENCHMARKING SERVICES 270334 OMG LLC PO BOX 37389 LOUISVILLE KY 40233 CONTRACT MANAGEMENT SERVICES 259704 SG-2 LLC 35347 EAGLE WAY CHICAGO IL 60678 WOMEN'S HEALTH FORUM CONSULTING 228158 17 33021 33021 MGMT AND ADMIN FEES 900099 39188408 39188408 39188408 2722 2722 180084 52274 127810 127810 OTHER OPERATING REV 900099 51624 51624 OTHER NON-OPR. REVENUE 900099 982 982 INCOME FROM NBPSC, LLC 900099 -5235 -5235 47371 39399332 39188408 0 177903 63931 63931 5141353 5141353 10446003 4019789 6426214 687122 461794 225328 2460574 1323927 1136647 1035704 616159 419545 505188 505188 240033 240033 40000 40000 6296613 3762342 2534271 259623 259174 449 1646807 1461459 184258 1090 3516595 3458530 58065 3027781 2787999 197857 41925 130429 80684 49745 170747 135023 31561 4163 2897153 2806414 90739 114329 114329 RECRUITING 369137 146857 222280 DUES & SUBSCRIPTIONS 165830 58450 107380 PUBLIC RELATIONS 161582 66626 94956 TAXES/LICENSES 138183 19842 118341 PROMOTIONS 30336 30064 272 670357 423544 238792 8021 40215410 21982608 18177603 55199 162205 215975 831151 2068273 100 100 75054 98169 847157 1496367 27585879 19362321 16629464 8223558 655985 987760 100 100 2382870 3765742 21584086 16856044 4636634 4539945 1599970 4636634 6139915 X 16947452 10701514 14615 16947452 10716129 21584086 16856044 X -816078 -5415245 X X 0 1 1 X 0 X X X 0 0 0 NORTHBAY HLTHCR GRP 941458282 3 1 1 1 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 229014 186478 42536 1458759 645864 812895 24916239 18294136 6622103 981867 235843 746024 8223558 DUE FROM SDI 3765742 3765742 39399332 40215410 -816078 -5415245 -5415245 -6231323 39977000 840866 840866 39136134 263198 263198 39399332 40156000 53061 53061 40102939 112471 112471 40215410 PART XI, LINE 8 - OTHER ADJUSTMENTS: INCOME FROM NORTHBAY PHYSICIANS SURGERY CENTER K-1 5,235. INTERCOMPANY RECEIVABLES/PAYABLES -5,420,487. ROUNDING 7. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING ADJUSTMENT 169. COST OF GOODS SOLD RECLASSIFIED FROM EXPENSES 52,273. REVENUES FROM AFFILIATE RECLASSIFIED FROM NET ASSETS 788,424. PART XII, LINE 4B - OTHER ADJUSTMENTS: INCOME FROM NORTHBAY PHYSICIANS SURGERY CENTER K-1 -5,235. TOTAL REVENUES ATTRIBUTABLE TO GUILD 251,096. CONTRIBUTIONS RECLASSIFIED FROM NET ASSETS 14,615. INVESTMENT INCOME 2,722. PART XIII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING ADJUSTMENT 788. COST OF GOODS SOLD RECLASSIFIED TO REVENUES 52,273. PART XIII, LINE 4B - OTHER ADJUSTMENTS: TOTAL EXPENSES ATTRIBUTABLE TO GUILD 112,471. 1 NORTHBAY HEALTHCARE GROUP 1200 B GALE WILSON BLVD FAIRFIELD CA 94533 941458282 501(C)(3) 58931 GENERAL SUPPORT 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: NORTHBAY HEALTHCARE CORPORATION AND NORTHBAY GUILD GRANT FUNDS TO NORTHBAY HEALTHCARE FOUNDATION TO ASSIST WITH THEIR DAILY OPERATIONS. NBHC DOES NOT MONITOR THE USE OF THE GRANT FUNDS; HOWEVER, THEY HAVE PROCEDURES TO DETERMINE THE AMOUNT OF GRANT FUNDS ISSUED TO NORTHBAY HEALTHCARE FOUNDATION. NORTHBAY GUILD ALSO GRANTS FUNDS TO LOCAL COLLEGES AND UNIVERSITIES FOR A TEEN VOLUNTEER SCHOLARSHIP PROGRAM. TEEN VOLUNTEER SCHOLARSHIP APPLICATION FORMS TO APPLY FOR COLLEGE SCHOLARSHIPS ARE SUBMITTED EACH YEAR. RECIPIENTS ARE SELECTED FROM THE POOL OF APPLICATIONS SUBMITTED BY THE HOSPITAL GUILD BOARD. EACH GRANT/ASSISTANCE REQUEST REQUIRES DOCUMENTATION AS TO THE USE OF THE FUNDS AND THE DISBURSEMENT OF THOSE FUNDS MUST BE APPROVED BY THE NORTHBAY GUILD MEMBERS AND AUXILLARY DIRECTOR. X X X X 0 1 0 0 0 0 1 0 0 GARY PASSAMA 448515 0 149389 0 227088 0 27347 0 652 0 852991 0 0 0 DEBORAH SUGIYAMA 333461 0 111265 0 15857 0 66616 0 2458 0 529657 0 0 0 ARTHUR DENIO 311972 0 87139 0 48052 0 13921 0 957 0 462041 0 0 0 PAUL ALCALA 314533 0 112341 0 58519 0 22115 0 204 0 507712 0 0 0 DONALD DENMARK 343663 0 78029 0 12973 0 52214 0 3921 0 490800 0 0 0 ELNORA CAMERON 270859 0 65857 0 12173 0 42335 0 3204 0 394428 0 0 0 KATHLEEN RICHERSON 241346 0 65169 0 16825 0 37744 0 957 0 362041 0 0 0 KENNETH MCCOLLUM 210918 0 55213 0 14518 0 30738 0 957 0 312344 0 0 0 BRIDGIT STRACHAN 206373 0 55089 0 12969 0 33576 0 957 0 308964 0 0 0 MARGARET WALBOLT 210423 0 49875 0 13357 0 35692 0 652 0 309999 0 0 0 STEVEN HUDDLESTON 198202 0 47957 0 2525 0 27132 0 6691 0 282507 0 0 0 BRETT JOHNSON 183685 0 47729 0 2542 0 32660 0 2471 0 269087 0 0 0 JOELYN GROPP 171112 0 11731 0 0 0 7466 0 957 0 191266 0 0 0 ROSE KENNEDY 160959 0 10920 0 2786 0 4691 0 0 0 179356 0 0 0 MICHELLE HEARNE 155045 0 10831 0 0 0 8306 0 3392 0 177574 0 0 0 PEGGY MORRISON 154702 0 9270 0 0 0 5126 0 3508 0 172606 0 0 0 REBECCA LESSLER 141646 0 9773 0 0 0 10669 0 2212 0 164300 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE ORGANIZATION'S 457(F) PLAN: -PAUL CHRISTOPHER ALCALA $39,735 -ELNORA L. CAMERON $20,845 -ARTHUR E DENIO $37,951 -DONALD M. DENMARK, MD $36,555 -STEVE C. HUDDLESTON $14,959 -BRETT N. JOHNSON $13,761 -KENNETH D MCCOLLUM $15,920 -GARY J. PASSAMA $64,721 -KATHLEEN RICHERSON, RN $18,788 -BRIDGIT E. STRACHAN $15,883 -DEBORAH A. SUGIYAMA $41,701 -MARGARET E. WALBOLT $15,883 PART I, LINE 6 PART OF A SENIOR MANAGEMENT INCENTIVE PROGRAM AND MANAGEMENT ACCOUNTABILITIES WHICH INCLUDE OTHER CRITERIA. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE SYSTEM CFO AND BY THE BOARD OF DIRECTORS OF NORTHBAY HEALTHCARE CORPORATION. A HARDCOPY OF THE FORM 990 IS SENT VIA US POSTAL SERVICE TO ALL VOTING MEMBERS FOR THEIR REVIEW AND COMMENTS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUESTS ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO SELF-MONITOR COMPLIANCE; IN ADDITION EACH OFFICER AND DIRECTOR MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST STATEMENT. FORM 990, PART VI, SECTION B, LINE 15 AN AD HOC COMPENSATION COMMITTEE OF THE SYSTEM BOARD REVIEWS EXECUTIVE COMPENSATION; THEY ARE ASSISTED BY INDEPENDENT CONSULTANTS. THE ORGANIZATION USES INDEPENDENT LOCAL SURVEYS AS A MEANS TO SUBSTANTIATE COMPENSATION DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST BY CALLING NORTHBAY HEALTHCARE SYSTEM AT 707-646-3102. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE FOR PUBLIC INSPECTION. HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS 990, PART VII, SECTION A, COLUMN B BEN HUBER'S TIME IS DIVIDED AS FOLLOWS: NORTHBAY HEALTHCARE CORPORATION: 1 HOUR NORTHBAY HEALTH ADVANTAGE: 1 HOUR ARCHIE HUMPHREY'S TIME IS DIVIDED AS FOLLOWS: NORTHBAY HEALTHCARE GROUP: 1 HOUR NORTHBAY HEALTHCARE CORPORATION: 1 HOUR MARK SIEVERS' TIME IS DIVIDED AS FOLLOWS: NORTHBAY HEALTHCARE GROUP: 1 HOUR NORTHBAY HEALTHCARE CORPORATION: 1 HOUR GARY PASSAMA'S TIME IS DIVIDED AS FOLLOWS: NORTHBAY HEALTHCARE GROUP: 12 HOURS NORTHBAY HEALTHCARE CORPORATION: 20 HOURS NORTHBAY HEALTH ADVANTAGE: 5 HOURS NORTHBAY HEALTHCARE FOUNDATION: 3 HOURS DEBORAH SUGIYAMA'S TIME IS DIVIDED AS FOLLOWS: NORTHBAY HEALTHCARE GROUP: 32 HOURS NORTHBAY HEALTHCARE CORPORATION: 8 HOURS ARTHUR E. DENIO'S TIME IS DIVIDED AS FOLLOWS: NORTHBAY HEALTHCARE GROUP: 20 HOURS NORTHBAY HEALTHCARE CORPORATION: 16 HOURS NORTHBAY HEALTH ADVANTAGE: 4 HOURS NORTHBAY HEALTHCARE FOUNDATION: 2 HOURS ELNORA CAMERON'S TIME IS DIVIDED AS FOLLOWS: NORTHBAY HEALTHCARE CORPORATION: 36 HOURS NORTHBAY HEALTH ADVANTAGE: 2 HOURS BRETT JOHNSON'S TIME IS DIVIDED AS FOLLOWS: NORTHBAY HEALTHCARE CORPORATION: 40 HOURS NORTHBAY HEALTHCARE FOUNDATION: 2 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: INCOME FROM NORTHBAY PHYSICIANS SURGERY CENTER K-1 5,235. INTERCOMPANY RECEIVABLES/PAYABLES -5,420,487. ROUNDING 7. TOTAL TO FORM 990, PART XI, LINE 5: -5,415,245. AUDIT COMMITTEE AND OVERSIGHT FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR. NORTHBAY HEALTH ADVANTAGE 4500 BUSINESS CTR DR FAIRFIELD CA 94534 942495998 MANAGES REAL ESTATE FOR NORTHBAY HEALTHCARE GROUP & AFFILIATES CA 501(C)(3) 11-II N/A 1 NORTHBAY HEALTHCARE GROUP 1200 B GALE WILSON BLVD FAIRFIELD CA 94533 941458282 OPERATES TWO NONPROFIT HOSPITALS CA 501(C)(3) 3 N/A 1 NORTHBAY HEALTHCARE FOUNDATION 4500 BUSINESS CTR DR FAIRFIELD CA 94534 942995085 PROVIDES FUNDRAISING FOR NORTHBAY HEALTHCARE GROUP & AFFILIATES CA 501(C)(3) 11-I N/A 1 NORTHBAY PHYSICIANS SURGERY CENTER LLC 1006 NUT TREE ROAD VACAVILLE CA 95687 203502901 MEDICAL SERVICE CA N/A UNRELATED -6414 885361 0 0 0.67000 SOLANO DIAGNOSTIC PARTNERS 1101 B GALE WILSON BLVD FAIRFIELD CA 94533 931013774 DIAGNOSTIC IMAGING CA NORTHBAY HEALTH ADVANTAGE INVESTMENT-EXCLUDED 1 0 0.05000 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 0 0 NORTHBAY HEALTHCARE FOUNDATION N 366303 BOOK VALUE NORTHBAY HEALTHCARE GROUP P 6224538 BOOK VALUE SOLANO DIAGNOSTIC PARTNERS P 1382873 BOOK VALUE NORTHBAY HEALTHCARE GROUP B 58931 BOOK VALUE SOLANO DIAGNOSTIC PARTNERS D 3765742 BOOK VALUE NORTHBAY PHYSICIANS SURGERY CENTER A 19658 BOOK VALUE