2011-11-15T18:55:10-06:00 2010-12-31 MOSS ADAMS LLP ONE CALIFORNIA STREET 4TH FLOOR SAN FRANCISCO CA 94111 990 2010-01-01 953766170 COMMUNITY HEALTH GROUP COMM 6194220422 740 BAY BLVD CHULA VISTA CA 91910 WILLIAM RICE 6194220422 2011-11-10 1 RENIE BURBANK 4159561500 2010 2016-03-07 17:11:31Z WILLIAM RICE 740 BAY BLVD CHULA VISTA CA 91910 47478204 0 X N/A X 1982 CA COMMUNITY HEALTH GROUP IS A HEALTH PLAN THAT IS DEDICATED TO IMPROVEMENT AND MAINTENANCE OF HEALTH FOR OUR MEMBERS TO HELP THEM ACHIEVE OPTIMUM HEALTH WHILE DEMONSTRATING EXCEPTIONAL SERVICE AND COMPETENCY IN SERVING DIVERSE POPULATION. 9 9 171 0 260241 -49410 0 0 31421794 33746484 69019 51345 8502035 9730225 39992848 43528054 0 0 0 0 7314009 8224355 0 0 0 30522518 32483536 37836527 40707891 2156321 2820163 24657682 36140130 7330429 15984365 17327253 20155765 COMMUNITY HEALTH GROUP IS A HEALTH PLAN THAT IS DEDICATED TO IMPROVEMENT AND MAINTENANCE OF HEALTH FOR OUR MEMBERS TO HELP THEM ACHIEVE OPTIMUM HEALTH WHILE DEMONSTRATING EXCEPTIONAL SERVICE AND COMPETENCY IN SERVING DIVERSE POPULATION. 0 0 28806143 43216468 TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO MEMBERS UNDER THE HEALTHY FAMILIES PROGRAM IN THE COUNTY OF SAN DIEGO AND PORTIONS OF THE COUNTY OF RIVERSIDE UNDER CONTRACT WITH THE STATE OF CALIFORNIA. ALSO TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO MEMBERS UNDER A MEDICARE ADVANTAGE SPECIAL NEEDS PLAN OPEN TO PEOPLE ELIGIBLE FOR MEDI-CAL AND MEDICARE UNDER CONTRACT WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. 28806143 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1877 0 1 171 1 1 1 0 0 0 0 0 0 0 0 0 X 9 9 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 1 1 0 CA X DIANE ERK 6194986427 740 BAY BLVD CHULA VISTA CA 91910 X ALBERT VITELA 2.00 X 2400 0 0 PAUL DATO 2.00 X 2400 0 0 CARLOTA SALAS 2.00 X 2400 0 0 CARLOS CESENA 2.00 X 2400 0 0 JOSE LUIS VALDIVIA 2.00 X 2400 0 0 GRACE KOJIMA 2.00 X 2400 0 0 TITO CALSADA 2.00 X 2400 0 0 ANITA HOLT 2.00 X 2400 0 0 WILLIAM MACFARLAND 2.00 X 500 0 0 NORMA DIAZ 20.00 X 447701 0 23399 EDWARD HUTT 20.00 X 381593 0 18827 WILLIAM RICE 20.00 X 625474 0 20994 JOSEPH GARCIA 20.00 X 307915 0 17849 JONATHAN TAMAYO 20.00 X 190948 0 25532 ANN WARREN 20.00 X 154315 0 18214 DIANE ERK 20.00 X 143431 0 17475 DAVID RITCHIE 20.00 X 128543 0 17387 NOREEN KOIZUMI 20.00 X 127089 0 19466 CAROLE ANDERSON 20.00 X 105097 0 15889 NORA PINTADO 20.00 X 104338 0 13940 2736144 0 208972 12 0 1 0 KP ON CALL 5855 COPLEY DRIVE STE 250 SAN DIEGO CA 92111 TELEPHONE ADVICE NURSE 216255 HEALTH MANAGEMENT SYSTEMS INC 401 PARK AVE SOUTH NEW YORK NY 10016 CLAIMS COORDINATION BENEFITS CONSULTANT 176652 PMPM CONSULTING GROUP INC 1900 POINT WEST WAY SUITE 111 SACRAMENTO CA 95815 CONSULTING SERVICES 120000 AXENE HEALTH PARTNERS 35067 MAHOGANY GLEN DRIVE WINCHESTER CA 92596 ACTUARIAL SERVICES 116726 MOSS ADAMS LLP 2030 MAIN ST SUITE 1400 IRVINE CA 92614 AUDITING AND TAX SERVICES 114400 6 HEALTHY FAMILY REVENUE 524114 23064027 23064027 MEDICARE REVENUES 524114 10682457 10682457 33746484 51354 51354 3950141 3950150 -9 -9 -9 ADMIN. FEE FROM FNDTN. 900099 9422193 9422193 TPA ADMIN. INCOME 900099 264147 3906 260241 OTHER OPER. REVENUE 900099 43885 43885 9730225 43528054 43216468 260241 51345 2252461 2252461 4534869 418909 4115960 181919 181919 762437 50652 711785 492669 27274 465395 175000 175000 114570 114570 650762 650762 43008 43008 816577 21655 794922 755053 21018 734035 291219 21018 270201 71215 71215 20128 20128 24818 18753 6065 618099 618099 189095 189095 HEALTH FACILITY PYMTS 9122188 9122188 CAPITATION 6272070 6272070 PHARMACY & MED. SRVCS 5300581 5300581 PROVIDER PRO. FEES 5052151 5052151 OTHER PROFESSIONAL SVCS 1046588 1046588 1920414 1433286 487128 40707891 28806143 11901748 0 1698537 3881314 16317660 25279843 2141085 2037735 377308 546665 6188789 2482234 3157913 3706555 229668 130474 727652 545739 7859 11805 24657682 36140130 6530874 6233454 57774 40780 741781 9710131 7330429 15984365 X 16827253 19855765 500000 300000 17327253 20155765 24657682 36140130 X 2820163 8349 X X 0 1 1 X 0 1750 0 0 0 0 1 0 ORGANIZATIONS DIRECT AND INDIRECT POLITICAL CAMPAIGN ACTIVITIES: PART I-A, LINE 1: DONATION TO POLITICAL CANDIDATES CAMPAIGN FUNDS. 1586659 1586659 3492487 1927380 1565107 765754 361217 404537 343889 193637 150252 3706555 DUE TO CHG FOUNDATION 9710131 9710131 43528054 40707891 2820163 8349 8349 2828512 210604569 8349 167071927 167080276 43524293 3761 3761 43528054 183371621 142669089 142669089 40702532 5359 5359 40707891 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: CHG ADOPTED THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARDS CODIFICATION ("ASC") 740-10, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS ON JANUARY 1, 2009. CHG FILES FEDERAL AND CALIFORNIA EXEMPT ORGANIZATION RETURNS. THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2007 FOR ITS FEDERAL AND 2006 FOR ITS STATE TAX FILINGS. THE COMPANY HAS NO UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2010 AND 2009. PART XII, LINE 2D - OTHER ADJUSTMENTS: TOTAL REVENUE ATTRIBUTABLE TO CHG FOUNDATION 176,494,120. LESS - MANAGEMENT FEE FROM FOUNDATION (ELIMINATED IN CONSOLIDATION) -9,422,193. PART XII, LINE 4B - OTHER ADJUSTMENTS: AMOUNTS ATTRIBUTABLE TO COMMUNITY CARE COMMITTEE NOT INCLUDED IN AFS 3,761. PART XIII, LINE 2D - OTHER ADJUSTMENTS: TOTAL EXPENSES ATTRIBUTABLE TO CHG FOUNDATION 152,091,282. LESS - MANAGEMENT FEE FROM FOUNDATION (ELIMINATED IN CONSOLIDATION) -9,422,193. PART XIII, LINE 4B - OTHER ADJUSTMENTS: AMOUNTS ATTRIBUTABLE TO COMMUNITY CARE COMMITTEE NOT INCLUDED IN AFS 5,359. X X X X 0 0 0 0 0 0 0 0 0 NORMA DIAZ 446290 0 0 0 1411 0 7350 0 16049 0 471100 0 0 0 EDWARD HUTT 371428 0 0 0 10165 0 7350 0 11477 0 400420 0 0 0 WILLIAM RICE 276530 0 345000 0 3944 0 7350 0 13644 0 646468 0 0 0 JOSEPH GARCIA 259391 0 0 0 48524 0 7350 0 10499 0 325764 0 0 0 JONATHAN TAMAYO 190051 0 0 0 897 0 5975 0 19557 0 216480 0 0 0 ANN WARREN 153899 0 0 0 416 0 4711 0 13503 0 172529 0 0 0 DIANE ERK 142255 0 0 0 1176 0 4348 0 13127 0 160906 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 NORMA DIAZ (CEO) IS MARRIED TO JOSEPH GARCIA (CHIEF OF OPERATIONS). FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS ENGAGES THE SERVICES OF AN INDEPENDENT PUBLIC ACCOUNTING FIRM (MOSS ADAMS, LLP) AS OUTSIDE EXPERTS TO COMPLETE THE ANNUAL CERTIFIED AUDIT. THE CERTIFIED FINANCIAL STATEMENTS ARE REVIEWED WITH AND APPROVED BY THE BOARD OF DIRECTORS. THE SERVICES OF MOSS ADAMS, LLP ARE ALSO ENGAGED TO PREPARE AND COMPLETE FORM 990. THE FORM 990 IS PREPARED UNDER THE DIRECTION, REVIEW AND OVERSIGHT OF COMMUNITY HEALTH GROUPS' FINANCE DEPARTMENT. THE BOARD OF DIRECTORS RELIES ON THE EXPERTISE OF INTERNAL MANAGEMENT AND MOSS ADAMS, LLP AS OUTSIDE EXPERTS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY THE BOARD OF DIRECTORS AND KEY MANAGEMENT RECEIVE REFRESHER TRAINING, CONDUCTED BY OUTSIDE LEGAL COUNSEL, ON THE IMPORTANCE OF IDENTIFYING ANY CONFLICT OF INTEREST AND THE DISCLOSURE OF ANY REAL OR POTENTIAL CONFLICTS OF INTEREST IS AN INTEGRAL PART OF THE CULTURE AT COMMUNITY HEALTH GROUP. ANY POTENTIAL CONFLICTS ARE REPORTED TO THE COMPLIANCE OFFICER FOR INVESTIGATION AND FOLLOW-UP. FORM 990, PART VI, SECTION B, LINE 15 A SALARY ANALYSIS IS PREPARED BY THE HUMAN RESOURCES DEPARTMENT USING THE WARREN SURVEY, WHICH IS THE ONLY SURVEY FOR HMO'S. THIS ANALYSIS IS THEN VALIDATED BY AN OUTSIDE CONSULTANT. AN EVALUATION COMMITTEE CONSISTING OF THE CHAIRMAN OF THE BOARD AND FOUR ADDITIONAL BOARD MEMBERS, REVIEWS THIS ANALYSIS AND MAKES A RECOMMENDATION TO THE BOARD OF DIRECTORS, WHO MAKE THE FINAL DECISION. THE ANALYSIS IS DONE ANNUALLY IN DECEMBER. SALARY ANALYSIS ARE PREPARED BY AN OUTSIDE CONSULTANT FOR ALL EXECUTIVE POSITIONS AND SOME MANAGEMENT POSITIONS. RESULTS ARE PRESENTED TO THE HUMAN RESOURCES DEPARTMENT. RECOMMENDATIONS ARE THEN MADE TO THE CEO FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 CONSOLIDATED AUDITED FINANCIAL STATEMENTS, INCLUDING COMMUNITY HEALTH GROUP AND COMMUNITY HEALTH GROUP FOUNDATION, ARE AVAILABLE TO THE PUBLIC ON THE DEPARTMENT OF MANAGED CARE WEBSITE. THE GOVERNING/ORGANIZING DOCUMENTS ARE ON FILE WITH THE DEPARTMENT OF MANAGED CARE AND CAN BE OBTAINED UNDER THE CALIFORNIA PUBLIC RECORDS ACT. THE CONFLICT OF INTEREST POLICY IS NOT MADE AVAILABLE TO THE PUBLIC. HOURS PER WEEK DEVOTED TO RELATED ORGANIZATION 990, PART VII, SECTION A ALBERT VITELA'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 2 HOURS CHG FOUNDATION: 2 HOURS PAUL DATO'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 2 HOURS CHG FOUNDATION: 2 HOURS CARLOTA SALAS' TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 2 HOURS CHG FOUNDATION: 2 HOURS CARLOS CESENA'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 2 HOURS CHG FOUNDATION: 2 HOURS JOSE LUIS VALDIVIA'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 2 HOURS CHG FOUNDATION: 2 HOURS GRACE KOJIMA'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 2 HOURS CHG FOUNDATION: 2 HOURS TITO CALSADA'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 2 HOURS CHG FOUNDATION: 2 HOURS ANITA HOLT'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 2 HOURS CHG FOUNDATION: 2 HOURS WILLIAM MCFARLAND'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 2 HOURS CHG FOUNDATION: 2 HOURS NORMA DIAZ'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 20 HOURS CHG FOUNDATION: 20 HOURS EDWARD HUTT'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 20 HOURS CHG FOUNDATION: 20 HOURS WILLIAM RICE'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 20 HOURS CHG FOUNDATION: 20 HOURS JOSEPH GARCIA'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 20 HOURS CHG FOUNDATION: 20 HOURS JONATHAN TAMAYO'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 20 HOURS CHG FOUNDATION: 20 HOURS ANN WARREN'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 20 HOURS CHG FOUNDATION: 20 HOURS DIANE ERK'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 20 HOURS CHG FOUNDATION: 20 HOURS DAVID RITCHIE'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 20 HOURS CHG FOUNDATION: 20 HOURS NOREEN KOIZUMI'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 20 HOURS CHG FOUNDATION: 20 HOURS CAROLE ANDERSON'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 20 HOURS CHG FOUNDATION: 20 HOURS NORA PINTADO'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH GROUP: 20 HOURS CHG FOUNDATION: 20 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 8,349. AUDIT COMMITTEE AND OVERSIGHT FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR. EXCESS OR (DEFICIT) FOR THE YEAR PER FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 10 THE AMOUNT AT SCHEDULE D, PART XI, LINE 10 DOES NOT TIE TO THE AUDITED FINANCIAL STATEMENTS AS THE AUDITED FINANCIAL STATEMENTS ARE PREPARED ON A CONSOLIDATED BASIS. THE AMOUNT AT SCHEDULE D, PART XI IS THE EXCESS FOR COMMUNITY HEALTH GROUP ONLY AND DOES NOT INCLUDE THE EXCESS OR DEFICIT ATTRIBUTABLE TO CHG FOUNDATION. THIS IS THE AMOUNT NECESSARY TO PROPERLY ROLL FORWARD NET ASSETS FOR THIS ENTITY ONLY. AUDITED FINANCIAL STATEMENTS FORM 990, PART XII, LINE 2 & PART IV, LINE 12 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE PREPARED ON A CONSOLIDATED BASIS; HOWEVER, THE ORGANIZATION MAINTAINS SEPARATE FINANCIAL RECORDS FOR EACH ENTITY. THIS SEPARATE FINANCIAL INFORMATION HAS BEEN USED TO COMPLETE THE RECONCILIATION AT SCHEDULE D, PART XI. CONSOLIDATED INFORMATION FROM THE AUDITED FINANCIAL STATEMENTS HAS BEEN USED IN PARTS XII & XIII. CHG FOUNDATION 740 BAY BLVD CHULA VISTA CA 91910 330586911 HEALTHCARE CA 501(C)(3) 9 N/A 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 CHG FOUNDATION E 9710131 BOOK/ACTUAL VALUE CHG FOUNDATION P 9422193 BOOK/ACTUAL VALUE