2024-05-09T12:54:40-05:00 2022-12-31 952302617 SLBIGGS A DIVISION OF SINGERLEWAK LLP 10960 WILSHIRE BLVD SUITE 1100 LOS ANGELES CA 90024 990 2022-01-01 951816005 BEVERLY COMMUNITY HOSPITAL ASSOCIATION BEVE 3104773924 SLBIGGS 10960 WILSHIRE BLVD 1100 LOS ANGELES CA 90024 HOWARD M EHRENBERG TRUSTEE 3104773924 2024-05-09 1 HOWARD EHRENBERG 999009999 0 SAMUEL BIGGS P00078192 3104773924 2024-05-09 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z HOWARD M EHRENBERG 1875 CENTURY PARK EAST SUITE 1900 LOS ANGELES CA 90067 147245922 0 X WWW.BEVERLY.ORG X 1949 CA SEE SCHEDULE O 15 14 654 17 0 0 4192700 0 169719170 155273472 81672 -4854318 673328 -3173232 174666870 147245922 0 0 0 0 73100542 81275092 0 0 0 105971930 112699274 179072472 193974366 -4405602 -46728444 205904470 152307735 132192500 125324209 73711970 26983526 X TO PROVIDE COMPASSIONATE AND QUALITY HEALTH CARE. 0 0 INPATIENT AND OUTPATIENT HOSPITAL SERVICES - HOSPITAL SERVICES PROVIDED BY BEVERLY COMMUNITY HOSPITAL ASSOCIATION INCLUDED 7,686 INPATIENT ADMISSIONS, 14,013 OUTPATIENT VISITS, AND 33,324 EMERGENCY ROOM VISITS IN 2022. CARE IS PROVIDED WITHOUT CHARGE TO PATIENTS WHO MEET SPECIFIED CRITERIA UNDER THE CHARITY CARE POLICY. CAPITATION SERVICES - BEVERLY COMMUNITY HOSPITAL ASSOCIATION CONTRACTSWITH BLUE CROSS OF CALIFORNIA AND HEALTH NET OF CALIFORNIA TO PROVIDE INPATIENT AND OUTPATIENT HOSPITAL SERVICES AT FULL RISK TO ENROLLED MEDI-CAL BENEFICIARIES WHO ARE CONCURRENTLY ENROLLED WITH A LOCAL MEDICAL GROUP. 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 654 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X DANIEL WAY 3238375190 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 90640 X MONICA THORNHILL-JOYNES MD BOARD MEMBER/CHIEF OF STAFF 2.00 2.00 X 0 0 0 LYLA EDDINGTON EDD RN CHAIRPERSON 2.00 2.00 X X 0 0 0 CARLOS MANUEL HARO PHD 1ST VICE CHAIRPERSON 2.00 2.00 X X 0 0 0 RENEE D MARTINEZ 2ND VICE CHAIRPERSON 2.00 2.00 X X 0 0 0 JOHN HSU CPM CCIM TREASURER 2.00 2.00 X X 0 0 0 GAUTAM GANGULY MD SECRETARY 2.00 2.00 X 0 0 0 RICHARD L ADAMS II BOARD MEMBER 2.00 2.00 X 0 0 0 GARY R EINSTEIN ESQ BOARD MEMBER 2.00 2.00 X 0 0 0 JULIE FRANCE EDRN BOARD MEMBER 2.00 2.00 X 0 0 0 GOHARIK GABRIEL BOARD MEMBER 2.00 2.00 X 0 0 0 RALPH HANSEN DMD BOARD MEMBER 2.00 2.00 X 0 0 0 AZIZ KHAN MD BOARD MEMBER 2.00 2.00 X 0 0 0 ROSEMARY OROZCO BOARD MEMBER 2.00 2.00 X 0 0 0 ALMA PEREZ BOARD MEMBER 2.00 2.00 X 0 0 0 PAMALA K SAKAMOTO BOARD MEMBER 2.00 2.00 X 0 0 0 ALICE CHENG FACHE PRESIDENT & CEO 40.00 3.00 X 0 0 0 HOUSANG ABD VP OF FINANCE & CFO 40.00 3.00 X 0 0 0 0 0 0 0 1 0 0 113 OPERATING REVENUE 621990 155273472 155273472 155273472 -4854318 -4854318 NON-OPERATING REVENUE -3173232 -3173232 -3173232 147245922 147245922 0 0 X 55290951 55290951 4347363 4347363 15859464 15859464 5777314 5777314 14571274 14571274 2763950 2763950 1553323 1553323 5873 5873 3346591 3346591 2193956 2193956 CAPITATED 20148771 20148771 SUPPLIES-GENERAL 17480227 17480227 OTHER EXPENSE 17180962 17180962 OTHER EXPENSE 11615908 11615908 21838439 21838439 193974366 0 193974366 0 15958202 17326557 27606910 2129322 19469430 20573784 3243710 2903011 1222900 2029387 214617853 130109324 90829770 84508529 5122090 0 42451458 22837145 205904470 152307735 18476810 18476810 10924850 10924850 58269640 58269640 11347855 11347855 33173345 26305054 132192500 125324209 X 73711970 26983526 73711970 26983526 205904470 152307735 -46728444 0 X 0 0 0 X 0 0 0 0 PART II-B, LINE 1, LOBBYING ACTIVITIES BEVERLY COMMUNITY HOSPITAL ASSOCIATION SUPPORTS CEERTAIN INITIATIVES AND ISSUES THAT ARE HEALTHCARE RELATED AND CONSISTENT WITH ITS MISSION OF PROMOTING HEALTHCARE IN THE COMMUNITY. EXPENDITURES INCURRED TO SUPPORT THESE INITIATIVES MAY BE CONSIDERED TO BE LOBBYING EXPENDITURES. AN INDIRECT EXPENDITURES OF THE HOSPITAL'S MEMBERSHIP DUES PAID TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA (HASC) WERE USED FOR LOBBYING ACTIVITIES. 1398730 1398730 144825250 75625520 69199730 584120 584120 0 49064303 40231814 8832489 18745450 13667870 5077580 84508529 MALPRACTICE/WORKER'S COMP INSURANCE RECEIVABLES 5516281 OTHER RECEIVABLES 23244 DUE FROM THIRD PARTY VENDORS 16891231 UNAMORTIZED LOAN COSTS 2860 OTHER 403529 22837145 OTHER LIABILTIITES 26305054 26305054 1 1 X 1 0 1 1 1 0 0 1 1 BEVERLY HOSPITAL 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 90640 WWW.BEVERLY.ORG 930000389 X X X 0 0 0 0 0 0 0 0 0 COMPENSATION OF OFFICERS, DIRECTORS, KEY EMPLOYEES COMPENSATION OF OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES WERE NOT PROVIDED, COMPENSATION AMOUNTS FOR 2022 NOT PROVIDED. FORM 990 BEVERLY COMMUNITY HOSPITAL ASSOCIATION NOTES TO FEDERAL/STATE TAX RETURNS FEIN: 95-1816005 GENERAL ON APRIL 19, 2023, THE DEBTOR, BEVERLY COMMUNITY HOSPITAL ASSOCIATION, FILED A VOLUNTARY PETITION UNDER CHAPTER 11 OF THE UNITED STATES BANKRUPTCY CODE (CASE NO. 2:23-BK-12359 SK). SUBSEQUENT TO THIS DATE, HOWARD EHRENBERG WAS APPOINTED TRUSTEE TO ADMINISTER THE AFFAIRS OF THE BANKRUPTCY ESTATE. ASSETS OF THE ESTATE THE ASSETS OF THE BUSINESS. OTHER EXPENSES INCLUDE CERTAIN ADMINISTRATIVE COSTS AND SIMILAR OTHER ITEMS INCURRED BY THE TRUSTEE. CERTAIN OTHER INCURRED AND UNPAID LIABILITIES OF THE BANKRUPTCY ESTATE INCLUDE TRUSTEE, LEGAL AND ACCOUNTING EXPENSES WHICH HAVE BEEN ACCRUED. ANY REMAINING EXPENSES AND NON-DEDUCTED FEES WILL BE PAID AT THE CONCLUSION OF THE CASE, WHICH IS ANTICIPATED TO CLOSE DURING 2024. ACCOUNTING RECORDS IN CONNECTION WITH THE TAXPAYER'S INSOLVENCY, MANY ACCOUNTING RECORDS WERE NOT ADEQUATELY MAINTAINED AND/OR WERE NOT PROVIDED TO THE TRUSTEE. RECORDS AND INFORMATION NECESSARY TO PROVIDE A COMPLETE AND ACCURATE ACCOUNTING ARE NOT AVAILABLE AND CANNOT BE RECONSTRUCTED. CONSEQUENTLY, NO ASSURANCE CAN BE PROVIDED BY EITHER THE TRUSTEE OR THE TAX PREPARER THAT THE RETURNS BEING FILED ACCURATELY REFLECT ALL TRANSACTIONS OF THE DEBTOR AND HIS RELATED TAX LIABILITY. TO THE EXTENT THAT ACCOUNTING TRANSACTIONS, RECORDS AND OTHER INFORMATION WERE AVAILABLE OR COULD BE RECONSTRUCTED; SUCH INFORMATION HAS BEEN INCLUDED HEREIN AND USED AS THE BASIS FOR COMPUTATION OF THE TAXPAYER'S INCOME TAX LIABILITY. FORM 990 TAX RETURN FYE 12/31/22 ON SEPTEMBER 6, 2023, ALL ASSETS AND BUSINESS OPERATIONS OF THIS TAXPAYER AND ITS RELATED ENTITIES, BEVERLY COMMUNITY HOSPITAL ASSOCIATION AND MONTEBELLO COMMUNITY HEALTH SERVICES, INC, WERE SOLD AND OPERATIONS OF THE HOSPITAL WERE TERMINATED. AS SUCH, FORMER EMPLOYEES WERE NOT AVAILABLE TO PROVIDE ACCOUNTING RECORDS AND INFORMATION REQUIRED TO PREPARE A COMPLETE TAX RETURN WITH ASSURANCE OF ALL ACCURACY. CONSEQUENTLY, THE ATTACHED TAX RETURN HAS BEEN PREPARED WITH INFORMATION AVAILABLE, BUT NO ASSURANCE OF COMPLETE ACCURACY IS PROVIDED BY EITHER THE TRUSTEE, HIS COUNSEL OR TAX PREPARER. THIS CASE IS STILL BEING ADMINISTERED BY THE TRUSTEE. FORM 990 FIDUCIARY BANKRUPTCY TAX RETURN: BEVERLY COMMUNITY HOSPITAL ASSOCIATION FEIN: 95-1816005 FYE: 12/31/22 TRUSTEE AND TAX PREPARER STATEMENT RELEVANT TO INFORMATION CONTAINED IN THIS RETURN ON APRIL 19, 2023, THE ABOVE-MENTIONED TAXPAYER FILED A VOLUNTARY PETITION UNDER CHAPTER 11 OF THE UNITED STATES BANKRUPTCY CODE (CASE NO. CASE NO. 2:23-BK-12359 SK). THIS CASE IS BEING JOINTLY ADMINISTERED WITH BEVERLY HOSPITAL FOUNDATION AND MONTEBELLO COMMUNITY HEALTH SERVICES, INC. THEREAFTER, HOWARD EHRENBERG WAS APPOINTED TRUSTEE TO ADMINISTER THE AFFAIRS OF THE BANKRUPTCY ESTATE. THIS TAX RETURN HAS BEEN PREPARED FROM AVAILABLE RECORDS OF THE DEBTOR AND FROM THE ACCOUNTING RECORDS PROVIDED TO THE CHAPTER 11 BANKRUPTCY TRUSTEE. CONCERNING THE DEBTOR'S INSOLVENCY, MANY ACCOUNTING RECORDS WERE NOT ADEQUATELY MAINTAINED AND/OR WERE NOT PROVIDED TO THE TRUSTEE. RECORDS AND INFORMATION NECESSARY TO PROVIDE A COMPLETE AND ACCURATE ACCOUNTING ARE NOT AVAILABLE AND CANNOT BE RECONSTRUCTED. CONSEQUENTLY, NEITHER THE TAX PREPARER NOR THE TRUSTEE CAN PROVIDE ANY ASSURANCE THAT THIS RETURN ACCURATELY REFLECTS ALL TRANSACTIONS OF THE TAXPAYER AND THE RELATED TAX LIABILITY. TO THE EXTENT, HOWEVER, THAT ACCOUNTING TRANSACTIONS, RECORDS AND OTHER INFORMATION WERE AVAILABLE OR COULD BE RECONSTRUCTED, SUCH INFORMATION HAS BEEN INCLUDED HEREIN AND USED AS THE BASIS FOR COMPUTATION OF TAXPAYER'S INCOME TAX LIABILITY. ADDITIONALLY, DUE TO TAXPAYER'S BANKRUPTCY, COMPLETE INFORMATION NECESSARY TO PREPARE TAXPAYER'S ACCOUNTING AND TAX RETURNS WAS NOT AVAILABLE TO TIMELY FILE THESE TAX RETURNS. BECAUSE OF THIS, IT WAS IMPOSSIBLE TO PREPARE TAX RETURNS FOR THE ESTATE UNTIL THIS DATE. THEREFORE, NO PENALTIES OR INTEREST FOR LATE FILING AS WELL AS LATE PAYMENT SHOULD BE ASSESSED AND SHOULD BE WAIVED FOR REASONABLE CAUSE. PART B. INDEPENDENT CONTRACTORS COMPENSATION AMOUNTS FOR INDEPENDENT CONTRACTORS IN 2022 WERE NOT PROVIDED. FORM 990, PART VI, SECTION B, LINE 11B A PUBLIC ACCOUNTING FIRM PREPARED THE FORM 990 IN CONJUNCTIONS WITH THE ORGANIZATION'S ACCOUNTING AND FINANCE STAFF. THE DRAFT FORM 990 IS INITIALLY REVIEWED BY THE FOUNDATION'S VICE PRESIDENT OF DEVELOPMENT AND COMMUNITY RELATIONS; CORRECTIONS OR ADJUSTMENTS ARE MADE, AS NECESSARY. THE COMPLETED FORM 990 IS TEHN REVIEWED IN ITS ENTIRETY BY ALL MEMBERS OF THE GOVERNING BOARD BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMEBERS OF THE BOARD OF DIRECTORS COMPLETE A QUESTIONNAIRE ANNUALLY. QUESTIONNAIRES ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF TEH BOARD OF DIRECTORS. THE GOVERNANCE COMMITTEE REFERS A CONFLICT OF INTEREST MATTER TO THE AUDIT & COMPLIANCE COMMITTEE OF BCHA WHEN THE GOVERNANCE COMMITTEE DEEMS IT APPROPRIATE IN INSTANCES WHEN A MEMBER OF THE GOVERNANCE COMMITTEE MAY HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE MATTER BEFORE THE COMMITTEE. IF A CONFLICT IS IDENTIFIED, THE CONFLICTED INDIVIDUAL DOES NOT PARTICIPATE IN DELIBERATIONS AND DECISIONS IMPACTING THE CONFLICTED MATTER. FORM 990, PART VI, SECTION B, LINE 15 BCHA DOES NOT COMPENSATE ANY OF ITS EMPLOYEES; RATHER, THE VICE PRESIDENT OF DEVELOPMENT AND COMMUNITY RELATIONS IS A PAID EMPLOYEE OF BCHA. THE COMPENSATION FOR THE VICE PRESIDENT OF DEVELOPMENT AND COMMUNITY RELATIONS IS REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BCHA BOARD OF DIRECTORS, WHICH TAKES INTO ACCOUNT AN ANNUAL SURVEY AND STUDY COMPLETED BY AN INDEPENDENT COMPENSATION CONDULTING FIRM. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 24E DEPRECIATION-HISTORICAL: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 10,060,549. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,060,549. SUPPLIES-PHARMACEUTICALS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,017,414. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,017,414. UTILITIES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,303,073. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,303,073. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,798,762. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,798,762. PURCHASED SERVICES- MEDICAL: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,616,838. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,616,838. SUPPLIES-BLOOD: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 806,958. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 806,958. LICENSES AND TAXES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 702,303. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 702,303. DUES AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 345,122. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 345,122. TELEPHONE AND TELEGRAPH: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 187,420. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 187,420. BEVERLY MSO 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 90640 352596953 MANAGEMENT SERVICE ORGANIZATION CA C 0 1 1 1 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 BEVERLY HOSPITAL FOUNDATION C AMOUNT NOT PROVIDED MONTEBELLO COMMUNITY HEALTH SERVICES INC E AMOUNT NOT PROVIDED