2023-11-14T12:37:46-06:00 2022-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2022-01-01 680046750 NORTHBAY HEALTHCARE CORPORATION NORT 7076463400 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 JOSEPH D'ANGINA VP AND CFO 7076463400 2023-11-14 1 JOSEPH DANGINA 999009999 0 MICHAEL LUMSDEN P01262236 4159561500 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z B KONARD JONES 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 94170563 0 X WWW.NORTHBAY.ORG X 1984 CA MANAGEMENT AND OTHER SUPPORT SERVICES FOR NORTHBAY HEALTHCARE AFFILIATED ORGANIZATIONS. 8 7 3118 1 0 0 0 90000 91080061 94073844 3571 5301 46506 1418 91130138 94170563 72609 90000 0 0 33478218 35885861 0 0 0 57579311 57960882 91130138 93936743 0 233820 22992689 81988832 49686106 75787362 -26693417 6201470 X COMPASSIONATE CARE, ADVANCED MEDICINE, CLOSE TO HOME. 0 1 69411448 90000 94073844 NORTHBAY HEALTHCARE CORPORATION (NBHC) IS THE PARENT ORGANIZATION 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 CLINICAL SERVICE AREAS, MANAGING CONTRACTS BETWEEN PROVIDERS AND PAYORS, AND FINANCING. 69411448 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 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 X 0 0 3118 1 0 0 0 0 0 0 0 0 0 0 1 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X JOSEPH D'ANGINA 7076463111 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 B KONARD JONES PRESIDENT & CEO / ASST SECRETARY 30.00 20.00 X X 1241415 0 422171 MARK SIEVERS CHAIR 1.00 1.00 X X 0 16898 0 STEPHEN J POWER VICE CHAIR 1.00 0.00 X X 0 16898 0 MARY MANCINI MD SECRETARY - TREASURER 1.00 0.00 X X 0 25381 0 GARY FALATI DIRECTOR 1.00 1.00 X 0 0 0 ARCHIE HUMPHREY DIRECTOR 1.00 1.00 X 0 17095 0 CHRIS SWEENEY DIRECTOR 1.00 0.00 X 0 16912 0 MURRAY WOOLF MD DIRECTOR 1.00 0.00 X 0 17043 0 MICHELE BOUIT VP, FINANCE & CFO THRU 11/2022 5.00 45.00 X 519394 0 83794 TIMOTHY MAURICE INT VP, FINANCE & CFO START 11/2022 5.00 45.00 X 145386 0 10 WAYNE GIETZ PRES NBHG / ASST SECR THRU 4/2022 5.00 45.00 X 469159 0 44405 SCOTT DAVIS VP, CSO / PRES NBHA THRU 8/2022 10.00 40.00 X 803881 0 94351 CHRISTOPHER TIMBERS VP, CHIEF INFORMATION OFFICER 10.00 40.00 X 515565 0 139297 SETH KAUFMAN MD CHIEF MEDICAL OFFICER 0.00 50.00 X 496437 0 114544 JIM ANDERSEN VP, HUMAN RESOURCES 5.00 45.00 X 412618 0 103723 SHENIECE SMITH ESQ FACHE VP, CAO & GENERAL COUNSEL 5.00 45.00 X 419888 0 78989 TRACY GEDDIS VP, OPERATIONS 5.00 45.00 X 361596 0 64588 STEVE HUDDLESTON VP, PUBLIC AFAIRS THRU 12/2022 5.00 45.00 X 314860 0 75449 HEATHER RESSEGER VP, CNO START 6/2022 0.00 50.00 X 338792 0 42110 TRACI DUNCAN VP, CNO THRU 6/2022 0.00 50.00 X 173755 0 52756 AROLD NELSON CLINICAL NURSE SUPERVISOR 0.00 40.00 X 416879 0 56013 JUAN ORIAS CLINICAL NURSE II 0.00 40.00 X 438582 0 31760 PAUL MCGINTY PRESIDENT, NBHF 0.00 50.00 X 318672 0 91924 THERESA BARTOLI CLINICAL COORDINATOR 0.00 40.00 X 367533 0 54523 PETER DHALIWAL CLINICAL NURSE II 0.00 40.00 X 369465 0 38799 8123877 110227 1589206 1097 0 1 0 OPTUM360 LLC PO BOX 88050 CHICAGO IL 606801050 REVENUE SERVICES 18633732 CERNER CORPORATION PO BOX 959156 ST LOUIS MO 631959156 IT SERVICES 4241304 DPR CONSTRUCTION INC 1801 J STREET SUITE 200 SACRAMENTO CA 95811 GENERAL CONTRACTOR 3539155 RECEIVABLE SOLUTIONS LLC 800 DUTCH SQUARE BLVD 100 COLUMBIA SC 29210 COLLECTIONS SERVICES 3090236 SIERRA VIEW GENERAL CONTRACTOR 4202 DOUGLAS BLVD 100 GRANITE BAY CA 95746 GENERAL CONTRACTOR 2498641 46 90000 90000 MANAGEMENT & ADMIN FEES 541900 93832920 93832920 REBATES & REFUNDS 900099 240924 240924 94073844 5301 0 5301 5301 5301 MISCELLANEOUS REVENUE 900099 1418 1418 1418 94170563 94073844 0 6719 X 90000 90000 6339755 2372849 3966906 22953816 12671042 10282774 896339 500622 395717 3883826 2643554 1240272 1812125 1065846 746279 2340930 1434439 906491 201654 201654 34209654 29601814 4607840 494914 494914 1356517 1077700 278817 8563474 8563474 3637009 3408431 228578 37097 9205 27892 63053 56742 6311 1058 861 197 3854235 3650581 203654 1556292 1556292 RECRUITING 477523 284421 193102 DUES & SUBSCRIPTIONS 379113 250563 128550 TAXES/LICENSES 379000 18469 360531 PUBLIC RELATIONS 172390 30198 142192 236969 124345 112624 93936743 69411448 24525295 0 -195924 579446 752302 187151 177537 12139 3369235 5105038 60981784 48468835 9580761 12512949 3173819 3822563 100 100 6134859 59769446 22992689 81988832 36776611 52708237 16605 4923 103719 103719 12789171 22970483 49686106 75787362 X -26687071 6190596 -6346 10874 -26693417 6201470 22992689 81988832 X 233820 32661067 X 0 1 X 1 0 X X 1 NORTHBAY HEALTHCARE GROUP 941458282 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PART I, SECTION A, LINE 12G, COLUMN (VI): THE ORGANIZATION PROVIDES COORDINATION, MANAGEMENT, AND OTHER SUPPORT SERVICES TO NORTHBAY HEALTHCARE GROUP. THESE SERVICES INCLUDE MARKETING, RESEARCH OF NEW CLINICAL SERVICE AREAS, MANAGING CONTRACTS BETWEEN PROVIDERS AND PAYORS, AND FINANCING. PART IV, SECTION C, LINE 1: NORTHBAY HEALTHCARE CORPORATION (NBHC) IS THE SOLE CORPORATE MEMBER OF NORTHBAY HEALTHCARE GROUP (NBHG), AS WELL AS NBHG'S OTHER SUPPORTING ORGANIZATIONS (NORTHBAY HEALTH ADVANTAGE AND NORTHBAY HEALTHCARE FOUNDATION). NBHC SERVES AS THE PARENT AND SUPPORTS AND CARRIES OUT THE PURPOSES AND FUNCTIONS OF NBHG. NBHC, A TYPE II SUPPORTING ORGANIZATION, HAS A HISTORICAL AND CONTINUOUS WORKING RELATIONSHIP WITH ITS SUPPORTED ORGANIZATION, NBHG, IN THAT TWO MEMBERS OF NBHC'S BOARD AND THE CEO OF NBHC SERVE AS VOTING DIRECTORS OF NBHG, THUS ENSURING NBHC WILL BE RESPONSIVE TO THE NEEDS OF NBHG. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 16395 16395 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA; A PORTION OF THOSE DUES ARE ATTRIBUTABLE TO LOBBYING, WHICH SUPPORTS CERTAIN INITIATIVES THAT ARE HEALTHCARE RELATED AND CONSISTENT WITH ITS MISSION OF PROMOTING HEALTHCARE WITHIN ITS COMMUNITY. 710938 710938 0 1242479 1089745 152734 57972063 45860281 12111782 1056304 807871 248433 12512949 OPERATING LEASE RIGHT-OF-USE ASSETS 4041809 INTERCOMPANY RECEIVABLE 55727637 59769446 WORKERS COMP RESERVE 4810256 OPERATING LEASE LIABILITIES 4857542 ACCRUED SETTLEMENT LIABILITY 13302685 22970483 1 SOLANO ECONOMIC DEVELOPMENT CORP 5050 BUSINESS CENTER DRIVE 200 FAIRFIELD CA 94534 942912759 501(C)(3) 0 25000 SPONSORSHIP OF EDC GOLD CLASSIC TOURO UNIVERSITY OF CALIFORNIA 1310 CLUB DRIVE VALLEJO CA 94592 133838740 501(C)(3) 0 12500 SPONSORSHIP FOR DIVERSITY SCHOLARSHIP FAIRFIELD-SUISUN CHAMBER OF COMMERCE 1111 WEBSTER STREET FAIRFIELD CA 94533 941059185 501(C)(6) 0 10000 SPONSORSHIP AND GENERAL SUPPORT SOLANO COUNTY LIBRARY FOUNDATION 601 KENTUCKY STREET FAIRFIELD CA 94533 680342423 501(C)(3) 0 17500 SPONSORSHIP OF REACH OUT AND READ LEAVEN PROGRAM 2220 BOYNTON AVE SUITE A FAIRFIELD CA 94533 263653717 501(C)(3) 0 25000 SPONSORSHIP AND GENERAL SUPPORT 4 1 PART I, LINE 2: NBHC GRANTS FUNDS TO OTHER LOCAL NON-PROFITS AND COMMUNITY ORGANIZATIONS KNOWN TO NBHC TO ASSIST WITH THEIR FUNDRAISING ENDEAVORS. NBHC DOES NOT MONITOR USE OF THESE GRANT FUNDS, AS GRANT FUNDS ARE UNRESTRICTED. X X X X 1 1 0 0 0 0 0 0 0 B KONARD JONES PRESIDENT & CEO / ASST SECRETARY 955902 0 0 0 285513 0 380198 0 41973 0 1663586 0 0 0 SCOTT DAVIS VP, CSO / PRES NBHA THRU 8/2022 286192 0 0 0 517689 0 50656 0 43695 0 898232 0 0 0 CHRISTOPHER TIMBERS VP, CHIEF INFORMATION OFFICER 416138 0 0 0 99427 0 64757 0 74540 0 654862 0 0 0 SETH KAUFMAN MD CHIEF MEDICAL OFFICER 441650 0 0 0 54787 0 50571 0 63973 0 610981 0 0 0 MICHELE BOUIT VP, FINANCE & CFO THRU 11/2022 451818 0 0 0 67576 0 66506 0 17288 0 603188 0 0 0 JIM ANDERSEN VP, HUMAN RESOURCES 360924 0 0 0 51694 0 56888 0 46835 0 516341 0 0 0 WAYNE GIETZ PRES NBHG / ASST SECR THRU 4/2022 192692 0 0 0 276467 0 29416 0 14989 0 513564 0 0 0 SHENIECE SMITH ESQ FACHE VP, CAO & GENERAL COUNSEL 401851 0 0 0 18037 0 55153 0 23836 0 498877 0 0 0 AROLD NELSON CLINICAL NURSE SUPERVISOR 398079 0 0 0 18800 0 12514 0 43499 0 472892 0 0 0 JUAN ORIAS CLINICAL NURSE II 419782 0 0 0 18800 0 1025 0 30735 0 470342 0 0 0 TRACY GEDDIS VP, OPERATIONS 339641 0 0 0 21955 0 29769 0 34819 0 426184 0 0 0 THERESA BARTOLI CLINICAL COORDINATOR 360460 0 0 0 7073 0 16676 0 37847 0 422056 0 0 0 PAUL MCGINTY PRESIDENT, NBHF 256267 0 50000 0 12405 0 40692 0 51232 0 410596 0 0 0 PETER DHALIWAL CLINICAL NURSE II 364239 0 0 0 5226 0 8310 0 30489 0 408264 0 0 0 STEVE HUDDLESTON VP, PUBLIC AFAIRS THRU 12/2022 198788 0 0 0 116072 0 46700 0 28749 0 390309 0 25267 0 HEATHER RESSEGER VP, CNO START 6/2022 307100 0 0 0 31692 0 10373 0 31737 0 380902 0 0 0 TRACI DUNCAN VP, CNO THRU 6/2022 109801 0 12000 0 51954 0 21841 0 30915 0 226511 0 14997 0 PART I, LINES 4A-B DURING THE 2022 CALENDAR YEAR, SCOTT DAVIS RECEIVED A $433,000 SEVERANCE PAYMENT AND WAYNE GIETZE RECEIVED A $149,600 SEVERANCE PAYMENT. BOTH PAYMENTS WERE TAXABLE COMPENSATION TO THE INDIVIDUALS, AND REPORTED WITHIN SCHEDULE J, PART II, COLUMN (B)(III). THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE ORGANIZATION'S SUPPLEMENTAL 457(F) RETIREMENT PLAN. EMPLOYER CONTRIBUTIONS TO THE PLAN DURING THE 2022 CALENDAR YEAR ARE AS FOLLOWS, WHICH HAS BEEN REPORTED AS "RETIREMENT AND OTHER DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C): B. KONARD JONES - $367,998 SCOTT DAVIS - $41,991 CHRISTOPHER TIMBERS - $54,573 SETH KAUFMAN, MD - $39,755 MICHELE BOUIT - $60,406 JIM ANDERSEN - $47,032 WAYNE GIETZ - $17,216 SHENIECE SMITH, ESQ., FACHE - $52,001 TRACY GEDDIS - $26,399 PAUL MCGINTY - $38,050 STEVE HUDDLESTON - $27,116 TRACI DUNCAN - $16,524 ADDITIONALLY, DUE TO VESTING OF THE 457(F) RETIREMENT PLAN, THE FOLLOWING INDIVIDUALS RECOGNIZED TAXABLE COMPENSATION IN THE FOLLOWING AMOUNTS, WHICH HAS BEEN REPORTED AS "OTHER REPORTABLE COMPENSATION" IN SCHEDULE J, PART II, COLUMN (B)(III) AND "COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED ON PRIOR FORM 990" IN SCHEDULE J, PART II, COLUMN (F). STEVE HUDDLESTON - $25,267 TRACI DUNCAN - $14,997 FORM 990, PART III, LINE 3 AT 1/1/2022, THE ORGANIZATION TRANSFERRED THE ACTIVITY OF NORTHBAY GUILD, THE VOLUNTEER ARM OF NORTHBAY HEALTH, TO NORTHBAY HEALTHCARE FOUNDATION. FORM 990, PART V, LINES 1A AND 2A: ALL FORM 1099S FOR NORTHBAY HEALTHCARE CORPORATION WERE FILED BY NORTHBAY HEALTHCARE GROUP, A RELATED ORGANIZATION. ACCORDINGLY, THE AMOUNT REPORTED ON FORM 990, PART V, LINE 1A (IN REGARDS TO THE AMOUNT REPORTED ON THE 2022 FORM 1096, BOX 3) REFLECTS ZERO. ADDITIONALLY, ALL FORM W-2S FOR NORTHBAY HEALTHCARE SYSTEM WERE FILED BY NORTHBAY HEALTHCARE CORPORATION, WHICH IS THE BASIS FOR THE NUMBER OF EMPLOYEES REPORTED ON FORM 990, PART V, LINE 2A. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER; ADJUSTMENTS ARE MADE, AS NECESSARY. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE GOVERNING BODY FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUESTS ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND MEMBERS OF COMMITTEES APPOINTED BY THE BOARD OF DIRECTORS TO SELF-MONITOR COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY; IN ADDITION, EACH OFFICER AND BOARD MEMBERS MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST STATEMENT. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND ALL RESPONSES FILED. IF A POTENTIAL CONFLICT ARISES, BOARD MEMBERS AND EMPLOYEES ARE REQUIRED TO SELF-DISCLOSE THE CONFLICT TO THE CORPORATE COMPLIANCE OFFICER. PROCESSES AND PROCEDURES ARE IN PLACE TO EVALUATE AND DETERMINE IF A POSSIBLE CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WILL PRESENT RELEVANT INFORMATION TO THE BOARD. AFTER SUCH PRESENTATION, THE INDIVIDUAL SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 AN AD HOC COMPENSATION COMMITTEE OF THE HEALTH SYSTEM BOARD REVIEWS EXECUTIVE COMPENSATION, INCLUDING THAT OF THE ORGANIZATION'S CEO, OTHER OFFICERS, AND KEY EMPLOYEES; 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 FINANCIAL STATEMENTS ARE AVAILABLE ON THE DIGITAL ASSURANCE CORPORATION WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G TEMPORARY LABOR: PROGRAM SERVICE EXPENSES 685,048. MANAGEMENT AND GENERAL EXPENSES 398,752. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,083,800. PROFESSIONAL FEES - MEDICAL: PROGRAM SERVICE EXPENSES 51,139. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 51,139. CONSULTING FEES: PROGRAM SERVICE EXPENSES 1,882,623. MANAGEMENT AND GENERAL EXPENSES 772,593. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,655,216. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 4,283. MANAGEMENT AND GENERAL EXPENSES 233,465. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 237,748. PURCHASED SERVICES - OTHER: PROGRAM SERVICE EXPENSES 26,978,721. MANAGEMENT AND GENERAL EXPENSES 3,203,030. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,181,751. FORM 990, PART XI, LINE 9: RELIEF OF DUE TO/DUE FROM RELATED ORGANIZATIONS 32,982,483. TRANSFER OF NORTHBAY HEALTHCARE GUILD NET ASSETS -321,416. NORTHBAY HEALTH ADVANTAGE 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 942495998 MANAGES REAL ESTATE FOR NORTHBAY HEALTHCARE GROUP & AFFILIATES CA 501(C)(3) LINE 12B, II NORTHBAY HEALTHCARE CORPORATION 1 NORTHBAY HEALTHCARE GROUP 1200 B GALE WILSON BOULEVARD FAIRFIELD CA 94533 941458282 OPERATES TWO NONPROFIT HOSPITALS CA 501(C)(3) LINE 3 NORTHBAY HEALTHCARE CORPORATION 1 NORTHBAY HEALTHCARE FOUNDATION 4500 BUSINESS CENTER DRIVE FAIRFIELD CA 94534 942995085 PROVIDES FUNDRAISING FOR NORTHBAY HEALTHCARE GROUP & AFFILIATES CA 501(C)(3) LINE 12B, II NORTHBAY HEALTHCARE CORPORATION 1 SOLANO DIAGNOSTIC PARTNERS 1101 B GALE WILSON BLVD FAIRFIELD CA 94533 931013774 DIAGNOSTIC IMAGING CA NORTHBAY HEALTH ADVANTAGE RELATED 20753 198987 0 0 0.05000 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 0 NORTHBAY HEALTH ADVANTAGE L 75377 BOOK VALUE NORTHBAY HEALTHCARE GROUP L 93107923 BOOK VALUE SOLANO DIAGNOSTIC PARTNERS L 601965 BOOK VALUE