BEVERLY COMMUNITY HOSPITAL ASSOCIATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- BEVERLY COMMUNITY HOSPITAL ASSOCIATION (EIN 95-1816005)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202213189349319261
- Schema version
- 2021v4.2
- 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 M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T19:18:57-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SECOND STREET SUITE 900 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 951816005 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEVERLY COMMUNITY HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BEVE | BusinessNameControlTxt |
| Phone | 3237261222 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 WEST BEVERLY BOULEVARD | AddressLine1Txt |
| City | MONTEBELLO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 906404308 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HOUSHANG S ABD | PersonNm |
| Person Title | SVP OF FINANCE/CFO | PersonTitleTxt |
| Phone | 3237261222 | PhoneNum |
| Signature | 2022-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | HOUSHANG | PersonFirstNm |
| Person Last | ABD | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAUREN HAVERLOCK | PreparerPersonNm |
| PTIN | P00545829 | PTIN |
| Phone | 4159561500 | PhoneNum |
| Preparation | 2022-11-07 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ALICE CHENG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 WEST BEVERLY BOULEVARD | AddressLine1Txt |
| City | MONTEBELLO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 906404308 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $174,666,870 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BEVERLY.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1949 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO BE A LEADING INDEPENDENT, NON-PROFIT COMMUNITY HOSPITAL IMPROVING THE QUALITY OF LIFE OF ITS CONSTITUENTS THROUGH HEALTH EDUCATION, DISEASE PREVENTION, AND STATE OF THE ART ILLNESS AND INJURY TREATMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 654 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $13,095,196 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,192,700 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $165,991,304 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $169,719,170 | CYProgramServiceRevenueAmt |
| PY Investment Income | $105,326 | PYInvestmentIncomeAmt |
| CY Investment Income | $81,672 | CYInvestmentIncomeAmt |
| PY Other Revenue | $818,800 | PYOtherRevenueAmt |
| CY Other Revenue | $673,328 | CYOtherRevenueAmt |
| PY Total Revenue | $180,010,626 | PYTotalRevenueAmt |
| CY Total Revenue | $174,666,870 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $71,246,517 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $73,100,542 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $112,132,761 | PYOtherExpensesAmt |
| CY Other Expenses | $105,971,930 | CYOtherExpensesAmt |
| PY Total Expenses | $183,379,278 | PYTotalExpensesAmt |
| CY Total Expenses | $179,072,472 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,368,652 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,405,602 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $209,889,423 | TotalAssetsBOYAmt |
| Total Assets EOY | $205,904,470 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $132,337,491 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $132,192,500 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $77,551,932 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $73,711,970 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE COMPASSIONATE AND QUALITY HEALTH CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $122,195,050 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $145,515,040 | RevenueAmt |
| Desc | 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 2021. CARE IS PROVIDED WITHOUT CHARGE TO PATIENTS WHO MEET SPECIFIED CRITERIA UNDER THE CHARITY CARE POLICY. THE COST OF CHARITY CARE PROVIDED TOTALED $1,211,000 IN 2021. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $18,570,925 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $24,204,130 | RevenueAmt |
| Desc | CAPITATION SERVICES - BEVERLY COMMUNITY HOSPITAL ASSOCIATION CONTRACTS WITH 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. ENROLLMENT DURING 2021 WAS 447,292 MEMBER MONTHS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $140,765,975 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 1100 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 654 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DANIEL WAY | PersonNm |
| Phone | 3238375190 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 WEST BEVERLY BOULEVARD | AddressLine1Txt |
| City | MONTEBELLO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90640 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| ALICE CHENG FACHE | |||||||||
| PRESIDENT & CEO | 40.00 | 3.00 | Yes (X) | $493,720 | $0 | $115,610 | |||
| NANCY E LEE MSHCM BSN | |||||||||
| SENIOR VP OF OPERATIONS / CNO | 40.00 | 0.00 | $256,007 | $0 | $12,792 | Yes (X) | |||
| JUNG-NA KIM | |||||||||
| REGISTERED NURSE | 36.00 | 0.00 | $231,562 | $0 | $21,249 | Yes (X) | |||
| SUSAN M JUSTIN | |||||||||
| REGISTERED NURSE | 36.00 | 0.00 | $240,231 | $0 | $8,488 | Yes (X) | |||
| LOIS A LONG | |||||||||
| REGISTERED NURSE | 36.00 | 0.00 | $225,434 | $0 | $20,510 | Yes (X) | |||
| CHARLENE CHU RN BSN | |||||||||
| ADMIN DIRECTOR, ACUTE CARE SERVICES | 40.00 | 0.00 | $223,136 | $0 | $19,565 | Yes (X) | |||
| ROY C RORICK | |||||||||
| RADIOLOGY NUCLEAR MED. TECHNOLOGIST | 36.00 | 0.00 | $208,902 | $0 | $27,991 | Yes (X) | |||
| MARGARET GUILLERMO | |||||||||
| REGISTERED NURSE | 36.00 | 0.00 | $208,307 | $0 | $27,404 | Yes (X) | |||
| GEORGE HOLTZ MSHRM BSBN | |||||||||
| ADMIN DIRECTOR, HUMAN RESOURCES | 40.00 | 0.00 | $195,364 | $0 | $25,688 | Yes (X) | |||
| K LAWRENCE COHEN MD | |||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 0.00 | $169,000 | $0 | $0 | Yes (X) | |||
| SABBIR DADABHAI | |||||||||
| VP OF FINANCE & CFO (THRU 7/2021) | 40.00 | 3.00 | Yes (X) | $161,122 | $0 | $1,811 | |||
| HOUSHANG ABD | |||||||||
| VP OF FINANCE & CFO (START 7/2021) | 40.00 | 3.00 | Yes (X) | $78,197 | $0 | $3,030 | |||
| MONICA THORNHILL-JOYNES MD | |||||||||
| BOARD MEMBER / CHIEF OF STAFF | 2.00 | 2.00 | $10,089 | $0 | $0 | Yes (X) | |||
| LYLA EDDINGTON EDD RN | |||||||||
| CHAIRPERSON | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CARLOS MANUEL HARO PHD | |||||||||
| 1ST VICE CHAIRPERSON | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| RENEE D MARTINEZ | |||||||||
| 2ND VICE CHAIRPERSON | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JOHN HSU CPM CCIM | |||||||||
| TREASURER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| GAUTAM GANGULY MD | |||||||||
| SECRETARY | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| RICHARD L ADAMS II | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| GARY R EINSTEIN ESQ | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| JULIE FRANCE EDRN | |||||||||
| BOARD MEMBER | 2.00 | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| GOHARIK GABRIEL | |||||||||
| BOARD MEMBER | 2.00 | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| DENTON GUTHRIE CPA | |||||||||
| BOARD MEMBER THROUGH 6/2021 | 2.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| RALPH HANSEN DMD | |||||||||
| BOARD MEMBER | 2.00 | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| AZIZ KHAN MD | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| ROSEMARY OROZCO | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| ALMA PEREZ | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| PAMALA K SAKAMOTO | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,701,071 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $284,138 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 175 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SODEXHO INC & AFFILIATES | |||||
| 309 W BEVERLY BLVD | MONTEBELLO | CA | 90640 | FOOD & HOUSEKEEPING SERVICES | $3,887,310 |
| SHIFTWISE | |||||
| PO BOX 70870 | ST PAUL | MN | 55170 | REGISTERED NURSE REGISTRY/TRAVELERS | $2,201,825 |
| MEDICAL SOLUTIONS LLC | |||||
| PO BOX 310737 | DES MOINES | IA | 50331 | REGISTERED NURSE REGISTRY/TRAVELERS | $1,600,018 |
| ALLIED UNIVERSAL SECURITY SERVICES | |||||
| PO BOX 31001-2374 | PASADENA | CA | 91110 | MANAGEMENT OF SECURITY SERVICES | $1,005,529 |
| HOSPITALIST GROUP OF MONTEBELLO | |||||
| PO BOX 28387 | ANAHEIM | CA | 92809 | MANAGEMENT OF PATIENT CARE | $912,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 113 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $189,755 | RelatedOrganizationsAmt |
| Government Grants | $4,002,945 | GovernmentGrantsAmt |
| Noncash Contributions | $3,018,583 | NoncashContributionsAmt |
| Total Contributions | $4,192,700 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621990 | $145,515,040 | $145,515,040 |
| PREMIUM REVENUE | 621990 | $24,204,130 | $24,204,130 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $169,719,170 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $78,112 | TotalRevenueColumnAmt |
| Exclusion | $78,112 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $44,680 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $44,680 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,680 | TotalRevenueColumnAmt |
| Exclusion | $44,680 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,560 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,560 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,560 | TotalRevenueColumnAmt |
| Exclusion | $3,560 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MISCELLANEOUS REVENUE | 900099 | $568,158 | $568,158 |
| REBATES & REFUNDS | 900099 | $60,490 | $60,490 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $628,648 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $174,666,870 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $169,719,170 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $755,000 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,744,418 | TotalAmt |
| Program Services | $690,590 | ProgramServicesAmt |
| Management And General | $1,053,828 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,744,885 | TotalAmt |
| Program Services | $51,048,964 | ProgramServicesAmt |
| Management And General | $4,695,921 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $329,773 | TotalAmt |
| Program Services | $142,852 | ProgramServicesAmt |
| Management And General | $186,921 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,782,427 | TotalAmt |
| Program Services | $4,711,204 | ProgramServicesAmt |
| Management And General | $6,071,223 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,499,039 | TotalAmt |
| Program Services | $4,129,916 | ProgramServicesAmt |
| Management And General | $369,123 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $575,332 | TotalAmt |
| Management And General | $575,332 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,652,271 | TotalAmt |
| Management And General | $2,652,271 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,000 | TotalAmt |
| Program Services | $65,000 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,980,231 | TotalAmt |
| Program Services | $30,668,691 | ProgramServicesAmt |
| Management And General | $3,311,540 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $259,960 | TotalAmt |
| Program Services | $217,863 | ProgramServicesAmt |
| Management And General | $42,097 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,366,894 | TotalAmt |
| Management And General | $1,366,894 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,812,032 | TotalAmt |
| Program Services | $273,144 | ProgramServicesAmt |
| Management And General | $2,538,888 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,624 | TotalAmt |
| Program Services | $1,530 | ProgramServicesAmt |
| Management And General | $94 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,072,744 | TotalAmt |
| Management And General | $3,072,744 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,560,522 | TotalAmt |
| Program Services | $2,525,788 | ProgramServicesAmt |
| Management And General | $7,034,734 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,058,334 | TotalAmt |
| Management And General | $2,058,334 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $20,502,192 | $20,500,207 | $1,985 |
| HOSPITAL FEE PROGRAM | $16,450,859 | $16,450,859 | |
| EQUIPMENT RENTALS | $2,346,712 | $1,731,244 | $615,468 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,267,223 | TotalAmt |
| Program Services | $7,608,123 | ProgramServicesAmt |
| Management And General | $2,659,100 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,072,472 | TotalAmt |
| Program Services | $140,765,975 | ProgramServicesAmt |
| Management And General | $38,306,497 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,035,454 | BOYAmt |
| EOY | $15,958,202 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,194,879 | BOYAmt |
| EOY | $27,606,910 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,371,409 | BOYAmt |
| EOY | $19,469,430 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,547,724 | BOYAmt |
| EOY | $3,243,710 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,215,562 | BOYAmt |
| EOY | $1,222,900 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $210,878,580 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $120,048,810 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,709,827 | BOYAmt |
| EOY | $90,829,770 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,620,986 | BOYAmt |
| EOY | $5,122,090 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,193,582 | BOYAmt |
| EOY | $42,451,458 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $209,889,423 | BOYAmt |
| EOY | $205,904,470 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,712,616 | BOYAmt |
| EOY | $18,476,810 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,972,820 | BOYAmt |
| EOY | $10,924,850 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,364,303 | BOYAmt |
| EOY | $58,269,640 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,666,420 | BOYAmt |
| EOY | $11,347,855 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,621,332 | BOYAmt |
| EOY | $33,173,345 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,337,491 | BOYAmt |
| EOY | $132,192,500 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,551,932 | BOYAmt |
| EOY | $73,711,970 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,551,932 | BOYAmt |
| EOY | $73,711,970 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $209,889,423 | BOYAmt |
| EOY | $205,904,470 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,405,602 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $565,640 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $0 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $79,049 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $79,049 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | BEVERLY COMMUNITY HOSPITAL ASSOCIATION SUPPORTS CERTAIN 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 EXPENDITURE OF THE HOSPITAL'S MEMBERSHIP DUES PAID TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA (HASC) WERE USED FOR LOBBYING ACTIVITIES. IN ADDITION, THE ORGANIZATION COMPENSATED A CONSULTANT $65,000 TO ASSIST IN HEALTHCARE RELATED LOBBYING ISSUES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,398,730 | OtherCostOrOtherBasisAmt |
| Book Value | $1,398,730 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $144,825,250 | OtherCostOrOtherBasisAmt |
| Depreciation | $75,625,520 | DepreciationAmt |
| Book Value | $69,199,730 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $584,120 | OtherCostOrOtherBasisAmt |
| Depreciation | $584,120 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $45,325,030 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,171,300 | DepreciationAmt |
| Book Value | $15,153,730 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,745,450 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,667,870 | DepreciationAmt |
| Book Value | $5,077,580 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $90,829,770 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (8 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| BENEFICIAL INTEREST IN FOUNDATION | $3,333,060 |
| DEPOSITS | $75,670 |
| DUE FROM RELATED PARTIES | $3,361,548 |
| MALPRACTICE/WORKER'S COMP INSURANCE RECEIVABLES | $3,755,000 |
| OTHER RECEIVABLES | $259,170 |
| REFUNDS | $6,090 |
| DUE FROM THIRD-PARTY PAYORS | $31,658,060 |
| UNAMORTIZED LOAN COSTS | $2,860 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $42,451,458 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED SELF-INSURANCE CLAIMS RESERVES | $7,237,870 |
| LEASE OBLIGATIONS | $8,354,455 |
| DUE TO RELATED PARTIES | $3,695,910 |
| MEDICAL CLAIMS LIABILITIES | $4,561,840 |
| SHARED RISK LIABILITY | $8,010,860 |
| DEFERRED EMPLOYER SOCIAL SECURITY TAX LIABILITY | $1,312,410 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $33,173,345 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE CORPORATION RECOGNIZES THE TAX EXPENSE OR PROVISION FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 350.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 450.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,211,345 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,211,345 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00680 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $80,728,668 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $69,506,659 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,222,009 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06270 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $81,940,013 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $69,506,659 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,433,354 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06950 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $277,607 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $277,607 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,452,637 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,452,637 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00810 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,295,659 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,914,725 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,380,934 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02450 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,025,903 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,914,725 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,111,178 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03420 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $89,965,916 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $71,421,384 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,544,532 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10370 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $10,685,860 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $51,835,045 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $60,891,206 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$9,056,161 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEVERLY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 WEST BEVERLY BOULEVARD | AddressLine1Txt |
| City | MONTEBELLO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90640 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.BEVERLY.ORG | WebsiteAddressTxt |
| State License | 930000389 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEVERLY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.BEVERLY.ORG/ABOUT-US/IN-THE-COMMUNITY/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.BEVERLY.ORG/ABOUT-US/IN-THE-COMMUNITY/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 350.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 450.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.BEVERLY.ORG/PATIENTS/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.BEVERLY.ORG/PATIENTS/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.BEVERLY.ORG/PATIENTS/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BEVERLY HOSPITAL | PART V, SECTION B, LINE 5: INTERVIEWS AND FOCUS GROUPS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL.FOURTEEN (14) INTERVIEWS WERE COMPLETED FROM JUNE THROUGH AUGUST 2019. COMMUNITY STAKEHOLDERS IDENTIFIED BY THE HOSPITAL WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND/OR REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. INPUT WAS OBTAINED FROM THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH. THE IDENTIFIED STAKEHOLDERS WERE INVITED BY EMAIL TO PARTICIPATE IN A PHONE INTERVIEW. APPOINTMENTS FOR THE INTERVIEWS WERE MADE ON DATES AND TIMES CONVENIENT TO THE STAKEHOLDERS. AT THE BEGINNING OF EACH INTERVIEW, THE PURPOSE OF THE INTERVIEW IN THE CONTEXT OF THE NEEDS ASSESSMENT WAS EXPLAINED, THE STAKEHOLDERS WERE ASSURED THEIR RESPONSES WOULD REMAIN CONFIDENTIAL, AND CONSENT TO PROCEED WAS GIVEN. INTERVIEW QUESTIONS FOCUSED ON THE FOLLOWING TOPICS: (I) MAJOR HEALTH ISSUES IN THE COMMUNITY; (II) SOCIOECONOMIC, BEHAVIORAL, OR ENVIRONMENTAL FACTORS THAT IMPACT HEALTH IN THE COMMUNITY; (III) WHO IS MOST AFFECTED BY THE SIGNIFICANT NEEDS; (IV) ISSUES, CHALLENGES AND BARRIERS EXPERIENCED IN THE COMMUNITY; (V) POTENTIAL RESOURCES TO ADDRESS THE IDENTIFIED HEALTH NEEDS, SUCH AS SERVICES, PROGRAMS AND/OR COMMUNITY EFFORTS; AND (VI) ADDITIONAL COMMENTS AND CONCERNS.IN ADDITION, COMMUNITY FOCUS GROUPS WERE HELD IN JUNE, JULY, AND AUGUST 2019 AND ENGAGED 48 PERSONS. FOCUS GROUP QUESTIONS FOCUSED ON THE FOLLOWING TOPICS: (I) BIGGEST HEALTH NEEDS IN THE COMMUNITY; (II) CHALLENGES AND BARRIERS FACED IN ADDRESSING HEALTH NEEDS; (III) PRIORITIZATION OF HEALTH NEEDS; AND (IV) ADDITIONAL COMMENTS.A LIST OF THE INTERVIEW AND FOCUS GROUP PARTICIPANTS CAN BE FOUND WITHIN THE CHNA POSTED ON THE ORGANIZATION'S WEBSITE. |
| BEVERLY HOSPITAL | PART V, SECTION B, LINE 11: IN 2019, BEVERLY HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO COMPLY WITH STATE AND FEDERAL REGULATIONS GUIDING TAX EXEMPT HOSPITALS. THE CHNA INCORPORATED DEMOGRAPHIC AND HEALTH DATA FOR THE COMMUNITIES SERVED BY THE HOSPITAL. SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED FROM PRIMARY AND SECONDARY DATA SOURCES AS WELL AS INFORMATIONAL INTERVIEWS AND FOCUS GROUPS. INDICATORS ASSOCIATED WITH HEALTH WERE CONSIDERED HEALTH NEEDS WHEN THEY COMPARED UNFAVORABLY TO BENCHMARK DATA, SPECIFICALLY COUNTY OR STATE RATES OR HEALTHY PEOPLE 2020 OBJECTIVES. THE FOLLOWING HEALTH NEEDS WERE IDENTIFIED: (I) ACCESS TO HEALTH CARE; (II) CHRONIC DISEASES (ASTHMA, CANCER, DIABETES, HEART DISEASE, LIVER DISEASE, KIDNEY DISEASE); (III) DENTAL CARE; (IV) ECONOMIC INSECURITY; (V) MENTAL HEALTH; (VI) OVERWEIGHT AND OBESITY; (VII) PREVENTIVE PRACTICES (VACCINES AND SCREENINGS); (VIII) SUBSTANCE USE AND MISUSE; AND (IX) VIOLENCE/COMMUNITY SAFETY.BEVERLY HOSPITAL PLANS TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA. APPLYING THE FOLLOWING CRITERIA, THE ORGANIZATION WAS ABLE TO ASSESS ITS ABILITY TO IMPACT THE IDENTIFIED AND PRIORITIZED HEALTH NEEDS. THESE CRITERIA INCLUDED: ORGANIZATIONAL CAPACITY, ESTABLISHED RELATIONSHIPS, ONGOING INVESTMENT, AND ACKNOWLEDGED COMPETENCIES AND EXPERTISE. AS A RESULT, BEVERLY HOSPITAL WILL ADDRESS THE FOLLOWING HEALTH NEEDS THROUGH A COMMITMENT OF COMMUNITY BENEFIT PROGRAMS AND CHARITABLE RESOURCES: (I) ACCESS TO HEALTH CARE: (II) CHRONIC DISEASES (INCLUDING HEALTHY EATING AND ACTIVE LIVING); (III) MENTAL HEALTH; AND (IV) PREVENTIVE CARE TO ADDRESS THE SIGNIFICANT HEALTH NEED OF "ACCESS TO HEALTH CARE", BEVERLY HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: (I) PROVIDE FINANCIAL ASSISTANCE THROUGH BOTH FREE AND DISCOUNTED CARE FOR HEALTH CARE SERVICES, CONSISTENT WITH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY; (II) PROVIDE TRANSPORTATION SUPPORT TO INCREASE ACCESS TO HEALTH CARE SERVICES; (III) OFFER INFORMATION AND ENROLLMENT ASSISTANCE IN THE COVERED CALIFORNIA HEALTH CARE EXCHANGE AND OTHER LOW-COST INSURANCE PROGRAMS AND PROVIDE INFORMATION ABOUT MEDICARE BENEFITS UPDATES; (IV) PURSUE FEDERALLY QUALIFIED HEALTH CARE STATUS FOR HOSPITAL-BASED CLINICS TO PROVIDE PRIMARY CARE SERVICES TO UNDERSERVED POPULATIONS; (V) PARTNER WITH BEVERLY URGENT CARE FACILITY IN MONTEBELLO MANAGED BY AME.TO ADDRESS THE SIGNIFICANT HEALTH NEED OF "CHRONIC DISEASES (INCLUDING HEALTHY EATING AND ACTIVE LIVING)", BEVERLY HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: (I) THROUGH THE DIABETES CENTER, PROVIDE FREE DIABETES EDUCATION, HOST DIABETES AWARENESS EVENTS, INCLUDING BLOOD GLUCOSE SCREENING AND NUTRITION CLASSES; (II) OFFER CPR CLASSES; (III) THROUGH THE WOUND CARE CENTER, PROVIDE EDUCATION FOOT CARE SCREENINGS; (IV) HOST HEALTH AND WELLNESS FAIRS FOR SENIORS, INCLUDING SCREENINGS; (V) INCREASE CARDIAC AWARENESS THROUGH HEALTH EDUCATION AND SCREENING TESTS TO IDENTIFY CARDIAC DISEASE; (VI) CONTINUE PARTICIPATION AS A STEMI RECEIVING CENTER DESIGNATION WITH LA COUNTY; (VII) PROVIDE SUPPORT GROUPS TO ASSIST THOSE WITH CHRONIC DISEASES AND THEIR FAMILIES; (VIII) PROVIDE PUBLIC HEALTH EDUCATION IN THE MEDIA AND COMMUNITY HEALTH AWARENESS EVENTS TO ENCOURAGE HEALTHY BEHAVIORS AND PREVENT CHRONIC DISEASES; (IX) CONTINUE PRIMARY STROKE CENTER DESIGNATION WITH LA COUNTY; (X) PROVIDE EDUCATIONAL TOURS OF SUPERMARKETS TO PROMOTE HEALTHY FOOD CHOICES; AND (XI) SUPPORT LOCAL FARMERS MARKETS.TO ADDRESS THE SIGNIFICANT HEALTH NEED OF "MENTAL HEALTH", BEVERLY HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: (I) OFFER COMMUNITY HEALTH EDUCATION, COMMUNITY LECTURES, PRESENTATIONS AND WORKSHOPS; (II) SUPPORT MULTISECTOR COLLABORATIVE EFFORTS THAT SUPPORT ACCESS TO MENTAL HEALTH SERVICES; (III) PROVIDE INCREASED ACCESS TO MENTAL HEALTH CARE THROUGH THE PROVISION OF TELE-PSYCH SERVICES; (IV) INCREASE COMMUNITY AWARENESS OF PREVENTION EFFORTS AND AVAILABILITY OF RESOURCES TO ADDRESS MENTAL HEALTH CONCERNS; (V) PURSUE FEDERALLY QUALIFIED HEALTH CARE STATUS FOR HOSPITAL-BASED CLINICS TO PROVIDE MENTAL HEALTH CARE SERVICES TO UNDERSERVED POPULATIONS; AND (VI) SUPPORT COMMUNITY COLLABORATION AND EDUCATION ON MENTAL HEALTH BY HOSTING THE BEVERLY HOSPITAL TASK FORCE ON HOMELESSNESS AND MENTAL HEALTH.TO ADDRESS THE SIGNIFICANT HEALTH NEED OF "PREVENTIVE PRACTICES", BEVERLY HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: (I) PROVIDE FREE HEALTH SCREENINGS; (II) PROVIDE EDUCATION AND RESOURCES FOCUSED ON HEALTHY LIVING AND DISEASE PREVENTION TO BE OFFERED IN ENGLISH AND SPANISH; (III) PROVIDE EDUCATION TO TEENS ON ABSTINENCE, BIRTH CONTROL, SEXUALLY TRANSMITTED DISEASES AND PREGNANCY PREVENTION; (IV) OFFER FREE CHILDHOOD IMMUNIZATIONS AND ADULT FLU SHOTS; (V) PROVIDE TB TESTING; (VI) OFFER BREAST AND CERVICAL CANCER SCREENINGS AT LOW AND NO-COST FOR WOMEN THROUGH THE FAMILY PACT AND EVERY WOMAN COUNTS PROGRAMS; AND (VI) PURSUE FEDERALLY QUALIFIED HEALTH CARE STATUS FOR HOSPITAL-BASED CLINICS TO PROVIDE PRIMARY CARE SERVICES TO UNDERSERVED POPULATIONS.BEVERLY HOSPITAL WILL MONITOR AND EVALUATE THE PROGRAMS AND ACTIVITIES OUTLINED ABOVE. THE HOSPITAL HAS A SYSTEM THAT TRACKS THE IMPLEMENTATION OF THE STRATEGIES AND DOCUMENTS THE ANTICIPATED IMPACT. THE REPORTING PROCESS INCLUDES THE COLLECTION AND DOCUMENTATION OF TRACKING MEASURES, SUCH AS THE NUMBER OF PEOPLE REACHED/SERVED AND COLLABORATIVE EFFORTS TO ADDRESS HEALTH NEEDS. AN EVALUATION OF THE IMPACT OF THE HOSPITAL'S ACTIONS TO ADDRESS THESE SIGNIFICANT HEALTH NEEDS WILL BE REPORTED IN THE NEXT SCHEDULED CHNA.TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, BEVERLY HOSPITAL WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA INCLUDING: DENTAL CARE, ECONOMIC INSECURITY, SUBSTANCE USE AND MISUSE, AND VIOLENCE/COMMUNITY SAFETY. BEVERLY HOSPITAL HAS ELECTED TO CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED, GIVEN THE ORGANIZATION'S CAPABILITIES. THE HOSPITAL HAS INSUFFICIENT RESOURCES TO EFFECTIVELY ADDRESS ALL THE IDENTIFIED NEEDS AND, IN SOME CASES, THE NEEDS ARE CURRENTLY ADDRESSED BY OTHERS IN THE COMMUNITY. BEVERLY HOSPITAL WILL CONTINUE TO LOOK FOR OPPORTUNITIES TO ADDRESS COMMUNITY NEEDS, WHERE WE CAN MAKE A MEANINGFUL CONTRIBUTION. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - WOMEN'S PAVILION & BREAST CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 E BEVERLY BLVD | AddressLine1Txt |
| City | MONTEBELLO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90640 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | OUTPATIENT CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | BEVERLY HOSPITAL USES COST TO CHARGE RATIO TO DETERMINE THE AMOUNTS ON SCHEDULE H, PART I, LINE 7B. COST ACCOUNTING WAS USED TO DETERMINE THE AMOUNTS ON PART I, LINES 7A, 7E, 7F, AND 7G. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE FOLLOWING NARRATIVE OUTLINES THE COMMUNITY BUILDING ACTIVITIES BCHA UNDERTOOK IN 2021; EXPENSES COULD NOT BE EASILY QUANTIFIED FOR PRESENTATION IN SCHEDULE H, PART II:ECONOMIC DEVELOPMENT: IN 2021, THE HOSPITAL PROVIDED SUPPORT TO THE CHAMBERS OF COMMERCE IN MONTEBELLO, PICO RIVERA, ROSEMEAD, AND WHITTIER.COMMUNITY SUPPORT: THE HOSPITAL PARTICIPATED IN COMMUNITY HEALTH FAIRS OR EVENTS AS A WAY TO CONNECT WITH THE COMMUNITY AND PROVIDE HEALTH EDUCATION, HEALTH SCREENINGS (SUCH AS BLOOD PRESSURE AND FOOT SCREENINGS), AND/OR INFORMATION ABOUT SERVICES. WE PARTICIPATED IN THE YMCA SENIOR HEALTH FAIR, THE SHOPS AT MONTEBELLO THINK PINK BREAST CANCER WALK, AND MONTEBELLO SENIOR CENTER SENIOR HEALTH FAIR.LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS: ACCREDITED BY THE AMERICAN ASSOCIATION OF DIABETES EDUCATORS, BEVERLY HOSPITAL PROVIDED EDUCATION ON PREVENTION, LIFESTYLE AND NUTRITION MANAGEMENT, AND TREATMENT OF DIABETES TO THE COMMUNITY THROUGH VIRTUAL LECTURES.COALITION BUILDING: BEVERLY HOSPITAL EXTENDED SUPPORT, SUCH AS SERVICES, IN-KIND DONATIONS, FINANCIAL CONTRIBUTIONS, AND DONATED SPACE, TO LIKE-MINDED COMMUNITY ORGANIZATIONS WITH SIMILAR COMMUNITY HEALTH GOALS. IN ADDITION, THE HOSPITAL HOSTED TASK FORCE MEETINGS TO ADDRESS HOMELESSNESS AND MENTAL HEALTH. THE TASK FORCE INCLUDED MEMBERS FROM BEVERLY HOSPITAL, MONTEBELLO FIRE DEPARTMENT, MONTEBELLO POLICE DEPARTMENT, PEOPLE ASSISTING THE HOMELESS (PATH), WHITTIER FIRST DAY, LA COUNTY MET TEAM, HEART OF COMPASSION FOOD BANK, HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA (HASC) AND LA COUNTY SUPERVISOR HILDA SOLIS'S OFFICE.COMMUNITY HEALTH IMPROVEMENT ADVOCACY: IN PARTNERSHIP WITH SOUTH BAY HEALTH AND INSURANCE SERVICES (SBHIS) AND THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH, BEVERLY HOSPITAL PROVIDED ENROLLMENT ASSISTANCE TO PATIENTS FOR NO COST OR LOW COST HEALTH INSURANCE COVERAGE PROGRAMS. IN 2021, THE HOSPITAL ASSISTED 144 PEOPLE WITH INFORMATION AND ENROLLMENT FOR MEDI-CAL.WORKFORCE DEVELOPMENT: THROUGHOUT THE YEAR, BEVERLY HOSPITAL PROVIDED CONTINUING EDUCATION OPPORTUNITIES FOR HEALTH PROFESSIONALS TO STAY UP-TO-DATE ON NEW MEDICAL AND SAFETY ADVANCEMENTS. EXAMPLES INCLUDED STROKE INFORMATION UPDATES AND EMPLOYEE SAFETY TRAINING.OTHER: TO HELP INCREASE ACCESSIBILITY TO THE COVID-19 VACCINE, BEVERLY HOSPITAL COLLABORATED WITH THE STATE OF CALIFORNIA TO LAUNCH AN ON-SITE COVID-19 VACCINE CLINIC. OVER THE COURSE OF 6 MONTHS, THE CLINIC PROVIDED OVER 13,780 COVID-19 VACCINES TO COMMUNITY MEMBERS. |
| PART III, LINE 2: | GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE HOSPITAL ALSO PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. |
| PART III, LINE 4: | THE FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS (ATTACHED TO THIS FORM 990) WHICH ADDRESSES "BAD DEBT EXPENSE" CAN BE FOUND ON PAGE 13 OF THE AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | A COST TO CHARGE RATIO IS USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE ON SCHEDULE H, PART III, LINE 6.IT IS THE HOSPITAL'S BELIEF THAT THE SHORTFALL REFLECTED ON PART III, LINE 7 SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN THE HOSPITAL'S COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS. |
| PART III, LINE 9B: | PATIENTS IN THE PROCESS OF QUALIFYING FOR GOVERNMENT OR HOSPITAL LOW-INCOME FINANCIAL ASSISTANCE PROGRAMS WILL NOT BE ASSIGNED TO COLLECTIONS PRIOR TO 150 DAYS FROM THE DATE OF INITIAL BILLING. ADDITIONALLY, LOW-INCOME PATIENTS, WHO AT THE SOLE DISCRETION OF THE HOSPITAL ARE REASONABLY COOPERATING TO SETTLE AN OUTSTANDING HOSPITAL BILL, WILL NOT BE SENT TO AN OUTSIDE COLLECTION AGENCY IF DOING SO WOULD NEGATIVELY IMPACT THE PATIENT'S CREDIT. |
| PART VI, LINE 2: | TO CONTINUE PROVIDING OUTSTANDING HEALTHCARE SERVICES AND VALUABLE COMMUNITY PROGRAMS, BEVERLY HOSPITAL EVALUATES THE NEEDS OF THE COMMUNITY ON AN ON-GOING BASIS THROUGH A COMMUNITY HEALTH NEEDS ASSESSMENT, AND PLANS FOR THE FUTURE ACCORDINGLY. THE 2019 COMMUNITY NEEDS ASSESSMENT WAS DEVELOPED THROUGH A COMBINED QUANTITATIVE AND QUALITATIVE INFORMATION BASED ON REVIEW AND ANALYSIS OF DEMOGRAPHIC TRENDS, ECONOMIC TRENDS, HEALTH CONDITIONS, FAMILY AND COMMUNITY ISSUES, EDUCATION AND YOUTH DEVELOPMENT ISSUES, SENIOR SERVICES ISSUES AND COMMUNITY INPUT. THE HOSPITAL HELD FOCUS GROUP SESSIONS AND A SURVEY WITH REPRESENTATIVES FROM A VARIETY OF COMMUNITY-SERVING ORGANIZATIONS TO IDENTIFY KEY THEMES.ADDITIONALLY, OFTEN BEVERLY HOSPITAL TAKES ITS SERVICES OUT OF THE WALLS OF THE HOSPITAL DIRECTLY INTO THE COMMUNITY. OUR OUTREACH ACTIVITIES HELP US TO OFFER A HEALTHIER LIFESTYLE THROUGH HEALTH SCREENINGS, PHYSICIAN LECTURES, IMMUNIZATIONS CLINICS, NUTRITION PROGRAMS, MATERNITY EDUCATION, CHILDREN AND SENIORS PROGRAMS, AND MORE. |
| PART VI, LINE 3: | PUBLIC NOTICES ARE POSTED OF THE FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE IN THE HIGH VOLUME INPATIENT, OUTPATIENT, AND EMERGENCY SERVICE AREAS OF THE HOSPITAL. NOTICES ARE ALSO POSTED IN THE PATIENT FINANCIAL AND COLLECTION DEPARTMENTS. THESE NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT MAY OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR SUCH ASSISTANCE. |
| PART VI, LINE 4: | BEVERLY HOSPITAL IS LOCATED AT 309 WEST BEVERLY BOULEVARD IN MONTEBELLO, CA 90640. THE HOSPITAL SERVICE AREA INCLUDES 11 CITIES AND 13 ZIP CODES: BELL/BELL GARDENS (90201); COMMERCE (90040); EAST LOS ANGELES (90022, 90023, 90063); EL MONTE (91732); MONTEBELLO (90640); MONTEREY PARK (91754, 91755); PICO RIVERA (90660); ROSEMEAD (91770); SOUTH EL MONTE (91733); AND WHITTIER (90601).THE POPULATION OF THE BEVERLY HOSPITAL SERVICE AREA IS 711,482. FROM 2012 TO 2017, THE POPULATION INCREASED BY 1.3%, WHICH IS LOWER THAN THE 2.7% INCREASE IN POPULATION COUNTYWIDE DURING THE SAME PERIOD. OF THE POPULATION, 49.5% IS MALE AND 50.5% ARE FEMALE. CHILDREN AND YOUTH, AGES 0-17, MAKE UP 24.4% OF THE POPULATION, 63% OF THE POPULATION IS ADULTS AGED 18-64, AND 12.6% OF THE POPULATION ARE SENIORS AGED 65 AND OVER. THE SERVICE AREA HAS A HIGHER PERCENTAGE OF CHILDREN AND YOUTH, AGES 0 TO 24, AND ELDERLY, 85 AND UP, THAN THE COUNTY.IN THE HOSPITAL SERVICE AREA, 76.4% OF THE POPULATION IS HISPANIC/LATINO, 17.4% ARE ASIAN, 4.8% ARE WHITE, AND .6% ARE BLACK/AFRICAN AMERICAN. THE REMAINING .9% ARE AMERICAN INDIAN/ALASKAN NATIVE, NATIVE HAWAIIAN/PACIFIC ISLANDER, AND OTHER OR MULTIPLE RACES. THERE IS A HIGHER PERCENTAGE OF LATINOS AND ASIANS, AND A LOWER PERCENTAGE OF WHITES AND BLACKS/AFRICANS AMERICANS IN THE HOSPITAL SERVICE AREA THAN FOUND IN THE COUNTY. IN THE SERVICE AREA, SPANISH IS SPOKEN IN THE HOME AMONG 63.5% OF THE POPULATION, ENGLISH IS SPOKEN IN THE HOME AMONG 20.3% OF THE POPULATION, 15.3% OF THE POPULATION SPEAKS AN ASIAN LANGUAGE, AND .7% OF THE POPULATIONS SPEAKS AN INDO-EUROPEAN LANGUAGE.THE SERVICE AREA HAS A SLIGHTLY HIGHER RATE OF POVERTY (19.3%) THAN FOUND IN THE COUNTY (17%). LEVELS OF LOW-INCOME (DEFINED AS EARNING LESS THAN 200% OF THE FPL) ARE 48.5% SERVICE-AREA WIDE, WHICH IS HIGHER THAN THE COUNTY AND STATE RATES. IN ADDITION, 29.1% OF SERVICE AREA CHILDREN (UNDER 18 YEARS OLD) ARE LIVING IN POVERTY, WHICH IS HIGHER THAN COUNTY AND STATE RATES.FOR ADDITIONAL POPULATION STATISTICS AND BENCHMARKS, PLEASE REFERENCE THE COMMUNITY HEALTH NEEDS ASSESSMENT POSTED ON THE ORGANIZATION'S WEBSITE). |
| PART VI, LINE 5: | OTHER INFORMATION IMPORTANT TO DESCRIBING HOW THE ORGANIZATION'S HOSPITAL FACILITIES OR OTHER HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY INCLUDE: (I) THE BOARD OF DIRECTORS IS MADE UP OF PRIMARILY OF MEMBERS OF THE SURROUNDING COMMUNITY WHO ARE NOT PAID BY BEVERLY HOSPITAL; (II) THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR, DEPENDING ON NEED; AND (III) SURPLUS FUNDS ARE APPLIED TO IMPROVE PATIENT CARE AND MEDICAL EDUCATION.ADDITIONALLY, BEVERLY HOSPITAL HAS AN ARRAY OF COMMUNITY OUTREACH PROGRAMS WHICH HELP TO PROMOTE THE HEALTH OF ITS SURROUNDING COMMUNITY. THESE PROGRAMS INCLUDE: FREE CHILDHOOD IMMUNIZATIONS FOR NEWBORNS TO THE AGE OF 18; MATERNITY CLASSES AND EVENTS; KIDSFIT AND TEENSFIT PROGRAMS, WHICH ARE DESIGNED TO HELP OVERWEIGHT KIDS DEVELOP GOOD EATING AND EXERCISE HABITS; A 50+ CONNECTION PROGRAM, WHICH PROVIDES REDUCED RATES ON PRESCRIPTIONS, MEDICAL EQUIPMENT, LEGAL COUNSELING, DENTAL AND VISION SERVICES, AND SOCIAL ACTIVITIES; SUPPORT GROUPS (GRIEF, ALZHEIMERS AND DEMENTIA, CAREGIVERS); AND VARIOUS HEALTH EDUCATION & SCREENINGS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | CA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALICE CHENG FACHE | ||||||||||||||
| PRESIDENT & CEO | $486,280 | $0 | $0 | $0 | $7,440 | $0 | $22,114 | $0 | $93,496 | $0 | $609,330 | $0 | $0 | $0 |
| NANCY E LEE MSHCM BSN | ||||||||||||||
| SENIOR VP OF OPERATIONS / CNO | $248,007 | $0 | $0 | $0 | $8,000 | $0 | $531 | $0 | $12,261 | $0 | $268,799 | $0 | $0 | $0 |
| JUNG-NA KIM | ||||||||||||||
| REGISTERED NURSE | $231,562 | $0 | $0 | $0 | $0 | $0 | $1,761 | $0 | $19,488 | $0 | $252,811 | $0 | $0 | $0 |
| SUSAN M JUSTIN | ||||||||||||||
| REGISTERED NURSE | $240,231 | $0 | $0 | $0 | $0 | $0 | $963 | $0 | $7,525 | $0 | $248,719 | $0 | $0 | $0 |
| LOIS A LONG | ||||||||||||||
| REGISTERED NURSE | $225,434 | $0 | $0 | $0 | $0 | $0 | $1,614 | $0 | $18,896 | $0 | $245,944 | $0 | $0 | $0 |
| CHARLENE CHU RN BSN | ||||||||||||||
| ADMIN DIRECTOR, ACUTE CARE SERVICES | $222,896 | $0 | $0 | $0 | $240 | $0 | $1,687 | $0 | $17,878 | $0 | $242,701 | $0 | $0 | $0 |
| ROY C RORICK | ||||||||||||||
| RADIOLOGY NUCLEAR MED. TECHNOLOGIST | $208,902 | $0 | $0 | $0 | $0 | $0 | $1,624 | $0 | $26,367 | $0 | $236,893 | $0 | $0 | $0 |
| MARGARET GUILLERMO | ||||||||||||||
| REGISTERED NURSE | $208,307 | $0 | $0 | $0 | $0 | $0 | $645 | $0 | $26,759 | $0 | $235,711 | $0 | $0 | $0 |
| GEORGE HOLTZ MSHRM BSBN | ||||||||||||||
| ADMIN DIRECTOR, HUMAN RESOURCES | $187,610 | $0 | $0 | $0 | $7,754 | $0 | $1,198 | $0 | $24,490 | $0 | $221,052 | $0 | $0 | $0 |
| K LAWRENCE COHEN MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $169,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $169,000 | $0 | $0 | $0 |
| SABBIR DADABHAI | ||||||||||||||
| VP OF FINANCE & CFO (THRU 7/2021) | $128,297 | $0 | $0 | $0 | $32,825 | $0 | $0 | $0 | $1,811 | $0 | $162,933 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY | ||||||||
| A | 680164610 | 13080SLL6 | 2015-12-02 | $41,768,337 | IMPROVEMENT, RENOVATION, AND EQUIPPING HOSPITAL/REFUND BOND DATED 9/30/2015 | 0 | 0 | 0 |
| CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY | ||||||||
| B | 680164610 | 13080SRG1 | 2017-05-09 | $20,998,252 | IMPROVEMENT, RENOVATION, AND EQUIPPING HOSPITAL | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capitalized InterestCapitalizedInterestAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $2,360,000 | $41,768,337 | $768,337 | $11,902,374 | $29,097,626 | 2016 | Yes (1) | 0 | Yes (1) | Yes (1) | |
| B | $215,000 | $20,998,252 | $20,601,452 | 2018 | 0 | 0 | Yes (1) | Yes (1) | $396,800 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | Yes (1) | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| B | 0 | 0 | Yes (1) | Yes (1) | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Schedule M IRS990ScheduleM
Real Estate Other RealEstateOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $3,018,583 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OF IMPROVEMENTS | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, COLUMN (B): | THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS RECEIVED IN SCHEDULE M, PART I, COLUMN (B). |
| SCHEDULE M, PART I, LINE 17: | DURING 2021, THE ORGANIZATION WAS THE BENEFACTOR OF VARIOUS IMPROVEMENTS TO ITS HOSPITAL, INCLUDING THE ADDITION OF OXYGEN LINES, MEDICAL GAS LINES, AND RELATED CONSTRUCTION, ALL AT NO COST TO THE ORGANIZATION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | A PUBLIC ACCOUNTING FIRM PREPARES THE FORM 990 IN CONJUNCTION WITH THE ORGANIZATION'S ACCOUNTING AND FINANCE STAFF. A DRAFT FORM 990 IS THEN REVIEWED BY THE CONTROLLER, CFO, AND CEO; ADJUSTMENTS ARE MADE, AS NECESSARY. THE COMPLETED FORM 990 IS THEN 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 MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES COMPLETE A QUESTIONNAIRE ANNUALLY. QUESTIONNAIRES SUBMITTED BY OFFICERS (OTHER THAN THE PRESIDENT/CEO) AND KEY EMPLOYEES ARE REVIEWED BY THE PRESIDENT/CEO. QUESTIONNAIRES SUBMITTED BY THE PRESIDENT/CEO AND DIRECTORS ARE REVIEWED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS. ALL DISCLOSED CONFLICTS ARE REPORTED TO THE BOARD OF DIRECTORS. IF A CONFLICT IS IDENTIFIED, THE CONFLICTED INDIVIDUAL WILL NOT PARTICIPATE IN DELIBERATIONS AND DECISIONS IMPACTING THE CONFLICTED MATTER. |
| FORM 990, PART VI, SECTION B, LINE 15 | CURRENT COMPARATIVE COMPENSATION INFORMATION IS OBTAINED FROM AN INDEPENDENT FIRM, MOST RECENTLY IN 2020. THE PRESIDENT & CEO EVALUATION COMMITTEE OF THE BOARD OF DIRECTORS USES THIS INFORMATION AND ITS EVALUATION OF PERFORMANCE TO SET THE ANNUAL COMPENSATION OF THE PRESIDENT/CEO. DOCUMENTATION OF THIS PROCESS IS RETAINED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS. THE PRESIDENT & CEO EVALUATION COMMITTEE ALSO SETS THE TARGET LEVEL OF ANNUAL COMPENSATION FOR OFFICERS AND KEY EMPLOYEES, WHICH IS NOT TO EXCEED THE 50TH PERCENTILE OF THE MARKET ANALYSIS PERFORMED BY THE INDEPENDENT COMPENSATION CONSULTANTS. THE PRESIDENT/CEO USES THE SAME PROCESS TO DETERMINE THE ANNUAL COMPENSATION ADJUSTMENTS OF OTHER OFFICERS AS WELL AS KEY EMPLOYEES. THE PRESIDENT/CEO DISCUSS THESE PROPOSED ANNUAL COMPENSATION ADJUSTMENTS WITH THE PRESIDENT & CEO EVALUATION COMMITTEE OF THE BOARD OF DIRECTORS. DOCUMENTATION OF THIS PROCESS IS RETAINED BY THE PRESIDENT/CEO. |
| FORM 990, PART VI, SECTION C, LINE 19 | REQUESTS TO VIEW THE CONFLICT OF INTEREST POLICY SHOULD BE MADE TO ADMINISTRATION, AND ARE MADE AVAILABLE UPON REQUEST. THE HOSPITAL DOES NOT MAKE EITHER THE GOVERNING/ORGANIZING DOCUMENTS OR AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | CAPITATED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 11,553,988. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,553,988. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 11,058,616. MANAGEMENT AND GENERAL EXPENSES 993,756. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,052,372. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,056,087. MANAGEMENT AND GENERAL EXPENSES 2,317,784. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,373,871. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN BEVERLY HOSPITAL FOUNDATION 565,640. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MONTEBELLO COMMUNITY HEALTH SERVICES INC | ||||||||||
| 309 WEST BEVERLY BOULEVARD | MONTEBELLO | CA | 90640 | 953823550 | SUPPORT BEVERLY COMMUNITY HOSPITAL ASSOCIATION | CA | 501(C)(3) | LINE 12B, II | BEVERLY COMMUNITY HOSPITAL ASSOCIATION | Yes (1) |
| BEVERLY HOSPITAL FOUNDATION | ||||||||||
| 309 WEST BEVERLY BOULEVARD | MONTEBELLO | CA | 90640 | 237429685 | SUPPORT BEVERLY COMMUNITY HOSPITAL ASSOCIATION | CA | 501(C)(3) | LINE 7 | BEVERLY COMMUNITY HOSPITAL ASSOCIATION | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEVERLY MSO | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 309 WEST BEVERLY BOULEVARD | AddressLine1Txt |
| City | MONTEBELLO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90640 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352596953 | EIN |
| Primary Activities | MANAGEMENT SERVICE ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| BEVERLY HOSPITAL FOUNDATION | ||
| C | $189,755 | BOOK VALUE |
| BEVERLY HOSPITAL FOUNDATION | ||
| O | $184,350 | BOOK VALUE |
| MONTEBELLO COMMUNITY HEALTH SERVICES INC | ||
| D | $3,361,548 | BOOK VALUE |
| MONTEBELLO COMMUNITY HEALTH SERVICES INC | ||
| E | $3,647,151 | BOOK VALUE |
| MONTEBELLO COMMUNITY HEALTH SERVICES INC | ||
| K | $248,754 | BOOK VALUE |